title: Planning-free cerebral blood flow territory mapping in patients with intracranial arterial stenosis.
abstract: A noninvasive method for quantifying cerebral blood flow and simultaneously visualizing cerebral blood flow territories is vessel-encoded pseudocontinuous arterial spin labeling MRI. However, obstacles to acquiring such information include limited access to the methodology in clinical centers and limited work on how clinically acquired vessel-encoded pseudocontinuous arterial spin labeling data correlate with gold-standard methods. The purpose of this work is to develop and validate a semiautomated pipeline for the online quantification of cerebral blood flow maps and cerebral blood flow territories from planning-free vessel-encoded pseudocontinuous arterial spin labeling MRI with gold-standard digital subtraction angiography. Healthy controls (n = 10) and intracranial atherosclerotic disease patients (n = 34) underwent 3.0 T MRI imaging including vascular (MR angiography) and hemodynamic (cerebral blood flow-weighted arterial spin labeling) MRI. Patients additionally underwent catheter and/or CT angiography. Variations in cross-territorial filling were grouped according to diameters of circle of Willis vessels in controls. In patients, Cohen's k-statistics were computed to quantify agreement in perfusion patterns between vessel-encoded pseudocontinuous arterial spin labeling and angiography. Cross-territorial filling patterns were consistent with circle of Willis anatomy. The intraobserver Cohen's k-statistics for cerebral blood flow territory and digital subtraction angiography perfusion agreement were 0.730 (95% CI = 0.593-0.867; reader one) and 0.708 (95% CI = 0.561-0.855; reader two). These results support the feasibility of a semiautomated pipeline for evaluating major neurovascular cerebral blood flow territories in patients with intracranial atherosclerotic disease.
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Arteaga
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Megan K
authors.initials: MK
authors.lastname: Strother
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: L Taylor
authors.initials: LT
authors.lastname: Davis
authors.affiliation: 2 Neurosurgery, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Fusco
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Carlos C
authors.initials: CC
authors.lastname: Faraco
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Brent A
authors.initials: BA
authors.lastname: Roach
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Allison O
authors.initials: AO
authors.lastname: Scott
authors.affiliation: 1 Radiology, Vanderbilt University Medical Center, Nashville, USA.|3 Psychiatry, Vanderbilt University Medical Center, Nashville, USA.|4 Physics and Astronomy, Vanderbilt University, Nashville, USA.|5 Neurology, Vanderbilt University Medical Center, Nashville, USA.
authors.forename: Manus J
authors.initials: MJ
authors.lastname: Donahue
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002533:Cerebral Angiography / Q000379:methods*; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged
keywords: Angiography; MR angiography; MRI; arterial spin labeling; atherosclerosis; cerebral blood flow territory; cerebrovascular disease; circle of Willis; collaterals; imaging; neuroradiology; vessel-encoded arterial spin labeling