Perfusion and Flow
September 28-30, 2006, Copenhagen / DK
Course Organisers:
Michael Markl
Department of Diagnostic Radiology Medical Physics
University Hospital Freiburg, DE
Matthias Günther
Department of Neurology
University Hospital Mannheim, DE
Local Organiser:
Karam Sidaros
Danish Research Centre for Magnetic Resonance
Hvidovre Hospital, DK
Course venue:
Hvidovre Hospital
Copenhagen, DK
Lecturers:
Michael Markl, Matthias Günther, Leif Ostergaard, Sebastian Kozerke, Karam Sidaros, Karin Markenroth
Course Description
This course is designed to provide deeper insight into flow and perfusion, their effects on data acquisition, and MR methodology for their qualitative and quantitative assessment. After an overview and introduction in basics, methods and clinical applications of perfusion and flow imaging, the course is divided into two parts focusing on each topic individually.
First, the consequence of the intrinsic sensitivity of MRI to flow and related MR signal properties are explained and discussed in the context of different pulse sequences, image artefacts and eventually flow encoding as used in phase contrast MRI. Based on these principles, the course will focus on more advanced topics such as optimised sequence design, eddy current effects, Fourier flow encoding, etc.
Then, fundamentals of the MR based analysis of tissue perfusion are introduced. Specifically, a detailed discussion of dynamic susceptibility weighted (DSC) and arterial spin labeling (ASL) techniques and associated data processing strategies are presented, followed by a critical evaluation of both methods, their properties, potential artefacts and practical applications.
As an integral part, the course will also include a substantial amount of time that will be spent on exercises, which are intended to enhance the understanding of basic and advanced topics and will be performed in small groups under guidance of the lecturers. In addition, 'hands on' experience at locally available MR systems will help addressing practical aspects of perfusion and flow in MRI.
The course is designed to provide a compact understanding and stable fundament for scientists who intend to enhance their knowledge with respect to perfusion and flow in MR imaging or who wish to get involved into methods development of flow and perfusion measurements
Program
“ESMRMB Lectures on Magnetic Resonance“
Perfusion and Flow
Copenhagen, DK, September 28-30, 2006
Thursday, September 28, 2006
12:00 – 13:15 Registration
13:15 – 13:30 Opening: Michael Markl, Freiburg, DE
Matthias Günther, Mannheim, DE
13:30 – 14:15 Introduction to Flow Michael Markl, Freiburg, DE
14:30 – 15:15 Clinical Applications
15:30 – 16:00 Coffee break
16:00 – 16:45 Introduction to Perfusion Matthias Günther, Mannheim, DE
17:00 – 17:45 Clinical Applications
Friday, September 29, 2006
08:45 – 09:30,
09:45 – 10:30 Topic 1 Karin Markenroth Bloch, Lund, SE
MR Physics of Flow
· MR-signal, phase effects, sensitivity to flow and motion
· Flow effects, in-flow, out-flow, dark blood, bright blood
· SE vs. GRE vs. SSFP
· Artifacts, pulsatile flow
· Flow compensation
· Flow encoding, bipolar gradients, velocity induced signal phase, velocity sensitivity
· Phase contrast MRI
10:30 – 11:00 Coffee break
11:00 - 13:00 Exercises and repetition of topic 1
13:00 - 14:00 Lunch
14:15 – 15:00
15:15 – 16:00 Topic 2 Sebastian Kozerke, Zürich, CH
Advanced Flow Imaging
· Implementation and pulse sequences, ECG gating, CINE imaging
· Fast imaging, Spirals, EPI, ungated flow measurements
· Phase Contrast-SSFP
· Fourier flow encoding, multiple-venc imaging
· Image acceleration, parallel imaging, view sharing
· Distortion and artifacts: Eddy Currents, Maxwell / concomitant gradients, gradient field non-linearities
