Flow-sensitive Alternating Inversion Recovery Research Articles

The importance of RF bandwidth for effective tagging in pulsed arterial spin labeling MRI at 9.4T

The movement towards MRI at higher field strengths (>7T) has enhanced the appeal of arterial spin labeling (ASL) for many applications due to improved SNR of the measurements. Greater field strength also introduces increased magnetic susceptibility effects resulting in marked B(0) field inhomogeneity. Although B(0) field perturbations can be minimised by shimming over the imaging volume, marked field inhomogeneity is likely to remain within the labeling region for pulsed ASL (PASL). This study highlights a potential source of error in cerebral blood flow quantification using PASL at high field. We show that labeling efficiency in flow-sensitive alternating inversion recovery (FAIR) displayed marked sensitivity to the RF bandwidth of the inversion pulse in a rat model at 9.4T. The majority of preclinical PASL studies have not reported the bandwidth of the inversion pulse. We show that a high bandwidth pulse of > = 15 kHz was required to robustly overcome the field inhomogeneity in the labeling region at high field strength, which is significantly greater than the inversion bandwidth ~2-3 kHz used in previous studies. Unless SAR levels are at their limit, we suggest the use of a high bandwidth labeling pulse for most PASL studies.

Optimization of flow-sensitive alternating inversion recovery (FAIR) for perfusion functional MRI of rodent brain

Arterial spin labeling (ASL) MRI provides a noninvasive method to image perfusion, and has been applied to map neural activation in the brain. Although pulsed labeling methods have been widely used in humans, continuous ASL with a dedicated neck labeling coil is still the preferred method in rodent brain functional MRI (fMRI) to maximize the sensitivity and allow multislice acquisition. However, the additional hardware is not readily available and hence its application is limited. In this study, flow-sensitive alternating inversion recovery (FAIR) pulsed ASL was optimized for fMRI of rat brain. A practical challenge of FAIR is the suboptimal global inversion by the transmit coil of limited dimensions, which results in low effective labeling. By using a large volume transmit coil and proper positioning to optimize the body coverage, the perfusion signal was increased by 38.3% compared with positioning the brain at the isocenter. An additional 53.3% gain in signal was achieved using optimized repetition and inversion times compared with a long TR. Under electrical stimulation to the forepaws, a perfusion activation signal change of 63.7 ± 6.3% can be reliably detected in the primary somatosensory cortices using single slice or multislice echo planar imaging at 9.4 T. This demonstrates the potential of using pulsed ASL for multislice perfusion fMRI in functional and pharmacological applications in rat brain.

MR perfusion imaging by alternate slab width inversion recovery arterial spin labeling (AIRASL): a technique with higher signal-to-noise ratio at 3.0 T

To propose a new arterial spin labeling (ASL) perfusion-imaging method (alternate slab width inversion recovery ASL: AIRASL) that takes advantage of the qualities of 3.0T. AIRASL utilizes alternate slab width IR pulses for labeling blood to obtain a higher signal-to-noise ratio (SNR). Numerical simulations were used to evaluate perfusion signals. In vivo studies were performed to show the feasibility of AIRASL on five healthy subjects. We performed a statistical analysis of the differences in perfusion SNR measurements between flow-sensitive alternating inversion recovery (FAIR) and AIRASL. In signal simulation, the signal obtained by AIRASL at 3.0 and 1.5T was 1.14 and 0.85%, respectively, whereas the signal obtained by FAIR at 3.0 and 1.5T was 0.57 and 0.47%, respectively. In an in vivo study, the SNR of FAIR (3.0T) and FAIR (1.5T) were 1.73±0.49 and 1.02±0.20, respectively, whereas the SNRs of AIRASL (3.0T) and AIRASL (1.5T) were 3.93±1.65 and 1.34±0.31, respectively. SNR in AIRASL at 3.0T was significantly greater than that in FAIR at 3.0T. The most significant potential advantage of AIRASL is its high SNR, which takes advantage of the qualities of 3.0T. This sequence can be easily applied in the clinical setting and will enable ASL to become more relevant for clinical application.

