Perfusion territory imaging of intracranial branching arteries - optimization of continuous artery-selective spin labeling (CASSL)

Continuous artery‐selective spin labeling (CASSL) is based on a standard continuous arterial spin labeling sequence with adiabatic flow‐driven inversion and an amplitude‐modulated control experiment, and has been proposed recently as a new method for the noninvasive flow territory mapping of cerebral arteries. Spatial selectivity is achieved by the rotation of a tilted labeling plane about the axis of a selected artery, which restricts the tagging pulses to the same spatial position for the vessel of interest but, for any other adjacent and parallel artery, the locus of resonance will vary in time and saturates the blood at a certain distance to the labeling focus. In numerical simulations and in a volunteer study, the key labeling parameters of CASSL were investigated with the goal of increasing the spatial selectivity whilst maintaining sufficient labeling efficiency, in order to selectively label the blood in small intracranial arteries distal to the circle of Willis. The optimized labeling parameters were employed in vivo and adapted to different vascular geometries. The labeling of small intracranial branches of the anterior, middle and posterior cerebral arteries in close vicinity to other vessels yielded clearly delineated perfusion territories and demonstrated the method's capability for highly selective perfusion measurements. Copyright © 2010 John Wiley & Sons, Ltd.     

Background suppression in arterial spin labeling MRI with a separate neck labeling coil

In arterial spin labeling (ASL) MRI to measure cerebral blood flow (CBF), pair-wise subtraction of temporally adjacent non-labeled and labeled images often can not completely cancel the background static tissue signal because of temporally fluctuating physiological noise. While background suppression (BS) by inversion nulling improves CBF temporal stability, imperfect pulses compromise CBF contrast. Conventional BS techniques may not be applicable in small animals because the arterial transit time is short. This study presents a novel approach of BS to overcome these drawbacks using a separate 'neck' radiofrequency coil for ASL and a 'brain' radiofrequency coil for BS with the inversion pulse placed before spin labeling. The use of a separate 'neck' coil for ASL should also improve ASL contrast. This approach is referred to as the inversion-recovery BS with the two-coil continuous ASL (IR-cASL) technique. The temporal and spatial contrast-to-noise characteristics of basal CBF and CBF-based fMRI of hypercapnia and forepaw stimulation in rats at 7 Tesla were analyzed. IR-cASL yielded two times better temporal stability and 2.0-2.3 times higher functional contrast-to-noise ratios for hypercapnia and forepaw stimulation compared with cASL without BS in the same animals. The Bloch equations were modified to provide accurate CBF quantification at different levels of BS and for multislice acquisition where different slices have different degree of BS and residual degree of labeling. Improved basal CBF and CBF-based fMRI sensitivity should lead to more accurate CBF quantification and should prove useful for imaging low CBF conditions such as in white matter and stroke.     

Optimization of flow‐sensitive alternating inversion recovery (FAIR) for perfusion functional MRI of rodent brain

Arterial spin labeling (ASL) MRI provides a noninvasive method to image perfusion, and has been applied to map neural activation in the brain. Although pulsed labeling methods have been widely used in humans, continuous ASL with a dedicated neck labeling coil is still the preferred method in rodent brain functional MRI (fMRI) to maximize the sensitivity and allow multislice acquisition. However, the additional hardware is not readily available and hence its application is limited. In this study, flow‐sensitive alternating inversion recovery (FAIR) pulsed ASL was optimized for fMRI of rat brain. A practical challenge of FAIR is the suboptimal global inversion by the transmit coil of limited dimensions, which results in low effective labeling. By using a large volume transmit coil and proper positioning to optimize the body coverage, the perfusion signal was increased by 38.3% compared with positioning the brain at the isocenter. An additional 53.3% gain in signal was achieved using optimized repetition and inversion times compared with a long TR. Under electrical stimulation to the forepaws, a perfusion activation signal change of 63.7 ± 6.3% can be reliably detected in the primary somatosensory cortices using single slice or multislice echo planar imaging at 9.4 T. This demonstrates the potential of using pulsed ASL for multislice perfusion fMRI in functional and pharmacological applications in rat brain. Copyright © 2012 John Wiley & Sons, Ltd.     

