MR perfusion studies with T1-weighted echo planar imaging

Perfusion imaging using arterial spin labeling

Arterial spin labeling is a magnetic resonance method for the measurement of cerebral blood flow. In its simplest form, the perfusion contrast in the images gathered by this technique comes from the subtraction of two successively acquired images: one with, and one without, proximal labeling of arterial water spins after a small delay time. Over the last decade, the method has moved from the experimental laboratory to the clinical environment. Furthermore, numerous improvements, ranging from new pulse sequence implementations to extensive theoretical studies, have broadened its reach and extended its potential applications. In this review, the multiple facets of this powerful yet difficult technique are discussed. Different implementations are compared, the theoretical background is summarized, and potential applications of various implementations in research as well as in the daily clinical routine are proposed. Finally, a summary of the new developments and emerging techniques in this field is provided.

Physiological basis and image processing in functional magnetic resonance imaging: neuronal and motor activity in brain

Functional magnetic resonance imaging (fMRI) is recently developing as imaging modality used for mapping hemodynamics of neuronal and motor event related tissue blood oxygen level dependence (BOLD) in terms of brain activation. Image processing is performed by segmentation and registration methods. Segmentation algorithms provide brain surface-based analysis, automated anatomical labeling of cortical fields in magnetic resonance data sets based on oxygen metabolic state. Registration algorithms provide geometric features using two or more imaging modalities to assure clinically useful neuronal and motor information of brain activation. This review article summarizes the physiological basis of fMRI signal, its origin, contrast enhancement, physical factors, anatomical labeling by segmentation, registration approaches with examples of visual and motor activity in brain. Latest developments are reviewed for clinical applications of fMRI along with other different neurophysiological and imaging modalities.

Two analytical solutions for a model of pulsed arterial spin labeling with randomized blood arrival times

A fairly general theoretical model for pulsed arterial spin labeling perfusion methods has been available for some time but analytical solutions were derived for only a small number of arterial blood input functions. These mostly assumed a sudden and simultaneous arrival of the tagged blood into the imaged region. More general cases had to be handled numerically. We present analytical solutions for two more realistic arterial input functions. They both allow the arrival times of the molecules of tagged arterial blood to be statistically distributed. We consider cases of (1) a uniform distribution on a finite time interval and (2) a normal distribution characterized by its mean and standard deviation. These models are physiologically meaningful because the statistical nature of the arrival times reflects the distribution of velocities and path lengths that the blood water molecules undertake from the tagging region to the imaged region. The model parameters can be estimated from the measured dependency of the perfusion signal on the tag inversion time.

Magnetic resonance imaging and spectroscopy in assessing 3-nitropropionic acid-induced brain lesions: an animal model of Huntington’s disease

Huntington's disease (HD) is an inherited neurodegenerative disease, in which there is progressive motor and cognitive deterioration, and for which the pathogenesis of neuronal death remains controversial. Mitochondrial toxins like 3-nitropropionic acid (3-NP) and malonate, functioning as the inhibitors of the complex II of mitochondrial respiratory chain, have been found to effectively induce specific behavioral changes and selective striatal lesions in rats and non-human primates mimicking those in HD. Furthermore, several kinds of transgenic mouse models of HD have been recently developed, and used in the development and assessment of novel treatments for HD. In the past, most studies evaluating the animal models for HD were based on histological changes or in vitro neuronal cultures. With the emergence of advanced magnetic resonance technologies, non-invasive magnetic resonance imaging (MRI) and spectroscopy provide more detail of cerebral alterations, including the changes of cerebral structure, function and metabolites. These studies support the hypothesis that mitochondrial dysfunction with increased excitation of N-methyl-D-aspartate (NMDA) receptors can replicate the neurobehavioral changes, selective brain injury and neurochemical alterations in HD. The present review focuses on our work as well as that of others regarding 3-NP-induced neurotoxicity and other animal models of HD. Using both conventional and advanced MRI and spectroscopy, we summarize the pathogenesis and possible therapeutic strategies in chemical and transgenic models of HD. The results show magnetic resonance techniques to be powerful techniques in the evaluation of pathogenesis and therapeutic intervention for both chemical and transgenic models of HD.

FAIR true-FISP perfusion imaging of the kidneys

Most arterial spin labeling (ASL) techniques apply echoplanar imaging (EPI) because this strategy provides relatively high SNR in short measuring times. Unfortunately, those techniques are very susceptible to static magnetic field inhomogeneities and perfusion signals from organs with fast transverse relaxation might decrease due to the exchange of water molecules in capillaries and organ tissue combined with relatively long echo times of EPI sequences. To overcome these problems a novel imaging technique, FAIR True-FISP, was developed. It combines a FAIR (flow-sensitive alternating inversion recovery) perfusion preparation and a true fast imaging with steady precession (True-FISP) data acquisition strategy. True-FISP was chosen since this sequence type does not show the mentioned disadvantages of EPI, but provides a similar SNR per measuring time. An important problem of this approach is that True-FISP sequences usually work in a steady state which is independent of a previous preparation of magnetization. For this reason a sequence structure had to be developed which keeps the advantages of True-FISP and makes the signal intensity sensitive to the FAIR preparation. Breathhold and nonbreathhold examinations of kidneys are presented and possible strategies to quantitative flow measurements are reported. It is shown that correction of spatially inhomogeneous receiver coil characteristics is easily feasible and leads to clinically valuable perfusion examinations of kidneys without application of potentially nephrotoxic contrast media.

Whole-brain 3D perfusion MRI at 3.0 T using CASL with a separate labeling coil

A variety of continuous and pulsed arterial spin labeling (ASL) perfusion MRI techniques have been demonstrated in recent years. One of the reasons these methods are still not routinely used is the limited extent of the imaging region. Of the ASL methods proposed to date, continuous ASL (CASL) with a separate labeling coil is particularly attractive for whole-brain studies at high fields. This approach can provide an increased signal-to-noise ratio (SNR) in perfusion images because there are no magnetization transfer (MT) effects, and lessen concerns regarding RF power deposition at high field because it uses a local labeling coil. In this work, we demonstrate CASL whole-brain quantitative perfusion imaging at 3.0 T using a combination of strategies: 3D volume acquisition, background tissue signal suppression, and a separate labeling coil. The results show that this approach can be used to acquire perfusion images in all brain regions with good sensitivity. Further, it is shown that the method can be performed safely on humans without exceeding the current RF power deposition limits. The current method can be extended to higher fields, and further improved by the use of multiple receiver coils and parallel imaging techniques to reduce scan time or provide increased resolution.