Perfusion MR imaging: Evolution from initial development to functional studies

A critical indicator of tissue viability and function is blood delivery to the capillary bed (referred to as perfusion or tissue/capillary blood flow), so the measurement of this process has been pursued by many MR scientists. Perfusion MRI is currently an effective tool to non-invasively quantify cerebral blood flow (CBF) and to easily obtain its relative change due to neural activity or other stimulus. This article describes the author's experiences in perfusion MRI over the past quarter-century, including initial development of the field, development of a flow-sensitive alternating inversion recovery (FAIR) MRI technique, development of a functional oxygen consumption MRI measurement approach, validation of the FAIR technique, characterization of perfusion changes induced by neural activity, and determination of arterial blood volume.

Cerebral blood flow quantification in the rat: a direct comparison of arterial spin labeling MRI with radioactive microsphere PET

BackgroundArterial spin labeling magnetic resonance imaging (ASL-MRI) has been recognised as a valuable method for non-invasive assessment of cerebral blood flow but validation studies regarding quantification accuracy by comparison against an accepted gold standard are scarce, especially in small animals. We have conducted the present study with the aim of comparing ASL flow-sensitive alternating inversion recovery (FAIR)-derived unidirectional water uptake (K1) and 68Ga/64Cu microsphere (MS)-derived blood flow (f) in the rat brain.MethodsIn 15 animals, K1and f were determined successively in dedicated small animal positron emission tomography and MR scanners. The Renkin-Crone model modified by a scaling factor was used for the quantification of f and K1.ResultsBelow about 1 mL/min/mL, we obtain an approximately linear relationship between f and K1. At higher flow values, the limited permeability of water at the blood brain barrier becomes apparent. Within the accessed dynamic flow range (0.2 to 1.9 mL/min/mL), the data are adequately described by the Renkin-Crone model yielding a permeability surface area product of (1.53±0.46) mL/min/mL.ConclusionThe ASL-FAIR technique is suitable for absolute blood flow quantification in the rat brain when using a one-compartment model including a suitable extraction correction for data evaluation.Trial registration24-9168.21-4/2004-1 (registered in Freistadt Sachsen, Landesdirektion Dresden)

Arterial Spin Labeled CMR Detects Clinically Relevant Increase in Myocardial Blood Flow With Vasodilation

This study sought to determine whether arterial spin labeled (ASL) cardiac magnetic resonance (CMR) is capable of detecting clinically relevant increases in regional myocardial blood flow (MBF) with vasodilator stress testing in human myocardium. Measurements of regional myocardial perfusion at rest and during vasodilatation are used to determine perfusion reserve, which indicates the presence and distribution of myocardial ischemia. ASL CMR is a perfusion imaging technique that does not require any contrast agents, and is therefore safe for use in patients with end-stage renal disease, and capable of repeated or continuous measurement. Myocardial ASL scans at rest and during adenosine infusion were incorporated into a routine CMR adenosine induced vasodilator stress protocol and was performed in 29 patients. Patients who were suspected of having ischemic heart disease based on first-pass imaging also underwent x-ray angiography. Myocardial ASL was performed using double-gated flow-sensitive alternating inversion recovery tagging and balanced steady-state free precession imaging at 3-T. Sixteen patients were found to be normal and 13 patients were found to have visible perfusion defect based on first-pass CMR using intravenous gadolinium chelate. In the normal subjects, there was a statistically significant difference between MBF measured by ASL during adenosine infusion (3.67 ± 1.36 ml/g/min), compared to at rest (0.97 ± 0.64 ml/g/min), with p < 0.0001. There was also a statistically significant difference in perfusion reserve (MBF(stress)/MBF(rest)) between normal myocardial segments (3.18 ± 1.54) and the most ischemic segments in the patients with coronary artery disease identified by x-ray angiography (1.44 ± 0.97), with p = 0.0011. This study indicates that myocardial ASL is capable of detecting clinically relevant increases in MBF with vasodilatation and has the potential to identify myocardial ischemia.