神经、精神疾病的动脉血质子自旋标记灌注成像研究

磁共振动脉血质子自旋标记(arterial spin labeling,ASL)灌注成像是将反转脉冲标记的动脉血质子作为内源性示踪剂、无创性的观测血流灌注,能够对脑血流量进行测量,提供血流动力学方面的信息。该技术无创、无需注射造影剂或放射性物质,空间和时间分辨率均较正电子发射体层摄影高。已经用于一些神经、精神疾病的检查与研究。     

The importance of RF bandwidth for effective tagging in pulsed arterial spin labeling MRI at 9.4T

The movement towards MRI at higher field strengths (>7T) has enhanced the appeal of arterial spin labeling (ASL) for many applications due to improved SNR of the measurements. Greater field strength also introduces increased magnetic susceptibility effects resulting in marked B₀ field inhomogeneity. Although B₀ field perturbations can be minimised by shimming over the imaging volume, marked field inhomogeneity is likely to remain within the labeling region for pulsed ASL (PASL). This study highlights a potential source of error in cerebral blood flow quantification using PASL at high field. We show that labeling efficiency in flow‐sensitive alternating inversion recovery (FAIR) displayed marked sensitivity to the RF bandwidth of the inversion pulse in a rat model at 9.4T. The majority of preclinical PASL studies have not reported the bandwidth of the inversion pulse. We show that a high bandwidth pulse of > = 15 kHz was required to robustly overcome the field inhomogeneity in the labeling region at high field strength, which is significantly greater than the inversion bandwidth ~2–3 kHz used in previous studies. Unless SAR levels are at their limit, we suggest the use of a high bandwidth labeling pulse for most PASL studies. Copyright © 2012 John Wiley & Sons, Ltd.     

Timing dependence of peripheral pulse‐wave‐triggered pulsed arterial spin labeling

Arterial spin labeling (ASL) has been developed into a useful technique that is capable of quantifying noninvasively local cerebral blood flow (CBF) using the water molecules in arterial blood as diffusible tracers. Pulsed ASL (PASL) is more strongly affected than continuous ASL (CASL) by cardiac pulsation, because the tag bolus is shorter than the cardiac cycle in most cases. No reports have yet clarified the effects of multiple cardiac phases on the quantification of CBF in PASL when triggering is used. Fourteen subjects participated in this study. Peripheral pulse‐wave‐triggered (PPWT)‐ASL was performed at various time points at the carotid artery (delay 0 ms, second point, foot, peak and tail) and compared with nontriggered (NT)‐ASL. Regions of interest (ROIs) were applied based on the anterior, middle and posterior cerebral artery (ACA, MCA, PCA) territories, and CBFs were compared among different time points and ROIs. PPWT‐ASL strongly affects CBF values compared with NT‐ASL in ACA and MCA territories, especially when measured at the foot of the carotid artery flow phase. CBF_NT was assumed to lie approximately between the minimum and maximum CBFs, with clear statistical significance in several ROIs at several time points of PPWT‐ASL, and CBF_NT was assumed to resemble ‘randomly triggered’ PPWT‐ASL. In conclusion, PPWT‐ASL strongly affects CBF values compared with NT‐ASL, particularly at the foot of the carotid artery flow in ACA and MCA territories. Copyright © 2013 John Wiley & Sons, Ltd.     

FAWSETS perfusion measurements in exercising skeletal muscle

Arterial spin labeling (ASL) techniques are now recognized as valid tools for providing accurate measurements of cerebral and cardiac perfusion. The labeling process used with most ASL techniques creates two problems, magnetization transfer (MT) effects and arterial transit time effects, that require compensation. The compensation process limits time resolution and hinders absolute quantification. MT effects are particularly problematic in skeletal muscle because they are large and change rapidly during exercise. The protocol presented here was developed specifically for quantification of perfusion in exercising skeletal muscle. The ASL technique that was implemented, FAWSETS, eliminates MT effects and arterial transit times. Localized, single-voxel perfusion measurements were acquired from rat hind limbs at rest, during ischemia and during three different levels of stimulated exercise. The results demonstrate sufficient sensitivity to determine the time constants for perfusion changes at onset of, and during recovery from, exercise and to distinguish the differences in the amplitude of the perfusion response to different levels of exercise. Additional measurements were conducted to demonstrate insensitivity to MT effects. The exercise protocol is easily adaptable to phosphorous magnetic resonance measurements, allowing the possibility to acquire local measurements of perfusion and metabolism from the same tissue in future experiments.     

