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Rentzeperis F, Abdennadher M, Snyder K, Dembny K, Abdollahi S, Zaghloul KA, Talagala L, Theodore WH, Inati SK. Lateralization of interictal temporal lobe hypoperfusion in lesional and non-lesional temporal lobe epilepsy using arterial spin labeling MRI. Epilepsy Res 2023; 193:107163. [PMID: 37187039 DOI: 10.1016/j.eplepsyres.2023.107163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/11/2023] [Accepted: 05/01/2023] [Indexed: 05/17/2023]
Abstract
PURPOSE Non-invasive imaging studies play a critical role in the presurgical evaluation of patients with drug-resistant temporal lobe epilepsy (TLE), particularly in helping to lateralize the seizure focus. Arterial Spin Labeling (ASL) MRI has been widely used to non-invasively study cerebral blood flow (CBF), with somewhat variable interictal alterations reported in TLE. Here, we compare temporal lobe subregional interictal perfusion and symmetry in lesional (MRI+) and non-lesional (MRI-) TLE compared to healthy volunteers (HVs). METHODS Twenty TLE patients (9 MRI+, 11 MRI-) and 14 HVs under went 3 T Pseudo-Continuous ASL MRI through an epilepsy imaging research protocol at the NIH Clinical Center. We compared normalized CBF and absolute asymmetry indices in multiple temporal lobe subregions. RESULTS Compared to HVs, both MRI+ and MRI- TLE groups demonstrated significant ipsilateral mesial and lateral temporal hypoperfusion, specifically in the hippocampal and anterior temporal neocortical subregions, with additional hypoperfusion in the ipsilateral parahippocampal gyrus in the MRI+ and contralateral hippocampus in the MRI- TLE groups. Contralateral to the seizure focus, there was significant relative hypoperfusion in multiple subregions in the MRI- compared to the MRI+ TLE groups. The MRI+ group therefore had significantly greater asymmetry across multiple temporal subregions compared to the MRI- TLE and HV groups. No significant differences in asymmetry were found between the MRI- TLE and HV groups. CONCLUSION We found a similar extent of interictal ipsilateral temporal hypoperfusion in MRI+ and MRI- TLE. However, significantly increased asymmetries were found only in the MRI+ group due to differences in perfusion contralateral to the seizure focus between the patient groups. The lack of asymmetry in the MRI- group may negatively impact the utility of interictal ASL for seizure focus lateralization in this patient population.
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Affiliation(s)
- Frederika Rentzeperis
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD, USA
| | - Myriam Abdennadher
- Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Kathryn Snyder
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD, USA
| | - Kate Dembny
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD, USA
| | - Shervin Abdollahi
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD, USA
| | - Kareem A Zaghloul
- Surgical Neurology Branch, NINDS, National Institutes of Health, USA
| | - Lalith Talagala
- NIH MRI Research Facility, NINDS, National Institutes of Health, USA
| | | | - Sara K Inati
- Office of the Clinical Director, NINDS, National Institutes of Health, Bethesda, MD, USA.
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Kerner DM, Nikam R, Kandula VVR, Averill LW. Pearls and Pitfalls in Arterial Spin Labeling Perfusion-Weighted Imaging in Clinical Pediatric Imaging. Semin Ultrasound CT MR 2022; 43:19-30. [PMID: 35164906 DOI: 10.1053/j.sult.2021.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Characteristic arterial spin labeling (ASL) perfusion patterns are seen in a wide variety of pediatric brain pathologies, highlighting the potential added value and prognostic role of this magnetic resonance imaging (MRI) perfusion-weighted imaging modality. Our objective is to review the basic clinical physics, technical underpinnings, and artifacts and challenges as we highlight some of the most clinically relevant pathologies to the application of ASL in the pediatric setting.
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Affiliation(s)
- David M Kerner
- Department of Radiology, Nemours Children's Health System, Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Rahul Nikam
- Department of Radiology, Nemours Children's Health System, Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Vinay V R Kandula
- Department of Radiology, Nemours Children's Health System, Alfred I. duPont Hospital for Children, Wilmington, DE
| | - Lauren W Averill
- Department of Radiology, Nemours Children's Health System, Alfred I. duPont Hospital for Children, Wilmington, DE.
