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Qin Q, Alsop DC, Bolar DS, Hernandez‐Garcia L, Meakin J, Liu D, Nayak KS, Schmid S, van Osch MJP, Wong EC, Woods JG, Zaharchuk G, Zhao MY, Zun Z, Guo J. Velocity-selective arterial spin labeling perfusion MRI: A review of the state of the art and recommendations for clinical implementation. Magn Reson Med 2022; 88:1528-1547. [PMID: 35819184 PMCID: PMC9543181 DOI: 10.1002/mrm.29371] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/16/2022] [Accepted: 06/08/2022] [Indexed: 12/11/2022]
Abstract
This review article provides an overview of the current status of velocity-selective arterial spin labeling (VSASL) perfusion MRI and is part of a wider effort arising from the International Society for Magnetic Resonance in Medicine (ISMRM) Perfusion Study Group. Since publication of the 2015 consensus paper on arterial spin labeling (ASL) for cerebral perfusion imaging, important advancements have been made in the field. The ASL community has, therefore, decided to provide an extended perspective on various aspects of technical development and application. Because VSASL has the potential to become a principal ASL method because of its unique advantages over traditional approaches, an in-depth discussion was warranted. VSASL labels blood based on its velocity and creates a magnetic bolus immediately proximal to the microvasculature within the imaging volume. VSASL is, therefore, insensitive to transit delay effects, in contrast to spatially selective pulsed and (pseudo-) continuous ASL approaches. Recent technical developments have improved the robustness and the labeling efficiency of VSASL, making it a potentially more favorable ASL approach in a wide range of applications where transit delay effects are of concern. In this review article, we (1) describe the concepts and theoretical basis of VSASL; (2) describe different variants of VSASL and their implementation; (3) provide recommended parameters and practices for clinical adoption; (4) describe challenges in developing and implementing VSASL; and (5) describe its current applications. As VSASL continues to undergo rapid development, the focus of this review is to summarize the fundamental concepts of VSASL, describe existing VSASL techniques and applications, and provide recommendations to help the clinical community adopt VSASL.
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Affiliation(s)
- Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - David C. Alsop
- Department of RadiologyBeth Israel Deaconess Medical Center and Harvard Medical SchoolBostonMassachusettsUSA
| | - Divya S. Bolar
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | | | - James Meakin
- Department of Radiology, Nuclear Medicine and AnatomyRadboud University Medical CenterNijmegenThe Netherlands
| | - Dapeng Liu
- The Russell H. Morgan Department of Radiology and Radiological ScienceJohns Hopkins University School of MedicineBaltimoreMarylandUSA
| | - Krishna S. Nayak
- Magnetic Resonance Engineering Laboratory, Ming Hsieh Department of Electrical EngineeringUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Sophie Schmid
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Matthias J. P. van Osch
- C.J. Gorter Center for high field MRI, Department of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Eric C. Wong
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | - Joseph G. Woods
- Center for Functional Magnetic Resonance Imaging, Department of RadiologyUniversity of CaliforniaSan Diego La JollaCaliforniaUSA
| | - Greg Zaharchuk
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Moss Y. Zhao
- Department of RadiologyStanford UniversityStanfordCaliforniaUSA
| | - Zungho Zun
- Department of RadiologyWeill Cornell MedicineNew YorkNew YorkUSA
| | - Jia Guo
- Department of BioengineeringUniversity of California RiversideRiversideCaliforniaUSA
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Holmes JH, Jen ML, Eisenmenger LB, Schubert T, Turski PA, Johnson KM. Spatial dependency and the role of local susceptibility for velocity selective arterial spin labeling (VS-ASL) relative tagging efficiency using accelerated 3D radial sampling with a BIR-8 preparation. Magn Reson Med 2021; 86:293-307. [PMID: 33615527 DOI: 10.1002/mrm.28726] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 01/17/2021] [Accepted: 01/20/2021] [Indexed: 01/31/2023]
Abstract
PURPOSE Velocity selective arterial spin labeling (VS-ASL) is a promising approach for non-contrast perfusion imaging that provides robustness to vascular geometry and transit times; however, VS-ASL assumes spatially uniform tagging efficiency. This work presents a mapping approach to investigate VS-ASL relative tagging efficiency including the impact of local susceptibility effects on a BIR-8 preparation. METHODS Numerical simulations of tagging efficiency were performed to evaluate sensitivity to regionally varying local susceptibility gradients and blood velocity. Tagging efficiency mapping was performed in susceptibility phantoms and healthy human subjects (N = 7) using a VS-ASL preparation module followed by a short, high spatial resolution 3D radial-based image acquisition. Tagging efficiency maps were compared to 4D-flow, B1 , and B0 maps acquired in the same imaging session for six of the seven subjects. RESULTS Numerical simulations were found to predict reduced tagging efficiency with the combination of high blood velocity and local gradient fields. Phantom experiments corroborated numerical results. Relative efficiency mapping in normal volunteers showed unique efficiency patterns depending on individual subject anatomy and physiology. Uniform tagging efficiency was generally observed in vivo, but reduced efficiency was noted in regions of high blood velocity and local susceptibility gradients. CONCLUSION We demonstrate an approach to map the relative tagging efficiency and show application of this methodology to a novel BIR-8 preparation recently proposed in the literature. We present results showing rapid flow in the presence of local susceptibility gradients can lead to complicated signal modulations in both tag and control images and reduced tagging efficiency.
