Simultaneous multislice acquisition with arterial-flow tagging (SMART) using echo planar imaging (EPI)

Clinical neuroimaging using arterial spin-labeled perfusion magnetic resonance imaging

The two most common methods for measuring perfusion with MRI are based on dynamic susceptibility contrast (DSC) and arterial spin labeling (ASL). Although clinical experience to date is much more extensive with DSC perfusion MRI, ASL methods offer several advantages. The primary advantages are that completely noninvasive absolute cerebral blood flow (CBF) measurements are possible with relative insensitivity to permeability, and that multiple repeated measurements can be obtained to evaluate one or more interventions or to perform perfusion-based functional MRI. ASL perfusion and perfusion-based functional MRI methods have been applied in many clinical settings, including acute and chronic cerebrovascular disease, CNS neoplasms, epilepsy, aging and development, neurodegenerative disorders, and neuropsychiatric diseases. Recent technical advances have improved the sensitivity of ASL perfusion MRI, and increasing use is expected in the coming years. The present review focuses on ASL perfusion MRI and applications in clinical neuroimaging.

Arterial Spin Labeling: Benefits and Pitfalls of High Magnetic Field

Arterial spin labeling (ASL) techniques are MR imaging methods designed to measure the endogenous perfusion signal coming from arterial blood by manipulation of its magnetization. These methods are based on the subtraction of two consecutively acquired images: one acquired after preparation of the arterial blood magnetization upstream to the area of interest, and the second without any manipulation of its arterial magnetization. The subtraction of both images provides information on the perfusion of the tissue present in the slice of interest. Because ASL is a very low SNR technique, the shift from 1.5 T to 3.0 T should be regarded as a great way to increase signal-to-noise ratio (SNR). Furthermore, the concomitant increase in blood T(1) should improve the SNR of ASL further. Other effects related to poorer magnetic filed homogeneities and reduced T(2) relaxation times, however, will counterbalance both effects partially. In this article, the pros and cons of the use of ASL at high field are summarized, after a brief description of the major techniques used and their theoretical limitations. Finally, a summary of the few existing dedicated ASL perfusion techniques available are presented.

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.

Methodology of brain perfusion imaging

Numerous techniques have been proposed in the last 15 years to measure various perfusion-related parameters in the brain. In particular, two approaches have proven extremely successful: injection of paramagnetic contrast agents for measuring cerebral blood volumes (CBV) and arterial spin labeling (ASL) for measuring cerebral blood flows (CBF). This review presents the methodology of the different magnetic resonance imaging (MRI) techniques in use for CBV and CBF measurements and briefly discusses their limitations and potentials.

Measuring cerebral blood flow using magnetic resonance imaging techniques

Magnetic resonance imaging techniques measuring CBF have developed rapidly in the last decade, resulting in a wide range of available methods. The most successful approaches are based either on dynamic tracking of a bolus of a paramagnetic contrast agent (dynamic susceptibility contrast) or on arterial spin labeling. This review discusses their principles, possible pitfalls, and potential for absolute quantification and outlines clinical and neuroscientific applications.

Multislice perfusion and perfusion territory imaging in humans with separate label and image coils

An arterial spin labeling technique using separate RF labeling and imaging coils was used to obtain multislice perfusion images of the human brain at 3 T. Continuous RF irradiation at a peak power of 0.3 W was applied to the carotid arteries to adiabatically invert spins. Labeling was achieved without producing magnetization transfer effects since the B1 field of the labeling coil did not extend into the imaging region or couple significant power into the imaging coil. Eliminating magnetization transfer allowed the acquisition of multislice perfusion images of arbitrary orientation. Combining surface coil labeling with a reduced RF duty cycle permitted significantly lower SAR than single coil approaches. The technique was also found to allow selective labeling of blood in either carotid, providing an assessment of the artery's perfusion territory. In normal subjects, these territories were well-defined and localized to the ipsilateral hemisphere.