Multi-Dimensional Flow-Preserving Compressed Sensing (MuFloCoS) for Time-Resolved Velocity-Encoded Phase Contrast MRI

4-D time-resolved velocity-encoded phase-contrast MRI (4-D PCI) is a fully non-invasive technique to assess hemodynamics in vivo with a broad range of potential applications in multiple cardiovascular diseases. It is capable of providing quantitative flow values and anatomical information simultaneously. The long acquisition time, however, still inhibits its wider clinical use. Acceleration is achieved at present using parallel MRI (pMRI) techniques which can lead to substantial loss of image quality for higher acceleration factors. Both the high-dimensionality and the significant degree of spatio-temporal correlation in 4-D PCI render it ideally suited for recently proposed compressed sensing (CS) techniques. We propose the Multi-Dimensional Flow-preserving Compressed Sensing (MuFloCoS) method to exploit these properties. A multi-dimensional iterative reconstruction is combined with an interleaved sampling pattern (I-VT), an adaptive masked and weighted temporal regularization (TMW) and fully automatically obtained vessel-masks. The performance of the novel method was analyzed concerning image quality, feasibility of acceleration factors up to 15, quantitative flow values and diagnostic accuracy in phantom experiments and an in vivo carotid study with 18 volunteers. Comparison with iterative state-of-the-art methods revealed significant improvements using the new method, the temporal normalized root mean square error of the peak velocity was reduced by 45.32% for the novel MuFloCoS method with acceleration factor 9. The method was furthermore applied to two patient cases with diagnosed high-grade stenosis of the ICA, which confirmed the performance of MuFloCoS to produce valuable results in the presence of pathological findings in 56 s instead of over 8 min (full sampling).