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J Cereb Blood Flow Metab. 2017 Sep;37(9):3184-3192. doi: 10.1177/0271678X16683690. Epub 2017 Jan 6.

The spatial coefficient of variation in arterial spin labeling cerebral blood flow images.

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1 Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Canada.
2 Department of Radiology, Academic Medical Center, Amsterdam, the Netherlands.
3 PET Center, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.
4 Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands.
5 Department of Neurology, Radboud University Medical Center, Nijmegen, the Netherlands.


Macro-vascular artifacts are a common arterial spin labeling (ASL) finding in populations with prolonged arterial transit time (ATT) and result in vascular regions with spuriously increased cerebral blood flow (CBF) and tissue regions with spuriously decreased CBF. This study investigates whether there is an association between the spatial signal distribution of a single post-label delay ASL CBF image and ATT. In 186 elderly with hypertension (46% male, 77.4 ± 2.5 years), we evaluated associations between the spatial coefficient of variation (CoV) of a CBF image and ATT. The spatial CoV and ATT metrics were subsequently evaluated with respect to their associations with age and sex - two demographics known to influence perfusion. Bland-Altman plots showed that spatial CoV predicted ATT with a maximum relative error of 7.6%. Spatial CoV was associated with age (β = 0.163, p = 0.028) and sex (β = -0.204, p = 0.004). The spatial distribution of the ASL signal on a standard CBF image can be used to infer between-participant ATT differences. In the absence of ATT mapping, the spatial CoV may be useful for the clinical interpretation of ASL in patients with cerebrovascular pathology that leads to prolonged transit of the ASL signal to tissue.


ASL; Arterial spin labeling; cerebral blood flow; cerebral hemodynamics; perfusion weighted MRI

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