Evaluating Vascular Hemodynamics in Cerebral Proliferative Angiopathy Using Advanced Arterial Spin Labeling MRI

Cerebral proliferative angiopathy (CPA) is a rare vascular disorder that affects normal blood circulation in the brain. Although the structural changes in CPA can be characterized using standard radiologic modalities, assessing the vascular hemodynamics in patients with CPA remains challenging due to inadequate imaging technologies. Arterial spin labeling (ASL) is a noninvasive magnetic resonance technique that allows quantitative assessments of cerebral blood flow. ASL with multiple labeling delays (multidelay ASL) also enables the quantification of arterial transit time. Here, we report the first application of multidelay ASL in a patient with CPA before and after bypass surgery. Our study demonstrated that ASL can be effectively applied to evaluating hemodynamic changes in patients with CPA. Our quantitative results indicated that, in regions affected by CPA, cerebral blood flow increased by at least 14% and arterial transit time decreased by 9.4% after bypass surgery.