Perfusion has no effect on the in vivo CEST effect from Cr (CrCEST) in skeletal muscle

Creatine, a key component of muscle energy metabolism, exhibits a chemical exchange saturation transfer (CEST) effect between its amine group and bulk water, which has been exploited to spatially and temporally map creatine changes in skeletal muscle before and after exercise. In addition, exercise leads to an increase in muscle perfusion. In this work, we determined the effects of perfused blood on the CEST effects from creatine in skeletal muscle. Experiments were performed on healthy human subjects (n = 5) on a whole‐body Siemens 7T magnetic resonance imaging (MRI) scanner with a 28‐channel radiofrequency (RF) coil. Reactive hyperemia, induced by inflation and subsequent deflation of a pressure cuff secured around the thigh, was used to increase tissue perfusion whilst maintaining the levels of creatine kinase metabolites. CEST, arterial spin labeling (ASL) and ³¹P MRS data were acquired at baseline and for 6 min after cuff deflation. Reactive hyperemia resulted in substantial increases in perfusion in human skeletal muscle of the lower leg as measured by the ASL mean percentage difference. However, no significant changes in CrCEST asymmetry (CrCEST_asym) or ³¹P MRS‐derived PCr levels of skeletal muscle were observed following cuff deflation. This work demonstrates that perfusion changes do not have a major confounding effect on CrCEST measurements.     

Optimization of 4D vessel‐selective arterial spin labeling angiography using balanced steady‐state free precession and vessel‐encoding

Vessel‐selective dynamic angiograms provide a wealth of useful information about the anatomical and functional status of arteries, including information about collateral flow and blood supply to lesions. Conventional x‐ray techniques are invasive and carry some risks to the patient, so non‐invasive alternatives are desirable. Previously, non‐contrast dynamic MRI angiograms based on arterial spin labeling (ASL) have been demonstrated using both spoiled gradient echo (SPGR) and balanced steady‐state free precession (bSSFP) readout modules, but no direct comparison has been made, and bSSFP optimization over a long readout period has not been fully explored. In this study bSSFP and SPGR are theoretically and experimentally compared for dynamic ASL angiography. Unlike SPGR, bSSFP was found to have a very low ASL signal attenuation rate, even when a relatively large flip angle and short repetition time were used, leading to a threefold improvement in the measured signal‐to‐noise ratio (SNR) efficiency compared with SPGR. For vessel‐selective applications, SNR efficiency can be further improved over single‐artery labeling methods by using a vessel‐encoded pseudo‐continuous ASL (VEPCASL) approach. The combination of a VEPCASL preparation with a time‐resolved bSSFP readout allowed the generation of four‐dimensional (4D; time‐resolved three‐dimensional, 3D) vessel‐selective cerebral angiograms in healthy volunteers with 59 ms temporal resolution. Good quality 4D angiograms were obtained in all subjects, providing comparable structural information to 3D time‐of‐flight images, as well as dynamic information and vessel selectivity, which was shown to be high. A rapid 1.5 min dynamic two‐dimensional version of the sequence yielded similar image features and would be suitable for a busy clinical protocol. Preliminary experiments with bSSFP that included the extracranial vessels showed signal loss in regions of poor magnetic field homogeneity. However, for intracranial vessel‐selective angiography, the proposed bSSFP VEPCASL sequence is highly SNR efficient and could provide useful information in a range of cerebrovascular diseases. © 2016 The Authors. NMR in Biomedicine published by John Wiley & Sons Ltd.     

