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<meta name="DC.Title" content="Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations" />
<meta name="DC.Identifier" content="10.3174/ajnr.A3638" />
<meta name="DC.Date" content="2014-01-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2014 by American Journal of Neuroradiology. Indicates open access to non-subscribers at www.ajnr.org" />
<meta name="DC.AccessRights" content="open-access" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Identifying feeding arteries of intracranial AVMs is very important for preoperative evaluation. DSA remains the reference standard for diagnosis but is invasive. Our aim was to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling in identifying feeding arteries of intracranial AVMs by using DSA as the criterion standard.

MATERIALS AND METHODS: Eighteen patients with AVMs were examined with vessel-encoded pseudocontinuous arterial spin-labeling and DSA. Three postlabeling delays (postlabeling delay = 1, 1.3, and 1.6 seconds) were applied in 6 patients, and a single postlabeling delay (1 second) was applied in the remainder. Perfusion-weighted images were decoded into individual vascular territories with standard and relative tagging efficiencies, respectively. The supply fraction of each feeding artery to the AVM was calculated. The within-subject ANOVA was applied to compare supply fractions acquired across 3 postlabeling delays. Receiver operating characteristic analysis curves were calculated to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling for identifying the feeding arteries of AVMs.

RESULTS: There were no significant differences in supply fractions of the 3 major arteries to AVMs acquired with 3 postlabeling delays ( P &gt; .05). For vessel-encoded pseudocontinuous arterial spin-labeling with standard labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.942. The optimal cutoff of the supply fraction for identifying feeding arteries was 15.17%, and the resulting sensitivity and specificity were 84.62% and 93.33%, respectively. For vessel-encoded pseudocontinuous arterial spin-labeling with relative labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.957. The optimal cutoff of the supply fraction was 11.73%, which yielded an 89.74% sensitivity and 93.33% specificity.

CONCLUSIONS: The contribution fraction of each feeding artery of the AVM can be reliably estimated by using vessel-encoded pseudocontinuous arterial spin-labeling. Vessel-encoded pseudocontinuous arterial spin-labeling with either standard or relative labeling efficiencies offers a high level of diagnostic accuracy compared with DSA for identifying feeding arteries.

