Arterial Spin Labelling in Routine Clinical Practice

Peter Brotchie¹, ², Pei Fun Kwan¹, ²

Arterial Spin Labelling (ASL) is an MRI sequence for performing perfusion imaging of the brain without the need for intravenous contrast agents. The sequence was first described almost 20 years ago. However, it has been slow to be adopted into clinical practice. This presentation is a pictorial review of ASL in a routine hospital based clinical practice, demonstrating the clinical utility of the sequence in a number of conditions. A number of ASL cases are presented including the grading of gliomas, assessing acute cerebral infarcts, post-endarterectomy hyperperfusion syndrome, dementia, epilepsy and migraine. In addition, a number of artefacts are demonstrated that are peculiar to ASL and need to be recognised to avoid misdiagnosing pathology. The studies were all performed on a 3 tesla Siemens Trio MRI scanner with a 32 channel head coil, using a pulsed ASL sequence supplied by Siemens.