Assessment of Collateral Supply by Two-Coil Continuous Arterial Spin Labeling after Coil Occlusion of the Internal Carotid Artery

H.E Moller,C Zimmer,D Y Von Cramon,T Mildner,C Preul

doi:10.3174/ajnr.a0552

Abstract

A patient undergoing coil occlusion of a left internal carotid artery aneurysm was investigated by continuous arterial spin labeling MR imaging to evaluate perfusion territory mapping. Labeling was restricted to the left- or right-sided carotid artery by use of a separate neck coil. Before embolization, perfusion contrast was largely restricted to the labeled hemisphere. After embolization, perfusion contrast was created symmetrically in both hemispheres on labeling the right side, verifying sufficient collateral supply.

Highlights

In carotid artery occlusive disease, the degree of stenosis is a critical parameter in the potential development of stroke.[1]
Knowledge of the amount of compromise of cerebral blood flow (CBF), of the affected perfusion territories, and of the status of collaterals would be desirable for assessing the hemodynamic status of the brain and predicting the outcome
The goal was to evaluate the potential of perfusion territory imaging for an assessment of the hemodynamic status of the brain in a patient undergoing coil occlusion of the internal carotid artery (ICA)

Summary

CASE REPORT

SUMMARY: A patient undergoing coil occlusion of a left internal carotid artery aneurysm was investigated by continuous arterial spin labeling MR imaging to evaluate perfusion territory mapping. Approaches for mapping the flow territories of major brain-supplying arteries have been suggested.[2,3,4,5,6] For this study, we used continuous arterial spin labeling (CASL) with a local transmit coil at the neck for selectively labeling the blood of either the right or left carotid artery and a separate head coil for imaging.[2] The goal was to evaluate the potential of perfusion territory imaging for an assessment of the hemodynamic status of the brain in a patient undergoing coil occlusion of the internal carotid artery (ICA).

Findings

Discussion

Conclusion