Dynamic contrast-enhanced brain perfusion imaging: technique and clinical applications

Area of Science:

• Radiology
• Medical Imaging
• Neuroscience

Background:

• Conventional MR and CT angiography lack capillary-level tissue perfusion evaluation.
• Perfusion imaging techniques are crucial for analyzing hemodynamic disturbances in various neurological disorders.
• Early and accurate delineation of ischemic tissue is vital for timely intervention.

Purpose of the Study:

• To review the principles, techniques, and clinical applications of noninvasive cerebral perfusion imaging.
• To highlight the utility of MR perfusion (MRP) and CT perfusion (CTP) in diagnosing and characterizing neurological conditions.
• To emphasize the role of perfusion imaging in differentiating between tumor recurrence and treatment effects.

Main Methods:

• Utilizes Magnetic Resonance (MR) and Computed Tomography (CT) perfusion imaging techniques.
• Assesses physiological parameters including cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT).
• Employs noninvasive scanning techniques for evaluating capillary-level tissue perfusion.

Main Results:

• MRP and CTP can accurately delineate ischemic tissue and analyze hemodynamic disturbances.
• These techniques provide valuable data for detecting and characterizing tumors, infections, inflammation, and infarctions.
• Perfusion imaging aids in evaluating conditions like dementia, psychiatric illnesses, and migraines, which may appear normal on conventional imaging.
• MRP and CTP can distinguish residual/recurrent tumors from treatment effects like radiation necrosis.

Conclusions:

• Noninvasive cerebral perfusion imaging, including MRP and CTP, offers significant advancements over conventional angiography.
• These techniques provide essential physiological data for a wide range of neurological conditions, enhancing diagnostic accuracy.
• Perfusion imaging plays a critical role in early detection, characterization, and management of brain disorders.