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3
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Pasca L, Sanvito F, Ballante E, Totaro M, Paoletti M, Bergui A, Varesio C, Rognone E, De Giorgis V, Pichiecchio A. Arterial spin labelling qualitative assessment in paediatric patients with MRI-negative epilepsy. Clin Radiol 2021; 76:942.e15-942.e23. [PMID: 34645570 DOI: 10.1016/j.crad.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 09/10/2021] [Indexed: 11/29/2022]
Abstract
AIM To evaluate the usefulness of arterial spin labelling (ASL) qualitative analysis for the localisation of seizure-related perfusion abnormalities in paediatric patients with negative brain magnetic resonance imaging (MRI) epilepsy. MATERIALS AND METHODS Forty-two patients with a diagnosis of MRI-negative focal or generalised epilepsy, who underwent electroencephalogram (EEG) and MRI with ASL in the interictal phase were included. Perfusion abnormalities were evaluated through a qualitative assessment and then compared to EEG seizure focus. RESULTS Among the 42 patients, 26 had focal epilepsy and 16 had generalised epilepsy. Thirty-three patients (79%) showed a perfusion abnormality, mainly hypoperfusion (74.5% of all ASL alterations), whereas hyperperfused alterations were more represented in patients who experienced the last seizure either less than 48 hours prior to ASL acquisition or in the time interval from 1 week to 1 month prior to ASL acquisition (p=0.034). Concordance of ASL abnormality and EEG focus was found in 33 patients (78.5%), as complete in 17 (40.5%) and as partial in 16 (38%). A trend of higher concordance was found in focal epilepsies compared to generalised epilepsies (p=0.059). The concordance between ASL and EEG major alterations was higher for hyperperfused anomalies than for hypoperfused ones (p=0.009). Variables such as age, sedation, and time from last seizure were not significant contributors for concordance. CONCLUSIONS The combined use of qualitative ASL and brain MRI and scalp EEG could be a potential tool in daily clinical practice.
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Affiliation(s)
- L Pasca
- Department of Child Neurology and Psychiatry, IRCSS Mondino Foundation, Pavia, Italy; Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy
| | - F Sanvito
- Unit of Radiology, Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - E Ballante
- Department of Mathematics, University of Pavia, Pavia, Italy; BioData Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - M Totaro
- Department of Child Neurology and Psychiatry, IRCSS Mondino Foundation, Pavia, Italy; Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy
| | - M Paoletti
- Advanced Imaging and Radiomics, Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - A Bergui
- Unit of Radiology, Department of Clinical, Surgical, Diagnostic, and Paediatric Sciences, University of Pavia, Pavia, Italy
| | - C Varesio
- Department of Child Neurology and Psychiatry, IRCSS Mondino Foundation, Pavia, Italy
| | - E Rognone
- Advanced Imaging and Radiomics, Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
| | - V De Giorgis
- Department of Child Neurology and Psychiatry, IRCSS Mondino Foundation, Pavia, Italy.
| | - A Pichiecchio
- Department of Brain and Behaviour Neuroscience, University of Pavia, Pavia, Italy; Advanced Imaging and Radiomics, Department of Neuroradiology, IRCCS Mondino Foundation, Pavia, Italy
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Wen Q, Wang K, Hsu YC, Xu Y, Sun Y, Wu D, Zhang Y. Chemical exchange saturation transfer imaging for epilepsy secondary to tuberous sclerosis complex at 3 T: Optimization and analysis. NMR IN BIOMEDICINE 2021; 34:e4563. [PMID: 34046976 DOI: 10.1002/nbm.4563] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/16/2021] [Accepted: 05/01/2021] [Indexed: 06/12/2023]
Abstract
The homeostasis of various metabolites is impaired in epilepsy secondary to the tuberous sclerosis complex (TSC). Chemical exchange saturation transfer (CEST) imaging is an emerging molecular MRI technique that can detect various metabolites and proteins in vivo. However, the role of CEST imaging for TSC-associated epilepsy has not been assessed. Here, we aim to investigate the feasibility of applying CEST imaging to TSC-associated epilepsy, optimize the CEST acquisition parameters, and provide an analysis method for exploring the dominant molecular contributors to the CEST signal measured. Nine TSC epilepsy patients were scanned on a 3-T MRI system. The CEST saturation frequencies were swept from -6 to 6 ppm with 12 different combinations of saturation power (4, 3, 2 and 1 μT) and duration (1000, 700 and 400 ms). Furthermore, a two-stage simulation method based on the seven-pool Bloch-McConnell model was proposed to assess the contribution of each exchangeable pool to the CEST signal in normal-appearing white matter and cortical tubers, which avoided the complexity and uncertainty of full Bloch-McConnell fitting. The results showed that under the optimal saturation duration of 1000 ms, the greatest contrast between tubers and normal tissues occurred around 3, 2.5, 1.75 and 3.5 ppm for B1 of 4, 3, 2 and 1 μT, respectively. At the optimal frequency offsets, the CEST values of tubers were significantly higher than those in the normal brain tissues (P < 0.01). Furthermore, the two-stage analysis suggested that the amine pool played a dominant role in yielding the contrast between cortical tubers and normal tissues. These results indicate that CEST MRI may serve as a potentially useful tool for identifying tubers in TSC, and the two-stage analysis method may provide a route for investigating the molecular contributions to the CEST contrast in biological tissues.
