Multislice continuous arterial spin-labeled perfusion MRI in patients with chronic occlusive cerebrovascular disease:: A correlative study with CO2PET validation

Purpose: To compare the use of multislice continuous arterial spin labeling (CASL) and CO(2) positron emission tomography (PET) to assess CBF in patients with chronic occlusive cerebrovascular disease for the validation of quantitative CASL per-fusion in an altered hemodynamic state. Materials and Methods: Eleven patients with occlusive carotid artery disease were studied with CASL and conventional MRI. Cerebral blood flow (CBF) was also measured with O(15)-labeled CO(2) gas using a whole-body PET scanner. The average values within region of interests (ROIs) drawn on coregistered CASL and PET images were used for the linear regression analysis and to assess the effect of transit time on the quantification using CASL. Result: In all patients there was a significant correlation between the CBF values from CASL and PET (r = 0.71 +/- 0.07, P < 0.001). The slope of regression lines varied widely among patients (0.54-1.77). Longer transit times were estimated in four of I I patients in the hypoperfusion region. Conclusion: Quantification of CBF using CASL is feasible and reasonable, even when employed in a routine clinical setting. However, the long transit time may lead to underestimation of the affected side in occlusive cerebrovascular disease.