Improved arterial spin labeling method: applications for measurements of cerebral blood flow in human brain at high magnetic field MRI

Measurements of cerebral blood flow (CBF) with arterial spin labeling (ASL) MRI are challenging primarily due to a poor signal-to-noise (SNR) ratio. Therefore, methods that improve SNR and minimize measurement errors can play a significant role for better estimations of CBF. The purpose of this work was to develop an ASL method for measurements of CBF at high magnetic field strength. In the proposed multislice ASL method, using in-plane double inversion for labeling, stationary spins are kept at equilibrium to avoid T1 relaxation effects, while blood water is labeled using a lower magnetic field gradient. Improvement for CBF measurements is demonstrated on subjects and by comparison with other multislice ASL MRI methods at 1.5 Tesla. Furthermore, echo-planar imaging (EPI) and Turbo-FLASH (TFL) at 4 T MRI are compared for mapping CBF in human brain using various postlabeling delay times. CBF maps were obtained and analyzed within region-of-interests encompassing either gray matter or white matter. Elimination of T1 dependence of stationary spins in conjunction with avoidance of magnetization transfer mismatch between labeling and control scans lead to improved CBF measurements. Although measurements of CBF in brain tissue are feasible at 4 T using either EPI or TFL, TFL reduced contaminations from an intravascular signal and susceptibility-related artifacts, providing overall more robust CBF measurements than EPI. Therefore, the proposed ASL method in combination with TFL should be used for measuring CBF of human brain at 4T.     

Arterial spin labeling‐fast imaging with steady‐state free precession (ASL‐FISP): a rapid and quantitative perfusion technique for high‐field MRI

Arterial spin labeling (ASL) is a valuable non‐contrast perfusion MRI technique with numerous clinical applications. Many previous ASL MRI studies have utilized either echo‐planar imaging (EPI) or true fast imaging with steady‐state free precession (true FISP) readouts, which are prone to off‐resonance artifacts on high‐field MRI scanners. We have developed a rapid ASL‐FISP MRI acquisition for high‐field preclinical MRI scanners providing perfusion‐weighted images with little or no artifacts in less than 2 s. In this initial implementation, a flow‐sensitive alternating inversion recovery (FAIR) ASL preparation was combined with a rapid, centrically encoded FISP readout. Validation studies on healthy C57/BL6 mice provided consistent estimation of in vivo mouse brain perfusion at 7 and 9.4 T (249 ± 38 and 241 ± 17 mL/min/100 g, respectively). The utility of this method was further demonstrated in the detection of significant perfusion deficits in a C57/BL6 mouse model of ischemic stroke. Reasonable kidney perfusion estimates were also obtained for a healthy C57/BL6 mouse exhibiting differential perfusion in the renal cortex and medulla. Overall, the ASL‐FISP technique provides a rapid and quantitative in vivo assessment of tissue perfusion for high‐field MRI scanners with minimal image artifacts. Copyright © 2014 John Wiley & Sons, Ltd.     

Whole‐brain perfusion imaging with balanced steady‐state free precession arterial spin labeling

Recently, balanced steady‐state free precession (bSSFP) readout has been proposed for arterial spin labeling (ASL) perfusion imaging to reduce susceptibility artifacts at a relatively high spatial resolution and signal‐to‐noise ratio (SNR). However, the main limitation of bSSFP‐ASL is the low spatial coverage. In this work, methods to increase the spatial coverage of bSSFP‐ASL are proposed for distortion‐free, high‐resolution, whole‐brain perfusion imaging. Three strategies of (i) segmentation, (ii) compressed sensing (CS) and (iii) a hybrid approach combining the two methods were tested to increase the spatial coverage of pseudo‐continuous ASL (pCASL) with three‐dimensional bSSFP readout. The spatial coverage was increased by factors of two, four and six using each of the three approaches, whilst maintaining the same total scan time (5.3 min). The number of segments and/or CS acceleration rate (R) correspondingly increased to maintain the same bSSFP readout time (1.2 s). The segmentation approach allowed whole‐brain perfusion imaging for pCASL‐bSSFP with no penalty in SNR and/or total scan time. The CS approach increased the spatial coverage of pCASL‐bSSFP whilst maintaining the temporal resolution, with minimal impact on the image quality. The hybrid approach provided compromised effects between the two methods. Balanced SSFP‐based ASL allows the acquisition of perfusion images with wide spatial coverage, high spatial resolution and SNR, and reduced susceptibility artifacts, and thus may become a good choice for clinical and neurological studies. Copyright © 2015 John Wiley & Sons, Ltd.     

