Multi-delay multi-parametric arterial spin-labeled perfusion MRI in acute ischemic stroke - Comparison with dynamic susceptibility contrast enhanced perfusion imaging
Danny J J Wang, Jeffry R Alger, Joe X Qiao, Matthias Gunther, Whitney B Pope, Jeffrey L Saver, Noriko Salamon, David S Liebeskind, UCLA Stroke Investigators, Danny J J Wang, Jeffry R Alger, Joe X Qiao, Matthias Gunther, Whitney B Pope, Jeffrey L Saver, Noriko Salamon, David S Liebeskind, UCLA Stroke Investigators
Abstract
The purpose of the present study was to present a multi-delay multi-parametric pseudo-continuous arterial spin labeling (pCASL) protocol with background suppressed 3D GRASE (gradient and spin echo) readout for perfusion imaging in acute ischemic stroke. PCASL data at 4 post-labeling delay times (PLD = 1.5, 2, 2.5, 3 s) were acquired within 4.5 min in 24 patients (mean age 79.7 ± 11.4 years; 11 men) with acute middle cerebral artery (MCA) stroke who also underwent dynamic susceptibility contrast (DSC) enhanced perfusion imaging. Arterial transit times (ATT) were estimated through the calculation of weighted delays across the 4 PLDs, which were included in the calculation of cerebral blood flow (CBF) and arterial cerebral blood volume (CBV). Mean perfusion parameters derived using pCASL and DSC were measured within MCA territories and infarct regions identified on diffusion weighted MRI. The results showed highly significant correlations between pCASL and DSC CBF measurements (r > = 0.70, p < = 0.0001) and moderately significant correlations between pCASL and DSC CBV measurements (r > = 0.45, p < = 0.027) in both MCA territories and infarct regions. ASL ATT showed correlations with DSC time to the maximum of tissue residual function (Tmax)(r = 0.66, p = 0.0005) and mean transit time (MTT)(r = 0.59, p = 0.0023) in leptomeningeal MCA territories. The present study demonstrated the feasibility for noninvasive multi-parametric perfusion imaging using ASL for acute stroke imaging.
Keywords: Acute stroke; Arterial spin labeling (ASL); Dynamic susceptibility contrast (DSC); Ischemia; Multi-delay; Multi-parametric; Perfusion MRI.
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References
- Bokkers R.P., Hernandez D.A., Merino J.G., Mirasol R.V., van Osch M.J., Hendrikse J., Warach S., Latour L.L. Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. Stroke; A Journal of Cerebral Circulation. 2012;43:1290–1294.
- Chalela J.A., Alsop D.C., Gonzalez-Atavalez J.B., Maldjian J.A., Kasner S.E., Detre J.A. Magnetic resonance perfusion imaging in acute ischemic stroke using continuous arterial spin labeling. Stroke. 2000;31:680–687.
- Chen J., Licht D.J., Smith S.E., Agner S.C., Mason S., Wang S., Silvestre D.W., Detre J.A., Zimmerman R.A., Ichord R.N., Wang J. Arterial spin labeling perfusion MRI in pediatric arterial ischemic stroke: initial experiences. Journal of Magnetic Resonance Imaging. 2009;29:282–290.
- Dai W., Robson P.M., Shankaranarayanan A., Alsop D.C. Reduced resolution transit delay prescan for quantitative continuous arterial spin labeling perfusion imaging. Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2012;67:1252–1265.
- Detre J.A., Rao H., Wang D.J., Chen Y.F., Wang Z. Applications of arterial spin labeled MRI in the brain. Journal of Magnetic Resonance Imaging: JMRI. 2012;35:1026–1037.
- Fernandez-Seara M.A., Edlow B.L., Hoang A., Wang J., Feinberg D.A., Detre J.A. Minimizing acquisition time of arterial spin labeling at 3 T. Magnetic Resonance in Medicine. 2008;59:1467–1471.
- Gunther M., Bock M., Schad L.R. Arterial spin labeling in combination with a look-locker sampling strategy: inflow turbo-sampling EPI-FAIR (ITS-FAIR) Magnetic Resonance in Medicine. 2001;46:974–984.
- Gunther M., Oshio K., Feinberg D.A. Single-shot 3D imaging techniques improve arterial spin labeling perfusion measurements. Magnetic Resonance in Medicine. 2005;54:491–498.
- Hernandez D.A., Bokkers R.P., Mirasol R.V., Luby M., Henning E.C., Merino J.G., Warach S., Latour L.L. Pseudocontinuous arterial spin labeling quantifies relative cerebral blood flow in acute stroke. Stroke; A Journal of Cerebral Circulation. 2012;43:753–758.
- Law M., Young R., Babb J., Rad M., Sasaki T., Zagzag D., Johnson G. Comparing perfusion metrics obtained from a single compartment versus pharmacokinetic modeling methods using dynamic susceptibility contrast-enhanced perfusion MR imaging with glioma grade. AJNR. American Journal of Neuroradiology. 2006;27:1975–1982.
- MacIntosh B.J., Lindsay A.C., Kylintireas I., Kuker W., Gunther M., Robson M.D., Kennedy J., Choudhury R.P., Jezzard P. Multiple inflow pulsed arterial spin-labeling reveals delays in the arterial arrival time in minor stroke and transient ischemic attack. AJNR. American Journal of Neuroradiology. 2010;31:1892–1894.
- Nael K., Meshksar A., Liebeskind D.S., Wang D.J., Ellingson B.M., Salamon N., Villablanca J.P. Periprocedural arterial spin labeling and dynamic susceptibility contrast perfusion in detection of cerebral blood flow in patients with acute ischemic syndrome. Stroke; A Journal of Cerebral Circulation. 2013;44:664–670.
- Qiu D., Straka M., Zun Z., Bammer R., Moseley M.E., Zaharchuk G. CBF measurements using multidelay pseudocontinuous and velocity-selective arterial spin labeling in patients with long arterial transit delays: comparison with xenon CT CBF. Journal of Magnetic Resonance Imaging. 2012;36:110–119.
- Tatu L., Moulin T., Bogousslavsky J., Duvernoy H. Arterial territories of the human brain: cerebral hemispheres. Neurology. 1998;50:1699–1708.
- Wang D.J., Alger J.R., Qiao J.X., Hao Q., Hou S., Fiaz R., Gunther M., Pope W.B., Saver J.L., Salamon N., Liebeskind D.S. The value of arterial spin-labeled perfusion imaging in acute ischemic stroke: comparison with dynamic susceptibility contrast-enhanced MRI. Stroke. 2012;43:1018–1024.
- Wolf R.L., Alsop D.C., McGarvey M.L., Maldjian J.A., Wang J., Detre J.A. Susceptibility contrast and arterial spin labeled perfusion MRI in cerebrovascular disease. Journal of Neuroimaging. 2003;13:17–27.
- Wu O., Ostergaard L., Weisskoff R.M., Benner T., Rosen B.R., Sorensen A.G. Tracer arrival timing-insensitive technique for estimating flow in MR perfusion-weighted imaging using singular value decomposition with a block-circulant deconvolution matrix. Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine/Society of Magnetic Resonance in Medicine. 2003;50:164–174.
- Zaharchuk G. Arterial spin label imaging of acute ischemic stroke and transient ischemic attack. Neuroimaging Clinics of North America. 2011;21:285–301.
- Zaharchuk G., El Mogy I.S., Fischbein N.J., Albers G.W. Comparison of arterial spin labeling and bolus perfusion-weighted imaging for detecting mismatch in acute stroke. Stroke; A Journal of Cerebral Circulation. 2012;43:1843–1848.
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