Arterial spin labelled imaging for Moyamoya disease

The four-dimensional pseudo-continuous arterial spin labeling (4D-pCASL)-based angiography using CENTRA-keyhole and view sharing (4D-PACK) provided better visualization and higher contrast-to-noise ratio (CNR) in distal cerebral arteries and leptomeningeal anastomosis (LMA) collaterals compared with contrast inherent inflow-enhanced multiphase angiography (CINEMA) 1)


Post-label delay times of ≥4 seconds are needed and may be combined with multidelay strategies for robust ASL assessment of CBF in Moyamoya disease 2).


ASL-PWI may provide a reliable and noninvasive means of predicting angiographic vascularity of meningiomas. It may thus assist in selecting potential candidates for preoperative digital subtraction angiography and embolization in clinical practice. 3).


High-grade pediatric brain tumors display higher CBF than do low-grade tumors, and they may be accurately graded by using these values. CBF is correlated with tumor microvascular density 4).


A study clearly demonstrates that the initial use of ASL and DWI could help to diagnose partial nonconvulsive status epilepticus (NCSE) and also combined use of the MRI and EEG allows documentation of the pathophysiological mechanism in each patient 5).


1)
Togao O, Hiwatashi A, Obara M, Yamashita K, Momosaka D, Nishimura A, Arimura K, Hata N, Yoshimoto K, Iihara K, Van Cauteren M, Honda H. 4D ASL-based MR angiography for visualization of distal arteries and leptomeningeal collateral vessels in moyamoya disease: a comparison of techniques. Eur Radiol. 2018 Nov;28(11):4871-4881. doi: 10.1007/s00330-018-5462-7. Epub 2018 May 8. PMID: 29737389.
2)
Fan AP, Guo J, Khalighi MM, Gulaka PK, Shen B, Park JH, Gandhi H, Holley D, Rutledge O, Singh P, Haywood T, Steinberg GK, Chin FT, Zaharchuk G. Long-Delay Arterial Spin Labeling Provides More Accurate Cerebral Blood Flow Measurements in Moyamoya Patients: A Simultaneous Positron Emission Tomography/MRI Study. Stroke. 2017 Aug 1. pii: STROKEAHA.117.017773. doi: 10.1161/STROKEAHA.117.017773. [Epub ahead of print] PubMed PMID: 28765286.
3)
Yoo RE, Yun TJ, Cho YD, Rhim JH, Kang KM, Choi SH, Kim JH, Kim JE, Kang HS, Sohn CH, Park SW, Han MH. Utility of arterial spin labeling perfusion magnetic resonance imaging in prediction of angiographic vascularity of meningiomas. J Neurosurg. 2016 Sep;125(3):536-43. doi: 10.3171/2015.8.JNS151211. Epub 2016 Jan 29. PubMed PMID: 26824378.
4)
Dangouloff-Ros V, Deroulers C, Foissac F, Badoual M, Shotar E, Grévent D, Calmon R, Pagès M, Grill J, Dufour C, Blauwblomme T, Puget S, Zerah M, Sainte-Rose C, Brunelle F, Varlet P, Boddaert N. Arterial Spin Labeling to Predict Brain Tumor Grading in Children: Correlations between Histopathologic Vascular Density and Perfusion MR Imaging. Radiology. 2016 Nov;281(2):553-566. PubMed PMID: 27257950.
5)
Shimogawa T, Morioka T, Sayama T, Haga S, Kanazawa Y, Murao K, Arakawa S, Sakata A, Iihara K. The initial use of arterial spin labeling perfusion and diffusion-weighted magnetic resonance images in the diagnosis of nonconvulsive partial status epileptics. Epilepsy Res. 2016 Dec 21;129:162-173. doi: 10.1016/j.eplepsyres.2016.12.008. [Epub ahead of print] PubMed PMID: 28092848.
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