Five-minute whole-heart coronary MRA with sub-millimeter isotropic resolution, 100% respiratory scan efficiency, and 3D-PROST reconstruction.

Purpose: To enable whole-heart 3D coronary magnetic resonance angiography (CMRA) with isotropic sub-millimeter resolution in a clinically feasible scan time by combining respiratory motion correction with highly accelerated variable density sampling in concert with a novel 3D patch-based undersampled reconstruction (3D-PROST). Methods: An undersampled variable density spiral-like Cartesian trajectory was combined with 2D image-based navigators to achieve 100% respiratory efficiency and predictable scan time. 3D-PROST reconstruction integrates structural information from 3D patch neighborhoods through sparse representation, thereby exploiting the redundancy of the 3D anatomy of the coronary arteries in an efficient low-rank formulation. The proposed framework was evaluated in a static resolution phantom and in 10 healthy subjects with isotropic resolutions of 1.2mm(3) and 0.9mm3 and undersampling factors of 35 and 39. 3D-PROST was compared against fully sampled (1.2mm(3) only), conventional parallel imaging, and compressed sensing reconstructions. Results: Phantom and in vivo (1.2mm(3)) reconstructions were in excellent agreement with the reference fully sampled image. In vivo average acquisition times (min: s) were 7: 57 +/- 61: 18 (35) and 4: 35 +/- 60: 44 (39) for 0.9mm(3) resolution. Sub-millimeter 3D-PROST resulted in excellent depiction of the left and right coronary arteries including small branch vessels, leading to further improvements in vessel sharpness and visible vessel length in comparison with conventional reconstruction techniques. Image quality rated by 2 experts demonstrated that 3D-PROST provides good image quality and is robust even at high acceleration factors. Conclusion: The proposed approach enables free-breathing whole-heart 3D CMRA with isotropic sub-millimeter resolution in <5min and achieves improved coronary artery visualization in a short and predictable scan time.