Comparison between multiparametric arterial spin labeling and 15O-water positron emission tomography in patients with moyamoya disease

Motivation: Multiparametric arterial spin labeling (MP-ASL) may detect early-stage hemodynamic impairment in patients with moyamoya disease. Goal(s): We aimed to evaluate the clinical relevance of MP-ASL in these patients. Approach: We compared MP-ASL parameters with cerebrovascular reactivity (CVR) measured using 15O-water positron emission tomography. Results: Arterial cerebral blood volume did not significantly correlate with CVR and showed no significant difference between the normal and reduced CVR groups. However, the residence time of labeled spins in the microvascular compartment significantly correlated with CVR and was prolonged in the reduced CVR group, suggesting its potential to differentiate between CVR conditions. Impact: Multiparametric arterial spin labeling enables a detailed, noninvasive evaluation of cerebral hemodynamics in patients with moyamoya disease, with a clinically acceptable scan time, and potentially allows for the detection of early-stage hemodynamic impairment in these patients.