Arterial spin-labeling in routine clinical practice, part 1: technique and artifacts.
The routine use of arterial spin-labeling (ASL) in a clinical population has led to the depiction of diverse brain pathologic features. Unique challenges in the acquisition, postprocessing, and analysis of cerebral blood flow (CBF) maps are encountered in such a population, and high-quality ASL CBF maps can be generated consistently with attention to quality control and with the use of a dedicated postprocessing pipeline. Familiarity with commonly encountered artifacts can help avoid pitfalls in the interpretation of CBF maps. The purpose of this review was to describe our experience with a heterogeneous collection of ASL perfusion cases with an emphasis on methodology and common artifacts encountered with the technique. In a period of 1 year, more than 3000 pulsed ASL cases were performed as a component of routine clinical brain MR evaluation at both 1.5 and 3T. These ASL studies were analyzed with respect to overall image quality and patterns of perfusion on final gray-scale DICOM images and color Joint Photographic Experts Group (JPEG) CBF maps, and common artifacts and their impact on final image quality were categorized.
Deibler
A R
AR
Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
Pollock
J M
JM
Kraft
R A
RA
Tan
H
H
Burdette
J H
JH
Maldjian
J A
JA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D016477:Artifacts; D001783:Blood Flow Velocity / Q000502:physiology; D001921:Brain / Q000098:blood supply*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D018810:Magnetic Resonance Angiography / Q000379:methods*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D012680:Sensitivity and Specificity; D012985:Software Design