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Chapter 8 - Detection of regional blood flow using arterial spin labeling

from Section 1 - Physiological MR techniques

Published online by Cambridge University Press:  05 March 2013

By
Alan P. Koretsky ,
S. Lalith Talagala  and
Afonso C. Silva
Edited by
Jonathan H. Gillard ,
Adam D. Waldman  and
Peter B. Barker
Jonathan H. Gillard
Affiliation:
University of Cambridge
Adam D. Waldman
Affiliation:
Imperial College London
Peter B. Barker
Affiliation:
The Johns Hopkins University School of Medicine
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Summary

Introduction

The motivation to measure regional perfusion is well established in physiology and medicine. Techniques to measure regional blood flow in animal models such as using microspheres [1] and radiolabeled tracers [2] have had a major impact on our understanding of the regulation of microcirculation in normal tissue and changes that occur during a variety of disease processes. A major limitation of these techniques is that, for the most part, they require sacrificing the animal after only one or a few independent measurements of blood flow. Techniques to measure regional blood flow in humans have relied on the wash-in/wash-out kinetics of tracers that can be detected by radiological imaging techniques. Most important have been the use of radiolabeled water detected by positron emission tomography (PET) [3] and regional distribution of inhaled xenon detected by X-ray computed tomography (CT).[4] The results from these techniques show a wide range of problems that perfusion imaging can address, from functional mapping of active brain regions during cognitive task activation to attempts to detect the development of Alzheimer’s disease. These techniques are limited by low spatial resolution compared with MRI and the inability to make numerous serial measurements owing to radiation dose issues. All of these approaches have been inspirational, offering theoretical frameworks and practical motivation to develop MRI techniques to measure regional perfusion. The goal has been to take advantage of the non-invasive nature of MRI and the very high resolution that can be obtained to make maps of tissue blood flow.

Early approaches to measure regional blood flow by MR techniques relied on adapting the well-developed class of techniques that measure tissue-specific wash-in and wash-out of tracers. Tracers such as deuterium oxide [5,6] or fluorinated inhalants [7,8] were first detected using MR spectroscopy (MRS) from specified regions and later images were made that enabled estimates of cerebral blood flow (CBF),[9,10] and blood flow in tumors.[11] A major drawback with the MR techniques that relied on directly detecting tracers was the low spatial resolution that could be obtained compared with normal MRI. A solution to this problem was to follow the tracer kinetics of MRI contrast agents indirectly through their effects on tissue water relaxation.[12,13] After a rapid bolus of gadolinium chelates, the change in contrast in a tissue can be used to calculate regional blood volume and blood flow at the resolution of standard MRI. This approach has become an important technique for assessing hemodynamics during ischemia in heart and brain [14] and is described in detail in Ch. 7.

Type
Chapter
Information
Clinical MR Neuroimaging
Physiological and Functional Techniques
 , pp. 94 - 112
Publisher: Cambridge University Press
Print publication year: 2009

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