Breast tissue differentiation using arterial spin tagging

An arterial spin tagging (AST) pulse sequence has been developed to measure T(1) and relative blood perfusion. This full sequence is composed of three sequences: selective tagging, nonselective tagging, and nontagging. Perfusion quantification error resulting from imperfect inversion and acquisition slice profiles has been addressed in the literature. In this work, the error is reduced through the application of optimized Shinnar-Le Roux (SLR) RF pulses and a semi-log linear regression data-processing technique. A threshold approach based on the breast tissue T(1) and relative blood perfusion is introduced to show that these two parameters can be applied to breast tissue differentiation and potentially to cancer detection.

MRI of blood volume with MS 325 in experimental choroidal melanoma

Functional magnetic resonance imaging (MRI) allows quantitative blood volume imaging in vivo at high tissue resolution. The purpose is to apply this technique for untreated and hyperthermia-treated experimental choroidal melanoma. MS 325 was used as new intravascular albumin-bound gadolinium-based contrast agent. Pigmented choroidal melanomas were established in albino rabbits. MRI was performed in 7 untreated eyes and 7 eyes treated with a Neodymium:Yttrium-Lanthanum-Fluoride-laser at 1047 nm. 3D-spoiled gradient echo pulse sequences were used to acquire T' weighted axial images. First, a set of images was collected without contrast agent. MS 325 was then injected i.v. and images were obtained within 12 min after injection. Signal intensities were measured within tumor, ciliary body, choroid, and iris and relative signal intensities were determined for these tissues in relation to vitreous. In untreated tumors, the relative signal intensity was higher after injection of MS 325 (5.61+0.70) than without MS 325 (2.90+0.33; p = 0.0002). In contrast, the relative signal intensity of treated tumors did not differ significantly before and after MS 325 (6.19+1.59 and 6.13+1.64). Histopathological sections indicated vascular occlusion in treated tumors. All other studied tissues of untreated and treated eyes showed a significant increase of relative signal intensities in the presence of MS 325. An animal model for the research on contrast agents in MRI is presented. Blood volume measurement with MS 325 was adapted for experimental choroidal melanomas. Reduced change of relative signal intensity indicates compromised blood volume after vascular occlusion in hyperthermia-treated melanoma. Further studies are needed to investigate whether this technique allows the evaluation of tumor viability following treatments.

Measuring the change in CBV upon cortical activation with high temporal resolution using look-locker EPI and Gd-DTPA

A method of simultaneously measuring the changes in cerebral blood volume (CBV) and T(*) (2) that occur on brain activation with high temporal resolution was developed. The method involves measuring the change in the longitudinal relaxation time (T(1)) that occurs following a bolus injection of Gd-DTPA and converting this measurement to a change in blood volume assuming fast exchange. The sequence was optimized for the measurement of changes in CBV with high temporal resolution. A change in CBV of 27 +/- 4% on activation of the primary visual cortex (V1) was measured across four subjects. The time course of changes in T(*) (2) showed a poststimulus undershoot (P = 0.008) corresponding approximately to a period over which CBV was still elevated above baseline, but falling (P = 0.01). The effects of perfusion, nonfulfillment of the assumption of fast exchange and of intrinsic T(1) changes on activation on the model used to calculate the change in CBV are discussed.

Quantitative perfusion mapping of the human lung using 1H spin labeling

PURPOSE

To evaluate the feasibility and reproducibility of a noninvasive, rapid and quantitative pulmonary perfusion mapping method using a two-compartment tissue model in combination with a (1)H spin labeling technique.

MATERIALS AND METHODS

Ten healthy volunteers and three patients with cystic fibrosis (CF) were examined on a 1.5-T whole-body scanner. Global and selective lung T(1) maps based on an inversion recovery Snapshot FLASH technique were acquired from each subject with breath-holds at end-expiration. For comparison, corresponding Gd-DTPA-enhanced (1)H MR perfusion images were also obtained from each CF patient.

RESULTS

Quantitative perfusion maps were calculated from the global and selective T(1) maps. The measured perfusion rates of the upper right lung in volunteers ranged from 400 to 600 mL/100 g/minute. The method showed a high intra-study reproducibility and low relative errors. In CF-patients, perfusion defects detected using Gd-DTPA-enhanced MR imaging were also detected using the spin labeling method. The perfusion rates of diseased lung tissues were less than 200 mL/100 g/minute.

CONCLUSION

Noninvasive, robust and quantitative (1)H MR mapping of pulmonary perfusion was successfully performed using a rapid lung T(1) mapping in combination with spin labeling within the imaging slice. The proposed method has the potential to provide both important qualitative functional information and quantitative pulmonary perfusion rates in various lung diseases at various stages without the need of contrast agents.

In vivo NMR studies of neurodegenerative diseases in transgenic and rodent models

In vivo magnetic resonance spectroscopy (MRS) and magnetic resonance imaging (MRI) provide unique quality to attain neurochemical, physiological, anatomical, and functional information non-invasively. These techniques have been increasingly applied to biomedical research and clinical usage in diagnosis and prognosis of diseases. The ability of MRS to detect early yet subtle changes of neurochemicals in vivo permits the use of this technology for the study of cerebral metabolism in physiological and pathological conditions. Recent advances in MR technology have further extended its use to assess the etiology and progression of neurodegeneration. This review focuses on the current technical advances and the applications of MRS and MRI in the study of neurodegenerative disease animal models including amyotrophic lateral sclerosis, Alzheimer's, Huntington's, and Parkinson's diseases. Enhanced MR measurable neurochemical parameters in vivo are described in regard to their importance in neurodegenerative disorders and their investigation into the metabolic alterations accompanying the pathogenesis of neurodegeneration.

Evaluation of systematic quantification errors in velocity-selective arterial spin labeling of the brain

Velocity-selective (VS) sequences potentially permit arterial spin labeling (ASL) perfusion imaging with labeling applied very close to the tissue. In this study the effects of cerebrospinal fluid (CSF) motion, radiofrequency (RF) field imperfections, and sequence timing parameters on the appearance and quantitative perfusion values obtained with VS-ASL were evaluated. Large artifacts related to CSF motion were observed with moderate velocity weighting, which were removed by inversion recovery preparation at the cost of increased imaging time. Imperfect refocusing and excitation pulses resulting from nonuniform RF fields produced systematic errors in the ASL subtraction images. A phase cycling scheme was introduced to eliminate these errors. Quantitative perfusion images were obtained with CSF suppression and phase cycling. Gray matter blood flow of 27.7 ml 100 g(-1) min(-1), approximately half the value reported in studies using spatially-selective ASL, was measured. Potential sources for this underestimation are discussed.

Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat

Plastic changes in motor cortex capillary structure and function were examined in three separate experiments in adult rats following prolonged exercise. The first two experiments employed T-two-star (T(2)*)-weighted and flow-alternating inversion recovery (FAIR) functional magnetic resonance imaging to assess chronic changes in blood volume and flow as a result of exercise. The third experiment used an antibody against the CD61 integrin expressed on developing capillaries to determine if motor cortex capillaries undergo structural modifications. In experiment 1, T(2)*-weighted images of forelimb regions of motor cortex were obtained following 30 days of either repetitive activity on a running wheel or relative inactivity. The proton signal intensity was markedly reduced in the motor cortex of exercised animals compared with that of controls. This reduction was not attributable to alterations of vascular iron levels. These results are therefore most consistent with increased capillary perfusion or blood volume of forelimb regions of motor cortex. FAIR images acquired during experiment 2 under normocapnic and hypercapnic conditions indicated that resting cerebral blood flow was not altered under normal conditions but was elevated in response to high levels of CO(2), suggesting that prolonged exercise increases the size of a capillary reserve. Finally, the immunohistological data indicated that exercise induces robust growth of capillaries (angiogenesis) within 30 days from the onset of the exercise regimen. Analysis of other regions failed to find any changes in perfusion or capillary structure suggesting that this motor activity-induced plasticity may be specific to motor cortex.These data indicate that capillary growth occurs in motor areas of the cerebral cortex as a robust adaptation to prolonged motor activity. In addition to capillary growth, the vascular system also experiences heightened flow under conditions of activation. These changes are chronic and observable even in the anesthetized animal and are measurable using noninvasive techniques.

High-resolution functional magnetic resonance imaging of the animal brain

To fully understand brain function, one must look beyond the level of a single neuron. By elucidating the spatial properties of the columnar and laminar functional architectures, information regarding the neural processing in the brain can be gained. To map these fine functional structures noninvasively and repeatedly, functional magnetic resonance imaging (fMRI) can be employed. In this article the basic principles of fMRI are introduced, including specific hardware requirements and the equipment necessary for animal magnetic resonance research. Since fMRI measures a change in secondary hemodynamic responses induced by neural activity, it is critical to understand the principles and potential pitfalls of fMRI techniques. Thus, the underlying physics of conventional blood oxygenation, cerebral blood flow, and cerebral blood volume-based fMRI techniques are extensively discussed. Tissue-specific signal change is close to the site of neural activity, while signals from large vessels can be distant from the actual active site. Thus, methods to minimize large vessel contributions and to maximize tissue signals are described. The fundamental limitation of fMRI spatial resolution is the intrinsic hemodynamic response. Based on our high-resolution fMRI studies, the hemodynamic response is regulated at submillimeter functional domains and thus spatial resolution can be achieved to an order of 100 microm. Since hemodynamic responses are sluggish, it is difficult to obtain very high temporal resolution. By using an approach with multiple experiments with different stimulus conditions, temporal resolution can be improved on the order of 100 ms. With current fMRI technologies, submillimeter columnar- and laminar-specific specific functional images can be obtained from animal brains.

Effects of hematocrit and oxygen saturation level on blood spin-lattice relaxation

In the present study blood T(1) was determined as a function of hematocrit and oxygen saturation. T(1) showed a significant linear dependency on both of these parameters. In addition, oxygen dissolved in blood plasma in hyperoxygenated blood resulted in relaxation enhancement, comparable in size to that due to the change in oxygenation state of hemoglobin. As blood T(1) is a key factor for quantification of flow with arterial spin labeling methods, the influence of T(1) variation in the physiological range of hematocrit and oxygen saturation to flow determination is discussed.

Pulsed arterial spin labeling using TurboFLASH with suppression of intravascular signal

Accurate quantification of perfusion with the ADC techniques requires the suppression of the majority of the intravascular signal. This is normally achieved with the use of diffusion gradients. The TurboFLASH sequence with its ultrashort repetition times is not readily amenable to this scheme. This report demonstrates the implementation of a modified TurboFLASH sequence for FAIR imaging. Intravascular suppression is achieved with a modified preparation period that includes a driven equilibrium Fourier transform (DEFT) combination of 90 degrees-180 degrees-90 degrees hard RF pulses subsequent to the inversion delay. These pulses rotate the perfusion-prepared magnetization into the transverse plane where it can experience the suitably placed diffusion gradients before being returned to the longitudinal direction by the second 90 degrees pulse. A value of b = 20-30 s/mm(2) was thereby found to suppress the majority of the intravascular signal. For single-slice perfusion imaging, quantification is only slightly modified. The technique can be readily extended to multislice acquisition if the evolving flow signal after the DEFT preparation is considered. An advantage of the modified preparation scheme is evident in the multislice FAIR images by the preservation of the sign of the magnetization difference.

Improved perfusion-weighted MRI by a novel double inversion with proximal labeling of both tagged and control acquisitions

A novel pulsed arterial spin labeling (PASL) technique for multislice perfusion-weighted imaging is proposed that compensates for magnetization transfer (MT) effects without sacrificing tag efficiency, and balances transient magnetic field effects (eddy currents) induced by pulsed field gradients. Improved compensation for MT is demonstrated using a phantom. Improvement in perfusion measurement was compared to other PASL techniques by acquiring perfusion images from 13 healthy volunteers (nine women and four men; age range 29-64 years; mean age 45 +/- 14 years) and second-order image texture analysis. The main improvements with the new method were significantly higher image contrast, higher mean signal intensity, and better signal uniformity across slices. In conclusion, this new PASL method should provide improved accuracy in measuring brain perfusion.

In vivo assessment of absolute perfusion in the murine skeletal muscle with spin labeling MRI. Magnetic resonance imaging

PURPOSE

To assess absolute perfusion in the skeletal muscle of mice in vivo with spin labeling magnetic resonance imaging (MRI) under normal and stress conditions.

MATERIALS AND METHODS

Absolute perfusion in the skeletal muscle of 27 C57BL/6 mice was assessed in vivo non-invasively by spin labeling MRI at 7.05 T. This technique was based on the acquisition of T1 maps with global and slice-selective spin inversion in separate acquisitions. T1 mapping was performed by inversion recovery snapshot fast low angle shot imaging. To guarantee proper spin inversion within the whole mouse, a dedicated radiofrequency (RF) coil combination was constructed. A birdcage resonator was used for transmission, while detection of the MRI signal was achieved by a surface coil.

