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De Simone M, Fontanella MM, Choucha A, Schaller K, Machi P, Lanzino G, Bijlenga P, Kurz FT, Lövblad KO, De Maria L. Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations. Biomedicines 2024; 12:753. [PMID: 38672109 PMCID: PMC11048131 DOI: 10.3390/biomedicines12040753] [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: 02/27/2024] [Revised: 03/22/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024] Open
Abstract
Arterial spin labeling (ASL) has emerged as a promising noninvasive tool for the evaluation of both pediatric and adult arteriovenous malformations (AVMs). This paper reviews the advantages and challenges associated with the use of ASL in AVM assessment. An assessment of the diagnostic workup of AVMs and their variants in both adult and pediatric populations is proposed. Evaluation after treatments, whether endovascular or microsurgical, was similarly examined. ASL, with its endogenous tracer and favorable safety profile, offers functional assessment and arterial feeder identification. ASL has demonstrated strong performance in identifying feeder arteries and detecting arteriovenous shunting, although some studies report inferior performance compared with digital subtraction angiography (DSA) in delineating venous drainage. Challenges include uncertainties in sensitivity for specific AVM features. Detecting AVMs in challenging locations, such as the apical cranial convexity, is further complicated, demanding careful consideration due to the risk of underestimating total blood flow. Navigating these challenges, ASL provides a noninvasive avenue with undeniable merits, but a balanced approach considering its limitations is crucial. Larger-scale prospective studies are needed to comprehensively evaluate the diagnostic performance of ASL in AVM assessment.
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Affiliation(s)
- Matteo De Simone
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
| | - Marco Maria Fontanella
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy; (M.M.F.); (L.D.M.)
| | - Anis Choucha
- Department of Neurosurgery, Aix Marseille University, APHM, UH Timone, 13005 Marseille, France;
- Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, 13005 Marseille, France
| | - Karl Schaller
- Division of Neurosurgery, Diagnostic Department of Clinical Neurosciences, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (K.S.); (P.B.)
| | - Paolo Machi
- Division of Interventional Neuroradiology, Department of Radiology and Medical Informatic, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (P.M.); (F.T.K.); (K.-O.L.)
| | - Giuseppe Lanzino
- Department of Neurosurgery and Interventional Neuroradiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA;
| | - Philippe Bijlenga
- Division of Neurosurgery, Diagnostic Department of Clinical Neurosciences, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (K.S.); (P.B.)
| | - Felix T. Kurz
- Division of Interventional Neuroradiology, Department of Radiology and Medical Informatic, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (P.M.); (F.T.K.); (K.-O.L.)
| | - Karl-Olof Lövblad
- Division of Interventional Neuroradiology, Department of Radiology and Medical Informatic, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (P.M.); (F.T.K.); (K.-O.L.)
| | - Lucio De Maria
- Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy; (M.M.F.); (L.D.M.)
- Division of Neurosurgery, Diagnostic Department of Clinical Neurosciences, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; (K.S.); (P.B.)
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Thatikunta PB, Zhou LW, Lee S. Dural Arteriovenous Fistula Presenting With Decreased Arterial-Spin-Labeling on Magnetic Resonance Imaging. Stroke 2023; 54:e69-e70. [PMID: 36382600 DOI: 10.1161/strokeaha.122.040639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Prateek B Thatikunta
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA (P.B.T., S.L.)
| | - Lily W Zhou
- Division of Neurology and Vancouver Stroke Program, University of British Columbia, Vancouver, Canada (L.W.Z.)
| | - Sarah Lee
- Department of Neurology and Neurological Sciences, Stanford University, Palo Alto, CA (P.B.T., S.L.)
