title: Assessment of cerebral blood perfusion reserve with acetazolamide using 3D spiral ASL MRI: Preliminary experience in pediatric patients.
abstract: To demonstrate the clinical feasibility of a new non-Cartesian cylindrically-distributed spiral 3D pseudo-continuous arterial spin labeling (pCASL) magnetic resonance imaging (MRI) pulse sequence in pediatric patients in quantifying cerebral blood flow (CBF) response to an acetazolamide (ACZ) vasodilator challenge.
  
  
  
  MRI exams were performed on two 3 Tesla Philips Ingenia systems using 32 channel head coil arrays. After local institutional review board approval, the 3D spiral-based pCASL technique was added to a standard brain MRI exam and evaluated in 13 pediatric patients (average age: 11.7±6.4years, range: 1.4-22.2years). All patients were administered ACZ for clinically indicated reasons. Quantitative whole-brain CBF measurements were computed pre- and post-ACZ to assess cerebrovascular reserve.
  
  
  
  3D spiral pCASL data were successfully reconstructed in all 13 cases. In 11 patients, CBF increased 2.8% to 93.2% after administration of ACZ. In the two remaining patients, CBF decreased by 2.4 to 6.0% after ACZ. The group average change in CBF due to ACZ was approximately 25.0% and individual changes were statistically significant (p<0.01) in all patients using a paired t-test analysis. CBF perfusion data were diagnostically useful in supporting conventional MR angiography and clinical findings.
  
  
  
  3D cylindrically-distributed spiral pCASL MRI provides a robust approach to assess cerebral blood flow and reserve in pediatric patients.
authors: Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA. Electronic address: hhu1@phoenixchildrens.com.
authors: Houchun H
authors: HH
authors: Hu
authors: Keller Center for Imaging Innovation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors: Zhiqiang
authors: Z
authors: Li
authors: Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors: Amber L
authors: AL
authors: Pokorney
authors: Philips HealthTech, Best, The Netherlands.
authors: Jonathan M
authors: JM
authors: Chia
authors: Philips HealthTech, Best, The Netherlands.
authors: Niccolo
authors: N
authors: Stefani
authors: Keller Center for Imaging Innovation, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
authors: James G
authors: JG
authors: Pipe
authors: Department of Medical Imaging and Radiology, Phoenix Children's Hospital, Phoenix, AZ, USA.
authors: Jeffrey H
authors: JH
authors: Miller
mesh_terms: D000086:Acetazolamide / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002257:Carbonic Anhydrase Inhibitors / Q000008:administration & dosage; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D013113:Spin Labels; D055815:Young Adult
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D013113:Spin Labels; D000086:Acetazolamide
keywords: 3D spiral MRI; Acetazolamide; Arterial spin labeling MRI; Cerebral blood flow; Children; Perfusion