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Affiliation(s)
- James H Holmes
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Mu-Lan Jen
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Laura B Eisenmenger
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Tilman Schubert
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Patrick A Turski
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kevin M Johnson
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Bones IK, Franklin SL, Harteveld AA, van Osch MJP, Schmid S, Hendrikse J, Moonen C, van Stralen M, Bos C. Exploring label dynamics of velocity-selective arterial spin labeling in the kidney. Magn Reson Med 2021; 86:131-142. [PMID: 33538350 PMCID: PMC8048977 DOI: 10.1002/mrm.28683] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 12/07/2020] [Accepted: 12/24/2020] [Indexed: 12/13/2022]
Abstract
Purpose Velocity‐selective arterial spin labeling (VSASL) has been proposed for renal perfusion imaging to mitigate planning challenges and effects of arterial transit time (ATT) uncertainties. In VSASL, label generation may shift in the vascular tree as a function of cutoff velocity. Here, we investigate label dynamics and especially the ATT of renal VSASL and compared it with a spatially selective pulsed arterial spin labeling technique, flow alternating inversion recovery (FAIR). Methods Arterial spin labeling data were acquired in 7 subjects, using free‐breathing dual VSASL and FAIR with five postlabeling delays: 400, 800, 1200, 2000, and 2600 ms. The VSASL measurements were acquired with cutoff velocities of 5, 10, and 15 cm/s, with anterior–posterior velocity‐encoding direction. Cortical perfusion‐weighted signal, temporal SNR, quantified renal blood flow, and arterial transit time were reported. Results In contrast to FAIR, renal VSASL already showed fairly high signal at the earliest postlabeling delays, for all cutoff velocities. The highest VSASL signal and temporal SNR was obtained with a cutoff velocity of 10 cm/s at postlabeling delay = 800 ms, which was earlier than for FAIR at 1200 ms. Fitted ATT on VSASL was ≤ 0 ms, indicating ATT insensitivity, which was shorter than for FAIR (189 ± 79 ms, P < .05). Finally, the average cortical renal blood flow measured with cutoff velocities of 5 cm/s (398 ± 84 mL/min/100 g) and 10 cm/s (472 ± 160 mL/min/100 g) were similar to renal blood flow measured with FAIR (441 ± 84 mL/min/100 g) (P > .05) with good correlations on subject level. Conclusion Velocity‐selective arterial spin labeling in the kidney reduces ATT sensitivity compared with the recommended pulsed arterial spin labeling method, as well as if cutoff velocity is increased to reduce spurious labeling due to motion. Thus, VSASL has potential as a method for time‐efficient, single‐time‐point, free‐breathing renal perfusion measurements, despite lower tSNR than FAIR.
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Affiliation(s)
- Isabell K Bones
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Suzanne L Franklin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anita A Harteveld
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Sophie Schmid
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Chrit Moonen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marijn van Stralen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
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Agarwal V, Singh P, Ahuja CK, Gupta SK, Aggarwal A, Narayanan R. Non-invasive assessment of cerebral microvascular changes for predicting postoperative cerebral hyperperfusion after surgical revascularisation for moyamoya disease: an arterial spin labelling MRI study. Neuroradiology 2020; 63:563-572. [PMID: 33098435 DOI: 10.1007/s00234-020-02583-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/13/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Cerebral hyperperfusion syndrome (CHPS) can result after anastomotic surgery as the reperfusion is established in chronically ischemic cerebral territories in patients of moyamoya disease (MMD). In this study, we have evaluated the feasibility of arterial spin labelling (ASL) perfusion MRI to predict cerebral hyperperfusion syndrome based on changes of cerebral blood flow (CBF) after revascularisation surgery in patients of MMD. METHODS Our prospective study included 25 patients with MMD who underwent superficial temporal artery-middle cerebral artery (STA-MCA) bypass with or without dural/muscle synangiosis. ASL MRI was performed before and 1-7 days after surgery. On the side planned for operation, 5-mm ROI circle was drawn on the predetermined regions in frontal lobe, temporal lobe, parietal lobe and basal ganglia in proximal and distal territories of MCA to calculate ipsilateral CBF values (CBFi). An attempt was made to select the same location on contralateral side (non-operative) (CBFc) for each measurement for calculation of hemispheric normalised CBF (nCBFh) ratios. To adjust for inter individual variation among MR imagers and CBF, additional regions of interest were drawn within the cerebellum (CBFcbl) for cerebellar CBF normalised ratios (nCBFCbl). RESULTS Of the 25 patients (26 operated hemispheres), 5 patients showed significant immediate postoperative symptoms suggestive of CHPS. Based on our findings, sensitivity and specificity of ASL perfusion to detect CHPS were evaluated. ASL was found to have 47-100% sensitivity and 45-88% specificity to detect CHPS. We have tried to calculate the prevalence of CHPS in postoperative patients of moyamoya disease, which in our study ranged from 6.83 to 40.70%. CONCLUSION Based on our results, we concluded that ASL perfusion is an appropriate alternative to standard nuclear medicine studies to monitor the changes in perfusion after STA-MCA bypass surgery in moyamoya patients. ASL MR perfusion can be used to identify changes in cerebral blood flow (CBF) for early detection of cerebral hyperperfusion syndrome in patients with otherwise normal conventional MRI sequences with very high sensitivity but moderate specificity.
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Affiliation(s)
- Vivek Agarwal
- Neuroradiology Division, Department of Radiodiagnosis and Imaging, Post Graduate institute of Medical Education and Research, Chandigarh, India.
| | - Paramjeet Singh
- Neuroradiology Division, Department of Radiodiagnosis and Imaging, Post Graduate institute of Medical Education and Research, Chandigarh, India
| | - Chirag K Ahuja
- Neuroradiology Division, Department of Radiodiagnosis and Imaging, Post Graduate institute of Medical Education and Research, Chandigarh, India
| | - Sunil Kumar Gupta
- Department of Neurosurgery, Post Graduate institute of Medical Education and Research, Chandigarh, India
| | - Ashish Aggarwal
- Department of Neurosurgery, Post Graduate institute of Medical Education and Research, Chandigarh, India
| | - Rajashekhar Narayanan
- Department of Neurosurgery, Post Graduate institute of Medical Education and Research, Chandigarh, India
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Ishida S, Kimura H, Isozaki M, Takei N, Fujiwara Y, Kanamoto M, Kosaka N, Matsuda T, Kidoya E. Robust arterial transit time and cerebral blood flow estimation using combined acquisition of Hadamard-encoded multi-delay and long-labeled long-delay pseudo-continuous arterial spin labeling: a simulation and in vivo study. NMR IN BIOMEDICINE 2020; 33:e4319. [PMID: 32424992 DOI: 10.1002/nbm.4319] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/03/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Arterial transit time (ATT) prolongation causes an error of cerebral blood flow (CBF) measurement during arterial spin labeling (ASL). To improve the accuracy of ATT and CBF in patients with prolonged ATT, we propose a robust ATT and CBF estimation method for clinical practice. The proposed method consists of a three-delay Hadamard-encoded pseudo-continuous ASL (H-pCASL) with an additional-encoding and single-delay with long-labeled long-delay (1dLLLD) acquisition. The additional-encoding allows for the reconstruction of a single-delay image with long-labeled short-delay (1dLLSD) in addition to the normal Hadamard sub-bolus images. Five different images (normal Hadamard 3 delay, 1dLLSD, 1dLLLD) were reconstructed to calculate ATT and CBF. A Monte Carlo simulation and an in vivo study were performed to access the accuracy of the proposed method in comparison to normal 7-delay (7d) H-pCASL with equally divided sub-bolus labeling duration (LD). The simulation showed that the accuracy of CBF is strongly affected by ATT. It was also demonstrated that underestimation of ATT and CBF by 7d H-pCASL was higher with longer ATT than with the proposed method. Consistent with the simulation, the 7d H-pCASL significantly underestimated the ATT compared to that of the proposed method. This underestimation was evident in the distal anterior cerebral artery (ACA; P = 0.0394) and the distal posterior cerebral artery (PCA; 2 P = 0.0255). Similar to the ATT, the CBF was underestimated with 7d H-pCASL in the distal ACA (P = 0.0099), distal middle cerebral artery (P = 0.0109), and distal PCA (P = 0.0319) compared to the proposed method. Improving the SNR of each delay image (even though the number of delays is small) is crucial for ATT estimation. This is opposed to acquiring many delays with short LD. The proposed method confers accurate ATT and CBF estimation within a practical acquisition time in a clinical setting.
