Arterial Spin Labeling‐Based MR Angiography for Cerebrovascular Diseases: Principles and Clinical Applications

作者：Osamu Togao, Makoto Obara, Koji Yamashita, Kazufumi Kikuchi, Tatsuhiro Wada, Hiroo Murazaki, Koichi Arimura, Ataru Nishimura, Nobutaka Horie, Kim van de Ven, Marc VAN CAUTEREN, Kousei Ishigami · 发表于：Journal of Magnetic Resonance Imaging · 年份：2023 · DOI：10.1002/jmri.29119 · 被引用次数：21 · 研究领域：Advanced MRI Techniques and Applications、Cerebrovascular and Carotid Artery Diseases、Intracranial Aneurysms: Treatment and Complications

Arterial spin labeling (ASL) is a noninvasive imaging technique that labels the proton spins in arterial blood and uses them as endogenous tracers. Brain perfusion imaging with ASL is becoming increasingly common in clinical practice, and clinical applications of ASL for intracranial magnetic resonance angiography (MRA) have also been demonstrated. Unlike computed tomography (CT) angiography and cerebral angiography, ASL-based MRA does not require contrast agents. ASL-based MRA overcomes most of the disadvantages of time-of-flight (TOF) MRA. Several schemes have been developed for ASL-based MRA; the most common method has been pulsed ASL, but more recently pseudo-continuous ASL, which provides a higher signal-to-noise ratio (SNR), has been used more frequently. New methods that have been developed include direct intracranial labeling methods such as velocity-selective ASL and acceleration-selective ASL. MRA using an extremely short echo time (eg, silent MRA) or ultrashort echo-time (TE) MRA can suppress metal susceptibility artifacts and is ideal for patients with a metallic device implanted in a cerebral vessel. Vessel-selective 4D ASL MRA can provide digital subtraction angiography (DSA)-like images. This review highlights the principles, clinical applications, and characteristics of various ASL-based MRA techniques. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.