Measurements of cerebral perfusion and arterial hemodynamics during visual stimulation using TURBO-TILT

Non-invasive visualization of collateral blood flow patterns of the circle of Willis by dynamic MR angiography

The circle of Willis plays an important role in the distribution of blood flow in the brain. To obtain dynamic information of the blood flow through the circle of Willis, a dynamic MRA technique based on arterial spin labeling (ASL) is introduced as a non-invasive technique. When the ASL labeling slab is restricted to a single artery, it is possible to visualize selectively the flow distribution of that specific artery. However, because of the decay of the label and the presence of noise it is difficult to extract functional information from these images. In the present study we propose three visualization and post-processing methods for the interpretation of these images. Firstly, the passage of labeled blood was corrected for decay of the label and hereafter shown as a movie. Secondly, by calculating the time of arrival at every location in the arteries of the circle of Willis, a 2D image was reconstructed summarizing the information of the movie. Finally, quantitative flow values were obtained by relating the arterial input function to the passage of labeled blood through a region of interest encompassing the vessel under investigation. Experiments in a circle of Willis phantom showed a high linear relation between measured flow and true flow, although the measured values were 10-15% lower than the true flow values. Measurements in healthy volunteers showed the potential to quantify the flow in all major arteries of the circle of Willis.

Perfusion imaging using arterial spin labeling

Arterial spin labeling is a magnetic resonance method for the measurement of cerebral blood flow. In its simplest form, the perfusion contrast in the images gathered by this technique comes from the subtraction of two successively acquired images: one with, and one without, proximal labeling of arterial water spins after a small delay time. Over the last decade, the method has moved from the experimental laboratory to the clinical environment. Furthermore, numerous improvements, ranging from new pulse sequence implementations to extensive theoretical studies, have broadened its reach and extended its potential applications. In this review, the multiple facets of this powerful yet difficult technique are discussed. Different implementations are compared, the theoretical background is summarized, and potential applications of various implementations in research as well as in the daily clinical routine are proposed. Finally, a summary of the new developments and emerging techniques in this field is provided.

Flow Territory Mapping of the Cerebral Arteries With Regional Perfusion MRI

BACKGROUND AND PURPOSE

Conventional contrast-enhanced angiography is the gold standard for visualization of the vascular tree supplied by the major cerebral arteries and assessment of collateral flow. Thus far, however, no methods are available to assess the actual flow territories of the individual cerebral arteries. In the present study, we evaluate a noninvasive arterial spin labeling MRI method for selective mapping of the flow territories of the left and right internal carotid arteries and posterior circulation (basilar artery and vertebral arteries).

METHODS

A spatially selective labeling approach, regional perfusion imaging, was developed on the basis of selective slab inversion of the arterial water with a pulsed arterial spin labeling sequence. The selectivity of this method was demonstrated.

RESULTS

Regional perfusion imaging enables assessment of the perfusion territories of the major cerebral arteries. With selective labeling of an internal carotid artery, signal is present in both the ipsilateral anterior cerebral artery and ipsilateral middle cerebral artery flow territory. With labeling of the basilar artery, perfusion-weighted signal is symmetrically present in both posterior cerebral artery flow territories. Cerebral blood flow values measured with regional perfusion imaging in the complete hemisphere (40.1 mL x min(-1) x 100 g(-1) tissue), white matter (22.1 mL x min(-1) x 100 g(-1) tissue), and gray matter (65.8 mL x min(-1) x 100 g(-1) tissue) are in agreement with data in the literature.

CONCLUSIONS

We present the first imaging method capable of evaluating both quantitatively and qualitatively the flow territories of the individual brain-feeding arteries in vivo.

Pulsed star labeling of arterial regions (PULSAR): A robust regional perfusion technique for high field imaging

Regional perfusion imaging (RPI) has recently been introduced as a potentially powerful technique to map the perfusion territories of patients with vascular diseases in a fully noninvasive manner. However, this technique suffers from the problems of the transfer insensitive labeling technique upon which it is based. In particular, RPI is very sensitive to magnetic field inhomogeneities, and therefore the definition of the labeled bolus can deteriorate at field strength higher than 1.5 T. Furthermore, the slab-selective triple-pulse postsaturation sequence used originally will also be impaired due to the same problem, rendering RPI unusable at higher field. In this work, an adiabatic-based signal targeting with alternating radiofrequency pulses sequence is proposed as a labeling scheme to solve the problems related to variations in local magnetic field, together with an improved four-pulse water suppression enhanced through T(1) effects technique as a presaturation scheme.