Hyperpolarized 13C MR angiography

Magnetic resonance angiography (MRA) is a non-invasive technology that can be used for diagnosis and monitoring of cardiovascular disease; the number one cause of mortality worldwide. Hyperpolarized imaging agents provide signal enhancement of more than 10, 000 times, which implies large reduction in acquisition time and improved spatial resolution. We review the role of hyperpolarized 13C agents for MR angiography and present the literature in the field. Furthermore, we present a study of the benefit of intra-arterial injection over intravenous injection of hyperpolarized agent for cerebral angiography in the rat, and compare the performance of two standard angiographic pulse sequences, the gradient echo (GRE) sequence and the balanced steady-state free precession (bSSFP). 2D coronal cerebral angiographies using intra-arterial injections were acquired with a GRE sequence with in-plane resolution of 0.27 mm and matrix size 256x128, and 2D coronal cerebral angiographies were acquired with a bSSFP sequence with in-plane resolution of 0.55 mm and matrix size 128x64. The bSSFP sequence provides higher SNR in phantoms than the GRE sequence. Similarly, intravenous injections are imaged with higher SNR with the bSSFP sequence, where the signal destruction of the GRE sequence is avoided. However, for intra-arterial injections, the bSSFP sequence results in strong artefacts, and the GRE sequence is preferred. Hyperpolarized MRA presents many challenges and cannot currently compete with conventional contrast enhanced MRA. Further research may change this since hyperpolarization is still an immature methodology.