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Affiliation(s)
- Shota Ishida
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Hirohiko Kimura
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Makoto Isozaki
- Department of Neurosurgery, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Naoyuki Takei
- Global MR Applications and Workflow, GE Healthcare Japan, Hino, Tokyo, Japan
| | - Yasuhiro Fujiwara
- Department of Medical Image Sciences, Faculty of Life Sciences, Kumamoto University, Chuo-ku, Kumamoto, Japan
| | - Masayuki Kanamoto
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
| | - Nobuyuki Kosaka
- Department of Radiology, Faculty of Medical Sciences, University of Fukui, Eiheiji, Fukui, Japan
| | - Tsuyoshi Matsuda
- Division of Ultra-high Field MRI, Institute for Biomedical Science, Iwate Medical University, Yahaba-cho, Shiwa-gun, Iwate, Japan
| | - Eiji Kidoya
- Radiological Center, University of Fukui Hospital, Eiheiji, Fukui, Japan
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Bones IK, Franklin SL, Harteveld AA, van Osch MJP, Hendrikse J, Moonen C, van Stralen M, Bos C. Influence of labeling parameters and respiratory motion on velocity-selective arterial spin labeling for renal perfusion imaging. Magn Reson Med 2020; 84:1919-1932. [PMID: 32180263 PMCID: PMC7384062 DOI: 10.1002/mrm.28252] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/15/2020] [Accepted: 02/19/2020] [Indexed: 12/12/2022]
Abstract
Purpose Arterial transit time uncertainties and challenges during planning are potential issues for renal perfusion measurement using spatially selective arterial spin labeling techniques. To mitigate these potential issues, a spatially non‐selective technique, such as velocity‐selective arterial spin labeling (VSASL), could be an alternative. This article explores the influence of VSASL sequence parameters and respiratory induced motion on VS‐label generation. Methods VSASL data were acquired in human subjects (n = 15), with both single and dual labeling, during paced‐breathing, while essential sequence parameters were systematically varied; (1) cutoff velocity, (2) labeling gradient orientation and (3) post‐labeling delay (PLD). Pseudo‐continuous ASL was acquired as a spatially selective reference. In an additional free‐breathing single VSASL experiment (n = 9) we investigated respiratory motion influence on VS‐labeling. Absolute renal blood flow (RBF), perfusion weighted signal (PWS), and temporal signal‐to‐noise ratio (tSNR) were determined. Results (1) With decreasing cutoff velocity, tSNR and PWS increased. However, undesired tissue labeling occurred at low cutoff velocities (≤ 5.4 cm/s). (2) Labeling gradient orientation had little effect on tSNR and PWS. (3) For single VSASL high signal appeared in the kidney pedicle at PLD < 800 ms, and tSNR and PWS decreased with increasing PLD. For dual VSASL, maximum tSNR occurred at PLD = 1200 ms. Average cortical RBF measured with dual VSASL (264 ± 34 mL/min/100 g) at a cutoff velocity of 5.4 cm/s, and feet‐head labeling was slightly lower than with pseudo‐continuous ASL (283 ± 55 mL/min/100 g). Conclusion With well‐chosen sequence parameters, tissue labeling induced by respiratory motion can be minimized, allowing to obtain good quality RBF maps using planning‐free labeling with dual VSASL.
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Affiliation(s)
- Isabell K Bones
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Suzanne L Franklin
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands.,C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anita A Harteveld
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Matthias J P van Osch
- C.J. Gorter Center for High Field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Chrit Moonen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marijn van Stralen
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Clemens Bos
- Center for Image Sciences, University Medical Center Utrecht, Utrecht, the Netherlands
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Harteveld AA, Hutter J, Franklin SL, Jackson LH, Rutherford M, Hajnal JV, van Osch MJP, Bos C, De Vita E. Systematic evaluation of velocity-selective arterial spin labeling settings for placental perfusion measurement. Magn Reson Med 2020; 84:1828-1843. [PMID: 32141655 PMCID: PMC7384055 DOI: 10.1002/mrm.28240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/04/2020] [Accepted: 02/10/2020] [Indexed: 01/15/2023]
Abstract
Purpose Placental function is key for successful human pregnancies. Perfusion may be a sensitive marker for the in vivo assessment of placental function. Arterial spin labeling (ASL) MRI enables noninvasive measurement of tissue perfusion and it was recently suggested that ASL with velocity‐selective (VS) labeling could be advantageous in the placenta. We systematically evaluated essential VS‐ASL sequence parameters to determine optimal settings for efficient placental perfusion measurements. Methods Eleven pregnant women were scanned at 3T using VS‐ASL with 2D multislice echo planar imaging (EPI)‐readout. One reference VS‐ASL scan was acquired in all subjects; within subgroups the following parameters were systematically varied: cutoff velocity, velocity encoding direction, and inflow time. Visual evaluation and region of interest analyses were performed to compare perfusion signal differences between acquisitions. Results In all subjects, a perfusion pattern with clear hyperintense focal regions was observed. Perfusion signal decreased with inflow time and cutoff velocity. Subject‐specific dependence on velocity encoding direction was observed. High temporal signal‐to‐noise ratios with high contrast on the perfusion images between the hyperintense regions and placental tissue were seen at ~1.6 cm/s cutoff velocity and ~1000 ms inflow time. Evaluation of measurements at multiple inflow times revealed differences in blood flow dynamics between placental regions. Conclusion Placental perfusion measurements are feasible at 3T using VS‐ASL with 2D multislice EPI‐readout. A clear dependence of perfusion signal on VS labeling parameters and inflow time was demonstrated. Whereas multiple parameter combinations may advance the interpretation of placental circulation dynamics, this study provides a basis to select an effective set of parameters for the observation of placenta perfusion natural history and its potential pathological changes.
