A Qualitative Comparison of Arterial Spin Labelling and Dynamic Susceptibility Contrast MRI in 52 Children with a Range of Neurological Conditions

OBJECTIVE: To assess the usefulness of Arterial Spin Labelling (ASL) compared with Dynamic Susceptibility Contrast (DSC) perfusion MRI for typical paediatric neuroimaging applications at 1.5 Tesla.

METHODS: 52 children (age: 4 months – 17 years) with a variety of neurological disorders were scanned using 3D ASL and Echo Planar Imaging DSC sequences. All images were reviewed by an experienced neuroradiologist, image quality recorded as ‘good’, ‘acceptable’, or ‘poor’ and diagnostic value noted as being ‘greater’, ‘similar’ or ‘less’ for ASL when compared to DSC.

RESULTS: ASL CBF images were judged to be acceptable in 89% of cases, poor in 11% and good in 0%, while DSC CBF images were acceptable in 88% of cases, poor in 12% and good in 0%. ASL images were judged to have better diagnostic value than DSC in 28% of cases, about the same in 58%, and worse in 14%.

CONCLUSION: The results of this study suggest that ASL offers a realistic alternative to DSC in the paediatric setting for the majority of cases encountered in this study. However, there are some situations where DSC outperforms ASL, so care is required to choose the most appropriate technique for the pathology under investigation. A larger study is required to corroborate these preliminary findings.

ADVANCES IN KNOWLEDGE: ASL is a relatively new perfusion imaging technique that’s use has not been explored extensively in the paediatric setting. This work is a preliminary study to evaluate its usefulness in paediatric neuroimaging.