Quantitative measurement of regional cerebral blood flow with flow-sensitive alternating inversion recovery imaging: comparison with [iodine 123]-iodoamphetamin single photon emission CT.
OBJECTIVE
Flow-sensitive alternating inversion recovery (FAIR) MR imaging is a technique for depicting cerebral perfusion without contrast enhancement. Our purpose was to determine whether quantification at FAIR imaging can be used to assess regional cerebral blood flow (rCBF) in a manner similar to [iodine 123]-iodoamphetamin ((123)I-IMP) single photon emission CT (SPECT).


METHODS
Nine patients with internal carotid or major cerebral arterial stenosis underwent (123)I-IMP SPECT and FAIR imaging (single section, different TIs, 1.5 T) at rest and after acetazolamide (Diamox) stress. FAIR and (123)I-IMP rCBF values were compared and correlated. Receiver operating characteristic analysis was conducted to detect hypoperfused segments on FAIR images.


RESULTS
rCBF values of normally perfused segments were 41.53 and 51.91 mL/100 g/min for pre- and post-acetazolamide (123)I-IMP studies, respectively. Corresponding values for pre- and post-acetazolamide FAIR images, respectively, were 46.64 and 59.60 mL/100 g/min with a TI of 1200 milliseconds and 53.23 and 68.17 mL/100 g/min with a TI of 1400 milliseconds. (123)I-IMP and FAIR results were significantly correlated, with both pre- and post-acetazolamide images. Sensitivity (86%) in detecting hypoperfused segments was significantly higher with post-acetazolamide images (TI, 1400 milliseconds), and specificity (82-85%) and accuracy (80-82%) were higher with all pre- and post-acetazolamide images (all TIs).


CONCLUSIONS
The significant correlation, high specificity and accuracy in detecting hypoperfused segments, similar increases in flow on both post-acetazolamide images, and absence of the need for contrast enhancement suggest that FAIR imaging, like nuclear medicine study, is complementary to routine MR imaging in the assessment of cerebral perfusion.
Arbab
Ali Syed
AS
Department of Radiology, Yamanashi Medical University, Nakakoma-gun, Yamanashi, Japan.
Aoki
Shigeki
S
Toyama
Keiji
K
Miyazawa
Nobuhiko
N
Kumagai
Hiroshi
H
Umeda
Takako
T
Arai
Takao
T
Araki
Tsutomu
T
Kabasawa
Hiroyuki
H
Takahashi
Yoshiyuki
Y
D000086:Acetazolamide / Q000008:administration & dosage; D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002539:Cerebral Arterial Diseases / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D020367:Iofetamine; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D015899:Tomography, Emission-Computed, Single-Photon
D019275:Radiopharmaceuticals; D020367:Iofetamine; D000086:Acetazolamide