Pseudo‐continuous arterial spin labeling at very high magnetic field (11.75 T) for high‐resolution mouse brain perfusion imaging

With the increasing number of transgenic mouse models of human brain diseases, there is a need for a sensitive method that allows assessing quantitative whole brain perfusion within a reasonable scan time. Arterial spin labeling (ASL), an MRI technique that permits the noninvasive quantification of cerebral blood flow, has been used to assess rodents brain perfusion. For mice, the reported experiments performed with continuous or pulsed ASL were challenged by poor multislice capability, limited sensitivity, or quantification issues. Here, the recently proposed pseudo-continuous ASL strategy, which has shown great promise for human studies, was investigated for mouse brain perfusion imaging at 11.75 T. Pseudo-continuous ASL was experimentally optimized and compared with a standard flow-sensitive alternating inversion recovery sequence for sensitivity, robustness, absolute quantification, and multislice imaging capability. A sensitivity gain up to 40% and clear advantages for multislice imaging are obtained with pseudo-continuous ASL.

Comparison of increased venous contrast in ischemic stroke using phase-sensitive MR imaging with perfusion changes on flow-sensitive alternating inversion recovery at 3 Tesla

Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas. To compare venous contrast on phase-sensitive MR images (PSI) with perfusion change on flow-sensitive alternating inversion recovery (FAIR) images, and to discuss the clinical use of PSI in ischemic stroke. Thirty patients with clinically suspected acute infarction of the middle cerebral artery (MCA) territory within 7 days of onset were evaluated. Phase-sensitive imaging (PSI), flow-sensitive alternating inversion recovery (FAIR), diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) were obtained using 3 Tesla scanner. Two neuroradiologists independently reviewed the MR images, as well as the PSI, DWI, and FAIR images. They were blinded to the clinical data and to each other's findings. The abnormal area of each image was ultimately identified after both neuroradiologists reached consensus. We analyzed areas of increased venous contrast on PSI, perfusion changes on FAIR images and signal changes on DWI for each case. Venous contrast increased on PSI and hypoperfusion was evident on FAIR images from 22 of the 30 patients (73%). The distribution of the increased venous contrast was the same as that of the hypoperfused areas on FAIR images in 16 of these 22. The extent of these lesions was larger than that of lesions visualized by on DWI in 18 of the 22 patients. Hypointense signals reflecting hemorrhage and no increased venous contrast on PSI and hyperperfusion on FAIR images were found in six of the remaining eight patients (20%). Findings on PSI were normal and hypoperfusion areas were absent on FAIR images of two patients (7%). Increased venous contrast on PSI might serve as an index of misery perfusion and provide useful information.

Reproducibility of renal perfusion MR imaging in native and transplanted kidneys using non‐contrast arterial spin labeling

To examine both inter-visit and intra-visit reproducibility of a MR arterial spin labeling (ASL) perfusion technique in native and transplanted kidneys over a broad range of renal function. Renal perfusion exams were performed at 1.5 T in a total of 24 subjects: 10 with native and 14 with transplanted kidneys. Using a flow-sensitive alternating inversion recovery (FAIR) ASL scheme, 32 control/tag pairs were acquired and processed using a single-compartment model. Two FAIR-ASL MR exams were performed at least 24 h apart on all the subjects to assess inter-visit reproducibility. ASL perfusion measurements were also repeated back-to-back within one scanning session in 8 native subjects and in 12 transplant subjects to assess intra-visit reproducibility. Intra-class correlations (ICCs) and coefficients of variation (CVs) were calculated as metrics of reproducibility. Intra-visit ICCs ranged from 0.96 to 0.98 while CVs ranged from 4.8 to 6.0%. Inter-visit measurements demonstrated slightly more variation with ICCs from 0.89 to 0.94 and CVs from 7.6 to 13.1%. Medullary perfusion demonstrated greater variability compared with cortical blood flow: intra-visit ICCs from 0.72 to 0.78 and CVs from 16.7 to 26.7%, inter-visit ICCs from 0.13 to 0.63 and CVs from 19.8 to 37%. This study indicates that a FAIR-ASL perfusion technique is reproducible in the cortex of native and transplanted kidneys over a broad range in renal function. In contrast, perfusion measurements in the medulla demonstrated moderate to poor reproducibility for intra-visit and inter-visit measures respectively.