RESULTS

Basal perfusion in the hindlimbs was determined to be 94 +/- 10 mL (100 g x minute)(-1) (mean +/- standard error of the mean [SEM], N = 27). This value is in good agreement with perfusion values determined by invasive techniques such as microspheres. A subgroup of six animals received a constant dose of 4 mg (kg x minute)(-1) of the vasodilator adenosine by an intraperitoneal catheter. In this case, perfusion was significantly increased to 179 +/- 56 mL (100 g x minute)(-1) (mean +/- SEM, N = 6, P < 0.02). Mean basal perfusion in this subgroup was 96 +/- 26 mL (100 g x minute)(-1).

CONCLUSION

Spin labeling MRI is a well-suited technique for the in vivo assessment of absolute perfusion in the murine skeletal muscle.

TurboFLASH FAIR imaging with optimized inversion and imaging profiles

Optimal implementation of pulsed arterial spin labeling (PASL) methods such as flow-sensitive alternating inversion recovery (FAIR), require the minimization of interactions between the inversion and imaging slabs. For FAIR, the inversion:imaging slice thickness ratio (STR) is usually at least 3:1 in order to fully contain the extent of the imaging slice. The resulting gap exacerbates the transit time. So far, efforts to minimize the STR have concentrated on the inversion profile. However, the imaging profile remains a limiting factor especially for rapid sequences such as turbo fast low-angle shot (TurboFLASH) which uses short pulses. This study reports the implementation of a TurboFLASH sequence with optimized inversion and imaging profiles. Slice-selection is achieved with a preparation module incorporating a pair of identical adiabatic frequency offset corrected inversion (FOCI) pulses. The optimum radiofrequency (RF) and gradient scheme for this pulse combination is described, and the relaxation characteristics of the slice-selection scheme are investigated. Phantom experiments demonstrate a reduction in the STR to approximately 1.13:1. Implementation in an animal model is described, and the benefit of the improved profile in probing the sensitivity of the flow signal to tagging geometry is demonstrated. Sensitivity to transit time effects can be minimized with this sequence, and ASL methodologies can be better explored as a result of the improved conformance with the ideal of square slice profiles.

Feature-based, automated segmentation of cerebral infarct patterns using T2- and diffusion-weighted imaging

Diffusion-weighted imaging enables the diagnosis of cerebral ischemias very early, thus supporting therapies such as thrombolysis. However, morphology and tissue-characterizing parameters (e.g. relaxation times or water diffusion) may vary strongly in ischemic regions, indicating different underlying pathologic processes. As the determination of the parameters by a supervised segmentation is very time consuming, we evaluated whether different infarct patterns may be segmented by an automated, multidimensional feature-based method using a unified segmentation procedure. Ischemias were classified into 5 characteristic patterns. For each class, a 3D histogram based on T(2)- and diffusion-weighted images as well as calculated apparent diffusion coefficients (ADC) was generated from a representative data set. Healthy and pathologic tissue classes were segmented in the histogram as separate, local density maxima with freely shaped borders. Segmentation control parameters were optimized in a 3-step procedure. The method was evaluated using synthetic images as well as results of a supervised segmentation. For the analysis of cerebral ischemias, the optimal control parameter set led to sensitivities and specificities between 1.0 and 0.9.

Microscopic spin tagging (MiST) for flow imaging

In this study, a new strategy for slow flow imaging is proposed. The basic idea is to generate flow contrast on a microscopic level below the spatial resolution of an imaging experiment. Since a microscopic spin tagging scheme is used, this concept is called MiST (Microscopic Spin Tagging). MiST is not a single specific measurement sequence, but rather a new flow sensitive preparation concept which is highly flexible and can be carried out in many ways. The common principle in all possible realizations of MiST is a periodic tagging of magnetization in thin planes (100-200 microm) within the imaging voxels by means of spatially selective RF-pulses. Therefore, flow sensitivity occurs via inflow of fresh spins on a microscopic scale. With this approach, short evolution times are sufficient to introduce inflow contrast and a spatial dependence of inflow times is avoided. The flow sensitive preparation and image orientation are also not connected as they are in conventional time-of-flight techniques. Another powerful feature of MiST is that it can be designed as a non-subtraction method, which results in no signal from stationary spins. Here we present a first realization of the MiST concept and its validation in quantitative flow measurements to demonstrate the feasibility of the proposed preparation concept.

Continuous arterial spin labeling using a local magnetic field gradient coil

Continuous arterial spin labeling (ASL) using a locally induced magnetic field gradient for adiabatic inversion of spins in the common carotid artery of human volunteers is demonstrated. The experimental setup consisted of a helmet resonator for imaging, a circular RF surface coil for labeling, and gradient loops to produce a magnetic field gradient. A spin-echo (SE) echo-planar imaging (EPI) sequence was used for imaging. The approach is independent of the gradients of the MR scanner. This technology may be used if the imaging gradient system does not produce an appropriate magnetic field gradient at the location of the carotid artery-for example, in a head-only scanner-and is a prerequisite for the development of a system that allows continuous labeling during the imaging experiment.

Aphasia severity: Association with cerebral perfusion and diffusion

BACKGROUND: Previous studies of the relationship between perfusion, diffusion, and stroke suggest that the extent of cerebral hypoperfusion may be a better indicator of neurological status than lesion size in the early phases of recovery. It is not clear how these factors are related to aphasia severity. AIMS: The purpose of this study was to investigate the relationship between cerebral perfusion, diffusion, and aphasia severity in stroke. METHODS #ENTITYSTARTX00026; PROCEDURE: Nine participants were examined within 24 hours of stroke onset and six were re-examined at 1 month post stroke. The examination included administration of an aphasia test, a face recognition task, and a neuroimaging session including T2-, perfusion-, and diffusion-weighted MRI. OUTCOMES #ENTITYSTARTX00026; RESULTS: Participants with a variety of aphasia types and severity were included in the study. Visual inspection suggested larger perfusion abnormality than the actual lesion in eight of nine subjects at day 1. The correlation between aphasia severity and hypoperfusion was significant at day 1 and at 1 month post stroke. However, this was not the case for the relationship between aphasia severity and lesion size where the correlation was not statistically significant at day 1 or at 1 month post stroke. CONCLUSIONS: These results suggest that cerebral hypoperfusion is a more accurate indicator of aphasia severity in early stroke than lesion volume.

FAIR and dynamic susceptibility contrast-enhanced perfusion imaging in healthy subjects and stroke patients

PURPOSE

To compare dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) and the flow-sensitive alternating inversion recovery (FAIR) technique for measuring brain perfusion.

