Susceptibility Contrast and Arterial Spin Labeled Perfusion MRI in Cerebrovascular Disease

Purpose: To directly compare dynamic susceptibility contrast (DSC) and continuous arterial spin labeled (CASL) magnetic resonance (MR) perfusion techniques in patients with known cerebrovascular disease, with the goals of identifying possible pitfalls in interpretation and determining potential for a complementary role in this setting.

Methods: DSC and CASL MR perfusion studies were performed and compared in 11 patients with acute and/or chronic cerebrovascular disease. Using an automated segmentation technique, Pearson correlation coefficients were generated for CASL perfusion measurements compared to DSC perfusion maps (time-to-peak [TTP], relative cerebral blood volume [rCBV], cerebral blood flow [rCBF], and mean transit time [MTT]) by hemisphere and vascular territory.

Results: TTP maps obtained using DSC perfusion MR correlated best both subjectively and objectively with CASL perfusion MR measurements when all patients studied were considered. If patients with a major transit delay were excluded, DSC rCBF correlated best with CASL CBF measurements.

Conclusion: There may be a complementary role for CASL and DSC perfusion MR methods in cerebrovascular disease, especially in the setting of a marked transit delay.