Anteroposterior perfusion heterogeneity in human hippocampus measured by arterial spin labeling MRI

Measurements of blood flow in the human hippocampus are complicated by its relatively small size, unusual anatomy and patterns of blood supply. Only a handful of arterial spin labeling (ASL) MRI articles have reported regional cerebral blood flow (rCBF) values for the human hippocampus. Numerous reports have found heterogeneity in a number of other physiological and biochemical parameters along the longitudinal hippocampal axis. There is, however, only one ASL study of perfusion properties as a function of anteroposterior location in the hippocampus, reporting that rCBF is lower and the arterial transit time (ATT) is longer in the anterior hippocampus than in the posterior hippocampus of the rat brain. The purpose of this article was to measure ATT and rCBF in anterior, middle and posterior normal adult human hippocampus. To better distinguish anteroposterior perfusion heterogeneity in the hippocampus, a modified ASL method, called Orthogonally Positioned Tagging Imaging Method for Arterial Labeling with Flow‐sensitive Alternating Inversion Recovery (OPTIMAL FAIR), was developed that provides high in‐plane resolution with oblique coronal imaging slices perpendicular to the long axis of the hippocampus to minimize partial volume effects. Perfusion studies performed with this modified FAIR method at 3 T indicated that anterior, middle and posterior human hippocampus segments have unique transit time and rCBF values. Of these three longitudinal hippocampal regions, the middle hippocampus has the highest perfusion and the shortest transit time and the anterior hippocampus has the lowest perfusion and the longest transit time. Copyright © 2013 John Wiley & Sons, Ltd.     

Cerebral perfusion and oxygenation differences in Alzheimer's disease risk

Functional MRI has demonstrated differences in response to memory performance based on risk for Alzheimer's disease (AD). The current study compared blood oxygen level dependent (BOLD) functional MRI response with arterial spin labeling (ASL) perfusion response during an associative encoding task and resting perfusion signal in different risk groups for AD. Thirteen individuals with a positive family history of AD and at least one copy of the apolipoprotien E epsilon4 (APOE4) gene (high risk) were compared to ten individuals without these risk factors (low risk). In the medial temporal lobes (MTLs) the high risk group had an elevated level of resting perfusion, and demonstrated decreased fractional BOLD and perfusion responses to the encoding task. However, there was no difference in the absolute cerebral blood flow during the task. These data demonstrate that individuals with increased risk for Alzheimer's disease have elevated MTL resting cerebral blood flow, which significantly influences apparent differences in BOLD activations. BOLD activations should be interpreted with caution, and do not necessarily reflect differences in neuronal activation.     

ASL‐MRICloud: An online tool for the processing of ASL MRI data

Arterial spin labeling (ASL) MRI is increasingly used in research and clinical settings. The purpose of this work is to develop a cloud‐based tool for ASL data processing, referred to as ASL‐MRICloud, which may be useful to the MRI community. In contrast to existing ASL toolboxes, which are based on software installation on the user's local computer, ASL‐MRICloud uses a web browser for data upload and results download, and the computation is performed on the remote server. As such, this tool is independent of the user's operating system, software version, and CPU speed. The ASL‐MRICloud tool was implemented to be compatible with data acquired by scanners from all major MRI manufacturers, is capable of processing several common forms of ASL, including pseudo‐continuous ASL and pulsed ASL, and can process single‐delay and multi‐delay ASL data. The outputs of ASL‐MRICloud include absolute and relative values of cerebral blood flow, arterial transit time, voxel‐wise masks indicating regions with potential hyper‐perfusion and hypo‐perfusion, and an image quality index. The ASL tool is also integrated with a T₁‐based brain segmentation and normalization tool in MRICloud to allow generation of parametric maps in standard brain space as well as region‐of‐interest values. The tool was tested on a large data set containing 309 ASL scans as well as on publicly available ASL data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study.     

