PT  - JOURNAL ARTICLE
AU  - S. Hara
AU  - Y. Tanaka
AU  - Y. Ueda
AU  - S. Hayashi
AU  - M. Inaji
AU  - K. Ishiwata
AU  - K. Ishii
AU  - T. Maehara
AU  - T. Nariai
TI  - Noninvasive Evaluation of CBF and Perfusion Delay of Moyamoya Disease Using Arterial Spin-Labeling MRI with Multiple Postlabeling Delays: Comparison with <sup>15</sup>O-Gas PET and DSC-MRI
AID  - 10.3174/ajnr.A5068
DP  - 2017 Feb 16
TA  - American Journal of Neuroradiology
4099  - http://www.ajnr.org/content/early/2017/02/16/ajnr.A5068.short
4100  - http://www.ajnr.org/content/early/2017/02/16/ajnr.A5068.full
AB  - BACKGROUND AND PURPOSE: Arterial spin-labeling MR imaging with multiple postlabeling delays has a potential to evaluate various hemodynamic parameters. To clarify whether arterial spin-labeling MR imaging can identify CBF and perfusion delay in patients with Moyamoya disease, we compared arterial spin-labeling, DSC, and 15O-gas PET in terms of their ability to identify these parameters.MATERIALS AND METHODS: Eighteen patients with Moyamoya disease (5 men, 13 women; ages, 21–55 years) were retrospectively analyzed. CBF values of pulsed continuous arterial spin-labeling using 2 postlabeling delays (short arterial spin-labeling, 1525 ms; delayed arterial spin-labeling, 2525 ms) were compared with CBF values measured by 15O-gas PET. All plots were divided into 2 groups by the cutoff of time-based parameters (the time of the maximum observed concentration, TTP, MTT, delay of MTT to cerebellum, and disease severity [symptomatic or not]). The ratio of 2 arterial spin-labeling CBFs (delayed arterial spin-labeling CBF to short arterial spin-labeling CBF) was compared with time-based parameters: time of the maximum observed concentration, TTP, and MTT.RESULTS: The short arterial spin-labeling–CBF values were significantly correlated with the PET-CBF values (r = 0.63; P = .01). However, the short arterial spin-labeling–CBF value dropped in the regions with severe perfusion delay. The delayed arterial spin-labeling CBF overestimated PET-CBF regardless of the degree of perfusion delay. Delayed arterial spin-labeling CBF/short arterial spin-labeling CBF was well correlated with the time of the maximum observed concentration, TTP, and MTT (ρ = 0.71, 0.64, and 0.47, respectively).CONCLUSIONS: Arterial spin-labeling using 2 postlabeling delays may detect PET-measured true CBF and perfusion delay in patients with Moyamoya disease. Provided its theoretic basis and limitations are considered, noninvasive arterial spin-labeling could be a useful alternative for evaluating the hemodynamics of Moyamoya disease.AbbreviationsASLarterial spin-labelingdASLdelayed arterial spin-labelingMTT delaydelay of MTT to cerebellumPLDpostlabeling delaysASLshort arterial spin-labelingTmaxtime of the maximum observed concentration