title: 3D GRASE pulsed arterial spin labeling at multiple inflow times in patients with long arterial transit times: comparison with dynamic susceptibility-weighted contrast-enhanced MRI at 3 Tesla.
abstract: Pulsed arterial spin labeling (PASL) at multiple inflow times (multi-TIs) is advantageous for the measurement of brain perfusion in patients with long arterial transit times (ATTs) as in steno-occlusive disease, because bolus-arrival-time can be measured and blood flow measurements can be corrected accordingly. Owing to its increased signal-to-noise ratio, a combination with a three-dimensional gradient and spin echo (GRASE) readout allows acquiring a sufficient number of multi-TIs within a clinically feasible acquisition time of 5 minutes. We compared this technique with the clinical standard dynamic susceptibility-weighted contrast-enhanced imaging-magnetic resonance imaging in patients with unilateral stenosis >70% of the internal carotid or middle cerebral artery (MCA) at 3 Tesla. We performed qualitative (assessment by three expert raters) and quantitative (region of interest (ROI)/volume of interest (VOI) based) comparisons. In 43 patients, multi-TI PASL-GRASE showed perfusion alterations with moderate accuracy in the qualitative analysis. Quantitatively, moderate correlation coefficients were found for the MCA territory (ROI based: r=0.52, VOI based: r=0.48). In the anterior cerebral artery (ACA) territory, a readout related right-sided susceptibility artifact impaired correlation (ROI based: r=0.29, VOI based: r=0.34). Arterial transit delay artifacts were found only in 12% of patients. In conclusion, multi-TI PASL-GRASE can correct for arterial transit delay in patients with long ATTs. These results are promising for the transfer of ASL to the clinical practice.
authors.affiliation: Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: Steve Z
authors.initials: SZ
authors.lastname: Martin
authors.affiliation: 1] Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany [2] Department of Neurology, Charité-Universtitätsmedizin, Berlin, Germany.
authors.forename: Vince I
authors.initials: VI
authors.lastname: Madai
authors.affiliation: 1] Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany [2] Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany.
authors.forename: Federico C
authors.initials: FC
authors.lastname: von Samson-Himmelstjerna
authors.affiliation: 1] Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany [2] Department of Neurology, Charité-Universtitätsmedizin, Berlin, Germany.
authors.forename: Matthias A
authors.initials: MA
authors.lastname: Mutke
authors.affiliation: Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: Miriam
authors.initials: M
authors.lastname: Bauer
authors.affiliation: Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany.
authors.forename: Cornelius X
authors.initials: CX
authors.lastname: Herzig
authors.affiliation: Berlin Center for Advanced Neuroimaging (BCAN), Berlin, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hetzer
authors.affiliation: 1] Fraunhofer MEVIS, Institute for Medical Image Computing, Bremen, Germany [2] Faculty of Physics and Electronics, University of Bremen, Bremen, Germany [3] mediri GmbH, Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Günther
authors.affiliation: 1] Center for Stroke Research Berlin (CSB), Charité-Universitätsmedizin, Berlin, Germany [2] Department of Neurology, Charité-Universtitätsmedizin, Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Sobesky
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000473:pathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000473:pathology; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D013113:Spin Labels
chemical_list: D013113:Spin Labels