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Affiliation(s)
- Anita A Harteveld
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Jana Hutter
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Suzanne L Franklin
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,C.J. Gorter Center for high field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Laurence H Jackson
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Mary Rutherford
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Joseph V Hajnal
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
| | - Matthias J P van Osch
- C.J. Gorter Center for high field MRI, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Clemens Bos
- Department of Radiology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Enrico De Vita
- Biomedical Engineering, School of Imaging Sciences and Biomedical Engineering, King's College London, London, United Kingdom
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Bolar DS, Gagoski B, Orbach DB, Smith E, Adalsteinsson E, Rosen BR, Grant PE, Robertson RL. Comparison of CBF Measured with Combined Velocity-Selective Arterial Spin-Labeling and Pulsed Arterial Spin-Labeling to Blood Flow Patterns Assessed by Conventional Angiography in Pediatric Moyamoya. AJNR Am J Neuroradiol 2019; 40:1842-1849. [PMID: 31694821 PMCID: PMC6975103 DOI: 10.3174/ajnr.a6262] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/21/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Imaging CBF is important for managing pediatric moyamoya. Traditional arterial spin-labeling MR imaging detects delayed transit thorough diseased arteries but is inaccurate for measuring perfusion because of these delays. Velocity-selective arterial spin-labeling is insensitive to transit delay and well-suited for imaging Moyamoya perfusion. This study assesses the accuracy of a combined velocity-selective arterial spin-labeling and traditional pulsed arterial spin-labeling CBF approach in pediatric moyamoya, with comparison to blood flow patterns on conventional angiography. MATERIALS AND METHODS Twenty-two neurologically stable pediatric patients with moyamoya and 5 asymptomatic siblings without frank moyamoya were imaged with velocity-selective arterial spin-labeling, pulsed arterial spin-labeling, and DSA (patients). Qualitative comparison was performed, followed by a systematic comparison using ASPECTS-based scoring. Quantitative pulsed arterial spin-labeling CBF and velocity-selective arterial spin-labeling CBF for the middle cerebral artery, anterior cerebral artery, and posterior cerebral artery territories were also compared. RESULTS Qualitatively, velocity-selective arterial spin-labeling perfusion maps reflect the DSA parenchymal phase, regardless of postinjection timing. Conversely, pulsed arterial spin-labeling maps reflect the DSA appearance at postinjection times closer to the arterial spin-labeling postlabeling delay, regardless of vascular phase. ASPECTS comparison showed excellent agreement (88%, κ = 0.77, P < .001) between arterial spin-labeling and DSA, suggesting velocity-selective arterial spin-labeling and pulsed arterial spin-labeling capture key perfusion and transit delay information, respectively. CBF coefficient of variation, a marker of perfusion variability, was similar for velocity-selective arterial spin-labeling in patient regions of delayed-but-preserved perfusion compared to healthy asymptomatic sibling regions (coefficient of variation = 0.30 versus 0.26, respectively, Δcoefficient of variation = 0.04), but it was significantly different for pulsed arterial spin-labeling (coefficient of variation = 0.64 versus 0.34, Δcoefficient of variation = 0.30, P < .001). CONCLUSIONS Velocity-selective arterial spin-labeling offers a powerful approach to image perfusion in pediatric moyamoya due to transit delay insensitivity. Coupled with pulsed arterial spin-labeling for transit delay information, a volumetric MR imaging approach capturing key DSA information is introduced.
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Affiliation(s)
- D S Bolar
- From the Department of Radiology (D.S.B.)
- Center for Functional Magnetic Resonance Imaging (D.S.B.), UC San Diego, La Jolla, California
| | - B Gagoski
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
| | - D B Orbach
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Neurointerventional Radiology (D.B.O.)
| | - E Smith
- Department of Neurosurgery (E.S.)
| | - E Adalsteinsson
- Department of Electrical Engineering & Computer Science (E.A.), Massachusetts Institute of Technology, Cambridge, Massachusetts
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - B R Rosen
- MGH/HST Athinoula A. Martinos Center for Biomedical Imaging (E.A., B.R.R.), Charlestown, Massachusetts
| | - P E Grant
- Fetal Neonatal Neuroimaging and Developmental Science Center (B.G., P.E.G.)
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
- Division of Newborn Medicine (P.E.G.), Department of Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - R L Robertson
- Department of Radiology (B.G., D.B.O., P.E.G., R.L.R.)
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Hutter J, Harteveld AA, Jackson LH, Franklin S, Bos C, van Osch MJP, O'Muircheartaigh J, Ho A, Chappell L, Hajnal JV, Rutherford M, De Vita E. Perfusion and apparent oxygenation in the human placenta (PERFOX). Magn Reson Med 2019; 83:549-560. [PMID: 31433077 PMCID: PMC6825519 DOI: 10.1002/mrm.27950] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 07/18/2019] [Accepted: 07/25/2019] [Indexed: 02/05/2023]
Abstract
PURPOSE To study placental function-both perfusion and an oxygenation surrogate ( T 2 * )-simultaneously and quantitatively in-vivo. METHODS Fifteen pregnant women were scanned on a 3T MR scanner. For perfusion measurements, a velocity selective arterial spin labeling preparation module was placed before a multi-echo gradient echo EPI readout to integrate T 2 * and perfusion measurements in 1 joint perfusion-oxygenation (PERFOX) acquisition. Joint motion correction and quantification were performed to evaluate changes in T 2 * and perfusion over GA. RESULTS The optimized integrated PERFOX protocol and post-processing allowed successful visualization and quantification of perfusion and T 2 * in all subjects. Areas of high T 2 * and high perfusion appear to correspond to placental sub-units and show a systematic offset in location along the maternal-fetal axis. The areas of highest perfusion are consistently closer to the maternal basal plate and the areas of highest T 2 * closer to the fetal chorionic plate. Quantitative results show a strong negative correlation of gestational age with T 2 * and weak negative correlation with perfusion. CONCLUSIONS A strength of the joint sequence is that it provides truly simultaneous and co-registered estimates of local T 2 * and perfusion, however, to achieve this, the time per slice is prolonged compared to a perfusion only scan which can potentially limit coverage. The achieved interlocking can be particularly useful when quantifying transient physiological effects such as uterine contractions. PERFOX opens a new avenue to elucidate the relationship between maternal supply and oxygen uptake, both of which are central to placental function and dysfunction.
