Chan Alex,  Laughlin Brady,  Abid Waqas,  Latshaw Rachael,  Iaia Alberto,  Moftakhar Parham,  Nikam Rahul,  Kandula Vinay,  Choudhary Arabinda

Final Pr. ID: Poster #: EDU-071

The goal of this educational exhibit is to use a graphical and image heavy Powerpoint presentation to familiarize the reader with the background necessary to understand common clinical ASL-PWI imaging techniques along with displaying a pictorial assay of different normal and abnormal ASL perfusion findings within the field of Pediatric Neuroradiology.

To introduce our topic, we will briefly discuss the physiology of cerebral blood flow and how it is measured with and without an exogenous tracer. Next, to serve as an overview, we will show the general ASL experiment, namely, labeling, post label delay, and readout. Following, we will discuss each of the above components, beginning with showing the different main labeling methods, CASL, PCASL, and PASL. Finally, the concept of post label delay will be illustrated respective to each of the main labeling methods.

In the second section, we will discuss the image acquisition component by first describing and illustrating two common readout methods, such as 2D-EPI and 3D-GRASE methods along with their advantages and disadvantages. Additionally, we will illustrate the process of background suppression along with its significance. Finally, we will review the process of obtaining perfusion weighted images through the subtraction between tagged and control images.

The third section will illustrate an assortment of clinical examples beginning with showing normal physiological hyper- and hypoperfusion and newborn perfusion characteristics. Following, we will highlight a spectrum of clinical cases including: moyamoya, HIE, medullary infarct with luxury perfusion, arteriovenous malformation, PRES, infections (intracerebral abscess, toxoplasmosis, cerebellitis), characteristics of headache, intracranial tumors (juvenile astrocytoma, hemangioblastoma, ATRT, and choroid plexus papilloma), cortical dysplasia, tuberous sclerosis with seizures, and variations presentations of methotrexate toxicity. Lastly, we will discuss cerebral blood reserve imaging utilizing acetazolamide challenge. All cases will contain pertinent clinical information and images from other sequences/modalities that aid in the diagnosis of disease. Read More

Authors:  Chan Alex , Laughlin Brady , Abid Waqas , Latshaw Rachael , Iaia Alberto , Moftakhar Parham , Nikam Rahul , Kandula Vinay , Choudhary Arabinda

Keywords:  Arterial Spin Labeling, Physics

Pfeifer Cory,  Miller Jeffrey

Final Pr. ID: Poster #: EDU-071

Chronic cerebrovascular disease is common in pediatric sickle cell patients, and these children often require serial imaging to assess cerebral blood flow perfusion. ASL MRI has been shown to be an effective technique to assess cerebral blood flow, but the evaluation of perfusion reserve is also of value to ordering clinicians. This educational exhibit describes the use of the vasodilator acetazolamide to gauge potential changes in perfusion as determined by ASL MRI. The biochemical basis for cerebrovascular autoregulation and mechanism of acetazolamide are discussed. Read More

Authors:  Pfeifer Cory , Miller Jeffrey

Keywords:  arterial spin labeling MRI, cerebral blood perfusion, acetazolamide

Cardenas Agustin,  Murnick Jonathan,  Whitehead Matthew

Final Pr. ID: Poster #: EDU-007

Recent literature has illuminated increasing diagnostic uses of arterial spin labeling (ASL). This MR technique obtains accurate and reliable CBF measurements non-invasively and can be performed multiple times during the same exam, unlike other perfusion techniques.

A wide variety of entities, including normal variants, pathological conditions, and technical errors can demonstrate abnormal CBF values.

This Educational Exhibit has three main purposes:

1. To classify the main abnormal ASL perfusion patterns in the pediatric brain.

2. To discuss the potential clinical significance of abnormal ASL values.

3. To discuss the utility of this technique in the pediatric clinical setting. Read More

Authors:  Cardenas Agustin , Murnick Jonathan , Whitehead Matthew

Keywords:  ASL, arterial spin labeling, perfusion

Zheng Qiang,  Viaene Angela,  Freeman Colbey,  Hwang Misun

Final Pr. ID: Paper #: 134

To provide radiologic-pathologic correlation of brain injury in the Papez circuit in neonates with hypoxic-ischemic encephalopathy (HIE) and correlate radiologic findings with long-term neurodevelopmental outcomes. Read More

Authors:  Zheng Qiang , Viaene Angela , Freeman Colbey , Hwang Misun

Keywords:  papez circuit, arterial spin labeling, pathology