syngo ASL. Powered by Tim.

Non-contrast enhanced perfusion

imaging
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syngo ASL. Powered by Tim.
Non-contrast enhanced perfusion imaging
Arterial Spin Labeling (ASL) is an MR tech-
nique using the water in arterial blood as
an endogenous contrast agent to evaluate
perfusion non-invasively. ASL provides
unique insight into human brain perfusion
and function physiology by evaluating
cerebral blood flow (CBF). ASL is capable
of high spatial resolution perfusion imag-
ing, making the technique very appealing
in the evaluation of stroke, tumors, degen-
erative diseases, epilepsy but also in basic
neuroscience, e.g. for studies of functional
CBF changes. Siemens is proud to introduce
syngo ASL, powered by Tim (Total imaging
matrix), thereby allowing the use of non-
contrast enhanced perfusion imaging in
both the clinical and research settings.
Principles of Arterial Spin Labeling
Initially the techniques used for determining
cerebral blood flow were rather invasive
and involved the use of exogenous contrast
agents, such as 15O labeled radiotracer in
Positron Emission Tomography (PET).
With MRI, brain perfusion studies have been
commonly performed using exogenous
Gadolinium-based contrast agent. The prin-
ciples behind ASL are quite similar to those
utilizing exogenous contrast agents. How-
ever, ASL is completely non-invasive: no
radiation and no injection of contrast media.
In ASL, first, arterial blood water is magneti-
cally labeled just below the region of interest
by applying a 180 degree radiofrequency
(RF) inversion pulse. The result of this pulse
is inversion of the net magnetization of the
blood water. In other words, the water mol-
ecules within the arterial blood are labeled
magnetically. After a period of time (called
the transit time), the magnetically labeled
water flows into the region of interest where
it exchanges with tissue water. The inflow-
ing inverted spins within the blood water
alter total tissue magnetization, reducing
it and, consequently, the MR signal and im-
age intensity. During this time, an image is
taken (called the tag image).
The experiment is then repeated without
labeling the arterial blood to create another
image (called the control image). The tag-
state is alternated with the control state,
in which the magnetization of the arterial
blood is not inverted. The control image and
the tag image are subtracted to produce
a perfusion image. This image will reflect
the amount of arterial blood delivered to
the slice within the transit time.
There are mainly two techniques for ASL;
PASL (pulsed ASL) and CASL (Continuous
ASL). In PASL, the RF pulse is applied in a
spatially selective manner (region-specific).
Consequently the inversion of the arte-
rial blood occurs over a specific area. PASL
is particularly attractive for higher field
strengths as other ASL schemes such as
CASL have to deal with the challenge
of high Specific Absorption Rate (SAR).
 Arterial Spin Labeling Applications

There are several applications for ASL

imaging tumor and pediatric perfusion
imaging being the primary. Other applica-
tions include stroke, epilepsy, degenerative
diseases such as dementia and Alzheimer’s
disease. ASL is also a great tool for function-
al evaluation of the brain in combination
with BOLD techniques. Changes in perfusion
are more localized to the parenchyma,
whereas BOLD changes are tied to the
veins and venules.

syngo ASL implementation

Siemens implemented PASL. This new ap-

plication, called syngo ASL makes use of the
unique Parallel Imaging capabilities of Tim
(Total imaging matrix) with the standard 12-
channel Head Matrix coil as well as the 32-
channel Head coil. syngo ASL is compatible
with GRAPPA parallel acquisition technique.
In order to make this advanced application
more efficient, Siemens has also enabled
the use of 3D PACE, prospective motion cor-
rection for ASL, thereby enabling a higher syngo ASL acquired with matrix 64 x 64 and slice thickness 5 mm, fused in the Neuro 3D card
robustness of the technique. with structural MR data.

Dark Fluid rel. CBF ASL TTP

Post-stroke examination showing good correlation between ASL and contrast-enhanced CBF and TTP perfusion data.
Note that Dark Fluid does not show yet the extent of the affected region. MAGNETOM Trio a Tim system. Courtesy of Xuanwu Hospital, CUMS, Beijing, P.R. China

T2 TSE Diffusion EPI Diffusion EPI ADC map Dark Fluid fused with Diffusion ASL

T2 TSE, DW EPI, ADC map and Dark Fluid images fused with the diffusion data and ASL again showing a considerably larger affected region. MAGNETOM Trio a Tim system.
Courtesy of Xuanwu Hospital, CUMS, Beijing, P.R.China
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