Implication of cerebral circulation time in intracranial stenosis measured by digital subtraction angiography on cerebral blood flow estimation measured by arterial spin labeling

Jann, Kay; Hauf, Martinus; Kellner-Weldon, Frauke; El-Koussy, Marwan; Kiefer, Claus; Federspiel, Andrea; Schroth, Gerhard (2016). Implication of cerebral circulation time in intracranial stenosis measured by digital subtraction angiography on cerebral blood flow estimation measured by arterial spin labeling. Diagnostic and interventional radiology, 22(5), pp. 481-488. Turkish Society of Radiology 10.5152/dir.2016.15204

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PURPOSE Arterial spin labeling (ASL) magnetic resonance imaging to assess cerebral blood flow (CBF) is of increasing interest in basic research and in diagnostic applications, since ASL provides similar information to positron emission tomography about perfusion in vascular territories. However, in patients with steno-occlusive arterial disease (SOAD), CBF as measured by ASL might be underestimated due to delayed bolus arrival, and thus increased spin relaxation. We aimed to estimate the extent to which bolus arrival time (BAT) was delayed in patients with SOAD and whether this resulted in underestimation of CBF. METHODS BAT was measured using digital subtraction angiography (DSA) in ten patients with high-grade stenosis of the middle carotid artery (MCA). Regional CBF was assessed with pseudocontinuous ASL. RESULTS BATs were nonsignificantly prolonged in the stenotic hemisphere 4.1±2.0 s compared with the healthy hemisphere 3.3±0.9 s; however, there were substantial individual differences on the stenotic side. CBF in the anterior and posterior MCA territories were significantly reduced on the stenotic hemisphere. Severe stenosis was correlated with longer BAT and lower quantified CBF. CONCLUSION ASL-based perfusion measurement involves a race between the decay of the spins and the delivery of labeled blood to the region of interest. Special caution is needed when interpreting CBF values quantified in individuals with altered blood flow and delayed circulation times. However, from a clinician's point of view, an accentuation of hypoperfusion (even if caused by underestimation of CBF due to prolonged BATs) might be desirable since it indexes potentially harmful physiologic deficits.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center

UniBE Contributor:

Jann, Kay; Hauf, Martinus; Kellner-Weldon, Frauke; El-Koussy, Marwan; Kiefer, Claus; Federspiel, Andrea and Schroth, Gerhard

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1305-3612

Publisher:

Turkish Society of Radiology

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

13 Sep 2016 14:17

Last Modified:

18 Sep 2016 17:18

Publisher DOI:

10.5152/dir.2016.15204

PubMed ID:

27411297

BORIS DOI:

10.7892/boris.87513

URI:

https://boris.unibe.ch/id/eprint/87513

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