Distribution of Cerebral Blood Flow in the Nucleus Caudatus, Nucleus Lentiformis, and Thalamus: A Study of Territorial Arterial Spin-labeling MR Imaging

Published Online:https://doi.org/10.1148/radiol.09090284

The advantages of the proposed MR imaging method for visualization of the perfusion territories of the deep-brain structures are its noninvasive nature and ability to image the perfusion territories of all the major brain-feeding arteries simultaneously.

Purpose

To investigate the effect of variations in anatomic features of the circle of Willis on the perfusion territory to deep structures, including the nucleus caudatus, the nucleus lentiformis, and the thalamus.

Materials and Methods

The ethics committee of the study institution approved the study protocol. A total of 159 patients with first-time clinical symptoms of cerebral ischemia were recruited. Contributions to the perfusion territory were visualized with territorial arterial spin-labeling magnetic resonance (MR) imaging. The anatomic features of the circle of Willis were evaluated with time-of-flight MR angiography. Perfusion territory contributions were compared among circle of Willis variants by using the Cochran-Mantel-Haenszel test.

Results

The perfusion territory contributions to the deep-brain structures could be evaluated in 119 of 159 patients (75%). With a fetal-type circle of Willis (41 of 238 hemispheres; 17%), there was a contribution from the ipsilateral internal carotid artery to the thalamus in all 41 hemispheres (100%), compared with 96 of the 197 hemispheres (49%) without a fetal-type circle of Willis. In the 19 patients with a hypoplastic A1 segment, there was more often a contribution of the contralateral internal carotid artery to the perfusion of the nucleus caudatus (10 of 19; 53%) and the nucleus lentiformis (5 of 19; 26%).

Conclusion

The perfusion territory contributions to deep-brain structures vary widely. These differences can be partly explained by variations in the anatomic features of the circle of Willis.

© RSNA, 2010

References

  • 1 Tatu L, Moulin T, Monnier G. The discovery of encephalic arteries. From Johann Jacob Wepfer to Charles Foix. Cerebrovasc Dis 2005;20:427–432.
  • 2 Beevor CE. The cerebral arterial supply. Brain 1908;30:403–425.
  • 3 van der Zwan A, Hillen B, Tulleken CAF, Dujovny M, Dragovic L. Variability of the territories of the major cerebral arteries. J Neurosurg 1992;77:927–940.
  • 4 Lasjaunias P, Berenstein A, Ter Brugge KG. Intradural arteries. In: Surgical neuro-angiography. Vol 1: Clinical vascular anatomy and variations 2nd ed. Berlin, Germany: Springer-Verlag, 2001; 479–629.
  • 5 Cosson A, Tatu L, Vuillier F, Parratte B, Diop M, Monnier G. Arterial vascularization of the human thalamus: extra-parenchymal arterial groups. Surg Radiol Anat 2003;25:408–415.
  • 6 Van Laar PJ, Hendrikse J, Golay X, Lu H, van Osch MJ, van der Grond J. In vivo flow territory mapping of major brain feeding arteries. Neuroimage 2006;29:136–144.
  • 7 Jeffery PJ, Monsein LH, Szabo Z, et al.. Mapping the distribution of amobarbital sodium in the intracarotid Wada test by use of Tc-99m HMPAO with SPECT. Radiology 1991;178:847–850.
  • 8 Lee JS, Lee DS, Kim YK, et al.. Probabilistic map of blood flow distribution in the brain from the internal carotid artery. Neuroimage 2004;23:1422–1431.
  • 9 Kim SJ, Kim IJ, Kim YK, et al.. Probabilistic anatomic mapping of cerebral blood flow distribution of the middle cerebral artery. J Nucl Med 2008;49:39–43.
  • 10 von Oertzen J, Klemm E, Urbach H, et al.. SATSCOM–Selective amobarbital test intraarterial SPECT coregistered to MRI: description of a method assessing selective perfusion. Neuroimage 2000;12:617–622.
  • 11 Hendrikse J, van der Grond J, Lu H, van Zijl PC, Golay X. Flow territory mapping of the cerebral arteries with regional perfusion MRI. Stroke 2004;35:882–887.
  • 12 Chng SM, Petersen ET, Zimine I, Sitoh YY, Lim CC, Golay X. Territorial arterial spin labeling in the assessment of collateral circulation: comparison with digital subtraction angiography. Stroke 2008;39:3248–3254.
  • 13 Kansagra AP, Wong EC. Mapping of vertebral artery perfusion territories using arterial spin labeling MRI. J Magn Reson Imaging 2008;28:762–766.
  • 14 Hendrikse J, Petersen ET, Cheze A, Chng SM, Venketasubramanian N, Golay X. Relation between cerebral perfusion territories and location of cerebral infarcts. Stroke 2009;40:1617–1622.
  • 15 Wu B, Wang X, Guo J, et al.. Collateral circulation imaging: MR perfusion territory arterial spin-labeling at 3T. AJNR Am J Neuroradiol 2008;29:1855–1860.
  • 16 Jones CE, Wolf RL, Detre JA, et al.. Structural MRI of carotid artery atherosclerotic lesion burden and characterization of hemispheric cerebral blood flow before and after carotid endarterectomy. NMR Biomed 2006;19:198–208.
  • 17 Petersen ET, Lim T, Golay X. Model-free arterial spin labeling quantification approach for perfusion MRI. Magn Reson Med 2006;55:219–232.
  • 18 Golay X, Petersen ET, Hui F. Pulsed star labeling of arterial regions (PULSAR): a robust regional perfusion technique for high field imaging. Magn Reson Med 2005;53:15–21.
  • 19 Ances BM, Roc AC, Wang J, et al.. Caudate blood flow and volume are reduced in HIV+ neurocognitively impaired patients. Neurology 2006;66:862–866.
  • 20 Alsop DC, Casement M, de BC, Fong T, Press DZ. Hippocampal hyperperfusion in Alzheimer’s disease. Neuroimage 2008;42:1267–1274.
  • 21 Asllani I, Habeck C, Scarmeas N, Borogovac A, Brown TR, Stern Y. Multivariate and univariate analysis of continuous arterial spin labeling perfusion MRI in Alzheimer’s disease. J Cereb Blood Flow Metab 2008;28:725–736.
  • 22 Jackson C, Sudlow C. Are lacunar strokes really different? A systematic review of differences in risk factor profiles between lacunar and nonlacunar infarcts. Stroke 2005;36:891–901.
  • 23 Gouw AA, van der Flier WM, Pantoni L, et al.. On the etiology of incident brain lacunes: longitudinal observations from the LADIS study. Stroke 2008;39:3083–3085.
  • 24 Bogousslavsky J, Regli F, Uske A. Thalamic infarcts: clinical syndromes, etiology, and prognosis. Neurology 1988;38:837–848.
  • 25 Weidauer S, Nichtweiss M, Zanella FE, Lanfermann H. Assessment of paramedian thalamic infarcts: MR imaging, clinical features and prognosis. Eur Radiol 2004;14:1615–1626.
  • 26 Wong EC. Vessel-encoded arterial spin-labeling using pseudocontinuous tagging. Magn Reson Med 2007;58:1086–1091.

Article History

Received February 14, 2009; revision requested April 18; revision received June 22; accepted July 15; final version accepted September 9.
Published online: Feb 8 2010
Published in print: Mar 2010