title: Vascular territorial segmentation and volumetric blood flow measurement using dynamic contrast enhanced magnetic resonance angiography of the brain.
abstract: This study proposes a method for territorial segmentation and volumetric flow rate (VFR) distribution measurement of cerebral territories based on time-resolved contrast enhanced magnetic-resonance-angiography (MRA). The method uses an iterative region-growing algorithm based on bolus-arrival-time with increased temporal resolution. Eight territories were segmented: (1) right and (2) left internal carotid arteries, including the middle cerebral artery (ICA+MCA), excluding the anterior cerebral arteries (ACA); (3) right and left ACA (R+L-ACA); (4) right and (5) left external carotid arteries (ECA); (6) right and (7) left posterior cerebral arteries (PCA); and (8) vertebrobasilar territory. VFR percentage, relative to the entire brain (rVFR), was measured based on territorial volume as a function of time. Mean rVFR values of fifteen healthy subjects were: ICA+MCA = 23 ± 2%, R + L-ACA = 17 ± 3%, ECA = 4 ± 2%, PCA = 12 ± 2%, and vertebrobasilar territory = 31 ± 4%. Excluding the ECA-rVFR, which is underestimated, these values are comparable to previously reported values. Six subjects were scanned twice, demonstrating comparable and even higher reproducibility than previously reported using phase-contrast, yet with faster scan time (∼1 min). This method was implemented in one patient with MCA occlusion and one with Moyamoya syndrome scanned before and after bypass surgery, demonstrating its clinical potential for quantitative assessment of the degree of occlusion and the effect of surgery.
authors.affiliation: 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|2 Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Oren
authors.initials: O
authors.lastname: Geri
authors.affiliation: 3 Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Shelly I
authors.initials: SI
authors.lastname: Shiran
authors.affiliation: 4 Department of NeuroSurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Roth
authors.affiliation: 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Moran
authors.initials: M
authors.lastname: Artzi
authors.affiliation: 3 Department of Radiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Liat
authors.initials: L
authors.lastname: Ben-Sira
authors.affiliation: 1 Functional Brain Center, The Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.|2 Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.|5 Sackler Faculty of Medicine, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
authors.forename: Dafna
authors.initials: D
authors.lastname: Ben Bashat
mesh_terms: D000328:Adult; D020771:Anterior Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D001488:Basilar Artery / Q000000981:diagnostic imaging / Q000502:physiology; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D002342:Carotid Artery, External / Q000000981:diagnostic imaging / Q000502:physiology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D009072:Moyamoya Disease / Q000000981:diagnostic imaging / Q000601:surgery; D020769:Posterior Cerebral Artery / Q000000981:diagnostic imaging / Q000502:physiology; D015203:Reproducibility of Results
keywords: MR angiography; Moyamoya; cerebral blood flow measurement; stroke; vascular territorial segmentation