1. CEREBRAL BLOOD FLOW QUANTIFICATION FOR ARTERIAL SPIN LABELED PERFUSION MRI AT 3 TESLA 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 M. Frascaroli, L. Moro*, L. Sibilla, M. Baldi, I. Carne*, D. Fantinato* Servizio di Radiologia, *Servizio di Fisica Sanitaria Fondazione Salvatore Maugeri, Pavia

2. Arterial Spin Labeling (ASL) is a well- established perfusion MRI method that can provide noninvasive quantitative measures of cerebral blood flow (CBF) in vivo. The objective of this study was to assess CBF values in different brain regions of healthy patients. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013

3. Study exclusion criteria: contraindications to MRI, major head trauma, abnormal structural MRI, other neurological diseases. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 Patients75 male34 female41 Age (mean ± st.dev.) 51.4 ± 17.0 years Range 16 – 83 years

4. Scanner GE Discovery MR750 3.0T body coil transmission 16-channel head coil reception Sequence - anatomical images of the brain high resolution volumetric T1-weighted sequence TR 8.2 ms, TE 3.4 ms, bandwidth ± 31.3 kHz, TI 450 ms, FOV 24 cm, slice thickness 1 mm, number of slices 156, matrix 256 x 256, NEX 1. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013

5. Sequence - ASL Epi-Gradient Echo 512 sampling points on eight spirals spatial resolution 3.64 mm TR 5327 ms, TE 10.5 ms bandwidth ± 62.5 kHz slice thickness 4 mm, number of slices 36 post labeling delay 2525 ms field of view (FOV) 24 cm, NEX 3. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013

6. Quantification was performed off-line using Functool 9.4.05a software. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 The mean CBF values were recorded on the brainstem…

7. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 … on the left and right thalamus and …

8. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 … and on the white matter in the frontal lobe area.

9. RESULTS 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 CBFml/100g/min Brainstem35.4 ± 8.4 Thalamus right 43.9 ± 9.6 left 41.0 ± 9.8 White matter right 28.7 ± 5.8 left 28.3 ± 5.9 The CBF values of the thalamus and the white matter were similar in the two hemisphere (p < 0.1).

10. RESULTS 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 CBFml/100g/min Brainstem35.4 ± 8.4 Thalamus right 43.9 ± 9.6 left 41.0 ± 9.8 White matter right 28.7 ± 5.8 left 28.3 ± 5.9 The thalamus is more perfused than brainstem (p < 0.001) and frontal lobe white matter (p < 0.0001).

11. A range of CBF normality values was obtained for the used scanner to create a personal database and evaluate the perfusion of patients in post-traumatic minimally conscious state pre and post rehabilitation treatment The brain stem is affected in 52% of head trauma. The occurrence of bilateral upper pontine lesions is of highest predictive value for a fatal outcome. Severe destruction of supratentorial white matter as demonstrated by MRI is not related to increased mortality, as long as the brain stem is spared. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013

12. 4° Congresso Annuale dell’Italian Chapter dell’ISMRM Perugia, 24-25 ottobre 2013 Chronic pain patients Is thalamus CBF involved in chronic pain?

13. Grazie