Pseudocontinuous arterial spin labeling perfusion magnetic resonance imaging—A normative study of reproducibility in the human brain

Pseudocontinuous arterial spin labeling (PCASL), a newly proposed perfusion magnetic resonance imaging (MRI) technique, has the potential of providing a better balance between labeling efficiency and signal-to-noise ratio than conventional ASL methods. The advantage will not be exploitable until adequate reproducibility can be achieved. In this study, we investigated the reproducibility of PCASL on twelve healthy volunteers by taking into account the inclusion of correction for coil sensitivity (CS) and labeling efficiency (α). Each subject underwent two identical sessions scheduled two weeks apart. For comparison, pulsed ASL (PASL) imaging was also conducted using the flow-sensitive alternating inversion recovery method. MR imaging was performed on a 3T whole body system using a 12-channel phased array for reception. Blood flow was quantified for gray matter and assessed globally as well as in the flow territories of the internal carotid arteries and posterior cerebral arteries. Experimental results showed that CS accounted for 35% and 60% of inter-session variability in PCASL and PASL, respectively. With CS correction alone, coefficient of variance (CV) remained larger with PCASL than PASL (p=0.02). CV was 12% with CS-corrected PASL and 11% with PCASL when CS and α were corrected for in conjunction. We concluded that CS correction is necessary for ASL imaging when using phased array receiver and that after CS correction, PCASL requires α correction to provide reproducibility comparable to PASL.

Myocardial ASL perfusion reserve test detects ischemic segments in initial cohort of 10 patients with angiographic CAD

Background Myocardial ASL is a technique for the assessment of myocardial blood flow (MBF) without contrast agents. It can be safely applied to patients with end-stage renal disease who are not candidates for first-pass imaging with contrast agents. Myocardial ASL perfusion imaging performed at rest and during adenosine stress provides perfusion reserve (MBFstress/MBFrest), which is a common indicator for the severity of coronary artery disease. In healthy myocardium, perfusion reserve is known to be approximately four [1]. Methods Twenty nine patients were recruited from those scheduled for routine cardiac MR (CMR) and X-ray angiography. Myocardial ASL measurements were obtained from a single mid short-axis slice at rest and during adenosine infusion (dosage: 0.14 mg/kg/min) on a GE Signa 3T scanner. The ASL sequence was composed of flow-sensitive alternating inversion recovery (FAIR) tagging and balanced steady-state free precession (SSFP) imaging [2]. Perfusion reserve maps were generated in a standard short-axis view illustration by convolution with a Gaussian filter and resampling onto a polar coordinate [3]. Results Ten of the twenty-nine patients were found to have significant stenosis on X-ray angiography. Table 1 contains the most ischemic myocardial segments in these ten patients as identified by two cardiologists using either X-ray angiogram or ASL perfusion reserve map independently. Based on McNemar’ st est with Bonferroni correction, there was no significant difference between X-ray and ASL MRI in identifying ischemia in all six myocardial segments (p = 1.0000, 0.6170, 0.4795, 0.1336, 0.4795, and 0.4795). Figure 1 contains perfusion reserve maps acquired using myocardial ASL in these patients. The average standard deviation of physiological noise

Arterial spin labeled MRI detects clinically relevant increases in myocardial blood flow with vasodilatation

