# Rapid Real-Time MR Angiography of Suspected Stroke

> **NIH NIH R01** · ENDEAVOR HEALTH CLINICAL OPERATIONS · 2020 · $470,478

## Abstract

Project Summary/Abstract:
The objective of this project is to develop and validate very rapid and robust next-generation magnetic
resonance (MR) protocols for anatomic and hemodynamic evaluation of the head and neck vessels in patients
with suspected stroke. Emergent diagnostic imaging evaluation of suspected stroke typically involves a non-
contrast CT to detect intracranial hemorrhage. However, subsequent patient management is based on the
much more extensive anatomical and functional information provided by magnetic resonance imaging (MRI).
The MRI protocol typically consists of anatomic imaging, diffusion-weighted imaging, MR angiography (MRA)
to detect stenosis and occlusion in the neurovascular system, and contrast-enhanced perfusion imaging. MRA
is by far the most time-consuming of these imaging techniques (typically requiring 15 minutes or longer for the
combined evaluation of the neck vessels and circle of Willis), and the most prone to degradation from patient
motion. Given that “time is brain” in the emergent evaluation of stroke, the first goal of this project is to achieve
a five-fold or greater decrease in scan time for neurovascular MRA to <3 minutes without the use of contrast
agents, while improving reliability using motion-insensitive imaging techniques. Another goal of this project is
to develop a rapid protocol for portraying and quantifying intracranial flow patterns and velocities in <30
seconds. We hypothesize that these two goals can be met through the development of two protocols: 1) a
highly-accelerated ungated quiescent-interval slice-selective (UnQISS) protocol leveraging radial sampling,
real-time motion detection, and simultaneous multi-slice acceleration; and 2) an efficient semi-projective cine
arterial spin-labeled (ASL) protocol providing high temporal resolution. A final goal of this project is to test the
developed rapid UnQISS and cine ASL protocols in a group of patients with suspected stroke. The expected
outcome of this project is a set of rapid protocols for evaluating the neurovascular system in patients with
suspected stroke that expeditiously informs the treatment team to guide management decisions regarding
medical and endovascular therapy. Since no contrast agents are involved, the developed protocols will be
especially useful in the many stroke patients (1 in 3) who present with chronic kidney disease. The specific
aims of this project are as follows: 1. To develop and optimize a rapid nonenhanced MRI protocol that
provides for anatomical assessment of the intracranial and extracranial vessels (aortic arch to circle of Willis) in
<3 minutes. 2. To develop a rapid semi-projective arterial spin-labeling cine technique for displaying and
quantifying intracranial flow in <30 sec. 3. In suspected stroke patients, to test the hypotheses that the
developed rapid protocols, with respect to currently-used MR protocols, improve image quality, provide more
diagnostic information, accurately portray intracranial...

## Key facts

- **NIH application ID:** 9937823
- **Project number:** 5R01EB027475-03
- **Recipient organization:** ENDEAVOR HEALTH CLINICAL OPERATIONS
- **Principal Investigator:** Ioannis Koktzoglou
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $470,478
- **Award type:** 5
- **Project period:** 2018-09-30 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9937823

## Citation

> US National Institutes of Health, RePORTER application 9937823, Rapid Real-Time MR Angiography of Suspected Stroke (5R01EB027475-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9937823. Licensed CC0.

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