Abstract
Ischemic cerebrovascular disease (ICVD) is a kind of brain dysfunction caused by intracranial vascular disease, which has a serious threat to the patient's quality of life. With the development of ICVD in the direction of high incidence and young age, the early diagnosis of ICVD has become an urgent need in clinical practice. Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) as a completely non-invasive perfusion imaging method can reflect changes of cerebral blood flow, and has been used in the study of ICVD. The aim of this paper is to review the research progress of 3D-pCASL in ICVD. By reviewing to the relevant domestic and foreign literatures on the value of ASL in ICVD in the past ten years, we found that 3D-pCASL technique has some advantages in the early evaluation of the abnormal perfusion of cerebral blood flow, the differential diagnosis, the reperfusion after cerebral infarction, the ischemic penumbra and the evaluation of prognosis, which has important guiding significance for the prevention of ICVD and the determination of the next treatment. Moreover, with the development of ASL technology and the appearance of new perfusion imaging method of ASL technology, it shows that it plays an inestimable role in the study of ischemic cerebrovascular diseases. In conclusion the role of 3D-pCASL in the cerebral perfusion of ICVD has been confirmed and has a very broad application prospect.
Highlights
Ischemic cerebrovascular disease (ICVD), mainly including transient ischemic attack (TIA) and cerebral infarction, refers to the disease of cerebral dysfunction due to decreased or disrupted cerebral blood flow caused by cerebral vascular stenosis, occlusion or carotid plaque rupture and thrombosis [1]
3D-pCASL does not require the injection of any contrast agent, so it has low cost and high repeatability of detection; more importantly, its imaging adopts water molecules in arterial blood as the endogenous tracer agent, rather than the blood-brain barrier, which is critical for evaluation on reperfusion after infarction of cerebral infarction patients
The new vessels of reperfusion after infarction would be lack of complete blood-brain barrier, which would greatly reduce the accuracy of dynamic susceptibility-weighted contrast-enhanced (DSC) relying on blood-brain-barrier imaging; 3D-pCASL does not rely on blood-brain barrier model, so it can reflect the presence of reperfusion more realistically [13]
Summary
Ischemic cerebrovascular disease (ICVD), mainly including transient ischemic attack (TIA) and cerebral infarction, refers to the disease of cerebral dysfunction due to decreased or disrupted cerebral blood flow caused by cerebral vascular stenosis, occlusion or carotid plaque rupture and thrombosis [1]. Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) is an imaging technique that may carry out non-invasive monitoring of blood flow changes. With the continuous progress of 3D-pCASL technology in recent years, its application value in ICVD has been increased year by year [4,5]. Through utilizing water molecules in autologous arterial blood as the endogenous tracer agent, ASL technique may quantitatively measure cerebral blood flow (CBF) based on. Lina Zhu et al.: Research Status of Three-Dimensional Pseudo-Continuous Arterial Spin Labeling in Ischemic Cerebrovascular Diseases signal changes resulted from labeled and unlabeled blood flowing through tissues. With the continuous improvement of ASL, pseudo-CASL (pCASL), selective ASL (SASL), velocity-selective ASL (VSASL), acceleration-selective arterial spin labeling (AccASL) and vessel-encoded arterial spin labeling (VE-ASL) have been successively proposed, which have broadened the clinical application of ASL. PCASL is the most widely used technique among all what mentioned above
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