Related Experiment Video
Updated: Feb 18, 2026
Author Spotlight: Noninvasive Cerebral Blood Flow Determination in Human Functional Brain Region for Diagnosis of Neurological Disorders
Published on: May 31, 2024
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.
Insights
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.
Background And Purpose:
The effect of delayed transit time is the main source of error in the quantitative measurement of CBF in arterial spin-labeling. In the present study, we evaluated the usefulness of the transit time-corrected CBF and arterial transit time delay from multiple postlabeling delays arterial spin-labeling compared with basal/acetazolamide stress technetium Tc99m-hexamethylpropylene amineoxime (Tc99m-HMPAO) SPECT in predicting impairment in the cerebrovascular reserve.
Materials And Methods:
Transit time-corrected CBF maps and arterial transit time maps were acquired in 30 consecutive patients with unilateral ICA or MCA steno-occlusive disease (severe stenosis or occlusion). Internal carotid artery territory-based ROIs were applied to both perfusion maps. Additionally, impairment in the cerebrovascular reserve was evaluated according to both qualitative and quantitative analyses of the ROIs on basal/acetazolamide stress Tc99m-HMPAO SPECT using a previously described method. The area under the receiver operating characteristic curve was used to evaluate the diagnostic accuracy of arterial spin-labeling in depicting impairment of the cerebrovascular reserve. The correlation between arterial spin-labeling and cerebrovascular reserve was evaluated.
Results:
The affected hemisphere had a decreased transit time-corrected CBF and increased arterial transit time compared with the corresponding values of the contralateral normal hemisphere, which were statistically significant (P < .001). The percentage change of transit time-corrected CBF and the percentage change of arterial transit time were independently differentiating variables (P < .001) for predicting cerebrovascular reserve impairment. The correlation coefficient between the arterial transit time and cerebrovascular reserve index ratio was -0.511.
Conclusions:
Our results demonstrate that the transit time-corrected CBF and arterial transit time based on arterial spin-labeling perfusion MR imaging can predict cerebrovascular reserve impairment.