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Senthilvelan S, Kannath SK, Arun KM, Menon R, Kesavadas C. Non-invasive assessment of cerebral hemoglobin parameters in intracranial dural arteriovenous fistula using functional near-infrared spectroscopy-A feasibility study. Front Neurosci 2022; 16:932995. [PMID: 36452332 PMCID: PMC9703974 DOI: 10.3389/fnins.2022.932995] [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: 04/30/2022] [Accepted: 09/27/2022] [Indexed: 11/05/2023] Open
Abstract
PURPOSE The purpose of this study was to assess the feasibility of non-invasive assessment of cerebral hemodynamics using functional near-infrared spectroscopy (fNIRS) in patients with intracranial dural arteriovenous fistula (DAVF) and to correlate the hemodynamic changes with definitive endovascular treatment. METHODOLOGY Twenty-seven DAVF patients and 23 healthy controls underwent 20-mins task-based functional near-infrared spectroscopy and neuropsychology evaluation. The mean change in the hemoglobin concentrations obtained from the prefrontal cortex was assessed for oxyhemoglobin, deoxyhemoglobin, and oxygen saturation (HbO, HbR, and SO2, respectively). The fNIRS data were analyzed and correlated with improvement in neuropsychology scores at 1-month follow-up. RESULTS There was a significant reduction in HbO in the patient group, while it increased in controls (-2.57E-05 vs. 1.09E-04 mM, p < 0.001). The reduced HbO significantly improved after embolization (-2.1E-04 vs. 9.9E-04, p = 0.05, q = 0.05). In patients with aggressive DAVF (Cognard 2B and above), the change was highly significant (p < 0.001; q = 0.001). A moderate correlation was observed between MMSE scores and HbO changes (ρ = 0.4). CONCLUSION fNIRS is a useful non-invasive modality for the assessment of DAVF, and could potentially assist in bedside monitoring of treatment response.
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Affiliation(s)
- Santhakumar Senthilvelan
- Neuroradiology Division, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Santhosh Kumar Kannath
- Neuroradiology Division, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Karumattu Manattu Arun
- Neuroradiology Division, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Ramshekhar Menon
- Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Chandrasekharan Kesavadas
- Neuroradiology Division, Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
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Ung TH, Delcont MR, Colakoglu S, Seinfeld J, French B, Wilkinson CC. Reconstruction of Complex Scalp Defect After Cirsoid Aneurysm Resection: A Multidisciplinary Approach. World Neurosurg 2020; 143:190-196. [DOI: 10.1016/j.wneu.2020.07.101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/16/2020] [Accepted: 07/17/2020] [Indexed: 10/23/2022]
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Arterial spin-labeling perfusion MR images with dual postlabeling delay reveals hemodynamic changes in dural arteriovenous fistulas following endovascular surgery. INTERDISCIPLINARY NEUROSURGERY 2020. [DOI: 10.1016/j.inat.2020.100733] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Tsuji Y, Miura H, Katsumori T, Kizu O, Yokoya S, Yamada K. Reversible Cortical Hypointensity on T
2
*‐Weighted MR Image After Embolization for Cerebral Dural Arteriovenous Fistula. J Magn Reson Imaging 2020; 52:311-313. [DOI: 10.1002/jmri.27005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 11/10/2019] [Accepted: 11/11/2019] [Indexed: 11/11/2022] Open
Affiliation(s)
- Yusuke Tsuji
- Department of RadiologyKyoto Prefectural University of Medicine Kyoto Japan
| | - Hiroshi Miura
- Department of RadiologyKyoto Prefectural University of Medicine Kyoto Japan
| | | | - Osamu Kizu
- Department of RadiologySaiseikai Shiga Hospital Shiga Japan
| | - Shigeomi Yokoya
- Department of NeurosurgerySaiseikai Shiga Hospital Shiga Japan
| | - Kei Yamada
- Department of RadiologyKyoto Prefectural University of Medicine Kyoto Japan
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Ramachandran S, Mukherjee D, Delf J, Bown MJ, Kandiyil N. A comparison of arterial spin labelling with catheter angiography in evaluating arteriovenous malformations: a systematic review. Br J Radiol 2020; 93:20190830. [PMID: 32208976 PMCID: PMC10993222 DOI: 10.1259/bjr.20190830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To compare the performance of arterial spin labelling (ASL) in evaluating arteriovenous malformations (AVMs) against the current gold standard of catheter angiography. METHODS We systematically reviewed the published literature using EMBASE and Medline. We included studies that compared ASL to catheter angiography in the assessment of AVMs in three outcome domains: detection, angioarchitectural and haemodynamic features. RESULTS From 314 unique citations, 19 studies representing 289 patients with intracranial AVMs met our inclusion criteria. We did not pool data due to marked heterogeneity in study outcome measures. Seven studies showed high diagnostic performance of ASL in identifying arterial feeders, with sensitivity ranging from 84.6 to 100% and specificity ranging from 93.3 to 100%. Six studies showed strong ability in detecting arteriovenous shunting, with sensitivity ranging from 91.7 to 100% and specificity ranging from 90 to 100%. Seven studies demonstrated that ASL could identify nidal location and size as well as catheter angiography, while five studies showed relatively poorer performance in delineating venous drainage. Two studies showed 100% sensitivity of ASL in the identification of residual or obliterated AVMs following stereotactic radiosurgery. CONCLUSIONS Despite limitations in the current evidence base and technical challenges, this review suggests that ASL has a promising role in the work-up and post-treatment follow-up of AVMs. Larger scale prospective studies assessing the diagnostic performance of ASL are warranted. ADVANCES IN KNOWLEDGE ASL demonstrates overall validity in the evaluation of intracranial AVMs.
