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Arterial spin labeling (ASL) is a magnetic resonance perfusion technique that allows for quantification of cerebral blood flow (CBF) without the use of contrast or radiation. Several applications of ASL have been described in diagnosis of strokes and stroke mimics, intracranial tumors, and other conditions. Various vascular anomalies exhibit specific CBF patterns that correlate with different signal intensities on ASL. In this case-based review, we demonstrate the utility of ASL in diagnosis and surveillance of vascular anomalies in the intracranial compartment. [ABSTRACT FROM AUTHOR]

Arterial spin labeling (ASL) is a noninvasive neuroimaging technique that allows for quantifying cerebral blood flow without intravenous contrast. Various neurovascular disorders and tumors have cerebral blood flow alterations. Identifying these perfusion changes through ASL can aid in the diagnosis, especially in entities with normal structural imaging. In addition, complications of tumor treatment and tumor progression can also be monitored using ASL. In this case-based review, we demonstrate the clinical applications of ASL in diagnosing and monitoring brain tumors and treatment complications. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke (AIS) is a leading cause of morbidity worldwide and can present with nonspecific symptoms, making diagnosis difficult. Many neurologic diseases present similarly to stroke; stroke mimics account for up to half of all hospital admissions for stroke. Stroke therapies carry risk, so accurate diagnosis of AIS is crucial for prompt treatment and prevention of adverse outcomes for patients with stroke mimics. Computed tomography (CT) perfusion techniques have been used to distinguish between nonviable tissue and penumbra. RAPID is an operator‑independent, automated CT perfusion imaging software that can aid clinicians in diagnosing strokes quickly and accurately. In this case‑based review, we demonstrate the applications of RAPID in differentiating between strokes and stroke mimics. [ABSTRACT FROM AUTHOR]

Stroke mimics constitute a significant proportion of patients with suspected acute ischemic stroke. These conditions may resemble acute ischemic stroke and demonstrate abnormalities on perfusion imaging sequences. The most common stroke mimics include seizure/epilepsy, migraine with aura, brain tumors, functional disorders, infectious encephalopathies, Wernicke's encephalopathy, and metabolic abnormalities. Brain perfusion imaging techniques, particularly computed tomography perfusion and magnetic resonance perfusion, are being widely used in routine clinical practice for treatment selection in patients presenting with large vessel occlusion. At the same time, the utilization of these imaging modalities enables the opportunity to better diagnose patients with stroke mimics in a time‐sensitive setting, leading to appropriate management, decision‐making, and resource allocation. In this review, we describe patterns of perfusion abnormalities that could discriminate patients with stroke mimics from those with acute ischemic stroke and provide specific case examples to illustrate these perfusion abnormalities. In addition, we discuss the challenges associated with interpretation of perfusion images in stroke‐related pathologies. In general, perfusion imaging can provide additional information in some cases—when used in combination with conventional magnetic resonance imaging and computed tomography—and might help in detecting stroke mimics among patients who present with acute onset focal neurological symptoms. [ABSTRACT FROM AUTHOR]

Purpose To compare language networks derived from resting-state fMRI (rs-fMRI) with task-fMRI in patients with brain tumors and investigate variables that affect rs-fMRI vs task-fMRI concordance. Materials and Methods Independent component analysis (ICA) of rs-fMRI was performed with 20, 30, 40, and 50 target components (ICA20 to ICA50) and language networks identified for patients presenting for presurgical fMRI mapping between 1/1/2009 and 7/1/2015. 49 patients were analyzed fulfilling criteria for presence of brain tumors, no prior brain surgery, and adequate task-fMRI performance. Rs-vs-task-fMRI concordance was measured using Dice coefficients across varying fMRI thresholds before and after noise removal. Multi-thresholded Dice coefficient volume under the surface (DiceVUS) and maximum Dice coefficient (MaxDice) were calculated. One-way Analysis of Variance (ANOVA) was performed to determine significance of DiceVUS and MaxDice between the four ICA order groups. Age, Sex, Handedness, Tumor Side, Tumor Size, WHO Grade, number of scrubbed volumes, image intensity root mean square (iRMS), and mean framewise displacement (FD) were used as predictors for VUS in a linear regression. Results Artificial elevation of rs-fMRI vs task-fMRI concordance is seen at low thresholds due to noise. Noise-removed group-mean DiceVUS and MaxDice improved as ICA order increased, however ANOVA demonstrated no statistically significant difference between the four groups. Linear regression demonstrated an association between iRMS and DiceVUS for ICA30-50, and iRMS and MaxDice for ICA50. Conclusion Overall there is moderate group level rs-vs-task fMRI language network concordance, however substantial subject-level variability exists; iRMS may be used to determine reliability of rs-fMRI derived language networks. Hum Brain Mapp 37:913-923, 2016. © 2015 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Purpose: To develop an experimental approach for determining in vivo transverse relaxation rates (T2) of metabolites that are detected by spectral editing without using simulations, and to demonstrate this approach to measure the T2 of γ-aminobutyric acid (GABA). Materials and Methods: The proposed method first determines the TE-dependence of the edited signals using measurements in a pure phantom solution (10 mM γ-aminobutyric acid; GABA); the phantom T2 is also determined. Once the editing echo time (TE) -modulation pattern is known, it can then be used to determine T2 in vivo. The method was applied to measure GABA T2 in the occipital lobe of five healthy adult subjects at 3T, using a J-difference editing method. Unwanted macromolecular contributions to the GABA signal were also measured. Results: The in vivo T2 of edited GABA signal was 88 ± 12 ms; this preliminary result is somewhat shorter than other metabolite T2 values in the literature at this field strength. Conclusion: Spectral editing methods are now widely used to detect low concentration metabolites, such as GABA, but to date no edited acquisition methods have been proposed for the measurement of transverse relaxation times (T2). The method described has been successfully applied to measuring the T2 of GABA. J. Magn. Reson. Imaging 2012;35:229-234. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]