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Affiliation(s)
- Qingqing Wen
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kang Wang
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi-Cheng Hsu
- MR Collaboration, Siemens Healthcare Ltd., Shanghai, China
| | - Yan Xu
- Department of Neurosurgery, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Yi Sun
- MR Collaboration, Siemens Healthcare Ltd., Shanghai, China
| | - Dan Wu
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Yi Zhang
- Key Laboratory for Biomedical Engineering of Ministry of Education, Department of Biomedical Engineering, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Neurology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Narayanan S, Schmithorst V, Panigrahy A. Arterial Spin Labeling in Pediatric Neuroimaging. Semin Pediatr Neurol 2020; 33:100799. [PMID: 32331614 DOI: 10.1016/j.spen.2020.100799] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Perfusion imaging using arterial spin labeling noninvasively evaluates cerebral blood flow utilizing arterial blood water as endogenous tracer. It does not require the need of radiotracer or intravenous contrast and offers unique complimentary information in the imaging of pediatric brain. Common clinical applications include neonatal hypoxic ischemic encephalopathy, pediatric stroke and vascular malformations, epilepsy and brain tumors. Future applications may include evaluation of silent ischemia in sickle cell patients, monitor changes in intracranial pressure in hydrocephalus, provide additional insights in nonaccidental trauma and chronic traumatic brain injury (TBI) and in functional Magnetic resonance imaging (MRI). The purpose of this review article is to evaluate the technical considerations including pitfalls, physiological variations, clinical applications and future directions of arterial spin labeling imaging.
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Affiliation(s)
- Srikala Narayanan
- Children's Hospital of Pittsburgh of UPMC, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.
| | - Vincent Schmithorst
- Children's Hospital of Pittsburgh of UPMC, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ashok Panigrahy
- John F. Caffey Endowed Chair in Pediatric Radiology, Children's Hospital of Pittsburgh of UPMC, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA
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Polyanskaya MV, Demushkina AA, Vasiliev IG, Gazdieva HS, Kholin AA, Zavadenko NN, Alikhanov AA. Role of contrast-free MR-perfusion in the diagnosis of potential epileptogenic foci in children with focal epilepsia. ACTA ACUST UNITED AC 2018. [DOI: 10.17749/2077-8333.2018.10.2.006-018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ASL (Arterial Spin Labeling) – a novel modality of MR angiography – is based on radio-frequency labeling of aqueous protons in the arterial blood; the method is used to monitor blood supply to organs, including the brain. So far there has been little information on the use of ASL in children with focal epilepsy, especially in the pre-surgery period.Aim:to evaluate the perfusion patterns in seizure-free children with drug resistant focal epilepsy (FE) using the ASL mode of MRI.Materials and methods.We studied the ASL data of 54 (23-boys/31 girls) patients with FE treated in the Dpt. of Neurology at the Russian State Children Hospital from 2015 to 2018. The patients’ age varied from 4 months to 17 years. All images were produced with a 3T GE Discovery 750W system.Results. We found several brain perfusion patterns in children with FE; among other factors, those patterns depended on the clinical status of the patient, i. e. the interictal period or the early post- seizure period. The main pattern of the interictal period was characterized by a focal decrease in perfusion located around a structural focus identified on MRI scans. In the early post-seizure period, there was an increase in the arterial perfusion in the area of a structural epileptogenic lesion.Conclusion.ASL-MRI is an effective diagnostic method providing more information on children with FE during their pre-surgery phase. The ASL modality needs further research to rationalize its wider use as a preferred diagnostic tool or as a combination with the more complex PET and SPECT.
