Multi-delay arterial spin labeling perfusion MRI in moyamoya disease–comparison with CT perfusion imaging

Abstract

Purpose To present a multi-delay multi-parametric pseudo-continuous ASL (pCASL) protocol that offers simultaneous measurements of cerebral blood flow (CBF), arterial transit time (ATT) and arterial cerebral blood volume (aCBV) and to evaluate its accuracy by comparison with CT perfusion in moyamoya disease. Materials and Methods A 4 post-labeling delay (PLD) pCASL protocol was applied on 17 patients with moyamoya disease who also underwent CT perfusion imaging. ATT was estimated using the multi-delay protocol and included in the calculation of CBF. ASL and CT perfusion images were rated for lesion severity/conspicuity. Pearson correlation coefficients were calculated across voxels between the two modalities in grey and white matter of each subject respectively and between normalized mean values of ASL and CT perfusion measures in major vascular territories. Results Significant associations between ASL and CT perfusion were detected using subjective ratings, voxel-wise analysis in grey and white matter and region of interest (ROI) based analysis of normalized mean perfusion. The correlation between ASL CBF and CT perfusion was improved using the multi-delay pCASL protocol compared to CBF acquired at a single PLD of 2 s (p<0.05). Conclusion There is a correlation between perfusion data from ASL and CT perfusion imaging in patients with moyamoya disease. Multi-delay ASL can improve CBF quantification, which could be a prognostic imaging biomarker in patients with moyamoya disease.

Detecting Perfusion Pattern Based on the Background Low-Frequency Fluctuation in Resting-State Functional Magnetic Resonance Imaging Data and Its Influence on Resting-State Networks: An Iterative Postprocessing Approach

“…However, several ASL studies demonstrated that the patterns of vascular response vary substantially in neocortical areas (Emmert et al, 2016;Hartkamp et al, 2013;Wang et al, 2014) as arterial spin labeling (ASL) MRI provides concomitant information on cerebral perfusion and brain anatomy allows for differentiating vascular territories in the brain (Damasio, 1983;Floyd et al, 2003;Tatu et al, 1998;.. Although some previous studies suggested that the "back ground noise" from white matter, grey matter and CSF should be regressed out during the post-processing pipeline of RS-fMRI data (Murphy et al, 2009;Schölvinck et al, 2010;Shmueli et al, 2007), the effects of vascular territories haven't been fully considered.…”

Can CT angiography reconstructed from CT perfusion source data on a 320-section volume CT scanner replace conventional CT angiography for the evaluation of intracranial arteries?

“…The effective dose for our CTP protocol was 4.2 mSv (the effective dose for CTP and conventional CTA was 5.75 mSv), which is lower than in earlier studies [20,21]. Cohnen et al reported that in acute stroke patients subjected to comprehensive CT of the head, including conventional CTA and CTP studies on conventional multislice CT scanners, it was up to 9.5 mSv [10].…”

Can Arterial Spin-Labeling with Multiple Postlabeling Delays Predict Cerebrovascular Reserve?

“…[31][32][33] The ATT is different from the MTT; however, it has been reported that there was significant correlation between the ATT and MTT (r ϭ 0.604, P ϭ .01). 16 To the best of our knowledge, there is no prior study about the correlation between the ATT and the CVR based on SPECT with acetazolamide challenge. With respect to predicting the CVR from baseline SPECT CBF scans, we found a poorer correlation between baseline CBF and CVR index (r ϭ Ϫ0.279, P ϭ .021) than for ATT or TCF and no significant correlation between baseline CBF and rCVR index (r ϭ Ϫ0.058, P ϭ .637).…”

“…12,15 Cerebral steno-occlusive diseases, however, are generally accompanied by an elongation of the transit time because of the formation of collateral blood flow, which limits the validity of CBF determined by ASL. [16][17][18] In this study, we present MP-ASL perfusion in unilateral steno-occlusive disease to predict the CVR relative to the widely used Tc99m-HMPAO basal/acetazolamide stress perfusion SPECT.…”