Repeatability of cerebral arteriovenous pulse wave propagation in flow-related enhancement MRI.

Authors

Norman Kornemann, Filip Klimeš, Agilo Luitger Kern, Van Dai Vo Chieu, Jan Wigand Eckstein, Frank Wacker, Julian Glandorf

Published in

Scientific reports. Volume 16. Issue 1. Jul 09, 2026. Epub Jul 09, 2026.

Abstract

Flow Related Enhancement (FREE) MRI is a non-contrast technique for temporally resolved cerebral pulse-wave analysis. Clinical implementation requires proven repeatability. We aimed to evaluate the intra- and inter-scan repeatability of FREE-MRI measurements in healthy volunteers. Twenty-four healthy volunteers were scanned on a 3T MRI using a balanced steady-state free precession (bSSFP) sequence. A test-retest protocol was performed: two scans, a break with repositioning, and two more scans. From the resulting pulse-wave delay maps, the arteriovenous delay (AVD) was computed for the anterior (ACA), middle (MCA), and posterior (PCA) cerebral arteries. Repeatability was assessed using Bland-Altman analysis and Spearman correlation. Mean AVDs were 366 ± 51 ms (ACA), 371 ± 55 ms (MCA), and 376 ± 53 ms (PCA). Intra-scan repeatability was variable; the first session (Run 1 vs. 2) showed no significant differences, whereas the second session (Run 3 vs. 4, post-repositioning) showed significant deviation. However, inter-scan repeatability (comparing pooled pre- vs. post-break acquisitions) showed no significant differences after Bonferroni correction. Bland-Altman analysis confirmed that averaging measurements (Before vs. After) narrowed the limits of agreement compared to single-run comparisons, indicating improved stability. FREE-MRI provides quantitative assessments of cerebral pulse-wave dynamics, though single-acquisition precision is sensitive to physiological state. While intra-scan repeatability was high at rest, immediate post-repositioning scans showed significant variability, highlighting the need for a settling period. Crucially, while averaging measurements across sessions (Before vs. After) helps mitigate this noise, inter-scan reproducibility remains limited and protocol-dependent. Despite these limitations, this study provides a foundational step toward establishing a practical protocol for future clinical and longitudinal applications.

PMID:
42426054
Bibliographic data and abstract were imported from PubMed on 10 Jul 2026.

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