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Nagesh C, Kumar S, Menon R, Thomas B, Radhakrishnan A, Kesavadas C. The Imaging of Localization Related Symptomatic Epilepsies: The Value of Arterial Spin Labelling Based Magnetic Resonance Perfusion. Korean J Radiol 2018; 19:965-977. [PMID: 30174487 PMCID: PMC6082755 DOI: 10.3348/kjr.2018.19.5.965] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/19/2018] [Indexed: 11/15/2022] Open
Abstract
Accurate identification of the epileptogenic zone is an important prerequisite in presurgical evaluation of refractory epilepsy since it affects seizure-free outcomes. Apart from structural magnetic resonance imaging (sMRI), delineation has been traditionally done with electroencephalography and nuclear imaging modalities. Arterial spin labelling (ASL) sequence is a non-contrast magnetic resonance perfusion technique capable of providing similar information. Similar to single-photon emission computed tomography, its utility in epilepsy is based on alterations in perfusion linked to seizure activity by neurovascular coupling. In this article, we discuss complementary value that ASL can provide in the evaluation and characterization of some basic substrates underlying epilepsy. We also discuss the role that ASL may play in sMRI negative epilepsy and acute scenarios such as status epilepticus.
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Affiliation(s)
- Chinmay Nagesh
- Department of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
| | - Savith Kumar
- Department of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
| | - Ramshekhar Menon
- Comprehensive Epilepsy Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
| | - Bejoy Thomas
- Department of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
| | - Ashalatha Radhakrishnan
- Comprehensive Epilepsy Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
| | - Chandrasekharan Kesavadas
- Department of Imaging Sciences & Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences & Technology (SCTIMST), Trivandrum 695011, India
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8
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Magnetic resonance imaging of tuberous sclerosis complex with or without epilepsy at 7 T. Neuroradiology 2018; 60:785-794. [DOI: 10.1007/s00234-018-2040-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 05/17/2018] [Indexed: 01/01/2023]
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9
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Proisy M, Bruneau B, Rozel C, Tréguier C, Chouklati K, Riffaud L, Darnault P, Ferré JC. Arterial spin labeling in clinical pediatric imaging. Diagn Interv Imaging 2015; 97:151-8. [PMID: 26456912 DOI: 10.1016/j.diii.2015.09.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 08/31/2015] [Accepted: 09/02/2015] [Indexed: 10/22/2022]
Abstract
Arterial spin labeling (ASL) perfusion-weighted magnetic resonance imaging is the only approach that enables direct and non-invasive quantitative measurement of cerebral blood flow in the brain regions without administration of contrast material and without radiation. ASL is thus a promising perfusion imaging method for assessing cerebral blood flow in the pediatric population. Concerning newborns, there are current limitations because of their smaller brain size and lower brain perfusion. This article reviews and illustrates the use of ASL in pediatric clinical practice and discusses emerging cerebral perfusion imaging applications for children due to the highly convenient implementation of the ASL sequence.
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Affiliation(s)
- M Proisy
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France; Inserm VisAGeS unité/projet U746, UMR 6074, Irisa, université Rennes 1, 35043 Rennes cedex, France.
| | - B Bruneau
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - C Rozel
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - C Tréguier
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - K Chouklati
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - L Riffaud
- Department of Pediatric Neurosurgery, CHU de Rennes, 2, rue Henri-Le-Guillou, 35033 Rennes cedex 9, France
| | - P Darnault
- Department of Radiology, hôpital Sud, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35203 Rennes cedex 2, France
| | - J-C Ferré
- Inserm VisAGeS unité/projet U746, UMR 6074, Irisa, université Rennes 1, 35043 Rennes cedex, France; Department of Radiology, hôpital Pontchaillou, CHU de Rennes, 2, rue Henri-Le-Guilloux, 35033 Rennes cedex 9, France
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10
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A neuroradiologist's guide to arterial spin labeling MRI in clinical practice. Neuroradiology 2015; 57:1181-202. [PMID: 26351201 PMCID: PMC4648972 DOI: 10.1007/s00234-015-1571-z] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 08/05/2015] [Indexed: 01/01/2023]
Abstract
Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood–brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies.
