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AJNR - American Journal of Neuroradiology

Published ahead of print on March 27, 2008
doi: 10.3174/ajnr.A1030

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American Journal of Neuroradiology 29:1228-1234, August 2008
© 2008 American Society of Neuroradiology

Review Article

Arterial Spin-Labeling in Routine Clinical Practice, Part 1: Technique and Artifacts

A.R. Deibler^a, J.M. Pollock^a, R.A. Kraft^b, H. Tan^b, J.H. Burdette^a and J.A. Maldjian^a

^a Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC
^b Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC

Please address correspondence to Joseph Maldjian, MD, Wake Forest University, Department of Radiology, Medical Center Blvd, Winston-Salem, NC 27157; e-mail: maldjian{at}wfubmc.edu

SUMMARY: The routine use of arterial spin-labeling (ASL) in a clinical population has led to the depiction of diverse brain pathologic features. Unique challenges in the acquisition, postprocessing, and analysis of cerebral blood flow (CBF) maps are encountered in such a population, and high-quality ASL CBF maps can be generated consistently with attention to quality control and with the use of a dedicated postprocessing pipeline. Familiarity with commonly encountered artifacts can help avoid pitfalls in the interpretation of CBF maps. The purpose of this review was to describe our experience with a heterogeneous collection of ASL perfusion cases with an emphasis on methodology and common artifacts encountered with the technique. In a period of 1 year, more than 3000 pulsed ASL cases were performed as a component of routine clinical brain MR evaluation at both 1.5 and 3T. These ASL studies were analyzed with respect to overall image quality and patterns of perfusion on final gray-scale DICOM images and color Joint Photographic Experts Group (JPEG) CBF maps, and common artifacts and their impact on final image quality were categorized.

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