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Affiliation(s)
- Sanjeev Ramachandran
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Deyashini Mukherjee
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Jonathan Delf
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
| | - Matthew James Bown
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
| | - Neghal Kandiyil
- University Hospitals of Leicester NHS Trust,
Leicester, United Kingdom
- University of Leicester,
Leicester, United Kingdom
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Kang JH, Yun TJ, Rhim JK, Cho YD, Yoo DH, Yoo RE, Kang KM, Choi SH, Kim JH, Sohn CH, Han MH. Arterial spin labeling MR imaging aids to identify cortical venous drainage of dural arteriovenous fistulas. Medicine (Baltimore) 2018; 97:e0697. [PMID: 29742722 PMCID: PMC5959413 DOI: 10.1097/md.0000000000010697] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Cortical venous drainage (CVD) increases the probability of intracranial hemorrhage and mortality rate of dural arteriovenous fistulas (DAVF). Although digital subtraction angiography (DSA) is the most accurate method to determine CVD in DAVFs, this modality has limitations due to its invasive nature and radiation issues. The purpose of this study was to evaluate the diagnostic utility of arterial spin-labeling perfusion-weighted images (ASL-PWI) to identify CVD in patients with DAVF.The Institutional Review Board of our hospital approved this retrospective study. ASL-PWI features of 22 patients with DAVF were retrospectively reviewed for the presence of bright signal intensity in cortical veins and brain parenchyma. DAVF with bright signal intensity in cortical veins and/or brain parenchyma was regarded as having CVD. Using DSA as a reference standard, sensitivity, specificity, positive predictive value, and negative predictive value of ASL-PWI for detecting CVD were calculated.Based on DSA features, 11 (11/22, 50%) patients were classified as having "aggressive" pattern with CVD. Eleven (11/22, 50%) patients also showed bright signal intensity in cortical veins (9/22, 41%) and/or brain parenchyma (4/22, 18%) on ASL-PWI. The 11 patients who had "Aggressive" pattern on DSA were the same 11 patients who were classified as having "aggressive" pattern on ASL-PWI. ASL-PWI showed perfect diagnostic performance for identifying CVD with sensitivity, specificity, positive predictive value, and negative predictive value of 100% for all.Thus, ASL-PWI could be used as a noninvasive mean to predict the presence of CVD in patients with DAVFs. It has the potential as a screening tool to evaluate DAVF prior to invasive DSA.