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Affiliation(s)
- Jana Hutter
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Anita A. Harteveld
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Laurence H. Jackson
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Suzanne Franklin
- C.J. Gorter Center for High Field MRIDepartment of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Clemens Bos
- Department of RadiologyUniversity Medical Center UtrechtUtrechtThe Netherlands
| | - Matthias J. P. van Osch
- C.J. Gorter Center for High Field MRIDepartment of RadiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Jonathan O'Muircheartaigh
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Alison Ho
- Academic Women's Health DepartmentKing's College LondonLondonUnited Kingdom
| | - Lucy Chappell
- Academic Women's Health DepartmentKing's College LondonLondonUnited Kingdom
| | - Joseph V. Hajnal
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Mary Rutherford
- Centre for the Developing BrainKing's College LondonLondonUnited Kingdom
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
| | - Enrico De Vita
- School of Medical EngineeringKing's College LondonLondonUnited Kingdom
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10
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Thamm T, Zweynert S, Piper SK, Madai VI, Livne M, Martin SZ, Herzig CX, Mutke MA, Siebert E, Liebig T, Sobesky J. Diagnostic and prognostic benefit of arterial spin labeling in subacute stroke. Brain Behav 2019; 9:e01271. [PMID: 30912272 PMCID: PMC6520295 DOI: 10.1002/brb3.1271] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/31/2019] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND PURPOSE Brain perfusion measurement in the subacute phase of stroke may support therapeutic decisions. We evaluated whether arterial spin labeling (ASL), a noninvasive perfusion imaging technique based on magnetic resonance imaging (MRI), adds diagnostic and prognostic benefit to diffusion-weighted imaging (DWI) in subacute stroke. METHODS In a single-center imaging study, patients with DWI lesion(s) in the middle cerebral artery (MCA) territory were included. Onset to imaging time was ≤7 days and imaging included ASL and DWI sequences. Qualitative (standardized visual analysis) and quantitative perfusion analyses (region of interest analysis) were performed. Dichotomized early outcome (modified Rankin Scale [mRS] 0-2 vs. 3-6) was analyzed in two logistic regression models. Model 1 included DWI lesion volume, age, vascular pathology, admission NIHSS, and acute stroke treatment as covariates. Model 2 added the ASL-based perfusion pattern to Model 1. Receiver-operating-characteristic (ROC) and area-under-the-curve (AUC) were calculated for both models to assess their predictive power. The likelihood-ratio-test compared both models. RESULTS Thirty-eight patients were included (median age 70 years, admission NIHSS 4, onset to imaging time 67 hr, discharge mRS 2). Qualitative perfusion analysis yielded additional diagnostic information in 84% of the patients. In the quantitative analysis, AUC for outcome prediction was 0.88 (95% CI 0.77-0.99) for Model 1 and 0.97 (95% CI 0.91-1.00) for Model 2. Inclusion of perfusion data significantly improved performance and outcome prediction (p = 0.002) of stroke imaging. CONCLUSIONS In patients with subacute stroke, our study showed that adding perfusion imaging to structural imaging and clinical data significantly improved outcome prediction. This highlights the usefulness of ASL and noninvasive perfusion biomarkers in stroke diagnosis and management.
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Affiliation(s)
- Thoralf Thamm
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sarah Zweynert
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Sophie K Piper
- Institute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Berlin Institute of Health (BIH), Berlin, Germany
| | - Vince I Madai
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Michelle Livne
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Steve Z Martin
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Cornelius X Herzig
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Matthias A Mutke
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neuroradiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Eberhard Siebert
- Department of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Thomas Liebig
- Department of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neuroradiology, Ludwig-Maximilian-University, Munich, Germany
| | - Jan Sobesky
- Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Johanna-Etienne-Hospital, Neuss, Germany
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11
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Hernandez-Garcia L, Lahiri A, Schollenberger J. Recent progress in ASL. Neuroimage 2019; 187:3-16. [PMID: 29305164 PMCID: PMC6030511 DOI: 10.1016/j.neuroimage.2017.12.095] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 12/21/2017] [Accepted: 12/30/2017] [Indexed: 11/26/2022] Open
Abstract
This article aims to provide the reader with an overview of recent developments in Arterial Spin Labeling (ASL) MRI techniques. A great deal of progress has been made in recent years in terms of the SNR and acquisition speed. New strategies have been introduced to improve labeling efficiency, reduce artefacts, and estimate other relevant physiological parameters besides perfusion. As a result, ASL techniques has become a reliable workhorse for researchers as well as clinicians. After a brief overview of the technique's fundamentals, this article will review new trends and variants in ASL including vascular territory mapping and velocity selective ASL, as well as arterial blood volume imaging techniques. This article will also review recent processing techniques to reduce partial volume effects and physiological noise. Next the article will examine how ASL techniques can be leveraged to calculate additional physiological parameters beyond perfusion and finally, it will review a few recent applications of ASL in the literature.
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Affiliation(s)
| | - Anish Lahiri
- FMRI Laboratory, University of Michigan, United States
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12
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Hernandez-Garcia L, Nielsen JF, Noll DC. Improved sensitivity and temporal resolution in perfusion FMRI using velocity selective inversion ASL. Magn Reson Med 2018; 81:1004-1015. [PMID: 30187951 DOI: 10.1002/mrm.27461] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/29/2018] [Accepted: 06/30/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE This work aims to investigate the utility of velocity selective inversion pulses for perfusion weighted functional MRI. METHODS Tracer kinetic properties of velocity selective inversion (VSI) pulses as an input function for an arterial spin labeling (ASL) experiment were characterized in a group of healthy participants. Numerical simulations were conducted to search for a robust set of timing parameters for FMRI time series acquisition with maximal signal to noise ratio efficiency. The performance of three VSI pulse sequences with different timing parameters was compared with a pseudocontinuous ASL sequence in a simple FMRI experiment conducted on healthy participants. RESULTS The fit to the tracer kinetic model yielded arterial CBV of 1.24% ± 0.52% and 0.45 ± 0.11% and perfusion rates of 60.8 ± 32.3 and 34.4 ± 5.4 mL/min/100 g for gray and white matter, respectively. Bolus arrival times were estimated as 75.7 ± 21 ms and 349 ± 78 ms for gray and white matter, respectively. The FMRI experiments showed that VSI pulses yield comparable sensitivity to PCASL with similar timing parameters (TR = 4 s). However, VSI pulses could be used at a faster acquisition speed (TR = 3 s) and were more sensitive to neuronal activity than PCASL pulses, as evidenced by the 31% higher Z scores obtained on average in the active regions. CONCLUSION VSI pulses can be very beneficial for perfusion weighted functional MRI because of their tracer kinetic characteristics, which allow a faster acquisition rate while maintaining an efficient labeling input function.