MATERIALS AND METHODS

We investigated 12 patients with acute stroke, and 10 healthy volunteers with FAIR and DSC maps of regional cerebral blood volume (rCBV), mean transit time (MTT), and regional cerebral blood flow (rCBF).

RESULTS

In volunteers good gray/white-matter contrast was observed in FAIR, rCBF, and rCBV maps. Regions with high signal intensities in FAIR matched well with high values of rCBV and rCBF. In ischemic stroke patients a high correlation (r = 0.78) of the ipsi- to contralateral signal intensity ratios in FAIR and rCBF was observed in areas with perfusion abnormalities. In contrast, FAIR and rCBV (r = 0.50), and FAIR and MTT (r = -0.22) correlated only modestly. Furthermore, FAIR and rCBF demonstrated similar sizes of perfusion abnormality.

CONCLUSION

This study demonstrates for the first time that FAIR and rCBF depict similar relations of perfusion in ischemic stroke patients and healthy subjects.

Comparison of first-pass Gd-DOTA and FAIRER MR perfusion imaging in a rabbit model of pulmonary embolism

PURPOSE

To compare the sensitivity of contrast-enhanced magnetic resonance imaging (MRI) and arterial spin labeling to perfusion deficits in the lung.

MATERIALS AND METHODS

A rabbit model of pulmonary embolism was imaged with both flow-sensitive alternating inversion recovery with an extra radiofrequency pulse (FAIRER) arterial spin labeling and Gd-DOTA enhanced MRI. The signal-to-noise ratio (SNR) was measured in the area of the perfusion deficit and the normal lung for both techniques.

RESULTS

The defect was readily visible in all images. The normal lung had an average of 3.8 +/- 1.2 times the SNR of the unperfused lung with the arterial spin labeling technique, and approximately 13.7 +/- 3.3 times the SNR with the contrast-enhanced technique.

CONCLUSION

Gd-DOTA enhanced MRI provides higher SNR in pulmonary perfusion imaging; however, arterial spin labeling is also adequate and may be used when repeated studies are indicated.

Comparison of quantitative perfusion imaging using arterial spin labeling at 1.5 and 4.0 Tesla

High-field arterial spin labeling (ASL) perfusion MRI is appealing because it provides not only increased signal-to-noise ratio (SNR), but also advantages in terms of labeling due to the increased relaxation time T(1) of labeled blood. In the present study, we provide a theoretical framework for the dependence of the ASL signal on the static field strength, followed by experimental validation in which a multislice pulsed ASL (PASL) technique was carried out at 4T and compared with PASL and continuous ASL (CASL) techniques at 1.5T, both in the resting state and during motor activation. The resting-state data showed an SNR ratio of 2.3:1.4:1 in the gray matter and a contrast-to-noise ratio (CNR) of 2.7:1.1:1 between the gray and white matter for the difference perfusion images acquired using 4T PASL, 1.5T CASL, and 1.5T PASL, respectively. However, the functional data acquired using 4T PASL did not show significantly improved sensitivity to motor cortex activation compared with the 1.5T functional data, with reduced fractional perfusion signal change and increased intersubject variability. Possible reasons for these experimental results, including susceptibility effects and physiological noise, are discussed.

Simultaneous perfusion and BOLD imaging using reverse spiral scanning at 3T: characterization of functional contrast and susceptibility artifacts

Reverse spiral scanning with arterial spin-labeling was developed at 3T to simultaneously detect perfusion and BOLD signals in the brain by subtracting or adding the control and labeled images, respectively, in the same dataset. BOLD contrast was improved with the longer effective echo time achieved in the reverse spiral scan compared to conventional forward spiral scans. Susceptibility artifacts near air-tissue interfaces in the brain were substantially reduced in the reverse spiral images due to their early data acquisition time and, hence, less signal attenuation. Brain activation experiments with the reverse spiral scan were performed on normal subjects and were compared to forward spiral imaging in the same subjects. The experiments demonstrated that reverse spiral imaging was able to detect perfusion and BOLD signals simultaneously and reliably, even in the brain regions with severe susceptibility-induced local gradients, while forward spiral scans were either not optimal for detecting the two functional signals at the same time or were vulnerable to susceptibility artifacts.

Ventilation-perfusion ratio of signal intensity in human lung using oxygen-enhanced and arterial spin labeling techniques

This study investigates the distribution of ventilation-perfusion (V/Q) signal intensity (SI) ratios using oxygen-enhanced and arterial spin labeling (ASL) techniques in the lungs of 10 healthy volunteers. Ventilation and perfusion images were simultaneously acquired using the flow-sensitive alternating inversion recovery (FAIR) method as volunteers alternately inhaled room air and 100% oxygen. Images of the T(1) distribution were calculated for five volunteers for both selective (T(1f)) and nonselective (T(1)) inversion. The average T(1) was 1360 ms +/- 116 ms, and the average T(1f) was 1012 ms +/- 112 ms, yielding a difference that is statistically significant (P < 0.002). Excluding large pulmonary vessels, the average V/Q SI ratios were 0.355 +/- 0.073 for the left lung and 0.371 +/- 0.093 for the right lung, which are in agreement with the theoretical V/Q SI ratio. Plots of the V/Q SI ratio are similar to the logarithmic normal distribution obtained by multiple inert gas elimination techniques, with a range of ratios matching ventilation and perfusion. This MRI V/Q technique is completely noninvasive and does not involve ionized radiation. A limitation of this method is the nonsimultaneous acquisition of perfusion and ventilation data, with oxygen administered only for the ventilation data.

Inversion profiles of adiabatic inversion pulses for flowing spins: the effects on labeling efficiency and labeling accuracy in perfusion imaging with pulsed arterial spin-labeling

The inversion profile of adiabatic inversion pulses is essential to the accuracy of perfusion measurement with pulsed arterial spin-labeling (ASL). In this paper, the inversion profiles for flowing spins were investigated using a numerical solution of the modified Bloch equations including a term for moving spins. Inversion profiles for spins flowing at a constant or varying velocity were examined for hyperbolic secant (HS) and frequency-offset corrected inversion (FOCI) pulses. Distortions of the inversion profiles were found for both pulses with spins flowing within physiological velocity range. The effects of the distorted profiles on labeling efficiency and labeling accuracy in the application of pulsed ASL perfusion imaging were analyzed. These effects should be taken into account in ASL techniques, in order to obtain robust and accurate perfusion measurements.

