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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 23:381-388, March 2002
© 2002 American Society of Neuroradiology

BRAIN

Quantitative Measurement of Regional Cerebral Blood Flow with Flow-Sensitive Alternating Inversion Recovery Imaging: Comparison with [Iodine 123]-Iodoamphetamin Single Photon Emission CT

Ali Syed Arbab^a, Shigeki Aoki^a, Keiji Toyama^a, Nobuhiko Miyazawa^b, Hiroshi Kumagai^a, Takako Umeda^a, Takao Arai^a, Tsutomu Araki^a, Hiroyuki Kabasawa^c and Yoshiyuki Takahashi^c

^a Department of Radiology Yamanashi Medical University, Yamanashi
^b Department of Neurosurgery Yamanashi Medical University, Yamanashi
^c Department of GE-YMS Tokyo, Japan

Address reprint requests to Ali Syed Arbab, MBBS, PhD, Radiology, Yamanashi Medical University, Shimokato 1110, Tamaho-cho, Nakakoma-gun, Yamanashi 409-3898, Japan

BACKGROUND AND PURPOSE: Flow-sensitive alternating inversion recovery (FAIR) MR imaging is a technique for depicting cerebral perfusion without contrast enhancement. Our purpose was to determine whether quantification at FAIR imaging can be used to assess regional cerebral blood flow (rCBF) in a manner similar to [iodine 123]-iodoamphetamin (¹²³I-IMP) single photon emission CT (SPECT).

METHODS: Nine patients with internal carotid or major cerebral arterial stenosis underwent ¹²³I-IMP SPECT and FAIR imaging (single section, different TIs, 1.5 T) at rest and after acetazolamide (Diamox) stress. FAIR and ¹²³I-IMP rCBF values were compared and correlated. Receiver operating characteristic analysis was conducted to detect hypoperfused segments on FAIR images.

RESULTS: rCBF values of normally perfused segments were 41.53 and 51.91 mL/100 g/min for pre- and post-acetazolamide ¹²³I-IMP studies, respectively. Corresponding values for pre- and post-acetazolamide FAIR images, respectively, were 46.64 and 59.60 mL/100 g/min with a TI of 1200 milliseconds and 53.23 and 68.17 mL/100 g/min with a TI of 1400 milliseconds. ¹²³I-IMP and FAIR resultswere significantly correlated, with both pre- and post-acetazolamide images. Sensitivity (86%) in detecting hypoperfused segments was significantly higher with post-acetazolamide images (TI, 1400 milliseconds), and specificity (82–85%) and accuracy (80–82%) were higher with all pre- and post-acetazolamide images (all TIs).

CONCLUSIONS: The significant correlation, high specificity and accuracy in detecting hypoperfused segments, similar increases in flow on both post-acetazolamide images, and absence of the need for contrast enhancement suggest that FAIR imaging, like nuclear medicine study, is complementary to routine MR imaging in the assessment of cerebral perfusion.

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