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Affiliation(s)
- Ji Hee Kang
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Tae Jin Yun
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jong Kook Rhim
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Young Dae Cho
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong Hyun Yoo
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Roh-Eul Yoo
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Koung Mi Kang
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seung Hong Choi
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ji-hoon Kim
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Moon Hee Han
- Institute of Radiation Medicine, Seoul National University Medical Research Center
- Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea
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Liu X, Ogata A, Masuoka J, Inoue K, Nakahara Y, Shimokawa S, Takase Y, Yakushiji Y, Hara H, Abe T. Dural arteriovenous fistula manifesting as pontine hemorrhage at the craniocervical junction. Acta Neurochir (Wien) 2017; 159:831-834. [PMID: 28271297 DOI: 10.1007/s00701-017-3135-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/20/2017] [Indexed: 11/24/2022]
Abstract
Craniocervical junction (CCJ) dural arteriovenous fistula (DAVF) manifesting as intracerebral hemorrhage is extremely rare. We report the first case of CCJ-DAVF manifesting as pontine hemorrhage. A 69-year-old male presented with a pontine hemorrhage manifesting as a sudden onset of right hemiparesis and dysarthria. Digital subtraction angiography revealed a CCJ-DAVF fed by the meningeal branches of the right vertebral artery. The patient underwent surgical ligation of the cerebral draining veins to prevent re-bleeding. The postoperative course was uneventful. The patient had no neurological deficit after 1 month rehabilitation.
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Affiliation(s)
- Xuan Liu
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Atsushi Ogata
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan.
| | - Jun Masuoka
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Kohei Inoue
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Yukiko Nakahara
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Shoko Shimokawa
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Yukinori Takase
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
| | - Yusuke Yakushiji
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Hideo Hara
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, 5-1-1 Nabeshima, Saga-shi, Saga, 849-8501, Japan
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Noguchi T, Yakushiji Y, Nishihara M, Togao O, Yamashita K, Kikuchi K, Matsuo M, Azama S, Irie H. Arterial Spin-labeling in Central Nervous System Infection. Magn Reson Med Sci 2016; 15:386-394. [PMID: 27001393 PMCID: PMC5608113 DOI: 10.2463/mrms.mp.2015-0140] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Purpose: To investigate the characteristics of arterial spin-labeling magnetic resonance imaging (ASL-MRI) in central nervous system (CNS) infection. Methods: Thirty-two patients with CNS infections underwent a pulsed ASL-MRI. The findings on ASL-MRI were retrospectively assessed for the pathogens as well as each of the following four pathology classified based on conventional MRI findings: non-purulent parenchymal involvement, meningeal involvement, abscess formation, and ventricular involvement. Results: Among the 17 patients with non-purulent parenchymal involvement, ASL-MRI revealed high perfusion in 8 patients (47%) and low perfusion 1 patient (6%). Especially, four of five patients (80%) with definite or suspected herpes simplex virus (HSV) infection showed high perfusion on ASL-MRI. Seventeen of 22 patients (77%) with meningeal involvement showed high perfusion along the cerebral sulci irrespective of the pathogens. Meanwhile, 4 of 16 lesions (25%) with abscess formation showed low perfusion and one of six patients (17%) with ventricular involvement had high perfusion. Conclusions: The characteristics of ASL-MRI in CNS infections were clearly delineated. ASL-MRI could be helpful for monitoring the brain function in CNS infections noninvasively.
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Affiliation(s)
- Tomoyuki Noguchi
- Department of Radiology, National Center for Global Health and Medicine
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Noguchi T, Nishihara M, Egashira Y, Azama S, Hirai T, Kitano I, Yakushiji Y, Kawashima M, Irie H. Arterial spin-labeling MR imaging of cerebral hemorrhages. Neuroradiology 2015; 57:1135-44. [PMID: 26280515 DOI: 10.1007/s00234-015-1574-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. METHODS Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. RESULTS Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. CONCLUSION The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients.
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Affiliation(s)
- Tomoyuki Noguchi
- Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan. .,Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan.