Technical aspects and utility of fMRI using BOLD and ASL

Functional magnetic resonance imaging (fMRI) is an emerging methodology which provides various approaches to visualizing regional brain activity non-invasively. Although the exact mechanisms underlying the coupling between neural function and fMRI signal changes remain unclear, fMRI studies have been successful in confirming task-specific activation in a variety of brain regions, providing converging evidence for functional localization. In particular, fMRI methods based on blood oxygenation level dependent (BOLD) contrast and arterial spin labeling (ASL) perfusion contrast have enabled imaging of changes in blood oxygenation and cerebral blood flow (CBF). While BOLD contrast has been widely used as the surrogate marker for neural activation and can provide reliable information on the neuroanatomy underlying transient sensorimotor and cognitive functions, recent evidence suggests perfusion contrast is suitable for studying relatively long term effects on CBF both at rest or during activation. New developments in combining or simultaneously measuring the electrophysiological and fMRI signals allow a new class of studies that capitalize on dynamic imaging with high spatiotemporal resolution. This article reviews the biophysical bases and methodologies of fMRI and its applications to the clinical neurosciences, with emphasis on the spatiotemporal resolution of fMRI and its coupling with neurophysiology under both normal and pathophysiological conditions.

Comparison of diffusion-weighted high-resolution CBF and spin-echo BOLD fMRI at 9.4 T

The quantification of blood oxygenation-level dependent (BOLD) functional MRI (fMRI) signals is closely related to cerebral blood flow (CBF) change; therefore, understanding the exact relationship between BOLD and CBF changes on a pixel-by-pixel basis is fundamental. In this study, quantitative CBF changes induced by neural activity were used to quantify BOLD signal changes during somatosensory stimulation in alpha-chloralose-anesthetized rats. To examine the influence of fast-moving vascular spins in quantifying CBF, bipolar gradients were employed. Our data show no significant difference in relative CBF changes obtained with and without bipolar gradients. To compare BOLD and CBF signal changes induced by neural stimulation, a spin-echo (SE) sequence with long SE time of 40 ms at 9.4 T was used in conjunction with an arterial spin labeling technique. SE BOLD changes were quantitatively correlated to CBF changes on a pixel-by-pixel and animal-by-animal basis. Thus, SE BOLD-based fMRI at high magnetic fields allows a quantitative comparison of functional brain activities across brain regions and subjects.

Visual cortex reactivity in sedated children examined with perfusion MRI (FAIR)

Sleeping and sedated children can respond to visual stimulation with a decrease in blood oxygenation level dependent (BOLD) functional MRI signal response. The contribution of metabolic and hemodynamic parameters to this inverse signal response is incompletely understood. It has been hypothesized that it is caused by a relatively greater increase of oxygen consumption compared to rCBF (regional cerebral blood flow) increase. We studied the rCBF changes during visual stimulation in four sedated children, aged 4-71 months, and four alert adults, with an arterial water spin labeling technique (FAIR) and BOLD fMRI in a 1.5T MR scanner. In the children, FAIR signal decreased by a mean of 0.96% (range 0.77-1.05) of the baseline periods of the non-selective images, while BOLD signal decreased by 2.03% (range 1.99-2.93). In the adults, FAIR and BOLD signal increased by 0.88% (range 0.8-0.99) and 2.63% (range 1.99-2.93), respectively. Thus, in the children, an rCBF increase could not be detected by perfusion MRI, but indications of a FAIR signal decrease were found. An rCBF decrease in the primary visual cortex during stimulation has not been reported previously, but it is a possible explanation for the negative BOLD response. Future studies will have to address if this response pattern is a consequence of age or sleep/sedation.

Pulsed arterial spin labeling: comparison of multisection baseline and functional MR imaging perfusion signal at 1.5 and 3.0 T: initial results in six subjects

Flow-alternating inversion-recovery magnetic resonance imaging was performed at 3.0 T to measure cerebral perfusion during rest and motor activation in six healthy adult volunteers. Results were compared with those at 1.5 T. The mean signal-to-noise ratio for both gray matter and white matter perfusion measured with and without vascular suppression at 3.0 T was significantly (P <.01) higher (n = 6) than that at 1.5 T. Brain perfusion activation maps collected during a motor task showed a substantially larger number of activated pixels (>80%) at 3.0 T, with activation in the supplementary motor area in the 3.0-T data that was not present on 1.5-T perfusion maps.

Magnetic resonance studies of brain function and neurochemistry

In the short time since its introduction, magnetic resonance imaging (MRI) has rapidly evolved to become an indispensable tool for clinical diagnosis and biomedical research. Recently, this methodology has been successfully used for the acquisition of functional, physiological, and biochemical information in intact systems, particularly in the human body. The ability to map areas of altered neuronal activity in the brain, often referred to as functional magnetic resonance imaging (fMRI), is probably one of the most significant recent achievements that rely on this methodology. This development has permitted the examination of functional specialization in human and animal brains with unprecedented spatial resolution, as demonstrated by mapping at the level of orientation and ocular dominance columns in the visual cortex. These functional imaging studies are complemented by the ability to study neurochemistry using magnetic resonance spectroscopy, allowing the determination of metabolic processes that support neurotransmission and neurotransmission rates themselves.

Simultaneous BOLD/perfusion measurement using dual-echo FAIR and UNFAIR: sequence comparison at 1.5T and 3.0T

Functional MRI (fMRI) studies designed for simultaneously measuring Blood Oxygenation Level Dependent (BOLD) and Cerebral Blood Flow (CBF) signal often employ the standard Flow Alternating Inversion Recovery (FAIR) technique. However, some sensitivity is lost in the BOLD data due to inherent T1 relaxation. We sought to minimize the preceding problem by employing a modified UN-inverted FAIR (UNFAIR) technique, which (in theory) should provide identical CBF signal as FAIR with minimal degradation of the BOLD signal. UNFAIR BOLD maps acquired from human subjects (n = 8) showed significantly higher mean z-score of approximately 17% (p < 0.001), and number of activated voxels at 1.5T. On the other hand, the corresponding FAIR perfusion maps were superior to the UNFAIR perfusion maps as reflected in a higher mean z-score of approximately 8% (p = 0.013), and number of activated voxels. The reduction in UNFAIR sensitivity for perfusion is attributed to increased motion sensitivity related to its higher background signal, and, T2 related losses from the use of an extra inversion pulse. Data acquired at 3.0T demonstrating similar trends are also presented.

