Phase contrast angiography (PCA)

Phase contrast angiography relies on dephasing the moving spins submitted to a bipolar gradient. For a bipolar gradient of a given intensity and time, the moving spins will dephase in proportion to their velocity.
Similar to spatial encoding in the phase direction, the possible phase values range from – π to + π. Beyond this range of values, aliasing occurs, causing poor velocity encoding (figure 10.8).
The encoding gradient characteristics are thus defined in order to encode flows within a certain velocity range from – venc to + venc to be determined by the user. Any velocity outside this range will be poorly encoded (similar to what happens in pulsed and color Doppler with PRF).

To neutralize these stationary spin dephasings produced by magnetic field heterogeneities, a second acquisition is made, reversing the order of the encoding gradient lobes, and the two acquisitions are then subtracted:

• The moving spins will cumulate two spin dephasings in the opposite direction, which will be added up by image subtraction
• The dephasing of stationary spins due to field heterogeneities will be identical for both acquisitions, canceling each other out in subtraction.

To study the movements in all the directions in space, the same is repeated with flow encoding gradients in each of the three directions in space. An additional acquisition with no flow-encoding gradient will serve as a reference. The sequences used are of the gradient echo type (figure 10.9).

The images acquired with flow encoding gradient are grouped to extract the magnitude of flow. The reference image without encoding gradient is then subtracted to leave only the vascular imaging.
This technique also gives a relative measurement of flow velocity and direction, using phase data. The flows moving toward the examiner are encoded in black, those moving away from him are encoded in white.
The limitations of this technique relate to complex or turbulent flows at the origin of intra-voxel dephasing and a loss of signal from the vascular loops, bifurcations or stenoses.

Déplacez les réglettes pour modifier la vitesse et la direction du flux, ainsi que la vitesse d'encodage.
Vous pourrez ainsi constater leurs conséquences sur l'encodage de phase et le phénomène d'aliasing

Phase contrast imaging from a thick 2D slice can be compared to projection angiography. Sequence adjustments are needed to suppress the stationary tissue signal and to calculate the phase difference.
The advantage of 2D single-slice acquisition is that it is fast, which is useful for testing different encoding speeds. This technique can also be employed in vascular flow cine imaging, using pulse or ECG synchronization (figure 10.10).

For the quantitative study of flows, the slice plane must be perpendicular to flow direction. Thus a flow velocity curve can be obtained as a function of time, which, when coupled with morphologic data (vascular section) will calculate the flow rate.

In phase contrast volumetric acquisition, each partition is encoded in 3 directions. To reduce acquisition time, the number of phase encoding steps must be reduced. The images are then reconstructed in maximum intensity projection (MIP).
The finesse of the acquisition volume partitions gives better quality images than in 2D single-slice acquisition. Moreover, this technique is more sensitive than time-of-flight for slow flows (which are saturated in time-of-flight).
Its applications namely concern 3D cerebral venous imaging (thrombosis of cerebral veins, fistula) and may also be used after injection of a contrast agent (particularly in cases of defective bolus and contrast-enhanced MRA acquisition). The scan time of these sequences can be greatly reduced by parallel imaging.