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Sierra-Marcos A, Carreño M, Setoain X, López-Rueda A, Aparicio J, Donaire A, Bargalló N. Accuracy of arterial spin labeling magnetic resonance imaging (MRI) perfusion in detecting the epileptogenic zone in patients with drug-resistant neocortical epilepsy: comparison with electrophysiological data, structural MRI, SISCOM and FDG-PET. Eur J Neurol 2015; 23:160-7. [DOI: 10.1111/ene.12826] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/06/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | - M. Carreño
- Institute of Neurosciences; Hospital Clinic; Barcelona Spain
| | - X. Setoain
- Image Diagnosis Center; Hospital Clinic; Barcelona Spain
- Centro de Investigación Biomédica en Red en Bioingeniería; Biomateriales y Nanomedicina (CIBER-BBN); Barcelona Spain
| | - A. López-Rueda
- Image Diagnosis Center; Hospital Clinic; Barcelona Spain
| | - J. Aparicio
- Institute of Neurosciences; Hospital Clinic; Barcelona Spain
| | - A. Donaire
- Institute of Neurosciences; Hospital Clinic; Barcelona Spain
| | - N. Bargalló
- Image Diagnosis Center; Hospital Clinic; Barcelona Spain
- Medical Image Core Facility; August Pi i Sunyer Biomedical Research Institute (IDIBAPS); Barcelona Spain
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12
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Zhang J. How far is arterial spin labeling MRI from a clinical reality? Insights from arterial spin labeling comparative studies in Alzheimer's disease and other neurological disorders. J Magn Reson Imaging 2015; 43:1020-45. [PMID: 26250802 DOI: 10.1002/jmri.25022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 07/16/2015] [Accepted: 07/19/2015] [Indexed: 12/26/2022] Open
Affiliation(s)
- Jing Zhang
- Department of Clinical Neurological Sciences, University of Western Ontario, London, ON, Canada
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13
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Miyaji Y, Kawabata Y, Joki H, Seki S, Mori K, Kamide T, Tamase A, Nomura M, Kitamura Y, Tanaka F. Arterial spin-labeling magnetic resonance imaging for diagnosis of early seizure after stroke. J Neurol Sci 2015; 354:127-8. [PMID: 25982502 DOI: 10.1016/j.jns.2015.04.049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 04/23/2015] [Accepted: 04/28/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Yosuke Miyaji
- Department of Neurology and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
| | - Yuichi Kawabata
- Department of Neurology and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Hideto Joki
- Department of Neurology and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Shunsuke Seki
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Kentaro Mori
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Tomoya Kamide
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Akira Tamase
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Motohiro Nomura
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Yoshihisa Kitamura
- Department of Neurosurgery and Stroke Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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14
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Blauwblomme T, Boddaert N, Chémaly N, Chiron C, Pages M, Varlet P, Bourgeois M, Bahi-Buisson N, Kaminska A, Grevent D, Brunelle F, Sainte-Rose C, Archambaud F, Nabbout R. Arterial Spin Labeling MRI: A step forward in non-invasive delineation of focal cortical dysplasia in children. Epilepsy Res 2014; 108:1932-9. [DOI: 10.1016/j.eplepsyres.2014.09.029] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 09/20/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
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15
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Affiliation(s)
- Karl-Olof Lövblad
- Service neuro-diagnostique et neuro-interventionnel, département DISIM, hôpitaux universitaires de Genève, 1211 Geneva, Switzerland.
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16
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Chalifoux JR, Perry N, Katz JS, Wiggins GC, Roth J, Miles D, Devinsky O, Weiner HL, Milla SS. The ability of high field strength 7-T magnetic resonance imaging to reveal previously uncharacterized brain lesions in patients with tuberous sclerosis complex. J Neurosurg Pediatr 2013; 11:268-73. [PMID: 23289918 DOI: 10.3171/2012.12.peds12338] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Tuberous sclerosis complex (TSC) brain pathology is characterized on MRI by cortical tubers, subependymal nodules, and subependymal giant cell astrocytomas. Seizures, the prominent feature of TSC, are frequently intractable to medical therapy and, in many patients, resection of tubers results in seizure control. However, in approximately 40% of patients, resection of tubers does not control seizures. This fact, as well as evidence from invasive electrophysiological recordings and experimental animal models, suggests that in patients with TSC, there may be extratuberal epileptogenic brain that does not display any apparent abnormality on conventional MRI. The authors hypothesized that high field strength MRI might uncover lesions not seen on conventional MRI in these patients. METHODS Institutional review board approval was obtained to scan 4 patients with TSC (ages 18-26 years) in a 7-T MR unit. Optimized 7-T sequences, including T1- and T2-weighted, FLAIR, SPACE FLAIR, T2*, and MPRAGE studies, were performed. Imaging studies were compared with identical sequences performed using a conventional 1.5-T MR scanner. RESULTS In all 4 patients, there was improved visualization of the findings demonstrated on conventional imaging. Importantly, new lesions were detected in all 4 patients, which were not well visualized with conventional MRI. Newly detected lesions included microtubers, radial glial signal abnormalities, subependymal nodules arising from the caudate nucleus, and caudate nucleus lesions. CONCLUSIONS High field strength MRI detects previously uncharacterized lesions in patients with TSC and allows better detection and delineation of subtle abnormalities. In addition, the data demonstrate a compelling relationship between intraventricular lesions and the caudate nucleus. These data support previous electrophysiological and animal-model findings that demonstrate neurological pathology beyond the conventionally detected lesions in TSC.