FAIR exempting separate T (1) measurement (FAIREST): a novel technique for online quantitative perfusion imaging and multi-contrast fMRI

A new pulse sequence, dubbed FAIR exempting separate T(1) measurement (FAIREST) in which a slice-selective saturation recovery acquisition is added in addition to the standard FAIR (flow-sensitive alternating inversion recovery) scheme, was developed for quantitative perfusion imaging and multi-contrast fMRI. The technique allows for clean separation between and thus simultaneous assessment of BOLD and perfusion effects, whereas quantitative cerebral blood flow (CBF) and tissue T(1) values are monitored online. Online CBF maps were obtained using the FAIREST technique and the measured CBF values were consistent with the off-line CBF maps obtained from using the FAIR technique in combination with a separate sequence for T(1) measurement. Finger tapping activation studies were carried out to demonstrate the applicability of the FAIREST technique in a typical fMRI setting for multi-contrast fMRI. The relative CBF and BOLD changes induced by finger-tapping were 75.1 +/- 18.3 and 1.8 +/- 0.4%, respectively, and the relative oxygen consumption rate change was 2.5 +/- 7.7%. The results from correlation of the T(1) maps with the activation images on a pixel-by-pixel basis show that the mean T(1) value of the CBF activation pixels is close to the T(1) of gray matter while the mean T(1) value of the BOLD activation pixels is close to the T(1) range of blood and cerebrospinal fluid.

Comparison of the experimental BOLD signal change in event-related fMRI with the balloon model

Event-related functional MRI (ER-fMRI) based on both blood oxygenation level-dependent (BOLD) contrast and cerebral blood flow (CBF) contrast has been developed to study the human brain response to transient stimulation. A balloon model has been developed and used in understanding the relationship between changes in CBF and in the BOLD signal in block-designed fMRI. In this report, the balloon model was used to interpret experimental event-related fMRI. Using experimental data acquired from CBF-based ER-fMRI as an input function in the balloon model, simulated BOLD signal changes were obtained. The simulated time course of the BOLD signal changes was directly compared with the experimentally acquired data. A chi-square (chi(2)) test showed excellent correlation between the simulated and experimental data (alpha <or= 0.05). Our results have demonstrated that the balloon model is useful in interpreting the transient features of the experimental data from the ER-fMRI studies.

MR ventilation-perfusion imaging of human lung using oxygen-enhanced and arterial spin labeling techniques

Magnetic resonance ventilation-perfusion (V/Q) imaging has been demonstrated using oxygen and arterial spin labeling techniques. Inhaled oxygen is used as a paramagnetic contrast agent in ventilation imaging using a multiple inversion recovery (MIR) approach. Pulmonary perfusion imaging is conducted using a flow-sensitive alternating inversion recovery with an extra radiofrequency pulse (FAIRER) technique. A half Fourier single-short turbo spin echo (HASTE) sequence is used for data acquisition in both techniques. V/Q imaging was performed in ten of the twenty volunteers, while either ventilation or perfusion was imaged in the other ten. This V/Q imaging scheme is completely noninvasive, does not involve ionized radiation, and shows promising potential for clinical use in the diagnosis of lung diseases such as pulmonary embolism.

Arterial spin labeling in combination with a look-locker sampling strategy: inflow turbo-sampling EPI-FAIR (ITS-FAIR)

Arterial spin labeling (ASL) permits quantification of tissue perfusion without the use of MR contrast agents. With standard ASL techniques such as flow-sensitive alternating inversion recovery (FAIR) the signal from arterial blood is measured at a fixed inversion delay after magnetic labeling. As no image information is sampled during this delay, FAIR measurements are inefficient and time-consuming. In this work the FAIR preparation was combined with a Look-Locker acquisition to sample not one but a series of images after each labeling pulse. This new method allows monitoring of the temporal dynamics of blood inflow. To quantify perfusion, a theoretical model for the signal dynamics during the Look-Locker readout was developed and applied. Also, the imaging parameters of the new ITS-FAIR technique were optimized using an expression for the variance of the calculated perfusion. For the given scanner hardware the parameters were: temporal resolution 100 ms, 23 images, flip-angle 25.4 degrees. In a normal volunteer experiment with these parameters an average perfusion value of 48.2 +/- 12.1 ml/100 g/min was measured in the brain. With the ability to obtain ITS-FAIR time series with high temporal resolution arterial transit times in the range of -138 - 1054 ms were measured, where nonphysical negative values were found in voxels containing large vessels.

Determination of skeletal muscle perfusion using arterial spin labeling NMRI: validation by comparison with venous occlusion plethysmography

T(1)-based determination of perfusion was performed with the high temporal and spatial resolution that monitoring of exercise physiology requires. As no data were available on the validation of this approach in human muscles, T(1)-based NMRI of perfusion was compared to standard strain-gauge venous occlusion plethysmography performed simultaneously within a 4 T magnet. Two different situations were investigated in 21 healthy young volunteers: 1) a 5-min ischemia of the leg, or 2) a 2-3 min ischemic exercise consisting of a plantar flexion on an amagnetic ergometer. Leg perfusion was monitored over 5-15 min of the recovery phase, after the air-cuff arterial occlusion had been released. The interesting features of the sequence were the use of a saturation-recovery module for the introduction of a T(1) modulation and of single-shot spin echo for imaging. Spatial resolution was 1.7 x 2.0 mm and temporal resolution was 2 s. For data analysis, ROIs were traced on different muscles and perfusion was calculated from the differences in muscle signal intensity in successive images. To allow comparison with the global measurement of perfusion by plethysmography, the T(1)-based NMR measurements in exercising muscles were rescaled to the leg cross-section. The perfusion measurements obtained by plethysmography and NMRI were in close agreement with a correlation coefficient between 0.87 and 0.92. This indicates that pulsed arterial techniques provide determination of muscle perfusion not only with superior spatial and temporal resolution but also with exactitude.

High-sensitivity single-shot perfusion-weighted fMRI

A method is presented for measurement of perfusion changes during brain activation using a single-shot pulsed spin labeling technique. By employing a double-inversion labeling strategy, stationary tissue (background) signal was suppressed while minimally affecting perfusion sensitivity. This allowed omission of the otherwise required reference scan, resulting in twofold-improved temporal resolution. The method was applied to visual and motor cortex activation studies in humans, and compared to standard FAIR-type perfusion labeling techniques. Experiments performed at 1.5T and 3.0T indicate a close to 90% suppression of background signal, at a cost of an 11% and 9%, respectively, reduction in perfusion signal. Combined with the twofold increase in signal averaging, and a reduction in background signal fluctuations, this resulted in a 64% (1.5T, N = 3) and a 128% (3T, N = 4) overall improvement in sensitivity for the detection of activation-related perfusion changes. Magn Reson Med 46:88-94, 2001. Published 2001 Wiley-Liss, Inc.

