Mapping of vertebral artery perfusion territories using arterial spin labeling MRI

Abstract

Purpose: To demonstrate the use of a noninvasive arterial spin labeling (ASL) MRI technique and evaluate vertebral artery (VA) territories in the brain. Materials and Methods:Vessel-encoded ASL was used to determine the territories of the left and right VAs in five healthy subjects. Territory maps were analyzed quantitatively by comparing the fractional contributions of the left and right VAs in selected regions of interest within the brain.Results: VA territory maps demonstrated a complicated pattern of perfusion to the posterior aspect of the brain, but were consistent with the posterior cerebral and cerebellar artery distributions. Cerebellar perfusion was predominantly ipsilateral (P Ͻ 0.01). The total left and right VA contributions were unequal (P Ͻ 0.01), and there was relatively little mixing in the vertebrobasilar system. Conclusion:Vessel-encoded ASL can reveal individual VA territories in the brain. In a small sample of healthy volunteers the VAs appeared to contribute unequally, provide predominantly ipsilateral supply to the cerebellum, and undergo minimal mixing in the basilar artery.

Blind detection of vascular sources and territories using random vessel encoded arterial spin labeling

“…Apparently in all five of the subjects studied, there is a sufficient lack of mixing in at least some portion of the posterior territory that both vertebral arteries could be identified. This is consistent with [13] in which a general lack of complete vertebral mixing was found, but it is not yet known whether this is reliably the case across the population.…”

Hemodynamic Alterations in Vertebrobasilar Large Artery Disease Assessed by Arterial Spin-Labeling MR Imaging

“…8,19,22 In addition, to our knowledge, this is the first study that has attempted to assess fitting results from the ASL model in a clinical population. Analyses could be extended to incorporate the number of ASL difference pairs that are required to produce reliable estimates 23 or by using a bootstrap approach on the residuals to assess the reliability of the ASL estimates.…”

“…ASL studies have shown that it is possible to assess perfusion specifically for the posterior circulation in the occipital region. 8,9 Patients with VB stenotic disease have a high risk of recurrent ischemic events. [10][11][12] In addition, intervention in VB stenotic disease is associated with a high procedural risk and its benefit is currently the object of clinical trials (eg, Vertebral Artery Ischemia Stent Placement Trial, Vertebral Artery Stent Placement Trial).…”

Perfusion territory imaging of intracranial branching arteries – optimization of continuous artery‐selective spin labeling (CASSL)

“…This technique, referred to as selective or regional ASL, is unique, as no other method exists to map perfusion territories with a direct correspondence between anatomy and perfusion territory. Selective ASL has already found widespread application and has made it possible to address several clinical questions in normal and diseased populations (1)(2)(3)(4)(5)(6)(7)(8)(9).…”