Journal Article Ppublish
PubMed: 40384685 DOI: 10.21037/qims-24-2274
Whole-cerebrum three-dimensional pseudo-continuous arterial spin labeling at 5T: reproducibility and preliminary application in moyamoya.
Quant Imaging Med Surg 15(5):3824-3838
Authors: Xiaoyuan Fan, Zhonghui Li, Guangsong Han, Gan Sun, Hualu Han, Yuehui Hong, Shuo Chen, Hui You, Jun Ni, Guobin Li, Mingli Li, Feng Feng
Affiliations
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Theranostics and Translational Research Center, National Infrastructures for Translational Medicine, Institute of Clinical Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
- Shanghai United Imaging Healthcare, Shanghai, China.
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China. State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Abstract
Background
Pseudo-continuous arterial spin labeling (PCASL) at 7T benefits from increased signal-to-noise ratio (SNR) and prolonged T1, but suffers from field inhomogeneities and increased specific absorption rate (SAR). We proposed that 5T magnetic resonance imaging (MRI) system may be a balanced choice for PCASL imaging. The aim of this study was to achieve whole-cerebrum PCASL imaging at ultra-high field 5T MRI system, assess the reproducibility and preliminarily explore its clinical application in moyamoya disease/syndrome.
Methods
Twenty healthy volunteers were prospectively recruited for the reproducibility analysis. Both single-delay and multi-delay PCASL sequences were scanned twice on the 5T MRI scanner separated by a 10-minute period. Uncorrected cerebral blood flow (uCBF) from single-delay arterial spin labeling (ASL), corrected cerebral blood flow (cCBF) and arterial transit time (ATT) from multi-delay ASL were computed. The reproducibility of uCBF, cCBF and ATT were evaluated by calculating intraclass correlation coefficient (ICC), within-subject coefficient of variation (wsCV) and Pearson correlation coefficients between twice scans in grey matter regions and white matter (WM). Also, 26 patients diagnosed with moyamoya disease/syndrome were included and underwent multi-delay PCASL. The severity of intracranial arteries was graded as magnetic resonance angiography (MRA) score using time-of-flight (TOF) MRA. The relationship between MRA score and cCBF/ATT were assessed by one-way analysis of variance and Pearson correlation analysis.
Results
uCBF, cCBF and ATT showed excellent reliability in all regions with ICCs ranging from 0.856 to 0.962, wsCVs ranging from 2.39% to 6.76% and Pearson correlation coefficients ranging from 0.865 to 0.966. Multi-delay ASL demonstrated superior reproducibility of CBF quantification compared to single-delay ASL in regions with heterogeneous transit time, including WM, occipital lobe, limbic system and subcortical region. In patients with moyamoya disease/syndrome, those with higher anterior cerebral artery (ACA) or middle cerebral artery (MCA) scores exhibited lower cCBF (P<0.05). Correlation analysis showed that MRA score was negatively associated with cCBF (r=-0.540, P<0.001) and positively associated with ATT (r=0.515, P<0.001).
Conclusions
Whole-cerebrum PCASL imaging at 5T ultra-high field was achieved with good reproducibility and applied well in patients with moyamoya disease/syndrome, which offers a promising tool in the assessment of hemodynamic conditions in cerebrovascular diseases.
MeSH
Blood, Cerebral Arteries, Multiple Chronic Conditions, Arteries, Blood Circulation, Moyamoya Disease, Cerebrum