Amukotuwa Shalini A, Yu Caroline, Zaharchuk Gregory
Department of Radiology, Stanford University and Stanford University Medical Center, Stanford, California, USA.
J Magn Reson Imaging. 2016 Jan;43(1):11-27. doi: 10.1002/jmri.24873. Epub 2015 Apr 9.
Arterial spin labeling (ASL) is a completely noninvasive magnetic resonance imaging (MRI) perfusion method for quantitatively measuring cerebral blood flow utilizing magnetically labeled arterial water. Advances in the technique have enabled the major MRI vendors to make the sequence available to the clinical neuroimaging community. Consequently, ASL is being increasingly incorporated into the routine neuroimaging protocol. Although a variety of ASL techniques are available, the ISMRM Perfusion Study Group and the European ASL in Dementia Consortium have released consensus guidelines recommending standardized implementation of 3D pseudocontinuous ASL with background suppression. The purpose of this review, aimed at the large number of neuroimaging clinicians who have either no or limited experience with this 3D pseudocontinuous ASL, is to discuss the common and clinically significant artifacts that may be encountered with this technique. While some of these artifacts hinder accurate interpretation of studies, either by degrading the images or mimicking pathology, there are other artifacts that are of clinical utility, because they increase the conspicuity of pathology. Cognizance of these artifacts will help the physician interpreting ASL to avoid potential diagnostic pitfalls, and increase their level of comfort with the technique.
动脉自旋标记（ASL）是一种完全无创的磁共振成像（MRI）灌注方法，它利用磁标记的动脉血来定量测量脑血流量。该技术的进步使得主要的MRI设备供应商能够将此序列提供给临床神经影像学界。因此，ASL越来越多地被纳入常规神经影像检查方案中。尽管有多种ASL技术可供使用，但国际磁共振医学学会（ISMRM）灌注研究组和欧洲痴呆症ASL联盟已发布共识指南，推荐采用具有背景抑制的三维伪连续ASL进行标准化操作。这篇综述针对大量对这种三维伪连续ASL没有经验或经验有限的神经影像临床医生，旨在讨论该技术可能遇到的常见且具有临床意义的伪影。虽然其中一些伪影会通过降低图像质量或模拟病变来妨碍对研究的准确解读，但也有其他一些伪影具有临床实用价值，因为它们能提高病变的辨识度。认识这些伪影将有助于解读ASL的医生避免潜在的诊断陷阱，并提高他们对该技术的熟悉程度。