| | - Masashi Nishihara
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Yoshiaki Egashira
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Shinya Azama
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Tetsuyoshi Hirai
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Isao Kitano
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Yusuke Yakushiji
- Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Masatou Kawashima
- Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
| | - Hiroyuki Irie
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan
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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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Noguchi T, Kawashima M, Nishihara M, Egashira Y, Azama S, Irie H. Noninvasive method for mapping CVR in moyamoya disease using ASL-MRI. Eur J Radiol 2015; 84:1137-43. [PMID: 25816991 DOI: 10.1016/j.ejrad.2015.03.011] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 03/02/2015] [Accepted: 03/10/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To project a noninvasive method for mapping cerebrovascular reserve (CVR) in moyamoya disease (MMD) using ASL-MRI. METHODS 16 MMD patients underwent cerebral blood flow (CBF) examinations by standard ASL-MRI, pulse-wave-synchronized ASL-MRI (pulsy ASL-MRI) which tagged the arterial blood coincident with a peak of a pulse wave, and single photon emission computed tomography (SPECT) imagings with iodine-123-N-isopropyl-p-iodoamphetamine in the resting (rest-IMP) and after acetazolamide challenge (ACZ-IMP). Hemispheric 32-sided cerebral blood flow (CBF) values were measured with normalized CBF maps created from standard ASL-MRI (standard-ASL value), pulsy ASL-MRI (pulsy-ASL value), rest-IMP (rest-IMP value), and ACZ-IMP (ACZ-IMP value). CVR based on rest-IMP and ACZ-IMP values (IMP-CVR) was calculated. ASL-CVR was also calculated on the basis of corrected standard-ASL values and pulsy-ASL values, which were adjusted to the ACZ-IMP values and rest-IMP values, respectively, by the least-squares method. We assessed the relationships between rest-IMP values and pulsy-ASL values, ACZ-IMP values and standard-ASL values, and IMP-CVR and ASL-CVR. RESULTS Significant relationships were observed between rest-IMP values and pulsy-ASL values (correlation coefficient (r=0.557, p<0.01)), ACZ-IMP values and standard-ASL values (r=0.825, p<0.01), and IMP-CVR and ASL-CVR (r=0.736, p<0.01). CONCLUSIONS ASL-MRI is equivalent to SPECT and that it might serve as a noninvasive method for mapping CVR in MMD.
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Affiliation(s)
- Tomoyuki Noguchi
- Department of Radiology, National center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo 162-8655, Japan; Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
| | - Masatou Kawashima
- Department of Neurosugery, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
| | - Masashi Nishihara
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
| | - Yoshiaki Egashira
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
| | - Shinya Azama
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
| | - Hiroyuki Irie
- Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, 5-1-1, Nabeshima, Saga 849-8501, Japan(1).
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Arterial spin-labeling MR imaging in moyamoya disease compared with clinical assessments and other MR imaging finings. Eur J Radiol 2013; 82:e840-7. [DOI: 10.1016/j.ejrad.2013.08.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2013] [Revised: 08/15/2013] [Accepted: 08/17/2013] [Indexed: 12/21/2022]
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Suazo L, Foerster B, Fermin R, Speckter H, Vilchez C, Oviedo J, Stoeter P. Measurement of blood flow in arteriovenous malformations before and after embolization using arterial spin labeling. Interv Neuroradiol 2012; 18:42-8. [PMID: 22440600 DOI: 10.1177/159101991201800106] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Accepted: 12/03/2011] [Indexed: 11/17/2022] Open
Abstract
The assessment of shunt reduction after an embolization of an arteriovenous malformation (AVM) or fistula (AVF) from conventional angiography is often difficult and may be subjective. Here we present a completely non-invasive method using magnetic resonance imaging (MRI) to measure shunt reduction. Using pulsed arterial spin labeling (PASL), we determined the relative amount of signal attributed to the shunt over 1.75 s and 6 different slices covering the lesion. This amount of signal from the shunt was related to the total signal from all slices and measured before and after embolization. The method showed a fair agreement between the PASL results and the judgement from conventional angiography. In the case of a total or subtotal shunt occlusion, PASL showed a shunt reduction between 69% and 92%, whereas in minimal shunt reduction as judged by conventional angiography, the ASL result was -6% (indicating slightly increased flow) to 35% in a partially occluded vein of Galen aneurysm. The PASL method proved to be fairly reproducible (up to 2% deviation between three measurements without interventions). On conclusion, PASL is able to reliably measure the amount of shunt reduction achieved by embolization of AVMs and AVFs.
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Affiliation(s)
- L Suazo
- CEDIMAT, Plaza de la Salud, Santo Domingo, Republica Dominicana
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