Measurement of changes in perfusion after carotid endarterectomy by 3D pseudo-continuous arterial spin labeling

Abstract Background:Carotid endarterectomy (CEA) is an effective method for treating cerebral ischemia caused by carotid stenosis, but there may be a risk of perfusion pressure breakthrough during early perfusion recovery. As a non-invasive and contrast-free magnetic resonance examination method, arterial spin labeling can be used for continuous observation and measurement in the early postoperative period of carotid endarterectomy. Results: Nineteen patients with severe unilateral carotid stenosis were examined using 3D pseudo-continuous arterial spin labeling before and after CEA, and we found that the pattern of dynamic cerebral blood flow changes is not the same in different regions.Conclusions: 3D pseudo-continuous arterial spin labeling might be helpful for the improvement of postoperative treatment and care of severe unilateral carotid stenosis patients.

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Characteristic distributions of regional cerebral blood flow changes in major depressive disorder patients: A pseudo-continuous arterial spin labeling (pCASL) study

Journal of Affective Disorders ◽

10.1016/j.jad.2014.04.032 ◽

2014 ◽

Vol 165 ◽

pp. 59-63 ◽

Cited By ~ 22

Author(s):

Miho Ota ◽

Takamasa Noda ◽

Noriko Sato ◽

Kotaro Hattori ◽

Toshiya Teraishi ◽

...

Keyword(s):

Blood Flow ◽

Major Depressive Disorder ◽

Cerebral Blood Flow ◽

Arterial Spin Labeling ◽

Regional Cerebral Blood Flow ◽

Spin Labeling ◽

Regional Cerebral Blood ◽

Major Depressive ◽

Flow Changes ◽

Continuous Arterial Spin Labeling

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Measurement of Blood Flow in Arteriovenous Malformations before and after Embolization Using Arterial Spin Labeling

Interventional Neuroradiology ◽

10.1177/159101991201800106 ◽

2012 ◽

Vol 18 (1) ◽

pp. 42-48 ◽

Cited By ~ 12

Author(s):

L. Suazo ◽

B. Foerster ◽

R. Fermin ◽

H. Speckter ◽

C. Vilchez ◽

...

Keyword(s):

Arterial Spin Labeling ◽

Spin Labeling ◽

Conventional Angiography ◽

Vein Of Galen Aneurysm ◽

Non Invasive ◽

Shunt Occlusion ◽

Before And After ◽

Invasive Method ◽

Magnetic Resonance Imaging Mri ◽

Partially Occluded

The assessment of shunt reduction after an embolization of an arteriovenous malformation (AVM) or fistula (AVF) from conventional angiography is often difficult and may be subjective. Here we present a completely non-invasive method using magnetic resonance imaging (MRI) to measure shunt reduction. Using pulsed arterial spin labeling (PASL), we determined the relative amount of signal attributed to the shunt over 1.75 s and 6 different slices covering the lesion. This amount of signal from the shunt was related to the total signal from all slices and measured before and after embolization. The method showed a fair agreement between the PASL results and the judgement from conventional angiography. In the case of a total or subtotal shunt occlusion, PASL showed a shunt reduction between 69% and 92%, whereas in minimal shunt reduction as judged by conventional angiography, the ASL result was −6% (indicating slightly increased flow) to 35% in a partially occluded vein of Galen aneurysm. The PASL method proved to be fairly reproducible (up to 2% deviation between three measurements without interventions). On conclusion, PASL is able to reliably measure the amount of shunt reduction achieved by embolization of AVMs and AVFs.

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Comparison of non-invasive MRI measurements of cerebral blood flow in a large multisite cohort

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x16646124 ◽

2016 ◽

Vol 36 (7) ◽

pp. 1244-1256 ◽

Cited By ~ 27

Author(s):

Sudipto Dolui ◽

Ze Wang ◽

Danny JJ Wang ◽

Raghav Mattay ◽

Mack Finkel ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Arterial Spin Labeling ◽

Phase Contrast ◽

Spin Labeling ◽

Flow Measurements ◽

Entire Cohort ◽

Non Invasive ◽

Global Cerebral Blood Flow ◽

Continuous Arterial Spin Labeling

Arterial spin labeling and phase contrast magnetic resonance imaging provide independent non-invasive methods for measuring cerebral blood flow. We compared global cerebral blood flow measurements obtained using pseudo-continuous arterial spin labeling and phase contrast in 436 middle-aged subjects acquired at two sites in the NHLBI CARDIA multisite study. Cerebral blood flow measured by phase contrast (CBFPC: 55.76 ± 12.05 ml/100 g/min) was systematically higher ( p < 0.001) and more variable than cerebral blood flow measured by pseudo-continuous arterial spin labeling (CBFPCASL: 47.70 ± 9.75). The correlation between global cerebral blood flow values obtained from the two modalities was 0.59 ( p < 0.001), explaining less than half of the observed variance in cerebral blood flow estimates. Well-established correlations of global cerebral blood flow with age and sex were similarly observed in both CBFPCASL and CBFPC. CBFPC also demonstrated statistically significant site differences, whereas no such differences were observed in CBFPCASL. No consistent velocity-dependent effects on pseudo-continuous arterial spin labeling were observed, suggesting that pseudo-continuous labeling efficiency does not vary substantially across typical adult carotid and vertebral velocities, as has previously been suggested. Conclusions: Although CBFPCASL and CBFPC values show substantial similarity across the entire cohort, these data do not support calibration of CBFPCASL using CBFPC in individual subjects. The wide-ranging cerebral blood flow values obtained by both methods suggest that cerebral blood flow values are highly variable in the general population.

