On the nature and reduction of plaque‐mimicking flow artifacts in black blood MRI of the carotid bifurcation

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Abstract
Cardiac‐gated black blood MRI of the carotid artery bifurcation in normal human subjects shows signal within the lumen suggesting wall thickening or atherosclerotic plaque. This signal was believed to be artifactual, arising from complex flow patterns present at the carotid bifurcation. Computer simulation of the hemodynamics and black blood multislice image acquisition in a model of the carotid bifurcation showed that these artifacts arise from spins recovering their signal within the slow, recirculating flow of the carotid bulb. The computed hemodynamics also suggested that these artifacts could be minimized or eliminated entirely by gating the acquisition of slices in the most artifact‐prone region of the carotid bulb within a 250‐ms window after peak systole. Application of these predictions to studies of normal volunteers showed that, in most cases, these flow artifacts in black blood MRI can be eliminated simply by altering the phase of the cardiac cycle to which the image acquisition is gated. The observation that the size and placement of the saturation slabs had little effect on these artifacts suggested that, in those cases in which recirculation persists throughout the cardiac cycle, either inversion‐recovery or presaturation within the bulb itself would be required to suppress them.