Theoretical analysis of the effect of imperfect slice profiles on tagging schemes for pulsed arterial spin labeling MRI

Pulsed arterial spin labeling (ASL) techniques provide a noninvasive method of obtaining qualitative and quantitative perfusion images with MRI. ASL techniques employ inversion recovery and/or saturation recovery to induce perfusion weighting, and thus the performance of these techniques is dependent on the slice profiles of the inversion or saturation pulses. This article systematically examines through simulations the effects of slice profile imperfections on the perfusion signal for nine labeling schemes, including FAIR, FAIRER, and EST (UNFAIR). Each sequence is evaluated for quantitative accuracy, suppression of stationary signal, and magnitude of perfusion signal. Perfusion effects are modeled from a modified Bloch equation and experimentally determined slice profiles. The results show that FAIR, FAIRER, and EST have excellent tissue suppression. The magnitude of the perfusion signal is comparable for FAIR and FAIRER, with EST providing a slightly weaker signal. For quantitative measurements, all three methods underestimate the perfusion signal by more than 20%. Of the additional six ASL techniques examined, only one performed well in this model. This method, which combines inversion and saturation recovery, yields improved signal accuracy (<15% difference from the theoretical value) and tissue suppression similar to that of FAIR and its variants, but has only half the signal. Magn Reson Med 46:141-148, 2001.

A tool for comparison of PET and fMRI methods: calculation of the uncertainty in the location of an activation site in a PET image

A technique for calculating the uncertainty in the location of an activation site in a PET image, without performing repeated measures, is presented. With the development of new fMRI methods for measuring cerebral hemodynamics, demonstration of the efficacy of these techniques will be critical to establish clinical utility. Comparisons with PET are a powerful tool for validating these new fMRI techniques. In addition to the fact that PET techniques are well-established methods for making physiological measurements in vivo, PET methods are also free of the geometric distortions and nonuniform signal-to-noise artifacts (due to signal dropout) common in fMRI techniques. Comparisons reported previously have been limited by the large number of trials acquired in single-subject fMRI studies and the small number of trials in a PET study (due to the radiation dose to the patient or the interscan delays for tracer decay). Our method calculates both the center of mass (CM) of a predefined region of interest and the uncertainty in the location of the CM using the preimage PET data (sinograms). Results of phantom studies demonstrate that our method is an unbiased measurement equivalent to that of repeated measures with a large number of images. Extension of this technique to estimate the uncertainty in the location of an activation site in a PET statistical parametric map will permit precise rigorous comparisons of PET and fMRI methods in single subjects without the constraints imposed by the relatively small number of PET measurements.

Improved perfusion quantification in FAIR imaging by offset correction

Perfusion quantification using pulsed arterial spin labeling has been shown to be sensitive to the RF pulse slice profiles. Therefore, in Flow-sensitive Alternating-Inversion Recovery (FAIR) imaging the slice selective (ss) inversion slab is usually three to four times thicker than the imaging slice. However, this reduces perfusion sensitivity due to the increased transit delay of the incoming blood with unperturbed spins. In the present article, the dependence of the magnetization on the RF pulse slice profiles is inspected both theoretically and experimentally. A perfusion quantification model is presented that allows the use of thinner ss inversion slabs by taking into account the offset of RF slice profiles between ss and nonselective inversion slabs. This model was tested in both phantom and human studies. Magn Reson Med 46:193-197, 2001.

Perfusion imaging using spin-labeling methods: contrast-to-noise comparison in functional MRI applications

In this study the performance of FLASH imaging with selective inversion preparation for functional perfusion studies was investigated. In addition to the absolute quantification of perfusion by measurement of the longitudinal relaxation times with global (T(1glob)) and selective (T(1sel)) inversion, the measurement of absolute (BASE) and relative (FAIR) perfusion increases by subtraction of appropriately weighted images was also considered. The subject averages of absolute perfusion obtained by the quantitative method were 70.7 +/- 4.0 ml/100g/min in gray matter, 10.2 +/- 3.4 ml/100g/min in white matter, and 89.0 +/- 3.1 ml/100g/min in visual cortex. These values, as well as the average increase of perfusion due to visual stimulation (44.4 +/- 3.7 ml/100g/min), agree well with respective data reported by PET and other MRI studies. However, for individual subjects the standard deviations over single ROIs inside the visual cortex lay around 100% which prevented the detection of significant activation. BASE and FAIR, on the other hand, were able to detect significant activation in single subjects. The measured average perfusion increases were 51.7 +/- 6.6 ml/100g/min and 56.5 +/- 13.8%, respectively. Magn Reson Med 46:172-182, 2001.

Effect of lung inflation on arterial spin labeling signal in MR perfusion imaging of human lung

The effect of lung inflation on arterial spin-labeling signal in lung perfusion is investigated. Arterial spin-labeling schemes, called alternation of selective inversion pulse (ASI) and its hybrid (HASI), which uses blood water as an endogenous, freely diffusible tracer, were applied to magnetic resonance (MR) perfusion imaging of the lung. Perfusion-weighted images of the lung from nine healthy volunteers were obtained at different time delays. There was a significant signal difference in ASI images acquired at different respiratory phases. Greater signal enhancement has been observed when the volunteers performed breath holding on end expiration than on end inspiration. This is in agreement with the normal physiologic effect of lung inflation on the pressure-flow relationship of pulmonary vasculature. ASI and HASI perfusion-weighted images show similar lung features and image quality. Preliminary results from pulmonary embolism patients indicate that arterial spin labeling is sensitive for the detection of areas of perfusion deficit. J. Magn. Reson. Imaging 2001;13:954-959.

Simultaneous noninvasive measurement of CBF and CBV using double-echo FAIR (DEFAIR)

A new method for measuring cerebral blood flow (CBF) and cerebral blood volume (CBV) noninvasively using MRI is presented. The approach is based on the technique of arterial spin labelling (ASL), in which CBF-based contrast is generated by controlled modulation of the longitudinal magnetization of the blood. The proposed method also uses differences in T(2) between tissue and blood to differentiate the two compartments and allow assessment of the relative size of each. Two successive EPI images are acquired following spin preparation using either a slice-selective or global inversion pulse, and the technique is therefore referred to as double-echo FAIR (DEFAIR). DEFAIR is demonstrated in the normal gerbil brain and during hypothermia, where reductions of both CBF and CBV are known to occur. It is also shown theoretically that this method can be extended to include a measurement of oxygen extraction fraction. The main drawbacks of the technique are the long acquisition time and relatively low sensitivity to hemodynamic changes compared to conventional qualitative T2(*)-weighted BOLD contrast, which may limit its applicability and practical use in monitoring functional cerebral activation. However, the technique can be used repetitively in longer-term time course studies due to its noninvasive and quantitative nature.