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(Stroke. 2008;39:2980.)
© 2008 American Heart Association, Inc.

Original Contributions

Quantitative Assessment of Mixed Cerebral Vascular Territory Supply With Vessel Encoded Arterial Spin Labeling MRI

From the School of Medicine (A.P.K.) and the Departments of Radiology (E.C.W.) and Psychiatry (E.C.W.) University of California, San Diego, Calif.

Correspondence to Akash P. Kansagra, MS, Center for Functional MRI, UCSD School of Medicine, 9500 Gilman Drive, La Jolla, CA 92093-0677. E-mail akansagra{at}ucsd.edu

Background and Purpose— Recent advances in arterial spin labeling MRI have permitted noninvasive evaluation of vascular territories. In the present study, we quantitatively assess mixing of internal carotid and basilar artery blood through cerebrovascular anastomoses using vessel-encoded arterial spin labeling and a new postprocessing method.

Methods— Vessel-encoded arterial spin labeling was used to determine the territories of the internal carotid and basilar arteries in 14 healthy subjects and one patient with asymptomatic high-grade carotid artery stenosis before and after endarterectomy. Contributions to individual vascular territories were quantified using a voxelwise supply fraction algorithm and the results were correlated with MR angiography.

Results— Vascular territories were consistent with cerebrovascular anatomy and the presence of pathology. The supply fraction method allowed quantification of mixed territorial supply arising from collateral flow and showed vascular supply changes in a patient with carotid artery stenosis after endarterectomy.

Conclusions— Vascular territories obtained with vessel-encoded arterial spin labeling correlate with cerebrovascular anatomy and allow quantitative assessment of mixed territorial supply in subjects with and without pathology.

Key Words: carotid endarterectomy • cerebral blood flow • collateral circulation • imaging techniques • magnetic resonance imaging