Retrospective multi-phase non-contrast-enhanced magnetic resonance angiography (ROMANCE MRA) for robust angiogram separation in the presence of cardiac arrhythmia

Purpose: To develop a novel, retrospective multi-phase non-contrast-enhanced MRA (ROMANCE MRA) in a single acquisition for robust angiogram separation even in the presence of cardiac arrhythmia. Methods: In the proposed ROMANCE MRA, data were continuously acquired over all cardiac phases using retrospective, multi-phase flow-sensitive single-slab 3D fast spin echo (FSE) with variable refocusing flip angles, while an external pulse oximeter was in sync with pulse repetitions in FSE to record real-time information on cardiac cycles. Data were then sorted into k-bin space using the real-time cardiac information. Angiograms were reconstructed directly from k-bin space by solving a constrained optimization problem with both subtraction-induced sparsity and low rank priors. Peripheral MRA was performed in normal volunteers with/without caffeine consumption and a volunteer with cardiac arrhythmia using conventional fresh blood imaging (FBI) and the proposed ROMANCE MRA for comparison. Results: The proposed ROMANCE MRA shows superior performance in accurately delineating both major and small vessel branches with robust background suppression if compared with conventional FBI. Even in the presence of irregular heartbeats, the proposed method exhibits clear depiction of angiograms over conventional methods within clinically reasonable imaging time. Conclusion: We successfully demonstrated the feasibility of the proposed ROMANCE MRA in generating robust angiograms with background suppression.