Multi-delay arterial spin labeling perfusion MRI in moyamoya disease--comparison with CT perfusion imaging.

To present a multi-delay multi-parametric pseudo-continuous ASL (pCASL) protocol that offers simultaneous measurements of cerebral blood flow (CBF), arterial transit time (ATT) and arterial cerebral blood volume (aCBV) and to evaluate its accuracy by comparison with CT perfusion in moyamoya disease. A 4 post-labeling delay (PLD) pCASL protocol was applied on 17 patients with moyamoya disease who also underwent CT perfusion imaging. ATT was estimated using the multi-delay protocol and included in the calculation of CBF. ASL and CT perfusion images were rated for lesion severity/conspicuity. Pearson correlation coefficients were calculated across voxels between the two modalities in grey and white matter of each subject respectively and between normalized mean values of ASL and CT perfusion measures in major vascular territories. Significant associations between ASL and CT perfusion were detected using subjective ratings, voxel-wise analysis in grey and white matter and region of interest (ROI) based analysis of normalized mean perfusion. The correlation between ASL CBF and CT perfusion was improved using the multi-delay pCASL protocol compared to CBF acquired at a single PLD of 2 s (p<0.05). There is a correlation between perfusion data from ASL and CT perfusion imaging in patients with moyamoya disease. Multi-delay ASL can improve CBF quantification, which could be a prognostic imaging biomarker in patients with moyamoya disease.

提出一种多延迟多参数伪连续动脉自旋标记（pCASL）方案，该方案可同时测量脑血流量（CBF）、动脉通过时间（ATT）和动脉脑血容量（aCBV），并通过与烟雾病的CT灌注对比来评估其准确性。 对17例烟雾病患者应用了一种4个标记后延迟（PLD）的pCASL方案，这些患者也接受了CT灌注成像。使用多延迟方案估计ATT，并将其纳入CBF的计算中。对动脉自旋标记和CT灌注图像的病变严重程度/显著程度进行评级。分别计算每个受试者的灰质和白质中两种模态之间体素的皮尔逊相关系数，以及主要血管区域中动脉自旋标记和CT灌注测量的标准化平均值之间的相关系数。 通过主观评级、灰质和白质的体素分析以及基于感兴趣区域（ROI）的标准化平均灌注分析，检测到动脉自旋标记和CT灌注之间存在显著关联。与在单个2秒标记后延迟获取的CBF相比，使用多延迟pCASL方案时，动脉自旋标记CBF和CT灌注之间的相关性得到改善（p<0.05）。 烟雾病患者的动脉自旋标记灌注数据和CT灌注成像之间存在相关性。多延迟动脉自旋标记可改善CBF定量，这可能是烟雾病患者的一种预后影像生物标志物。