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Affiliation(s)
| | | | - Douglas C Noll
- University of Michigan FMRI Laboratory, Ann Arbor, Michigan
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13
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van Osch MJ, Teeuwisse WM, Chen Z, Suzuki Y, Helle M, Schmid S. Advances in arterial spin labelling MRI methods for measuring perfusion and collateral flow. J Cereb Blood Flow Metab 2018; 38:1461-1480. [PMID: 28598243 PMCID: PMC6120125 DOI: 10.1177/0271678x17713434] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
With the publication in 2015 of the consensus statement by the perfusion study group of the International Society for Magnetic Resonance in Medicine (ISMRM) and the EU-COST action 'ASL in dementia' on the implementation of arterial spin labelling MRI (ASL) in a clinical setting, the development of ASL can be considered to have become mature and ready for clinical prime-time. In this review article new developments and remaining issues will be discussed, especially focusing on quantification of ASL as well as on new technological developments of ASL for perfusion imaging and flow territory mapping. Uncertainty of the achieved labelling efficiency in pseudo-continuous ASL (pCASL) as well as the presence of arterial transit time artefacts, can be considered the main remaining challenges for the use of quantitative cerebral blood flow (CBF) values. New developments in ASL centre around time-efficient acquisition of dynamic ASL-images by means of time-encoded pCASL and diversification of information content, for example by combined 4D-angiography with perfusion imaging. Current vessel-encoded and super-selective pCASL-methodology have developed into easily applied flow-territory mapping methods providing relevant clinical information with highly similar information content as digital subtraction angiography (DSA), the current clinical standard. Both approaches seem therefore to be ready for clinical use.
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Affiliation(s)
- Matthias Jp van Osch
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Wouter M Teeuwisse
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
| | - Zhensen Chen
- 3 Department of Biomedical Engineering, Tsinghua University, Beijing, China
| | - Yuriko Suzuki
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael Helle
- 4 Philips GmbH Innovative Technologies, Research Laboratories, Hamburg, Germany
| | - Sophie Schmid
- 1 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.,2 Leiden Institute of Brain and Cognition, Leiden University, Leiden, The Netherlands
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14
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Donahue MJ, Achten E, Cogswell PM, De Leeuw FE, Derdeyn CP, Dijkhuizen RM, Fan AP, Ghaznawi R, Heit JJ, Ikram MA, Jezzard P, Jordan LC, Jouvent E, Knutsson L, Leigh R, Liebeskind DS, Lin W, Okell TW, Qureshi AI, Stagg CJ, van Osch MJP, van Zijl PCM, Watchmaker JM, Wintermark M, Wu O, Zaharchuk G, Zhou J, Hendrikse J. Consensus statement on current and emerging methods for the diagnosis and evaluation of cerebrovascular disease. J Cereb Blood Flow Metab 2018; 38:1391-1417. [PMID: 28816594 PMCID: PMC6125970 DOI: 10.1177/0271678x17721830] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 05/26/2017] [Accepted: 06/10/2017] [Indexed: 01/04/2023]
Abstract
Cerebrovascular disease (CVD) remains a leading cause of death and the leading cause of adult disability in most developed countries. This work summarizes state-of-the-art, and possible future, diagnostic and evaluation approaches in multiple stages of CVD, including (i) visualization of sub-clinical disease processes, (ii) acute stroke theranostics, and (iii) characterization of post-stroke recovery mechanisms. Underlying pathophysiology as it relates to large vessel steno-occlusive disease and the impact of this macrovascular disease on tissue-level viability, hemodynamics (cerebral blood flow, cerebral blood volume, and mean transit time), and metabolism (cerebral metabolic rate of oxygen consumption and pH) are also discussed in the context of emerging neuroimaging protocols with sensitivity to these factors. The overall purpose is to highlight advancements in stroke care and diagnostics and to provide a general overview of emerging research topics that have potential for reducing morbidity in multiple areas of CVD.
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Affiliation(s)
- Manus J Donahue
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
- Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
| | - Eric Achten
- Department of Radiology and Nuclear Medicine, Universiteit Gent, Gent, Belgium
| | - Petrice M Cogswell
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Frank-Erik De Leeuw
- Radboud University, Nijmegen Medical Center, Donders Institute Brain Cognition & Behaviour, Center for Neuroscience, Department of Neurology, Nijmegen, The Netherlands
| | - Colin P Derdeyn
- Department of Radiology and Neurology, University of Iowa, Iowa City, IA, USA
| | - Rick M Dijkhuizen
- Biomedical MR Imaging and Spectroscopy Group, Center for Image Sciences, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Audrey P Fan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | - Rashid Ghaznawi
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jeremy J Heit
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
- Department of Radiology, Erasmus MC, Rotterdam, The Netherlands
| | - Peter Jezzard
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Lori C Jordan
- Department of Pediatrics, Division of Pediatric Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric Jouvent
- Department of Neurology, AP-HP, Lariboisière Hospital, Paris, France
| | - Linda Knutsson
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Medical Radiation Physics, Lund University, Lund, Sweden
| | - Richard Leigh
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | | | - Weili Lin
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Thomas W Okell
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Adnan I Qureshi
- Department of Neurology, Zeenat Qureshi Stroke Institute, St. Cloud, MN, USA
| | - Charlotte J Stagg
- Oxford Centre for Human Brain Activity, University of Oxford, Oxford, UK
| | | | - Peter CM van Zijl
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jennifer M Watchmaker
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Max Wintermark
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - Ona Wu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
- Department of Radiology, Harvard Medical School, Boston, MA, USA
| | - Greg Zaharchuk
- Department of Radiology, Neuroimaging and Neurointervention Division, Stanford University, CA, USA
| | - Jinyuan Zhou
- Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Jeroen Hendrikse
- Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands
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15
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Zhao L, Wang Y, Jia Y, Zhong S, Sun Y, Zhou Z, Zhang Z, Huang L. Microstructural Abnormalities of Basal Ganglia and Thalamus in Bipolar and Unipolar Disorders: A Diffusion Kurtosis and Perfusion Imaging Study. Psychiatry Investig 2017; 14:471-482. [PMID: 28845175 PMCID: PMC5561406 DOI: 10.4306/pi.2017.14.4.471] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 06/23/2016] [Accepted: 07/25/2016] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), leading to mistreatment and poor clinical outcomes. However, little is known about the similarities and differences in subcorticalgray matter regions between BD and UD. METHODS Thirty-five BD patients, 30 UD patients and 40 healthy controls underwent diffusional kurtosis imaging (DKI) and three dimensional arterial spin labeling (3D ASL). The parameters including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr) and cerebral blood flow (CBF) were measured by using regions-of-interest analysis in the caudate, putamen and thalamus of the subcortical gray matter regions. RESULTS UD exhibited differences from controls for DKI measures and CBF in the left putamen and caudate. BD showed differences from controls for DKI measures in the left caudate. Additionally, BD showed lower Ka in right putamen, higher MD in right caudate compared with UD. Receiver operating characteristic analysis revealed the Kr of left caudate had the highest predictive power for distinguishing UD from controls. CONCLUSION The two disorders may have overlaps in microstructural abnormality in basal ganglia. The change of caudate may serve as a potential biomarker for UD.
