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Arterial spin-labeling MR imaging of cerebral hemorrhages

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages.

Methods

Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations.

Results

Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values.

Conclusion

The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients.

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Acknowledgments

This work was partly supported by Grant-in-Aid for Scientific Research of Japan Society for the Promotion of Science.

Ethical standards and patient consent

We declare that all human and animal studies have been approved by the Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that the IRB waived written, informed consent.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Radiology, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-ku, Tokyo, 162-8655, Japan

    Tomoyuki Noguchi

  2. Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan

    Tomoyuki Noguchi, Masashi Nishihara, Yoshiaki Egashira, Shinya Azama, Tetsuyoshi Hirai, Isao Kitano & Hiroyuki Irie

  3. Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan

    Yusuke Yakushiji

  4. Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga University, Saga, Japan

    Masatou Kawashima

Authors
  1. Tomoyuki Noguchi
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  2. Masashi Nishihara
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  3. Yoshiaki Egashira
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  4. Shinya Azama
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  5. Tetsuyoshi Hirai
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  6. Isao Kitano
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  7. Yusuke Yakushiji
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  8. Masatou Kawashima
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  9. Hiroyuki Irie
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Corresponding author

Correspondence to Tomoyuki Noguchi.

Appendix 1

Appendix 1

The following 4 steps were performed to obtain CBF-ASL values from ASL-MRI.

  1. Step 1

    CBF maps generated by ASL-MRI were converted into a special map named the ANALYZE format by using a free computer software MRIcro (version 1.40 build 1, Professor Chris Rorden, Georgia Institute of Technology, Atlanta GA, USA, http://www.cabiatl.com/mricro/mricro/index.html).

  2. Step 2

    Converted CBF maps were normalized and thereafter smoothed with a value of 8-mm FWHM by using a free computer software package SPM2 (Statistical Parametric Mapping version 2, Institute of Neurology, London, http://www.lion.ucl.ac.uk/spm/) running on a non-free software Matlab (Matlab version 6.5.2, MathWorks Inc., Natick, MA, USA).

  3. Step 3

    Masking ROI maps of the bilateral cerebral hemispheres except lentiform nuclei or cerebral hemispheres except thalami, cerebellar hemispheres, frontal lobes, lentiform nuclei, limbic lobes, occipital lobes, parietal lobes, temporal lobes, and thalami, were created by using a free add-on software WFU Pickatlas (WFU PickAtlas, Joseph Maldjian, MD, Wake Forest University School of Medicine, North Carolina, USA, http://www.fmri.wfubmc.edu/download.htm) running on SPM2, and thereafter the normalization of masking ROI maps was carried out using SPM2.

  4. Step 4

    Hemispheric CBF values were calculated from the normalized and smoothed CBF maps and the normalized hemispheric ROI map using free software ImageJ (Wayne Raqsband, National Institutes of Health, Bethesda, Maryland, USA, http://rsb.info.nih.gov/ij/index.html).

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Noguchi, T., Nishihara, M., Egashira, Y. et al. Arterial spin-labeling MR imaging of cerebral hemorrhages. Neuroradiology 57, 1135–1144 (2015). https://doi.org/10.1007/s00234-015-1574-9

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  • DOI: https://doi.org/10.1007/s00234-015-1574-9

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