Comparison of single-postlabeling delay and seven-delay three-dimensional pseudo-continuous arterial spin labeling in the assessment of intracranial atherosclerotic disease

BACKGROUND: The assessment of cerebral blood flow (CBF) is crucial in the evaluation of intracranial atherosclerotic disease. This study was performed to compare single postlabeling delay (PLD) 3-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) and 7-delay 3D-pCASL magnetic resonance imaging in patients with intracranial atherosclerotic stenosis. METHODS: A total of 26 patients with moderate to severe atherosclerotic stenosis or occlusion of an intracranial artery were prospectively enrolled in the study. Perfusion parameters were obtained in various regions of interest (ROIs), namely CBF for single PLDs of 1,525 ms (CBF(1525 ms)), 2,025 ms (CBF(2025 ms)), and 2,525 ms (CBF(2525 ms)) with 3D-pCASL, as well as arterial transit time (ATT) and transit-corrected CBF (CBF(transit-corrected)) for 7-delay 3D-pCASL. The consistency of the perfusion parameters between single-PLD 3D-pCASL and 7-delay 3D-pCASL was investigated, and the relationship between vascular stenosis and perfusion parameters was explored. RESULTS: Bland-Altman plots compared the CBF values derived from single-PLD 3D-pCASL to those from CBF(transit-corrected). ATT significantly correlated with the difference between CBF(transit-corrected) and CBF(1525 ms), CBF(2025 ms, and )CBF(2525 ms), respectively (P<0.05). Binary logistic regression analysis revealed that the CBF(transit-corrected) and ATT correlated with the presence of moderate or more severe stenotic vascular territories (P<0.05). CONCLUSIONS: The single-PLD 3D-pCASL and the 7-delay 3D-pCASL showed inconsistencies in the assessment of CBF, and the perfusion parameters generated under the standard single-PLD 3D-pCASL were more affected by ATT. Moreover, CBF(transit-corrected )and ATT were consistent with stenotic vascular territories, which is useful in the evaluation of intracranial atherosclerotic disease.