Mapping of cerebral perfusion territories using territorial arterial spin labeling: Techniques and clinical application

Nolan S. Hartkamp, Esben T. Petersen, Jill B. De Vis, Reinoud P H Bokkers, Jeroen Hendrikse

Research output: Contribution to journalArticle

Abstract

A knowledge of the exact cerebral perfusion territory which is supplied by any artery is of great importance in the understanding and diagnosis of cerebrovascular disease. The development and optimization of territorial arterial spin labeling (T-ASL) MRI techniques in the past two decades have made it possible to visualize and determine the cerebral perfusion territories in individual patients and, more importantly, to do so without contrast agents or otherwise invasive procedures. This review provides an overview of the development of ASL techniques that aim to visualize the general cerebral perfusion territories or the territory of a specific artery of interest. The first efforts of T-ASL with pulsed, continuous and pseudo-continuous techniques are summarized and subsequent clinical studies using T-ASL are highlighted. In the healthy population, the perfusion territories of the brain-feeding arteries are highly variable. This high variability requires special consideration in specific patient groups, such as patients with cerebrovascular disease, stroke, steno-occlusive disease of the large arteries and arteriovenous malformations. In the past, catheter angiography with selective contrast injection was the only available method to visualize the cerebral perfusion territories in vivo. Several T-ASL methods, sometimes referred to as regional perfusion imaging, are now available that can easily be combined with conventional brain MRI examinations to show the relationship between the cerebral perfusion territories, vascular anatomy and brain infarcts or other pathology. Increased availability of T-ASL techniques on clinical MRI scanners will allow radiologists and other clinicians to gain further knowledge of the relationship between vasculature and patient diagnosis and prognosis. Treatment decisions, such as surgical revascularization, may, in the near future, be guided by information provided by T-ASL MRI in close correlation with structural MRI and quantitative perfusion information.

Original languageEnglish (US)
Pages (from-to)901-912
Number of pages12
JournalNMR in Biomedicine
Volume26
Issue number8
DOIs
StatePublished - Aug 1 2013
Externally publishedYes

Fingerprint

Labeling
Magnetic resonance imaging
Perfusion
Arteries
Brain
Cerebrovascular Disorders
Angiography
Catheters
Pathology
Perfusion Imaging
Arteriovenous Malformations
Contrast Media
Blood Vessels
Availability
Anatomy
Imaging techniques
Stroke
Injections
Population

Keywords

  • Arterial spin labeling
  • Cerebral perfusion territories
  • Selective ASL
  • Territorial ASL

ASJC Scopus subject areas

  • Spectroscopy
  • Molecular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Mapping of cerebral perfusion territories using territorial arterial spin labeling : Techniques and clinical application. / Hartkamp, Nolan S.; Petersen, Esben T.; De Vis, Jill B.; Bokkers, Reinoud P H; Hendrikse, Jeroen.

In: NMR in Biomedicine, Vol. 26, No. 8, 01.08.2013, p. 901-912.

Research output: Contribution to journalArticle

Hartkamp, Nolan S. ; Petersen, Esben T. ; De Vis, Jill B. ; Bokkers, Reinoud P H ; Hendrikse, Jeroen. / Mapping of cerebral perfusion territories using territorial arterial spin labeling : Techniques and clinical application. In: NMR in Biomedicine. 2013 ; Vol. 26, No. 8. pp. 901-912.
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