Arterial spin labeling perfusion in neonates

Tortora, Domenico; Severino, Mariasavina; Rossi, Andrea

doi:10.1016/j.siny.2020.101130

Cited by 12 publications

(6 citation statements)

References 54 publications

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“…In this study, the CBF values of the focal area in the study subjects at PLD1.5s and PLD2.5s were significantly lower than that of the control area. 3DASL is a non-invasive and quantitative diagnostic method, which can accurately evaluate blood flow in the entire brain, determine the blood flow status of the local infarction area, quantitatively analyze blood flow velocity, and evaluate the establishment of collateral circulation, which is of crucial significance for the formulation of a treatment plan and the evaluation of its curative effect[ 13 - 15 ].…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Jiang¹,

Zhong²,

Zuo³

2022

WJCC

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BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction, especially since the onset of thrombolytic therapy takes 1-6 h. Therefore, early diagnosis and evaluation of cerebral infarction is important. AIM To investigate the diagnostic value of magnetic resonance multi-delay three-dimensional arterial spin labeling (3DASL) and diffusion kurtosis imaging (DKI) in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia. METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included. All patients in the acute stage underwent magnetic resonance-based examination, and the data were processed by the system’s own software. The apparent diffusion coefficient (ADC), average diffusion coefficient (MD), axial diffusion (AD), radial diffusion (RD), average kurtosis (MK), radial kurtosis (fairly RK), axial kurtosis (AK), and perfusion parameters post-labeling delays (PLD) in the focal area and its corresponding area were compared. The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging (T2WI) was analyzed. RESULTS The DKI parameters of focal and control areas in the study subjects were compared. The ADC, MD, AD, and RD values in the lesion area were significantly lower than those in the control area. The MK, RK, and AK values in the lesion area were significantly higher than those in the control area. The MK/MD value in the infarct lesions was used to determine the matching situation. MK/MD < 5 mm was considered matching and MK/MD ≥ 5 mm was considered mismatching. PLD1.5s and PLD2.5s perfusion parameters in the central, peripheral, and control areas of the infarct lesions in MK/MD-matched and -unmatched patients were not significantly different. PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and -unmatched patients were significantly lower than those in peripheral and control areas. The MK and MD maps showed a lesion area of 20.08 ± 5.74 cm 2 and 22.09 ± 5.58 cm 2 , respectively. T2WI showed a lesion area of 19.76 ± 5.02 cm 2 . There were no significant differences in the cerebral infarction lesion areas measured using the three methods. MK, MD, and T2WI showed a good correlation. CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction. 3DASL can effectively determine the changes in perfusion levels in the lesion area. There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Jiang¹,

Zhong²,

Zuo³

2022

WJCC

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“…In our centre, after long discussions, taking into account all the pros and cons, we agreed - as a consensus among neonatologists, anaesthesiologists, and radiologists - that all newborns are examined under general anaesthesia. That is why motion artifacts are not a limiting factor when using ASL in neonatal neuroimaging in most cases [ 2 ]. And if they are, the obtained images may serve as neuroradiological artworks [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our neonates were examined between the ages of 28 and 46 gestational weeks, and we could observe lower brain perfusion in preterm neonates compared to those at the end of the neonatal period. It has already been demonstrated that whole brain CBF increases during the first weeks of life due to vivid processes of development and maturation [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Arterial spin labeling in neonatal magnetic resonance imaging – first experience and new observations

Bekiesińska‐Figatowska

Szkudlińska-Pawlak

Kwaśniewicz

et al. 2021

Pol J Radiol

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IntroductionArterial spin labeling (ASL) is a noninvasive non-contrast technique of perfusion imaging that uses endogenous water from the blood as the perfusion tracer, with very scant data on its use in neonates. The authors present the added value of ASL in the examined babies in their own material and discuss it in the light of the existing literature.Material and methodsDuring the first 10 months after the purchase of a new magnetic resonance imaging (MRI) scanner, 123 neonates were examined using it in an MR-compatible incubator, 117 of them had brain MRI, and in 104 ASL was incorporated in the routine protocol, which resulted in prolongation of the study time by approximately 4 minutes. 3D ASL sequence uses Pulsed Continuous Arterial Spin Labeling (PCASL; aka pseudo continuous) technique.ResultsThe quality of the cerebral blood flow (CBF) maps was good in all cases but 2 because all the babies were sedated. Apart from the knowledge about normal perfusion patterns in the preterm and term neonatal brains, the use of ASL sequence provided important additional information in 11 cases (10.8%): increased CBF correlating with electroencephalographic seizure localization in otherwise normal MRI (n = 1), increased CBF in the cortex without clinical information about seizures and with posthaemorrhagic changes (n = 1), increased CBF in the brain stem and decreased in the upper parts of the brain (n = 2), probably reflecting the homeostatic mechanism which allows preferential perfusion of the vital structures of the brain stem, hypoperfusion (n = 1) or hypoperfusion with peripheral hyperperfusion (n = 1) in the area of stroke, hypoperfusion of the posterior areas of the brain in the presence of subarachnoid or epidural haemorrhage (n = 3), significantly increased CBF in the presumed nidus of arteriovenous malformation causing haemorrhage (n = 1), and lack of perfusion in the supratentorial compartment in a case of suspected brain death (n = 1).ConclusionsOur short experience but relatively large volume of material encourages the use of ASL in routine neonatal MRI as a useful and non-time-consuming tool providing additional important clinical information in a significant percentage of cases.

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“…Overall flow velocities may be further reduced in the setting of perinatal asphyxia and other birth complications. 28,80 In preterm infants, the cerebral circulation and neuroglial progenitor cells are immature, such that ischemic injury impacts the draining medullary veins and germinal matrix remnants. This can lead to white matter injury and intraventricular hemorrhage, respectively.…”

Section: Vasculopathymentioning

confidence: 99%

Multidelay ASL of the pediatric brain

Golay

2022

The British Journal of Radiology

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Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is the choice of postlabel delay (PLD), which refers to the timing between the labeling of arterial free water and measurement of flow into the brain. Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF calculations using arterial transit time (ATT) correction. This approach is particularly helpful in situations where ATT is unknown, including young subjects and slow-flow conditions. In this article, we discuss the technical considerations for MDASL, including labeling techniques, quantitative metrics, and technical artifacts. We then provide a practical summary of key clinical applications with real-life imaging examples in the pediatric brain, including stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor, infection, and metabolic disease.

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Arterial spin labeling perfusion in neonates

Cited by 12 publications

References 54 publications

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Three-dimensional arterial spin labeling and diffusion kurtosis imaging in evaluating perfusion and infarct area size in acute cerebral ischemia

Arterial spin labeling in neonatal magnetic resonance imaging – first experience and new observations

Multidelay ASL of the pediatric brain

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