Abstract Purpose Multiparametric arterial spin labeling (MP‐ASL) using delays alternating with nutation for tailored excitation (DANTE) pulse (MP‐ASL DANTE ) can noninvasively quantify arterial cerebral blood volume (CBV a ) and the residence time of labeled spins in the microvascular compartment (ΔTT). We hypothesized that MP‐ASL DANTE could identify the early stages of hemodynamic impairment in patients with moyamoya disease (MMD) by detecting autoregulatory vasodilation, specifically the elevation of CBV a . However, the clinical relevance of MP‐ASL DANTE has not yet been fully evaluated. Therefore, we compared MP‐ASL DANTE with 15 OH 2 O positron emission tomography (PET) to assess its clinical relevance in patients with MMD. Methods MP‐ASL DANTE was performed on 11 patients, and the parameters were estimated using simulation‐based deep neural networks. Furthermore, cerebrovascular reactivity (CVR) was calculated from the cerebral blood flow (CBF) before and after acetazolamide challenge using 15 OH 2 O PET. Spearman's correlation analyses and group comparisons were performed. Results Although CBV a (ρ = 0.0288; p = 0.6876) did not significantly correlate with PET‐CVR, ΔTT showed a significant correlation with PET‐CVR (ρ = −0.2599; p = 0.0002). Moreover, CBV a could not differentiate between the normal and reduced CVR groups, regardless of the CBF conditions. However, within the normal CBF group, the reduced CVR group exhibited a significantly longer ΔTT than the normal CVR group ( p = 0.0069), suggesting its capability to differentiate CVR conditions even under normal CBF conditions. Conclusion The comprehensive use of MP‐ASL DANTE parameters enables a detailed noninvasive evaluation of cerebral hemodynamics in patients with MMD and potentially allows for the detection of early stages of hemodynamic impairment in these patients.
Ishida et al. (Fri,) studied this question.