Transit time mapping in the mouse brain using time‐encoded pCASL

The cerebral blood flow (CBF) is a potential biomarker for neurological disease. However, the arterial transit time (ATT) of the labeled blood is known to potentially affect CBF quantification. Furthermore, ATT could be an interesting biomarker in itself, as it may reflect underlying macro‐ and microvascular pathologies. Currently, no optimized magnetic resonance imaging (MRI) sequence exists to measure ATT in mice. Recently, time‐encoded labeling schemes have been implemented in rats and humans, enabling ATT mapping with higher signal‐to‐noise ratio (SNR) and shorter scan time than multi‐delay arterial spin labeling (ASL). In this study, we show that time‐encoded pseudo‐continuous arterial spin labeling (te‐pCASL) also enables transit time measurements in mice. As an optimal design that takes the fast blood flow in mice into account, time encoding with 11 sub‐boli of 50 ms is proposed to accurately probe the inflow of labeled blood. For perfusion imaging, a separate, traditional pCASL scan was employed. From the six studied brain regions, the hippocampus showed the shortest ATT (169 ± 11 ms) and the auditory/visual cortex showed the longest (284 ± 16 ms). Furthermore, ATT was found to be preserved in old wild‐type mice. In a mouse with an induced carotid artery occlusion, prolongation of ATT was shown. In conclusion, this study shows the successful implementation of te‐pCASL in mice, making it possible, for the first time, to measure ATT in mice in a time‐efficient manner.     

动脉自旋标记在急性脑梗死中的应用

目的 探讨动脉自旋标记（ASL）在急性脑梗死中的应用价值。方法 选取2016年8月~2018年2月我院收治的脑梗死患者29例,所有患者均行扩散加权（DWI）、ASL及脑血管成像（MRA）扫描。分析急性脑梗死患者的基线ASL数据,比较治疗前后存在缺血半暗带（IP）患者DWI高信号区与周边低灌注区CBF患侧、CBF对侧、rCBF以及ASL-CBF。结果 29例急性脑梗死患者中,22例患者存在IP,7例患者不存在IP。22例IP患者中,DWI高信号区CBF患侧血流值低于CBF对侧,周边低灌注区3、6、9、12点钟ROI CBF患侧血流值低于CBF对侧,且高于DWI高信号区,差异有统计学意义（P＜0.05）。DWI高信号区与周边低灌注区对侧血流值比较,差异无统计学意义（P＞0.05）。DWI高信号区治疗前后ASL-CBF比较,差异无统计学意义（P＞0.05）。治疗后,周边低灌注区3、6、9、12点钟ROI ASL-CBF均高于治疗前,差异有统计学意义（P＜0.05）。结论 ASL能在一定程度上反映脑低灌注水平,与DWI配合可辅助诊断IP,可提示预后。     

Time‐efficient measurement of multi‐phase arterial spin labeling MR signal in white matter