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Affiliation(s)
- Jason R Chalifoux
- Department of Neurosurgery, Division of Pediatric Neurosurgery, New York University Langone Medical Center, New York, NY 10016, USA
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Donahue MJ, Strother MK, Hendrikse J. Novel MRI approaches for assessing cerebral hemodynamics in ischemic cerebrovascular disease. Stroke 2012; 43:903-15. [PMID: 22343644 DOI: 10.1161/strokeaha.111.635995] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Changes in cerebral hemodynamics underlie a broad spectrum of ischemic cerebrovascular disorders. An ability to accurately and quantitatively measure hemodynamic (cerebral blood flow and cerebral blood volume) and related metabolic (cerebral metabolic rate of oxygen) parameters is important for understanding healthy brain function and comparative dysfunction in ischemia. Although positron emission tomography, single-photon emission tomography, and gadolinium-MRI approaches are common, more recently MRI approaches that do not require exogenous contrast have been introduced with variable sensitivity for hemodynamic parameters. The ability to obtain hemodynamic measurements with these new approaches is particularly appealing in clinical and research scenarios in which follow-up and longitudinal studies are necessary. The purpose of this review is to outline current state-of-the-art MRI methods for measuring cerebral blood flow, cerebral blood volume, and cerebral metabolic rate of oxygen and provide practical tips to avoid imaging pitfalls. MRI studies of cerebrovascular disease performed without exogenous contrast are synopsized in the context of clinical relevance and methodological strengths and limitations.
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Affiliation(s)
- Manus J Donahue
- Department of Radiology, Vanderbilt University, Nashville, TN, USA.
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Canale S, Rodrigo S, Tourdias T, Mellerio C, Perrin M, Souillard R, Oppenheim C, Meder JF. [Grading of adults primitive glial neoplasms using arterial spin-labeled perfusion MR imaging]. J Neuroradiol 2011; 38:207-13. [PMID: 21353707 DOI: 10.1016/j.neurad.2010.12.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2010] [Revised: 12/05/2010] [Accepted: 12/12/2010] [Indexed: 11/29/2022]
Abstract
PURPOSE We investigated the relationship between tumor blood-flow measurement based on perfusion-imaging by arterial spin-labeling (ASL) and histopathologic findings in adults' primitive glial tumours. PATIENTS AND METHODS Thus, 40 primitive brain tumors (8 low-grade and 32 high-grade gliomas according to the Sainte-Anne classification) were imaged using pulsed (n=19) or continuous (n=21) ASL. Relative cerebral blood flow (rCBF=tumoral blood flow/normal cerebral blood flow) between high- and low-grade gliomas were compared. RESULTS Using pulsed ASL, differences in mean rCBF were observed in high- and low-grade gliomas although no significant (respectively 1.95 and 1.5). Using continuous ASL, mean rCBF were significantly higher for high-grade than for low-grade gliomas (P<0.05). High-grade gliomas could be discriminated using a CBF threshold of 1.18, with a sensitivity of 88%, specificity of 60%, predictive positive value of 88%, and predictive negative value of 60%. CONCLUSION ASL-based perfusion provides a quantitative, non-invasive alternative to dynamic susceptibility contrast perfusion MR methods for evaluating CBF. ASL is a suitable method for gliomas initial staging and could be useful to identify intermediate tumoral evolution.
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Affiliation(s)
- S Canale
- Service de neuroradiologie, centre hospitalier Sainte-Anne, université Paris Descartes, 1, rue Cabanis, 75014 Paris, France
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Nguyen D, Kapina V, Seeck M, Viallon M, Fedespiel A, Lovblad K. Ictal hyperperfusion demonstrated by arterial spin-labeling MRI in status epilepticus. J Neuroradiol 2010; 37:250-1. [DOI: 10.1016/j.neurad.2009.12.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 12/03/2009] [Indexed: 11/16/2022]
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