OBJECTIVES This study sought to determine whether arterial spin labeled (ASL) cardiac magnetic resonance (CMR) is capable of detecting clinically relevant increases in regional myocardial blood flow (MBF) with vasodilator stress testing in human myocardium. BACKGROUND Measurements of regional myocardial perfusion at rest and during vasodilatation are used to determine perfusion reserve, which indicates the presence and distribution of myocardial ischemia. ASL CMR is a perfusion imaging technique that does not require any contrast agents, and is therefore safe for use in patients with end-stage renal disease, and capable of repeated or continuous measurement. METHODS Myocardial ASL scans at rest and during adenosine infusion were incorporated into a routine CMR adenosine induced vasodilator stress protocol and was performed in 29 patients. Patients who were suspected of having ischemic heart disease based on first-pass imaging also underwent x-ray angiography. Myocardial ASL was performed using double-gated flow-sensitive alternating inversion recovery tagging and balanced steady-state free precession imaging at 3-T. RESULTS Sixteen patients were found to be normal and 13 patients were found to have visible perfusion defect based on first-pass CMR using intravenous gadolinium chelate. In the normal subjects, there was a statistically significant difference between MBF measured by ASL during adenosine infusion (3.67 1.36 ml/g/min), compared to at rest (0.97 0.64 ml/g/min), with p 0.0001. There was also a statistically significant difference in perfusion reserve (MBFstress/MBFrest) between normal myocardial segments (3.18 1.54) and the most ischemic segments in the patients with coronary artery disease identified by x-ray angiography (1.44 0.97), with p 0.0011. CONCLUSIONS This study indicates that myocardial ASL is capable of detecting clinically relevant increases in MBF with vasodilatation and has the potential to identify myocardial ischemia. (J Am Coll Cardiol Img 2011;4:1253– 61) © 2011 by the American College of Cardiology Foundation

Improved renal perfusion measurement with a dual navigator‐gated Q2TIPS fair technique

A dual navigator-gated, flow-sensitive alternating inversion recovery (FAIR) true fast imaging with steady precession (True-FISP) sequence has been developed for accurate quantification of renal perfusion. FAIR methods typically overestimate renal perfusion when respiratory motion causes the inversion slice to move away from the imaging slice, which then incorporates unlabeled spins from static tissue. To overcome this issue, the dual navigator scheme was introduced to track inversion and imaging slices, and thus to ensure the same position for both slices. Accuracy was further improved by a well-defined bolus length, which was achieved by a modification version of Q2TIPS (quantitative imaging of perfusion using a single subtraction, second version with interleaved thin-slice TI(1) periodic saturation): a series of saturation pulses was applied to both sides of the imaging slice at a certain time after the inversion. The dual navigator-gated technique was tested in eight volunteers. The measured renal cortex perfusion rates were between 191 and 378 mL/100 g/min in the renal cortex with a mean of 376 mL/100 g/min. The proposed technique may prove most beneficial for noncontrast-based renal perfusion quantification in young children and patients who may have difficulty holding their breath for prolonged periods or are sedated/anesthetized.

Evaluation of angiogenesis of VX2 soft tissue tumor by arterial spin labeling perfusion imaging

Objective To evaluate the relationship between the blood flow values generated from MR arterial spin labeling (ASL) perfusion imaging and pathologic indicators of angiogenesis including microvascular density (MVD) counts and vascular endothelial growth factor (VEGF) expression levels of VX2 carcinoma in rabbit soft tissue. Methods VX2 tumor was inoculated in the muscular tissue of right posterior limbs of 18 healthy New Zealand white rabbits ,on which arterial spin labeling perfusion imaging was performed by using flow sensitive alternating inversion recovery pulse sequence 3 to 4 weeks later. Arterial spin labeling images were transferred to an independent computer for post-processing and blood flow (BF) maps were generated from them. BF values were measured in 2-4 regions of interest (ROIs) for each tumor. The rabbits were sacrificed after MR imaging. The gross specimens of tumors were obtained and tumor tissues were taken from the non-necrotic regions corresponding to ROIs on BF maps. Immunohistochemical staining of the specimens was performed by using CD31 monoclonal antibody to calculate MVD counts, using VEGF antibody to calculate VEGF expression levels. Correlation between BF values and MVD counts as well as between BF values and VEGF expression levels was evaluated using Spearman correlative analysis.Results On BF maps, viable tumor tissues showed high BF values compared with muscle, but there were areas without blood perfusion in some tumors. Under microscope, the microvessels positively stained by CD31 appeared as light brown areas, and the cells positively staied by VEGF showed reddish brown areas within their cytoplasm. Totally 39 pieces of VX2 tumor tissue were analyzeed There was a significant positive correlation between the BF values(M =6. 4 ml · 100 g-1 · min-1 ) and MVD counts(M =6. 8) (r = 0. 906,P ＜ 0. 01 ), and no significant correlation between BF values and VEGF expression levels ( M = 8％ ) ( r =0. 116, P=0.483). Conclusion BF value can be used in evaluating angiogenesis of soft tissue tumor through its reflection of MVD counts, and thus may be helpful in evaluating the prognosis of soft tissue tumor and making plan for their treatment. Key words: Magnetic resonance imaging; Perfusion; Arterial spin labeling; Soft tissue tumor; Angiogenesis