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Abstract TP116: Perioperative Assessment of Cerebral Perfusion Territories Through Arterial Spin Labeling Magnetic Resonance Imaging in Carotid Stenosis

Stroke ◽

10.1161/str.48.suppl_1.tp116 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Kohkichi Hosoda ◽

Daisuke Yamamoto ◽

Yoshito Uchihashi ◽

Jun Tanaka ◽

Yusuke Yamamoto ◽

...

Keyword(s):

Carotid Stenosis ◽

Arterial Spin Labeling ◽

Internal Carotid ◽

Spin Labeling ◽

Before And After ◽

Feeding Vessels ◽

Left And Right ◽

Electromagnetic Flow Meter ◽

Perioperative Assessment ◽

Internal Carotid Arteries

Backgroud: Territorial arterial spin labeling (TASL) is a MRI technique that permits independent labeling of major individual feeding vessels and noninvasive visualization of their perfusion territories. Objective: The objectives of this study were to use TASL to assess perioperative changes in the perfusion territories of the internal carotid arteries (ICAs) in carotid stenosis patients and to investigate the usefulness of this technique. Methods: Thirty-two patients underwent TASL and SPECT before and after carotid endarterectomy (CEA) or carotid artery stenting (CAS). ICA perfusion volume was calculated using TASL images. ICA flow was measured during CEA, both before and after reconstruction, using electromagnetic flow meter. Results: In most cases, preoperative asymmetry ( Fig. A ) of ICA perfusion volume improved postoperatively ( Fig B ) (red, rt ICA; green, lt ICA; blue, VA-BA). We classified patients into the following two groups: (1) an elevated CBF group (CBF increase after surgery ≥50%, n=4) and (2) a stable CBF group (CBF increase after surgery <50%, n=28). ICA perfusion volume increased significantly after surgery in the stable CBF group (291.1±89.0cm 3 versus 396.4±40.9cm 3 , p<0.0001) but did not increase significantly in the elevated CBF group (246.4±103.2cm 3 versus 268.7±107.7cm 3 ) ( Fig. C ). However, ICA flow increased significantly after reconstruction in both the elevated CBF group (54.0±58.2ml/min → 177.7±25.4ml/min) and the stable CBF group (85.7±50.0ml/min → 171.8±56.1ml/min) (p<0.0001) ( Fig. D ). Conclusion: TASL clearly demonstrated that CEA and CAS elicited increases in the perfusion volumes of stenotic ICAs, which resulted in equalization of the perfusion volumes of the left and right ICA. In the elevated CBF group, however, ICA perfusion volume increased slightly, despite marked increase in ICA flow. These findings suggest that an imbalance between these parameters plays an important role in the pathophysiology of hyperperfusion.

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Abstract TP169: Perioperative Assessment of Cerebral Perfusion Territories using Arterial Spin Labeling Magnetic Resonance Imaging in Patients with Carotid stenosis

Stroke ◽

10.1161/str.44.suppl_1.atp169 ◽

2013 ◽

Vol 44 (suppl_1) ◽

Author(s):

Daisuke Yamamoto ◽

Kohkichi Hosoda ◽

Yoshito Uchihashi ◽

Eiji Kohmura

Keyword(s):

Blood Flow ◽

Carotid Stenosis ◽

Arterial Spin Labeling ◽

Cerebral Perfusion ◽

Electromagnetic Flowmeter ◽

Spin Labeling ◽

Selective Labeling ◽

Before And After ◽

The Asymmetry ◽

Perioperative Assessment

[Background] Territorial arterial spin labeling (TASL) MRI offers a unique opportunity to visualize non-invasively cerebral perfusion territory (PT) by selective labeling of the feeding arteries without contrast medium. The objective of this study was to evaluate the PT status in patients with carotid stenosis and effect of carotid endarterectomy (CEA) on PT. [Materials and Methods] This study included 22 patients with carotid stenosis (20 men and 2 women; mean age 73 years) treated by CEA. All of them underwent TASL preoperatively and on the day after surgery. Ipsilateral internal carotid artery (ICA) blood flow (ICF) was measured by electromagnetic flowmeter just before and after endarterectomy during the surgery. Perfused volume (PV) of each feeding artery was calculated from perfused area and thickness of slices. Cerebral blood flow (CBF) was calculated as ICF/PV. [Results] Before CEA, the PV of ipsilateral ICA were significantly smaller than those of contralateral ICA. After CEA, the ipsilateral PV significantly increased and the asymmetry of PV of ICA was corrected (Fig.1 & 2). ICF also increased (82 to 178 ml/min). Accordingly, ipsilateral CBF defined by ICF/PV significantly increased (28 to 50 ml/100cm 3 /min). In a patient with postoperative hyperperfusion (HP), however, ICF remarkably increased from 10 to 200 ml/min while the PV increased only slightly (111 to 127 cm 3 , Fig.2). [Conclusion] TASL could evaluate the peri-operative change of cerebral PT non-invasively. CEA corrected the asymmetry of PT measured by TASL in patients with carotid stenosis. In a patient with HP after CEA, however, the increase of PT was small, which may suggest pathophysiological basis for HP.

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