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Affiliation(s)
- Lianping Zhao
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Department of Radiology, Gansu Provincial Hospital, Gansu, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
- Clinical Experimental Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yao Sun
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhifeng Zhou
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - Li Huang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou, China
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16
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Liu D, Xu F, Lin DD, van Zijl PCM, Qin Q. Quantitative measurement of cerebral blood volume using velocity-selective pulse trains. Magn Reson Med 2016; 77:92-101. [PMID: 27797101 DOI: 10.1002/mrm.26515] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 09/26/2016] [Accepted: 09/26/2016] [Indexed: 12/20/2022]
Abstract
PURPOSE To develop a non-contrast-enhanced MRI method for cerebral blood volume (CBV) mapping using velocity-selective (VS) pulse trains. METHODS The new pulse sequence applied velocity-sensitive gradient waveforms in the VS label modules and velocity-compensated ones in the control scans. Sensitivities to the gradient imperfections (e.g., eddy currents) were evaluated through phantom studies. CBV quantification procedures based on simulated labeling efficiencies for arteriolar, capillary, and venular blood as a function of cutoff velocity (Vc) are presented. Experiments were conducted on healthy volunteers at 3T to examine the effects of unbalanced diffusion weighting, cerebrospinal (CSF) contamination and variation of Vc. RESULTS Phantom results of the used VS pulse trains demonstrated robustness to eddy currents. The mean CBV values of gray matter and white matter for the experiments using Vc = 3.5 mm/s and velocity-compensated control with CSF-nulling were 5.1 ± 0.6 mL/100 g and 2.4 ± 0.2 mL/100 g, respectively, which were 23% and 32% lower than results from the experiment with velocity-insensitive control, corresponding to 29% and 25% lower in averaged temporal signal-to-noise ratio values. CONCLUSION A novel technique using VS pulse trains was demonstrated for CBV mapping. The results were both qualitatively and quantitatively close to those from existing methods. Magn Reson Med 77:92-101, 2017. © 2016 International Society for Magnetic Resonance in Medicine.
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Affiliation(s)
- Dexiang Liu
- Department of Radiology, Panyu District Central Hospital, Guangzhou, Guangdong Province, China.,The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Feng Xu
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Doris D Lin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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17
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Schmid S, Petersen ET, Van Osch MJP. Insight into the labeling mechanism of acceleration selective arterial spin labeling. MAGNETIC RESONANCE MATERIALS IN PHYSICS BIOLOGY AND MEDICINE 2016; 30:165-174. [PMID: 27787676 PMCID: PMC5364255 DOI: 10.1007/s10334-016-0596-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 11/21/2022]
Abstract
Objectives Acceleration selective arterial spin labeling (AccASL) is a spatially non-selective labeling technique, used in traditional ASL methods, which labels spins based on their flow acceleration rather than spatial localization. The exact origin of the AccASL signal within the vasculature is not completely understood. To obtain more insight into this, the acceleration selective module was performed followed by a velocity selective module, which is used in velocity selective arterial spin labeling (VS-ASL). Materials and methods Nine healthy volunteers were scanned with various combinations of the control and label conditions in both the acceleration and velocity selective module. The cut-off acceleration (0.59 m/s2) or velocity (2 cm/s) was kept constant in one module, while it was varied over a large range in the other module. With the right subtractions this resulted in AccASL, VS-ASL, combined AccASL and VS-ASL signal, and signal from one module with crushing from the other. Results The label created with AccASL has an overlap of approximately 50% in the vascular region with VS-ASL, but also originates from smaller vessels closer to the capillaries. Conclusion AccASL is able to label spins both in the macro- and meso-vasculature, as well as in the microvasculature. Electronic supplementary material The online version of this article (doi:10.1007/s10334-016-0596-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sophie Schmid
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, C3-Q, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.
| | - Esben T Petersen
- Danish Research Centre for Magnetic Resonance, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Matthias J P Van Osch
- Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, C3-Q, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands.,Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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18
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Qin Q, van Zijl PCM. Velocity-selective-inversion prepared arterial spin labeling. Magn Reson Med 2016; 76:1136-48. [PMID: 26507471 PMCID: PMC4848210 DOI: 10.1002/mrm.26010] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/22/2015] [Accepted: 09/15/2015] [Indexed: 12/17/2022]
Abstract
PURPOSE To develop a Fourier-transform based velocity-selective inversion (FT-VSI) pulse train for velocity-selective arterial spin labeling (VSASL). METHODS This new pulse contains paired and phase cycled refocusing pulses. Its sensitivities to B0/B1 inhomogeneity and gradient imperfections such as eddy currents were evaluated through simulation and phantom studies. Cerebral blood flow (CBF) quantification using FT-VSI prepared VSASL was compared with conventional VSASL and pseudocontinuous ASL (PCASL) at 3 Tesla. RESULTS Simulation and phantom results of the proposed FT-VSI pulse train demonstrated excellent robustness to B0/B1 field inhomogeneity and eddy currents. The estimated CBF of gray matter and white matter for the FT-VSI prepared VSASL, averaged among eight healthy volunteers, were 49.5 ± 7.5 mL/100 g/min and 14.8 ± 2.4 mL/100 g/min, respectively. Excellent correlation and agreement between the FT-VSI method and conventional VSASL and PCASL were found. The averaged signal-to-noise ratio (SNR) value in gray matter of the FT-VSI method was 39% higher than VSASL using conventional double refocused hyperbolic tangent pulses and 9% lower than PCASL. CONCLUSION A novel FT-VSI pulse train was demonstrated to be a suitable labeling module for VSASL with robustness of velocity-selective profile to B0/B1 field inhomogeneity and gradient imperfections. Compared with conventional VSASL, FT-VSI prepared VSASL produced consistent CBF maps with higher SNR values. Magn Reson Med 76:1136-1148, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Qin Qin
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA.
