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Brain Perfusion Territory Imaging: Methods and Clinical Applications of Selective Arterial Spin-labeling MR Imaging¹

¹ From the Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, the Netherlands. Received October 13, 2006; revision requested December 13; revision received December 21; accepted January 23, 2007; final version accepted April 2; final review by P.J.v.L. August 6. Address correspondence to P.J.v.L. (e-mail: p.j.vanlaar{at}umcutrecht.nl).

The ability to visualize perfusion territories in the brain is important for many clinical applications. The aim of this overview is to highlight the possibilities of selective arterial spin-labeling (ASL) magnetic resonance (MR) imaging techniques in the assessment of the perfusion territories of the cerebral arteries. In the past decade, the optimization of selective ASL MR techniques to image the cerebral perfusion territories has resulted in numerous labeling approaches and an increasing number of clinical applications. In this article, the methods and clinical applications of selective ASL MR imaging are described and the importance of perfusion territory information in studying cerebral hemodynamic changes in patients with cerebrovascular disease is shown. In specific patient groups with cerebrovascular disease, such as acute stroke, large artery steno-occlusive disease, and arteriovenous malformation, selective ASL MR imaging provides valuable hemodynamic information when added to current MR protocols. As a noninvasive tool for perfusion territory measurements, selective ASL may contribute to a better understanding of the relation between the vasculature, perfusion, and brain function.