Quantitative perfusion imaging using arterial spin labeling.

MRI-based perfusion imaging techniques can be classified into those that use exogenously administered contrast agents and those that use an endogenous material that reflects blood flow. This chapter focuses on the technique of arterial spin labeling (ASL), in which endogenous water is made a freely diffusible perfusion tracer by perturbing the magnetization of blood water in arteries prior to their entry into tissue of interest. The technique is totally noninvasive and allows repeated quantitative blood flow measurements in a time scale limited only by the spin lattice relaxation time (T1). Absolute quantitation requires measurement of T1, transit time, and labeling efficiency, as well as careful control for magnetization transfer effects. Two main variants of the ASL technique are in use: continuous ASL (CASL) and pulsed ASL (PASL). This chapter describes basic theory for CASL, and experimental and computational procedures for obtaining quantitative perfusion maps of the brain. Extension of the technique for renal perfusion imaging is outlined.