Collateral circulation imaging: MR perfusion territory arterial spin-labeling at 3T.
OBJECTIVE
Current knowledge of the collateral circulation remains sparse, and a noninvasive method to better characterize the role of collaterals is desirable. The aim of our study was to investigate the presence and distal flow of collaterals by using a new MR perfusion territory imaging, vessel-encoded arterial spin-labeling (VE-ASL).


METHODS
Fifty-six patients with internal carotid artery (ICA) or middle cerebral artery (MCA) stenosis were identified by sonography. VE-ASL was performed to assess the presence and function of collateral flow. The perfusion information was combined with VE maps into high signal-intensity-to-noise-ratio 3-colored maps of the left carotid, right carotid, and posterior circulation territories. The presence of the anterior and posterior collateral flow was demonstrated by the color of the standard anterior cerebral artery/MCA flow territory. The distal function of collateral flow was categorized as adequate (cerebral blood flow [CBF] >/=10 mL/min/100 g) or deficient (CBF <10 mL/min/100 g). The results were compared with those of MR angiography (MRA) and intra-arterial digital subtraction angiography (DSA) in cross table, and kappa coefficients were calculated to determine the agreement among different methods.


RESULTS
The kappa coefficients of the presence of anterior and posterior collaterals by using VE-ASL and MRA were 0.785 and 0.700, respectively. The kappa coefficient of the function of collaterals by using VE-ASL and DSA was 0.726. Apart from collaterals through the circle of Willis, VE-ASL showed collateral flow via leptomeningeal anastomoses.


CONCLUSIONS
In patients with ICA or MCA stenosis, VE-ASL could show the presence, the origin, and distal function of collateral flow noninvasively.
Wu
B
B
Department of Radiology, Peking University First Hospital, Beijing, China.
Wang
X
X
Guo
J
J
Xie
S
S
Wong
E C
EC
Zhang
J
J
Jiang
X
X
Fang
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013113:Spin Labels
D013113:Spin Labels
AJNR Am J Neuroradiol. 1992 Sep-Oct;13(5):1435-8
1414838
AJNR Am J Neuroradiol. 2007 Mar;28(3):447-8
17353310
Med Image Anal. 2006 Feb;10(1):59-70
15950521
J Neurosurg. 1992 Dec;77(6):927-40
1432137
Stroke. 2000 Jan;31(1):128-32
10625727
AJNR Am J Neuroradiol. 1993 Jan-Feb;14(1):19-25
8427087
Stroke. 2003 Sep;34(9):2279-84
12881609
Radiology. 2007 Feb;242(2):526-34
17255422
Neurology. 1992 Feb;42(2):289-98
1736156
Neuroimage. 2006 Jan 1;29(1):136-44
16095923
Cardiovasc Surg. 1994 Apr;2(2):164-9
8049941
Magn Reson Med. 2004 Sep;52(3):679-82
15334591
Stroke. 2000 Aug;31(8):1913-20
10926956
Magn Reson Med. 2007 Dec;58(6):1086-91
17969084
Radiology. 2003 Nov;229(2):340-6
14500855
Eur J Vasc Endovasc Surg. 1995 Nov;10(4):424-30
7489210
Stroke. 2004 Apr;35(4):882-7
14988567
J Magn Reson Imaging. 2005 Dec;22(6):727-31
16261572
Stroke. 2006 May;37(5):1334-9
16574919
Magn Reson Med. 1998 Sep;40(3):383-96
9727941
J Clin Ultrasound. 2003 Mar-Apr;31(3):142-51
12594799
Magn Reson Med. 2008 Apr;59(4):788-95
18383289