Arterial spin labeling MRI for assessment of perfusion in native and transplanted kidneys

PurposeTo apply a magnetic resonance arterial spin labeling (ASL) technique to evaluate kidney perfusion in native and transplanted kidneys. Materials and MethodsThis study was compliant with the Health Insurance Portability and Accountability Act and approved by the institutional review board. Informed consent was obtained from all subjects. Renal perfusion exams were performed at 1.5 T in a total of 25 subjects: 10 with native and 15 with transplanted kidneys. A flow-sensitive alternating inversion recovery (FAIR) ASL sequence was performed with respiratory triggering in all subjects and under free-breathing conditions in five transplant subjects. Thirty-two control/tag pairs were acquired and processed using a single-compartment model. Perfusion in native and transplanted kidneys was compared above and below an estimated glomerular filtration rate (eGFR) threshold of 60 ml/min per 1.73 m2 and correlations with eGFR were determined. ResultsIn many of the transplanted kidneys, major feeding vessels in the coronal plane required a slice orientation sagittal to the kidney. Renal motion during the examination was observed in native and transplant subjects and was corrected with registration. Cortical perfusion correlated with eGFR in native (r=0.85, P=.002) and transplant subjects (r=0.61, P=.02). For subjects with eGFR >60 ml/min per 1.73 m2, native kidneys demonstrated greater cortical (P=.01) and medullary (P=.04) perfusion than transplanted kidneys. For subjects with eGFR <60 ml/min per 1.73 m2, native kidneys demonstrated greater medullary perfusion (P=.04) compared to transplanted kidneys. Free-breathing acquisitions provided renal perfusion measurements that were slightly lower compared to the coached/triggered technique, although no statistical differences were observed. ConclusionIn conclusion, FAIR-ASL was able to measure renal perfusion in subjects with native and transplanted kidneys, potentially providing a clinically viable technique for monitoring kidney function.

Feasibility of FAIR imaging for evaluating tumor perfusion

To evaluate the feasibility of flow-sensitive alternating inversion recovery (FAIR) for measuring blood flow in tumor models. In eight mice tumor models, FAIR and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was performed. The reliability for measuring blood flow on FAIR was evaluated using the coefficient of variation of blood flow on psoas muscle. Three regions of interest (ROIs) were drawn in the peripheral, intermediate, and central portions within each tumor. The location of ROI was the same on FAIR and DCE-MR images. The correlation between the blood flow on FAIR and perfusion-related parameters on DCE-MRI was evaluated using the Pearson correlation coefficient. The coefficient of variation for measuring blood flow was 9.8%. Blood flow on FAIR showed a strong correlation with Kep (r = 0.77), percent relative enhancement (r = 0.73), and percent enhancement ratio (r = 0.81). The mean values of blood flow (mL/100 g/min) (358 vs. 207), Kep (sec(-) (1)) (7.46 vs. 1.31), percent relative enhancement (179% vs. 134%), and percent enhancement ratio (42% vs. 26%) were greater in the peripheral portion than in the central portion (P < 0.01). As blood flow measurement on FAIR is reliable and closely related with that on DCE-MR, FAIR is feasible for measuring tumor blood flow.

