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Super selective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients with extracranial steno-occlusive disease. The detected vessel occlusions/stenoses and perfusion patterns corresponded between cerebral DSA and super selective pseudocontinuous ASL maps in all cases. Perfusion deficits on DSC-CBF maps significantly correlated with those on super selective pseudocontinuous ASL maps. The authors conclude that superselectivepseudocontinuousASL is a robust technique for regional brain perfusion imaging, suitable for the noninvasive diagnostics of individual patient perfusion patterns.

Fourteen patients with tumefactive demyelinating lesions and 21 patients with high-grade gliomas underwent MR imaging with conventional, DTI, and DSC perfusion imaging. Conventional imaging sequences had a sensitivity of 80.9% and specificity of 57.1% in differentiating high-grade gliomas from tumefactive demyelinating lesions. DTI metrics (p:q tensor decomposition) and DSC perfusion demonstrated a statistically significant difference among enhancing portions in tumefactive demyelinating lesions and high-grade gliomas. The highest specificity was found for ADC, the anisotropic component of the diffusion tensor, and relative CBV. The authors conclude that DTI and DSC perfusion add profoundly to conventional imaging in differentiating tumefactive demyelinating lesions and high-grade gliomas.