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Multi-delay arterial spin labeling perfusion MRI in moyamoya disease–comparison with CT perfusion imaging

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Objectives

To present a multi-delay pseudo-continuous ASL (pCASL) protocol that offers simultaneous measurements of cerebral blood flow (CBF) and arterial transit time (ATT), and to study correlations between multi-delay pCASL and CT perfusion in moyamoya disease.

Methods

A 4 post-labeling delay (PLD) pCASL protocol was applied on 17 patients with moyamoya disease who also underwent CT perfusion imaging. ATT was estimated using the multi-delay protocol and included in the calculation of CBF. ASL and CT perfusion images were rated for lesion severity/conspicuity. Pearson correlation coefficients were calculated across voxels between the two modalities in grey and white matter of each subject respectively and between normalized mean values of ASL and CT perfusion measures in major vascular territories.

Results

Significant associations between ASL and CT perfusion were detected using subjective ratings, voxel-wise analysis in grey and white matter and region of interest (ROI)-based analysis of normalized mean perfusion. The correlation between ASL CBF and CT perfusion was improved using the multi-delay pCASL protocol compared to CBF acquired at a single PLD of 2 s (P < 0.05).

Conclusions

There is a correlation between perfusion data from ASL and CT perfusion imaging in patients with moyamoya disease. Multi-delay ASL can improve CBF quantification, which could be a prognostic imaging biomarker in patients with moyamoya disease.

Key Points

• Simultaneous measurements of CBF and ATT can be achieved using multi-delay pCASL.

• Multi-delay ASL was compared with CT perfusion in patients with moyamoya disease.

• Statistical analyses showed significant associations between multi-delay ASL and CT perfusion.

• Multi-delay ASL can improve CBF quantification in moyamoya disease.

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Abbreviations

ACA:

Anterior cerebral artery

ATT:

Arterial transit time

bSVD:

Block-circulant singular-value decomposition

CBF:

Cerebral blood flow

CBFmean :

Mean of the estimated CBF at each PLD

CBF2,000 :

CBF calculated using the typical PLD of 2,000 ms

CBV:

Cerebral blood volume

CTP:

CT perfusion

GRASE:

Gradient and spin echo

MRI:

Magnetic resonance imaging

MCA:

Middle cerebral artery

pCASL:

Pseudo-continuous arterial spin labeling

PLD:

Post-labeling delay

ROI:

Region of interest

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Acknowledgement

The scientific guarantor of this publication is Rong Xue. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. This study has received funding from the Ministry of Science and Technology (MOST) of China (grant number 2012CB825500, 2010IM030800), National Nature Science Foundation of China (NSFC) (grant number 30830101, 91132302, 90820307), CAS Knowledge Innovation Project (grant number KSCX2-YW-R-259), CAS Strategic Priority Research Program (grant number XDB02010001, XDB02050001) and US NIH grants (R01-MH080892, R01-NS081077 and R01-EB014922). No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. No study subjects or cohorts have been previously reported. Methodology: prospective, cross sectional study, multicenter study.

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Correspondence to Rong Xue.

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Wang, R., Yu, S., Alger, J.R. et al. Multi-delay arterial spin labeling perfusion MRI in moyamoya disease–comparison with CT perfusion imaging. Eur Radiol 24, 1135–1144 (2014). https://doi.org/10.1007/s00330-014-3098-9

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  • DOI: https://doi.org/10.1007/s00330-014-3098-9

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