ASL
:   arterial spin-labeling
AUC
:   area under the ROC curve
LICA
:   left internal carotid artery
PLD
:   postlabeling delay
RICA
:   right internal carotid artery
ROC
:   receiver operating characteristic analysis
VA
:   vertebral artery
VE-PCASL
:   vessel-encoded pseudocontinuous arterial spin-labeling" />
<meta name="DC.Contributor" content="S.L. Yu" />
<meta name="DC.Contributor" content="R. Wang" />
<meta name="DC.Contributor" content="R. Wang" />
<meta name="DC.Contributor" content="S. Wang" />
<meta name="DC.Contributor" content="Y.Q. Yao" />
<meta name="DC.Contributor" content="D. Zhang" />
<meta name="DC.Contributor" content="Y.L. Zhao" />
<meta name="DC.Contributor" content="Z.T. Zuo" />
<meta name="DC.Contributor" content="R. Xue" />
<meta name="DC.Contributor" content="D.J.J. Wang" />
<meta name="DC.Contributor" content="J.Z. Zhao" />
<meta name="article:published_time" content="2014-01-01" />
<meta name="article:section" content="Brain" />
<meta name="citation_title" content="Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Identifying feeding arteries of intracranial AVMs is very important for preoperative evaluation. DSA remains the reference standard for diagnosis but is invasive. Our aim was to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling in identifying feeding arteries of intracranial AVMs by using DSA as the criterion standard.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Eighteen patients with AVMs were examined with vessel-encoded pseudocontinuous arterial spin-labeling and DSA. Three postlabeling delays (postlabeling delay = 1, 1.3, and 1.6 seconds) were applied in 6 patients, and a single postlabeling delay (1 second) was applied in the remainder. Perfusion-weighted images were decoded into individual vascular territories with standard and relative tagging efficiencies, respectively. The supply fraction of each feeding artery to the AVM was calculated. The within-subject ANOVA was applied to compare supply fractions acquired across 3 postlabeling delays. Receiver operating characteristic analysis curves were calculated to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling for identifying the feeding arteries of AVMs.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;There were no significant differences in supply fractions of the 3 major arteries to AVMs acquired with 3 postlabeling delays (&lt;i&gt;P&lt;/i&gt; &amp;gt; .05). For vessel-encoded pseudocontinuous arterial spin-labeling with standard labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.942. The optimal cutoff of the supply fraction for identifying feeding arteries was 15.17%, and the resulting sensitivity and specificity were 84.62% and 93.33%, respectively. For vessel-encoded pseudocontinuous arterial spin-labeling with relative labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.957. The optimal cutoff of the supply fraction was 11.73%, which yielded an 89.74% sensitivity and 93.33% specificity.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;The contribution fraction of each feeding artery of the AVM can be reliably estimated by using vessel-encoded pseudocontinuous arterial spin-labeling. Vessel-encoded pseudocontinuous arterial spin-labeling with either standard or relative labeling efficiencies offers a high level of diagnostic accuracy compared with DSA for identifying feeding arteries.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2014/01/01" />
<meta name="citation_mjid" content="ajnr;35/1/65" />
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<meta name="citation_issn" content="0195-6108" />
<meta name="citation_issn" content="1936-959X" />
<meta name="citation_doi" content="10.3174/ajnr.A3638" />
<meta name="citation_pmid" content="23868147" />
<meta name="citation_volume" content="35" />
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<meta name="citation_article_type" content="Research Article" />
<meta name="citation_section" content="Brain" />
<meta name="citation_firstpage" content="65" />
<meta name="citation_lastpage" content="71" />
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<meta name="citation_author" content="S.L. Yu" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China" />
<meta name="citation_author" content="R. Wang" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China" />
<meta name="citation_author" content="R. Wang" />
<meta name="citation_author_institution" content="bState Key Laboratory of Brain and Cognitive Science (Rui Wang, Z.T.Z., R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China" />
<meta name="citation_author_institution" content="eUniversity of California, Los Angeles–Beijing Joint Center for Advanced Brain Imaging (R.X., Rui Wang, D.J.J.W.), Los Angeles, California and Beijing, China." />
<meta name="citation_author" content="S. Wang" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China" />
<meta name="citation_author" content="Y.Q. Yao" />
<meta name="citation_author_institution" content="cDepartment of Neurosurgery (Y.Q.Y.), Beijing Jishuitan Hospital, Peking University, Beijing, China" />
<meta name="citation_author" content="D. Zhang" />
<meta name="citation_author_institution" content="aFrom the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China" />
<meta name="citation_author" content="Y.L. Zhao" />
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<meta name="citation_author" content="Z.T. Zuo" />
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<meta name="citation_author" content="R. Xue" />
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<meta name="twitter:title" content="Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Identifying feeding arteries of intracranial AVMs is very important for preoperative evaluation. DSA remains the reference standard for diagnosis but is invasive. Our aim was to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling in identifying feeding arteries of intracranial AVMs by using DSA as the criterion standard.

MATERIALS AND METHODS: Eighteen patients with AVMs were examined with vessel-encoded pseudocontinuous arterial spin-labeling and DSA. Three postlabeling delays (postlabeling delay = 1, 1.3, and 1.6 seconds) were applied in 6 patients, and a single postlabeling delay (1 second) was applied in the remainder. Perfusion-weighted images were decoded into individual vascular territories with standard and relative tagging efficiencies, respectively. The supply fraction of each feeding artery to the AVM was calculated. The within-subject ANOVA was applied to compare supply fractions acquired across 3 postlabeling delays. Receiver operating characteristic analysis curves were calculated to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling for identifying the feeding arteries of AVMs.

