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Perfusion Imaging

An Overview
Perfusion MRI gives access to information on the capillary microcirculation of tissue. The main quantitative parameters measured are blood volumes and temporal data (transit time, time to contrast peak).

The ultimate goal of perfusion MRI is to measure or assess the blood flow irrigating the explored organ, expressed in milliliters per 100 gram of tissue per minute. This flow corresponds to microcirculatory tissue perfusion rather than the flow of the main vascular axes.

The two most common methods for measuring perfusion using H MRI are the dynamic susceptibility contrast (DSC) approach, which detects the first passage of an intravascular contrast agent such as a gadolinium chelate, and arterial spin labeling (ASL), which uses magnetically labeled arterial blood water as a diffusible flow tracer. DSC perfusion MRI, also termed perfusion=weighted imaging, is more widely applied clinically and has been extensively reviewed elsewhere. The present review focuses on ASL perfusion MRI, including methodological considerations and applications in basic and clinical neuroscience. Practical utility of ASL methodology has been demonstrated for several neuroimaging applications, including acute and chronic cerebrovascular disease, CNS neoplasms, epilepsy, and functional MRI fMRI). Recent technical advances have dramatically improved the sensitivity of ASL perfusion MRI, and its use is likely to increase in the coming years.

Perfusion Imaging Publication References
Provenzale JM, Wintermark M. “Optimization of perfusion imaging for acute cerebral ischemia: review of recent clinical trials and recommendations for future studies”: AJR. American Journal of Roentgenology. Oct 2008;191(4):1263-70.

Deibler AR, Pollock JM, Kraft RA, Tan H, Burdette JH, Maldjian JA. “Arterial spin labeling in routine clinical practice, part 3: hyperperfusion patterns”. AJNR American Journal Neuroradiology. Sept 2008;29(8): 1428-35.

Deibler AR, Pollock JM, Kraft RA, Tan H, Burdette JH, Maldjian JA. “Arterial Spin-labeling in routine clinical practice, part 1:technique and artifacts”. AJNR America Journal Neuroradiology. Aug 2008;29(7): 1228-34.

Deibler AR, Pollock JM, Kraft RA, Tan H, Burdette JH, Maldjian JA. “Arterial spin labeling in routine clinical practice, part 2: hypoperfusion patterns”. AJNR American Journal Neuroradiology. Aug 2008;29(7): 1235-41.

Law M, Young RJ, Babb JS, Peccerelli N, Chheang S, Gruber ML, Miller DC, Golfinos JG, Zagzag D, Johnson G. “Gliomas: predicting time to progression of survival with cerebral blood volume measurements at dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging”. Radiology. May 2008;247 (2): 490-8.

Chawla S, Wang S, Wolf RL, Woo JH, Wang J, O’Rourke DM, Judy KD, Grady MS, Melhem ER, Poptani H: “Arterial Spin-Labeling and MR Spectroscopy in the Differentiation of Gliomas”: American Journal of Neuroradiology. Oct 2007;26:1683-1689. American Society of Neuroradiology. Oct 2007.

Wolf RL, Detre JA. “Clinical Neuroimaging Using Arterial Spin-Labeled Perfusion Magnetic resonance Imaging”. The American Society for Experimental NeuroTherapeutics, Inc. Jul 2007;Vol. 4, 2346-359.

Perfusion imaging with computed tomography: brain and beyond”: Review European Radiology. Nov 2006;16 Suppl 7:M37-43.

Shetty SK, Lev MH. “CT Perfusion in Acute Stroke”: Neuroimaging Clinic of North America. 2005;15; 481-501.

Law M, Yang S, Wang H, Babb JS, Johnson G, Cha S, Knopp EA, Zagzag D. “Glioma grading: sensitivity, specificity, and predictive values of perfusion MR imaging and proton MR spectroscopic imaging compared with conventional MR imaging”: AJNR Am J Neuroradiology. Nov-Dec 2003;24(10):1989-98.

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