Abstract
Perfusion imaging of the brain encompasses a broad range of imaging modalities, involving invasive and noninvasive techniques, employing endogenous and exogenous tracer that emit nonionizing or ionizing radiation. Each of these examinations bears its own risks and provides specific benefits, and appropriate medical knowledge is required to select the correct test for each of the specific clinical settings. In this chapter, we shall provide a review of this technology and discuss nuclear perfusion techniques, including positron emission tomography (PET) and single-photon emission computed tomography (SPECT); perfusion computed tomography (PCT); MR perfusion techniques such as dynamic susceptibility contrast (DSC) MRI, dynamic contrast-enhanced (DCE) MRI, and arterial spin labeling (ASL) MRI; and transcranial Doppler (TCD) ultrasound.
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Abbreviations
- ASL (arterial spin labeling):
-
MR perfusion technique that uses water molecules in blood instead of injected contrast to evaluate cerebral perfusion.
- Autoregulation:
-
Response of the cerebral vasculature to decreased perfusion.
- CBF (cerebral blood flow):
-
Blood supply in the brain per unit of time.
- CBV (cerebral blood volume):
-
Cerebral blood volume within the capillary bed.
- DCE (dynamic contrast enhancement):
-
Dynamic MR imaging technique that tracks the circulation and recirculation of a bolus of contrast material to evaluate blood-brain barrier permeability.
- DSC (dynamic susceptibility contrast):
-
Dynamic MR technique that tracks a first pass of a bolus of contrast material through signal decrease as the contrast enters the capillary bed.
- MTT (mean transit time):
-
Length of time a volume of blood spends traveling in the cerebral capillaries.
- OEF (oxygen extraction fraction):
-
Fraction of oxygen extracted by blood.
- PET (positron emission tomography):
-
Nuclear imaging technique that allows assessment of cerebral perfusion and metabolic activity.
- SPECT (single-photon emission computed tomography):
-
Nuclear imaging technique which displays tomographic imaging with the use of gamma rays.
- T1 MRI sequence:
-
Also referred to as T1W1. A basic pulse sequence that relates to a short TR (repetition time) and a short TE (echo time) and gives structural information.
- T2 MRI sequence:
-
Also referred to as T2WI. A basic pulse sequence that relates to a long TR and a long TE and gives pathologic information (edema).
- T2* MRI sequence:
-
Pulse sequence that relates to T2 relaxation time and magnetic field inhomogeneity.
- TCD (transcranial Doppler):
-
Ultrasound technique that evaluates cerebral blood flow in large cerebral arteries.
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Beer, A.J., Wintermark, M. (2015). Perfusion Measurements of the Brain. In: Lanzer, P. (eds) PanVascular Medicine. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-37078-6_44
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DOI: https://doi.org/10.1007/978-3-642-37078-6_44
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Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-37077-9
Online ISBN: 978-3-642-37078-6
eBook Packages: MedicineReference Module Medicine