MR Imaging of Individual Perfusion Reorganization Using Superselective Pseudocontinuous Arterial Spin-Labeling in Patients with Complex Extracranial Steno-Occlusive Disease.

Richter, V; Helle, M; van Osch, M J P; Lindner, T; Gersing, A S; Tsantilas, P; Eckstein, H-H; Preibisch, C; Zimmer, C

doi:10.3174/ajnr.A5090

journal article

Titel:: MR Imaging of Individual Perfusion Reorganization Using Superselective Pseudocontinuous Arterial Spin-Labeling in Patients with Complex Extracranial Steno-Occlusive Disease.
Dokumenttyp:: Journal Article
Autor(en):: Richter, V; Helle, M; van Osch, M J P; Lindner, T; Gersing, A S; Tsantilas, P; Eckstein, H-H; Preibisch, C; Zimmer, C
Abstract:: Patients with multiple stenoses or occlusions of the extracranial arteries require an individualized diagnostic approach. We evaluated the feasibility and clinical utility of a novel MR imaging technique for regional perfusion imaging in this patient group.Superselective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients (10 women, 70.05 ± 10.55 years of age) with extracranial steno-occlusive disease. Thirty-three had infarct lesions. DSC-MR imaging was performed in 16/50 (32%), and cerebral DSA, in 12/50 patients (24%). Vascular anatomy and the distribution of vessel stenoses and occlusions were defined on sonography and TOF-MRA. Stenoses were classified according to the NASCET criteria. Infarct lesions and perfusion deficits were defined on FLAIR and DSC-MR imaging, respectively. Individual perfusion patterns were defined on the superselective pseudocontinuous arterial spin-labeling maps and were correlated with vascular anatomy and infarct lesion localization.The superselective pseudocontinuous arterial spin-labeling imaging sequence could be readily applied by trained technicians, and the additional scan time of 12.7 minutes was well-tolerated by patients. The detected vessel occlusions/stenoses and perfusion patterns corresponded between cerebral DSA and superselective pseudocontinuous arterial spin-labeling maps in all cases. Perfusion deficits on DSC-CBF maps significantly correlated with those on superselective pseudocontinuous arterial spin-labeling maps (Pearson r = 0.9593, P < .01). Individual collateral recruitment patterns were not predictable from the vascular anatomy in 71% of our patients.Superselective pseudocontinuous arterial spin-labeling is a robust technique for regional brain perfusion imaging, suitable for the noninvasive diagnostics of individual perfusion patterns in patients with complex cerebrovascular disease.
Zeitschriftentitel:: AJNR Am J Neuroradiol
Jahr:: 2017
Band / Volume:: 38
Heft / Issue:: 4
Seitenangaben Beitrag:: 703-711
Sprache:: eng
Volltext / DOI:: doi:10.3174/ajnr.A5090
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/28183839
Print-ISSN:: 0195-6108
TUM Einrichtung:: Fachgebiet Gefäßchirurgie (Prof. Eckstein); Fachgebiet Neuroradiologie (Prof. Zimmer)
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