Arterial Spin Labeling in Pediatric Neuroimaging

Area of Science:

• Neuroimaging
• Medical Physics
• Pediatric Radiology

Background:

• Arterial spin labeling (ASL) provides noninvasive cerebral blood flow (CBF) assessment using endogenous arterial water as a tracer.
• Unlike conventional methods, ASL avoids radiotracers and intravenous contrast agents, making it suitable for pediatric imaging.
• It offers unique complementary information for various pediatric neurological conditions.

Purpose of the Study:

• To review the technical considerations, including pitfalls and physiological variations, of ASL imaging.
• To explore current clinical applications of ASL in pediatric neuroimaging.
• To discuss the future directions and potential applications of ASL in pediatric neurology.

Main Methods:

• This review synthesizes information from existing literature on ASL techniques.
• It focuses on the principles, advantages, and limitations of ASL in the context of pediatric brain imaging.
• Clinical case examples and research findings are discussed to illustrate applications.

Main Results:

• ASL is valuable for diagnosing neonatal hypoxic ischemic encephalopathy, pediatric stroke, vascular malformations, epilepsy, and brain tumors.
• It has potential applications in evaluating silent ischemia in sickle cell disease, monitoring intracranial pressure in hydrocephalus, and assessing traumatic brain injury (TBI).
• ASL can also contribute to functional MRI (fMRI) studies.

Conclusions:

• ASL is a versatile, noninvasive tool for evaluating pediatric cerebral blood flow with broad clinical utility.
• Understanding its technical aspects and physiological variations is crucial for accurate interpretation.
• Future research will likely expand ASL's role in managing complex pediatric neurological disorders.