· Applications, quantification, flow visualization
· PC-angiography, TOF, CE-MRA
· Advantages and limitations at high field strength
16:00 – 16:30 Coffee break
16:30 - 18:30 Exercises and repetition of topic 2
19:30 Social event
Saturday, September 30, 2006
08:45 – 09:30,
09:45 – 10:30 Topic 3 Leif Østergaard, Århus, DK
Dynamic Susceptibility Contrast Perfusion Imaging (DSC-MRI)
· Basic principles & theory, effect of contrast agent, T1, T2, T2* effects
· Basic physiology of blood circulation
· Contrast agent dynamics, bolus, first pass
· Quantification, arterial input function, de-convolution, central volume theorem
· Implementation & pulse sequences, EPI, SE-EPI, GRE
· Cranial perfusion, blood brain barrier, leakage, CBF, CBV, MTT
· Myocardial perfusion, viability, delayed enhancement
· Vessel size imaging
· Advantages and limitations at high field strength
10:30 – 11:00 Coffee break
11:00 – 12:30 Exercises and repetition of topic 3
12:30 – 13:30 Lunch
13:45 – 14:30
14:45 – 15:30 Topic 4 Karam Sidaros, Copenhagen, DK
Arterial Spin Labeling (ASL)
· Basic Principles of ASL
· Continuous versus pulsed ASL
· Implementation and labeling schemes (CASL, STAR, PICORE, FAIR)
· Adiabatic inversion RF-pulses
· Quantification, QUIPSS, time-series, transit time
· Readout modules, 2D, 3D, multi-slice, background suppression
· Other ASL techniques: Dynamic ASL, Velocity selective ASL
· Artifacts, MT effect, saturation effects
· Vascular territory mapping
· Advantages and limitations at high field strength
· Applications within fMRI
15:30 – 16:00 Coffee break
16:00 – 17:30 Exercises and repetitions of topic 4
17:30 – 18:30 General repetition and comparison of flow and perfusion techniques
18:30 End of course
Learning Objectives
MR Physics of Flow
* MR-signal, phase effects, sensitivity to flow and motion
* Flow effects, in-flow, out-flow, dark blood, bright blood
* SE vs. GRE vs. SSFP
* Artefacts, pulsatile flow
* Flow compensation
* Flow encoding, bipolar gradients, velocity induced signal phase, velocity sensitivity
* Phase contrast MRI
Advanced Flow Imaging
* Implementation and pulse sequences, ECG gating, CINE imaging
* Fast imaging, Spirals, EPI, ungated flow measurements
* Phase Contrast -SSFP
* Fourier flow encoding, multiple-venc imaging
* Image acceleration, parallel imaging, view sharing
* Distortion and artefacts: Eddy Currents, Maxwell/concomitant gradients, gradient field non-linearities
* Applications, quantification, flow visualisation
* PC-angiography, TOF, CE-MRA
* Advantages and limitations at high field strength
Dynamic Susceptibility Contrast Perfusion Imaging (DSC-MRI)
* Basic principles and theory, effect of contrast agent, T1, T2, T2* effects
* Basic physiology of blood circulation
* Contrast agent dynamics, bolus, first pass
* Quantification, arterial input function, de-convolution, central volume theorem
* Implementation and pulse sequences, EPI, SE-EPI, GRE
* Cranial perfusion, blood brain barrier, leakage, CBF, CBV, MTT
* Myocardial perfusion, viability, delayed enhancement
* Vessel size imaging
* Advantages and limitations at high field strength
Arterial Spin Labeling (ASL)
* Basic Principles of ASL
* Continuous vs. pulsed ASL
* Implementation and labelling schemes (CASL, STAR, PICORE, FAIR)
* Adiabatic inversion RF-pulses
* Quantification, QUIPSS, time-series, transit time
* Readout modules, 2D, 3D, multi-slice, background suppression
* Other ASL techniques: Dynamic ASL, Velocity selective ASL
* Artefacts, MT effect, saturation effects
* Vascular territory mapping
* Advantages and limitations at high field strength
* Applications within fMRI
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