High‐sensitivity cerebral perfusion mapping in mice by kbGRASE‐FAIR at 9.4 T

The combination of flow-sensitive alternating inversion recovery (FAIR) and single-shot k-space-banded gradient- and spin-echo (kbGRASE) is proposed here to measure perfusion in the mouse brain with high sensitivity and stability. Signal-to-noise ratio (SNR) analysis showed that kbGRASE-FAIR boosts image and temporal SNRs by 2.01 ± 0.08 and 2.50 ± 0.07 times, respectively, when compared with standard single-shot echo planar imaging (EPI)-FAIR implemented in our experimental systems, although the practically achievable spatial resolution was slightly reduced. The effects of varying physiological parameters on the precision and reproducibility of cerebral blood flow (CBF) measurements were studied following changes in anesthesia regime, capnia and body temperature. The functional MRI time courses with kbGRASE-FAIR showed a more stable response to 5% CO(2) than did those with EPI-FAIR. The results establish kbGRASE-FAIR as a practical and robust protocol for quantitative CBF measurements in mice at 9.4 T.

Flow-sensitive alternating inversion recovery (fair) imaging for retrograde cortical venous drainage related to intracranial dural arteriovenous fistula

To evaluate the hypothesis that flow-sensitive alternating inversion recovery (FAIR) magnetic resonance (MR) imaging can detect retrograde cortical venous drainage (RCVD) in patients with intracranial dural arteriovenous fistula (DAVF). Seven patients with angiographically confirmed DAVF with RCVD and two DAVF patients without RCVD underwent examinations with conventional MR imaging and FAIR, five of these seven patients with RCVD also underwent examination with dynamic susceptibility contrast (DSC) MR imaging. The ability of FAIR to depict prominent cerebral veins was evaluated, and FAIR was compared with the relative cerebral blood volume (rCBV) maps created with DSC. In all DAVF patients with RCVD, FAIR clearly showed prominent veins on the surface of the brain in affected hemisphere, and FAIR corresponded well with the areas of increased rCBV. In all DAVF patients without RCVD, FAIR showed no prominent veins. FAIR can detect RCVD in patients with DAVF.

Accurate, localized quantification of white matter perfusion with single‐voxel ASL

Quantification of perfusion in white matter is still difficult due to its low level, causing an often insufficiently low signal-to-noise ratio, and its long and inhomogeneous transit delays. Here, a technique is presented that accurately measures white matter perfusion by combining a spectroscopic single-voxel localization technique (point-resolved spectroscopy) with a pulsed arterial spin labeling encoding scheme (flow-sensitive alternating inversion recovery) to specifically address the properties of white matter. The transit delay was measured by shifting the position of a slice-selective saturation pulse between inversion and acquisition. Perfusion measurements resulted in values of 15.6 ± 3.2 mL/100 g/min in the left and 15.2 ± 4.8 mL/100 g/min in the right hemispheric white matter and 83.2 ± 15.2 mL/100 g/min in cortical gray matter. Taking dispersion of the transit times into account does not cause a significant change in the measured values.

Magnetic resonance perfusion imaging without contrast media

Principles of magnetic resonance imaging techniques providing perfusion-related contrast weighting without administration of contrast media are reported and analysed systematically. Especially common approaches to arterial spin labelling (ASL) perfusion imaging allowing quantitative assessment of specific perfusion rates are described in detail. The potential of ASL for perfusion imaging was tested in several types of tissue. After a systematic comparison of technical aspects of continuous and pulsed ASL techniques the standard kinetic model and tissue properties of influence to quantitative measurements of perfusion are reported. For the applications demonstrated in this paper a flow-sensitive alternating inversion recovery (FAIR) ASL perfusion preparation approach followed by true fast imaging with steady precession (true FISP) data recording was developed and implemented on whole-body scanners operating at 0.2, 1.5 and 3 T for quantitative perfusion measurement in various types of tissue. ASL imaging provides a non-invasive tool for assessment of tissue perfusion rates in vivo. Images recorded from kidney, lung, brain, salivary gland and thyroid gland provide a spatial resolution of a few millimetres and sufficient signal to noise ratio in perfusion maps after 2-5 min of examination time. Newly developed ASL techniques provide especially high image quality and quantitative perfusion maps in tissues with relatively high perfusion rates (as also present in many tumours). Averaging of acquisitions and image subtraction procedures are mandatory, leading to the necessity of synchronization of data recording to breathing in abdominal and thoracic organs.