Intracranial simultaneous noncontrast angiography and intraplaque hemorrhage (SNAP) MRA: Analyzation, optimization, and extension for dynamic MRA

Purpose: Simultaneous noncontrast angiography and intraplaque (SNAP) imaging, as a noncontrast-enhanced MRA technique, may not provide consistent vessel visualization for intracranial artery imaging among subjects. This study aims to investigate the underlying mechanism and extend SNAP to dynamic MRA. Methods: The cause of the instability of intracranial SNAP-MRA was investigated through theoretical analysis and simulations. The scan parameters, including TI and flip angle, were optimized for reliable imaging. In vivo experiments were conducted to validate the simulation results. The simulation results were correlated with real intracranial blood flow by introducing the concept of blood travel time, and intracranial SNAP-MRA was revealed to reflect the cerebral blood expanse region in 5 TI. A new noncontrast-enhanced dynamic MRA technique, termed 4D SNAP-MRA, was proposed and demonstrated through in vivo scans. Results: The cause of the instability of intracranial SNAP-MRA was proved to be the slow or fast blood flow in the imaging slab. This instability can be mitigated by adjusting TI and flip angle in the SNAP sequence. The proposed 4D SNAP-MRA can provide dynamic visualization of the cerebral blood circulation and cerebral hemodynamic information such as blood travel time. Conclusion: The 3D SNAP-MRA with optimal imaging parameters can generate cerebral angiography with hemodynamic information, and the 4D SNAP-MRA provides dynamic visualization of the cerebral blood circulation.