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Can Arterial Spin-Labeling with Multiple Postlabeling Delays Predict Cerebrovascular Reserve?
H J Choi1, C-H Sohn2, S-H You3
1From the Department of Radiology (H.J.C.), CHA Bundang Medical Center, CHA University, Seongnam, Korea.
AJNR. American Journal of Neuroradiology
|November 18, 2017
Summary
Arterial spin-labeling (ASL) magnetic resonance imaging (MRI) with transit time correction accurately predicts cerebrovascular reserve impairment. This method enhances the reliability of cerebral blood flow (CBF) measurements in patients with steno-occlusive disease.
Area of Science:
- Neuroimaging
- Cerebrovascular Physiology
- Medical Physics
Background:
- Delayed transit time is a major source of error in arterial spin-labeling (ASL) for quantitative cerebral blood flow (CBF) measurement.
- Accurate assessment of cerebrovascular reserve is crucial for managing steno-occlusive disease.
Purpose of the Study:
- To evaluate the utility of transit time-corrected CBF and arterial transit time (ATT) derived from multi-delay ASL.
- To compare ASL findings with technetium Tc99m-hexamethylpropylene amineoxime (Tc99m-HMPAO) SPECT in predicting cerebrovascular reserve impairment.
Main Methods:
- Acquired transit time-corrected CBF and ATT maps in 30 patients with unilateral internal carotid artery (ICA) or middle cerebral artery (MCA) steno-occlusive disease.
- Applied internal carotid artery territory-based regions of interest (ROIs) to ASL perfusion maps.
- Evaluated cerebrovascular reserve impairment using basal/acetazolamide stress Tc99m-HMPAO SPECT and analyzed the diagnostic accuracy of ASL using receiver operating characteristic (ROC) curves.
Main Results:
- Affected hemispheres showed significantly decreased transit time-corrected CBF and increased ATT compared to contralateral hemispheres (P < .001).
- Percentage changes in transit time-corrected CBF and ATT were independent predictors of cerebrovascular reserve impairment (P < .001).
- A significant correlation was found between ATT and the cerebrovascular reserve index ratio (r = -0.511).
Conclusions:
- Transit time-corrected CBF and ATT derived from ASL perfusion MRI can reliably predict cerebrovascular reserve impairment.
- ASL offers a valuable tool for assessing cerebrovascular function in patients with steno-occlusive disease.
