A novel application of four-dimensional magnetic resonance angiography using an arterial spin labeling technique for noninvasive diagnosis of Moyamoya disease

Uchino, Haruto; Ito, Masaki; Fujima, Noriyuki; Kazumata, Ken; Yamazaki, Kazuyoshi; Nakayama, Naoki; Kuroda, Satoshi; Houkin, Kiyohiro

doi:10.1016/j.clineuro.2015.07.003

Cited by 30 publications

(24 citation statements)

References 19 publications

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“…Although the ideal spatial resolution has not been standardized yet, the voxel-sizes from previous studies are typically 1.0-1.25 mm in in-plane and 1.0-2.0 mm in through-plane direction (potentially reconstructed at even higher resolution). 1,4,[22][23][24] Therefore, the entire scan-time usually needs to be spent for completing k-space, not for signal averaging as in perfusion imaging. The typical readout sequence used for ASL-MRA is based on gradient-echo sequences, such as turbo field-echo (TFE) 2,3 and spoiled gradient-echo (SPGR), [24][25][26][27] in which quite a number of excitation RF-pulses are applied.…”

Section: Spatial Resolution and Readout Sequencementioning

confidence: 99%

“…using echo planar imaging (EPI) readout. In a turbo field EPI (TFEPI) sequence, 29 a segmented EPI readout (with typical EPI-factor of 5-7 4,30,31 ) is performed after each excitation pulse of the TFE sequence to reduce the number of excitation RF-pulse, thereby limiting the attenuation of the ASL-signal. The downside of inserting an EPI readout is that it causes ghosting artefacts due to pulsatile flow, which happens more frequently in young subjects, typically at the M1 section of the middle cerebral artery (arrows in Fig.…”

Section: Spatial Resolution and Readout Sequencementioning

confidence: 99%

“…31 However, none of these three options should be considered to provide a perfect solution, which explains why PASL is still considered as one of preferred labeling techniques for dynamic ASL-MRA, and has proved its clinical usefulness in several previous clinical studies. [2][3][4][5] When imaging static 3D-MRA, however, the abovementioned dilemma is no longer relevant, and long pCASL labeling duration will ensures visualization of the complete arterial trees from proximal to distal vessels with adequate SNR. 16,25,27 Moreover, a hybrid of pCASL and PASL was suggested when using large FOV for imaging of extracranial carotid arteries, which could also minimize disappearance of the arterial signal due to fresh unlabeled blood flowing into the imaging volume.…”

Section: Labeling Module (General)mentioning

confidence: 99%

“…By taking advantage of this completely non-invasive feature, many studies were conducted to demonstrate that ASL can be an alternative technique for other more invasive techniques using X-ray and/or contrast agent. [1][2][3][4][5][6][7] This would especially be important for pediatric patients who need repetitive examinations to monitor disease progression. Whereas MR contrast agents used to be considered relatively safe, due to the established link between several linear gadolinium contrast agents and nephrogenic systemic fibrosis in patients with poor renal function as well as the recent observation of gadolinium deposition in the brain, 8 the European Medicines Agency decided to recommend the suspension of the use of four linear MR contrast agents and advise to limit the use of gadolinium based contrast agents to the lowest dose for diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Intracranial 3D and 4D MR Angiography Using Arterial Spin Labeling: Technical Considerations

2020

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In the 1980's some of the earliest studies of arterial spin labeling (ASL) MRI have demonstrated its ability to generate MR angiography (MRA) images. Thanks to many technical improvements, ASL has been successfully moving its position from the realm of research into the clinical area, albeit more known as perfusion imaging than as MRA. For MRA imaging, other techniques such as time-of-flight, phase contrast MRA and contrast-enhanced (CE) MRA are more popular choices for clinical applications. In the last decade, however, ASL-MRA has been experiencing a remarkable revival, especially because of its non-invasive nature, i.e. the fact that it does not rely on the use of contrast agent. Very importantly, there are additional benefits of using ASL for MRA. For example, its higher flexibility to achieve both high spatial and temporal resolution than CE dynamic MRA, and the capability of vessel specific visualization, in which the vascular tree arising from a selected artery can be exclusively visualized. In this article, the implementation and recent developments of ASL-based MRA are discussed; not only focusing on the basic sequences based upon pulsed ASL or pseudo-continuous ASL, but also including more recent labeling approaches, such as vessel-selective labeling, velocity-selective ASL, vessel-encoded ASL and time-encoded ASL. Although these ASL techniques have been already utilized in perfusion imaging and their usefulness has been suggested by many studies, some additional considerations should be made when employing them for MRA, since there is something more than the difference of the spatial resolution of the readout sequence. Moreover, extensive discussion is included on what readout sequence to use, especially by highlighting how to achieve high spatial resolution while keeping scan-time reasonable such that the ASL-MRA sequence can easily be included into a clinical examination.

