Significance of ASL in MR- Neuroimaging

Congress:

ECR 2020

Poster Number:

C-06264

Type:

Educational Exhibit

Keywords:

Performed at one institution, Not applicable, Seizure disorders, Ischaemia / Infarction, Arteriovenous malformations, Molecular imaging, Education, MR-Functional imaging, MR-Diffusion/Perfusion, Neuroradiology brain, MR physics, Neuro

Authors:

S. BEVOOR CHOWDAIAH¹, U. ACHARYA², D. R. GARAPATI², P. R. vakati¹; ¹BANGALORE, KARNATAKA/IN, ²BANGALORE/IN

DOI:

10.26044/ecr2020/C-06264

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-06264

Fig. 1: Case 1: Right motor cortex glioblastoma multiforme. [Axial T2 weighted (A),...

Fig. 2: Case 2: Radiation necrosis. Axial T2 (A), T2 perfusion (B), Post contrast T1...

Fig. 3: Case 3: Recurrent GBM with radiation necrosis (First row at the level of body...

Fig. 4: Case 4: Meningioma. Axial FLAIR (A), T2 (B), post contrast T1 (C) and ASL (D).

Learning objectives

To briefly describe the physics and technique of arterial spin labeling (ASL). To demonstrate the clinical utility of ASL in further characterizing the pathologies identified on traditional MR sequences as a problem solving tool.

Background

ASL is a non-invasive MR technique that measures tissue perfusion by using magnetically-labeled arterial blood water protons as an endogenous tracer. The parameter most commonly derived is CBF. It's a non-ionizing & non-invasive technique useful in all pediatric patients, patients with renal insufficiency and for repeated follow-ups.

Findings and procedure details

There are many opportunities to use the ASL in clinical practice. In this section we review the usage of ASL in different pathologies. Tumors Case 1 Irregular rim enhancing lesion in right motor cortex. Co-registration of fiber tracks on post contrast T1 demonstrates proximity of corticospinal tract with the lesion. ASL shows increased perfusion in the wall, suggesting a high-grade glioma which corresponded with histopathology report ofGBM. Case 2 Left temporal recurrent GBM with two surgeries. Irregular rim enhancing post-operative cavity in left temporal region....

Conclusion

Addition of PCASL in recent commercial MRI scanners has expanded the armamentarium of a neuroradiologist and has become an essential complimentary imaging technique along with other advanced and conventional neuroimaging techniques. This review addressed a few of its varied clinical utility. Role of ASL in cerebrovascular diseases like steno-occlusive diseases, vascular malformations; Posterior Reversible Encephalopathy Syndrome (PRES); brain tumours; epilepsy and CNS infections were discussed. There are numerous other applications where ASL has been used such as in imaging of dementia and cognitive disorders, neuropsychiatric...

Personal information and conflict of interest

S. Bevoor Chowdaiah; Bangalore, KARNATAKA/IN - nothing to disclose; D. U. V.Acharya; Bangalore/IN - nothing to disclose; D. R. Garapati; Bangalore/IN - nothing to disclose

References

Arterial spin labeling in neuroimaging. (2010) World Journal of Radiology. 2 (10): 384.doi:10.4329/wjr.v2.i10.384 Sven Haller, Greg Zaharchuk, David L. Thomas, Karl-Olof Lovblad, Frederik Barkhof, Xavier Golay. Arterial Spin Labeling Perfusion of the Brain: Emerging Clinical Applications. (2016) Radiology. 281 (2): 337-356. doi:10.1148/radiol.2016150789