White matter (WM) perfusion has great potential as a physiological biomarker in many neurological diseases. Although it has been demonstrated previously that arterial spin labeling magnetic resonance imaging (ASL‐MRI) enables the detection of the perfusion‐weighted signal in most voxels in WM, studies of cerebral blood flow (CBF) in WM by ASL‐MRI are relatively scarce because of its particular challenges, such as significantly lower perfusion and longer arterial transit times relative to gray matter (GM). Recently, ASL with a spectroscopic readout has been proposed to enhance the sensitivity for the measurement of WM perfusion. However, this approach suffers from long acquisition times, especially when acquiring multi‐phase ASL datasets to improve CBF quantification. Furthermore, the potential increase in the signal‐to‐noise ratio (SNR) by spectroscopic readout compared with echo planar imaging (EPI) readout has not been proven experimentally. In this study, we propose the use of time‐encoded pseudo‐continuous ASL (te‐pCASL) with single‐voxel point‐resolved spectroscopy (PRESS) readout to quantify WM cerebral perfusion in a more time‐efficient manner. Results are compared with te‐pCASL with a conventional EPI readout for both WM and GM perfusion measurements. Perfusion measurements by te‐pCASL PRESS and conventional EPI showed no significant difference for quantitative WM CBF values (Student's t‐test, p = 0.19) or temporal SNR (p = 0.33 and p = 0.81 for GM and WM, respectively), whereas GM CBF values (p = 0.016) were higher using PRESS than EPI readout. WM CBF values were found to be 18.2 ± 7.6 mL/100 g/min (PRESS) and 12.5 ± 5.5 mL/100 g/min (EPI), whereas GM CBF values were found to be 77.1 ± 11.2 mL/100 g/min (PRESS) and 53.6 ± 9.6 mL/100 g/min (EPI). This study demonstrates the feasibility of te‐pCASL PRESS for the quantification of WM perfusion changes in a highly time‐efficient manner, but it does not result in improved temporal SNR, as does traditional te‐pCASL EPI, which remains the preferred option because of its flexibility in use.     

Application of arterial spin labeling and susceptibility weighted imaging in the diagnosis of ischemic cerebrovascular diseases

Objective: To investigate the application value of arterial spin labeling (ASL) and susceptibility weighted imaging (SWI) in the diagnosis of acute ischemic cerebrovascular disease (CVDs). Methods: A total of 124 patients who received fluid attenuated inversion recovery (FLAIR), diffusion weighted imaging (DWI), ASL, time of flight magnetic resonance angiography (TOF-MRA) and SWI scan sequentially were included in this study. The area of the abnormal perfusion region was compared with that of the restricted diffusion region. The cerebral blood flow (CBF) value and apparent diffusion coefficient (ADC) value were compared in ischemic penumbra (IP), infarct core and mirror region. The susceptibility vessel sign (SVS) detection rate was compared with the major vessel severe stenosis or occlusion rate as revealed by MRA. A receiver operating characteristic curve (ROC) was used to analyze the value of SVS as revealed by SWI. Results: In total, 124 cases were included in this study, and 77 cases showed acute cerebral infarction. Among the 77 cases, 59 cases showed an IP. There were significant differences in ADC and CBF values between the infarct core and mirror region (P < 0.01). There was no significant difference in ADC value between IP and mirror region (P = 0.176), but there was significant difference in CBF value between IP and mirror region (P < 0.01). There was no significant difference in SVS detection rate compared with the vessel severe stenosis or occlusion rate in MRA (P = 0.111). Based on the MRA standards, the area under curve (AUC) of ROC for the SVS as revealed by SWI was 0.86 (95% CI: 0.753-0.962). Conclusions: ASL combined with DWI contributed to IP evaluation of acute cerebral infarction. SWI showed higher diagnostic value for intravascular thrombus in acute cerebral infarction.     

Mapping of arterial transit time by intravascular signal selection

The arterial transit time (δ_a) is a potentially important physiological parameter which may provide valuable information for the characterization of cerebrovascular diseases. The present study shows that δ_a can be measured by arterial spin labeling (ASL) applied quasi‐continuously in an amplitude‐modulated fashion at the human neck. Imaging was performed using short repetition times and excitation flip angles of 90°, which resulted in the selection of an ASL signal of mostly intravascular origin. Model‐independent estimates of δ_a were obtained directly from the temporal shift of the ASL time series. An extended two‐compartment perfusion model was developed in order to simulate the basic features of the proposed method and to validate the evaluation procedure. Vascular structures found in human δ_a maps, such as the circle of Willis or cerebral border zones, hint at the sensitivity of the method to most sizes of arterial vessels. Group‐averaged values of δ_a measured from the carotid bifurcation to the tissue of interest in selected regions of the human brain ranged from 925 ms in the insular cortex to 2000 ms in the thalamic region. Copyright © 2014 John Wiley & Sons, Ltd.