| | - Peter C M van Zijl
- The Russell H. Morgan Department of Radiology and Radiological Science, Division of MR Research, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, Maryland, USA
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Cerebellar microstructural abnormalities in bipolar depression and unipolar depression: A diffusion kurtosis and perfusion imaging study. J Affect Disord 2016; 195:21-31. [PMID: 26852094 DOI: 10.1016/j.jad.2016.01.042] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/21/2015] [Accepted: 01/26/2016] [Indexed: 01/02/2023]
Abstract
BACKGROUND Depression in the context of bipolar disorder (BD) is often misdiagnosed as unipolar depression (UD), leading to mistreatment and poor clinical outcomes. However, little is known about the similarities and differences in cerebellum between BD and UD. METHODS Patients with BD (n=35) and UD (n=30) during a depressive episode as well as 40 healthy controls underwent diffusional kurtosis imaging (DKI) and three dimensional arterial spin labeling (3D ASL). The DKI parameters including mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr),fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da) and radial diffusivity (Dr) and 3D ASL parameters (i.e. cerebral blood flow) was measured by using regions-of-interest (ROIs) analysis in the superior cerebellar peduncles (SCP), middle cerebellar peduncles (MCP) and dentate nuclei (DN) of cerebellum. RESULTS Patients with UD exhibited significant differences from controls for DKI measures in bilateral SCP and MCP and cerebral blood flow (CBF) in bilateral SCP and left DN. Patients with BD exhibited significant differences from controls for DKI measures in the right MCP and left DN and CBF in the left DN. Patients with UD showed significantly lower MD values compared with patients with BD in the right SCP. Correlation analysis showed there were negative correlations between illness duration and MD and Dr values in the right SCP in UD. LIMITATIONS This study was cross-sectional and the sample size was not large. Parts of the patients included were under medication prior to MRI scanning. CONCLUSIONS Our findings provide new evidence of microstructural changes in cerebellum in BD and UD. The two disorders may have overlaps in microstructural abnormality in MCP and DN during the depressive period. Microstructural abnormality in SCP may be a key neurobiological feature of UD.
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Fan AP, Jahanian H, Holdsworth SJ, Zaharchuk G. Comparison of cerebral blood flow measurement with [15O]-water positron emission tomography and arterial spin labeling magnetic resonance imaging: A systematic review. J Cereb Blood Flow Metab 2016; 36:842-61. [PMID: 26945019 PMCID: PMC4853843 DOI: 10.1177/0271678x16636393] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 01/19/2016] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Abstract
Noninvasive imaging of cerebral blood flow provides critical information to understand normal brain physiology as well as to identify and manage patients with neurological disorders. To date, the reference standard for cerebral blood flow measurements is considered to be positron emission tomography using injection of the [(15)O]-water radiotracer. Although [(15)O]-water has been used to study brain perfusion under normal and pathological conditions, it is not widely used in clinical settings due to the need for an on-site cyclotron, the invasive nature of arterial blood sampling, and experimental complexity. As an alternative, arterial spin labeling is a promising magnetic resonance imaging technique that magnetically labels arterial blood as it flows into the brain to map cerebral blood flow. As arterial spin labeling becomes more widely adopted in research and clinical settings, efforts have sought to standardize the method and validate its cerebral blood flow values against positron emission tomography-based cerebral blood flow measurements. The purpose of this work is to critically review studies that performed both [(15)O]-water positron emission tomography and arterial spin labeling to measure brain perfusion, with the aim of better understanding the accuracy and reproducibility of arterial spin labeling relative to the positron emission tomography reference standard.
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Affiliation(s)
- Audrey P Fan
- Department of Radiology, Stanford University, Stanford, CA, USA
| | | | | | - Greg Zaharchuk
- Department of Radiology, Stanford University, Stanford, CA, USA
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Bokkers RPH, De Cocker LJ, van Osch MJP, Hartkamp NS, Hendrikse J. Selective Arterial Spin Labeling: Techniques and Neurovascular Applications. Top Magn Reson Imaging 2016; 25:73-80. [PMID: 27049244 DOI: 10.1097/rmr.0000000000000078] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Knowledge of the distribution of blood flowing from the heart to the brain-feeding arteries is important for the understanding and diagnosis of cerebrovascular diseases. Due to anatomical variations and anomalies within the cerebrovasculature, together with changes caused by various cerebrovascular diseases, there is high variability in the distribution of blood to the parenchyma. This article reviews the various methods that are available for determining the flow territories of the brain-feeding arteries and provides an overview of the different territorial arterial spin labeling (ASL) magnetic resonance imaging (MRI) techniques that have been introduced during the past 2 decades. ASL is a noninvasive method that uses arterial blood as an endogenous contrast agent by magnetically labeling the inflowing blood with radiofrequency pulses. Several selective ASL MRI methods are available to visualize the perfusion territories of individual brain feeding arteries and determine the presence of collateral blood flow pathways. Clinically, these selective perfusion methods may replace more invasive procedures such as catheter angiography for various diseases in which it is of importance to determine the feeding blood vessels, evaluate the presence potential collateral pathways, and monitor the patency of surgical bypasses.
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Affiliation(s)
- Reinoud P H Bokkers
- *Department of Radiology, University of Groningen, Groningen, The Netherlands †Department of Radiology, University Medical Center Groningen, Groningen, The Netherlands ‡Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands §Department of Radiology, C.J. Gorter Center for High Field MRI, Leiden University Medical Center, Leiden, The Netherlands
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