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Section: Spatial Resolution and Readout Sequencementioning

confidence: 99%

Section: Spatial Resolution and Readout Sequencementioning

confidence: 99%

Section: Labeling Module (General)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intracranial 3D and 4D MR Angiography Using Arterial Spin Labeling: Technical Considerations

2020

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“…By subtraction of these two images, the background static tissue signal is cancelled out and the inflow of the labeled arterial blood is visualized. The mean acquisition time of previously reported ASL‐based 4D‐MRA is approximately 7 minutes (5 min–8.5 min) , which is not always fast enough to enable its use in clinical protocols.…”

Section: Introductionmentioning

confidence: 99%

Acceleration of ASL‐based time‐resolved MR angiography by acquisition of control and labeled images in the same shot (ACTRESS)

Suzuki

Fujima

Ogino³

et al. 2017

Magnetic Resonance in Med

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PurposeNoncontrast 4D‐MR‐angiography (MRA) using arterial spin labeling (ASL) is beneficial because high spatial and temporal resolution can be achieved. However, ASL requires acquisition of labeled and control images for each phase. The purpose of this study is to present a new accelerated 4D‐MRA approach that requires only a single control acquisition, achieving similar image quality in approximately half the scan time.MethodsIn a multi‐phase Look‐Locker sequence, the first phase was used as the control image and the labeling pulse was applied before the second phase. By acquiring the control and labeled images within a single Look‐Locker cycle, 4D‐MRA was generated in nearly half the scan time of conventional ASL. However, this approach potentially could be more sensitive to off‐resonance and magnetization transfer (MT) effects. To counter this, careful optimizations of the labeling pulse were performed by Bloch simulations. In in‐vivo studies arterial visualization was compared between the new and conventional ASL approaches.ResultsOptimization of the labeling pulse successfully minimized off‐resonance effects. Qualitative assessment showed that residual MT effects did not degrade visualization of the peripheral arteries.ConclusionThis study demonstrated that the proposed approach achieved similar image quality as conventional ASL‐MRA approaches in just over half the scan time. Magn Reson Med 79:224–233, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

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Arterial Spin Labeling‐Based MR Angiography for Cerebrovascular Diseases: Principles and Clinical Applications

Togao,

Obara,

Yamashita

et al. 2023

Magnetic Resonance Imaging

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Arterial spin labeling (ASL) is a noninvasive imaging technique that labels the proton spins in arterial blood and uses them as endogenous tracers. Brain perfusion imaging with ASL is becoming increasingly common in clinical practice, and clinical applications of ASL for intracranial magnetic resonance angiography (MRA) have also been demonstrated. Unlike computed tomography (CT) angiography and cerebral angiography, ASL‐based MRA does not require contrast agents. ASL‐based MRA overcomes most of the disadvantages of time‐of‐flight (TOF) MRA. Several schemes have been developed for ASL‐based MRA; the most common method has been pulsed ASL, but more recently pseudo‐continuous ASL, which provides a higher signal‐to‐noise ratio (SNR), has been used more frequently. New methods that have been developed include direct intracranial labeling methods such as velocity‐selective ASL and acceleration‐selective ASL. MRA using an extremely short echo time (eg, silent MRA) or ultrashort echo‐time (TE) MRA can suppress metal susceptibility artifacts and is ideal for patients with a metallic device implanted in a cerebral vessel. Vessel‐selective 4D ASL MRA can provide digital subtraction angiography (DSA)‐like images. This review highlights the principles, clinical applications, and characteristics of various ASL‐based MRA techniques.Level of Evidence5Technical EfficacyStage 2

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A novel application of four-dimensional magnetic resonance angiography using an arterial spin labeling technique for noninvasive diagnosis of Moyamoya disease

Cited by 30 publications

References 19 publications

Intracranial 3D and 4D MR Angiography Using Arterial Spin Labeling: Technical Considerations

Intracranial 3D and 4D MR Angiography Using Arterial Spin Labeling: Technical Considerations

Acceleration of ASL‐based time‐resolved MR angiography by acquisition of control and labeled images in the same shot (ACTRESS)

Arterial Spin Labeling‐Based MR Angiography for Cerebrovascular Diseases: Principles and Clinical Applications

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