RESULTS: There were no significant differences in supply fractions of the 3 major arteries to AVMs acquired with 3 postlabeling delays ( P &gt; .05). For vessel-encoded pseudocontinuous arterial spin-labeling with standard labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.942. The optimal cutoff of the supply fraction for identifying feeding arteries was 15.17%, and the resulting sensitivity and specificity were 84.62% and 93.33%, respectively. For vessel-encoded pseudocontinuous arterial spin-labeling with relative labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.957. The optimal cutoff of the supply fraction was 11.73%, which yielded an 89.74% sensitivity and 93.33% specificity.

CONCLUSIONS: The contribution fraction of each feeding artery of the AVM can be reliably estimated by using vessel-encoded pseudocontinuous arterial spin-labeling. Vessel-encoded pseudocontinuous arterial spin-labeling with either standard or relative labeling efficiencies offers a high level of diagnostic accuracy compared with DSA for identifying feeding arteries.

ASL
:   arterial spin-labeling
AUC
:   area under the ROC curve
LICA
:   left internal carotid artery
PLD
:   postlabeling delay
RICA
:   right internal carotid artery
ROC
:   receiver operating characteristic analysis
VA
:   vertebral artery
VE-PCASL
:   vessel-encoded pseudocontinuous arterial spin-labeling" />
<meta name="og-title" property="og:title" content="Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/35/1/65" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Identifying feeding arteries of intracranial AVMs is very important for preoperative evaluation. DSA remains the reference standard for diagnosis but is invasive. Our aim was to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling in identifying feeding arteries of intracranial AVMs by using DSA as the criterion standard.

MATERIALS AND METHODS: Eighteen patients with AVMs were examined with vessel-encoded pseudocontinuous arterial spin-labeling and DSA. Three postlabeling delays (postlabeling delay = 1, 1.3, and 1.6 seconds) were applied in 6 patients, and a single postlabeling delay (1 second) was applied in the remainder. Perfusion-weighted images were decoded into individual vascular territories with standard and relative tagging efficiencies, respectively. The supply fraction of each feeding artery to the AVM was calculated. The within-subject ANOVA was applied to compare supply fractions acquired across 3 postlabeling delays. Receiver operating characteristic analysis curves were calculated to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling for identifying the feeding arteries of AVMs.

RESULTS: There were no significant differences in supply fractions of the 3 major arteries to AVMs acquired with 3 postlabeling delays ( P &gt; .05). For vessel-encoded pseudocontinuous arterial spin-labeling with standard labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.942. The optimal cutoff of the supply fraction for identifying feeding arteries was 15.17%, and the resulting sensitivity and specificity were 84.62% and 93.33%, respectively. For vessel-encoded pseudocontinuous arterial spin-labeling with relative labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.957. The optimal cutoff of the supply fraction was 11.73%, which yielded an 89.74% sensitivity and 93.33% specificity.

CONCLUSIONS: The contribution fraction of each feeding artery of the AVM can be reliably estimated by using vessel-encoded pseudocontinuous arterial spin-labeling. Vessel-encoded pseudocontinuous arterial spin-labeling with either standard or relative labeling efficiencies offers a high level of diagnostic accuracy compared with DSA for identifying feeding arteries.

ASL
:   arterial spin-labeling
AUC
:   area under the ROC curve
LICA
:   left internal carotid artery
PLD
:   postlabeling delay
RICA
:   right internal carotid artery
ROC
:   receiver operating characteristic analysis
VA
:   vertebral artery
VE-PCASL
:   vessel-encoded pseudocontinuous arterial spin-labeling" />
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    <title>Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations | American Journal of Neuroradiology</title>  
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node12647--5" data-node-nid="12647" id="top-node-12647--6801954848" data-pisa="ajnr;35/1/65" data-pisa-master="ajnr;ajnr.A3638" data-apath="/ajnr/35/1/65.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Brain</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
      <h1 class="highwire-cite-title" id="page-title">Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S.L. Yu</span>, <span class="highwire-citation-author" data-delta="1">R. Wang</span>, <span class="highwire-citation-author" data-delta="2">R. Wang</span>, <span class="highwire-citation-author" data-delta="3">S. Wang</span>, <span class="highwire-citation-author" data-delta="4">Y.Q. Yao</span>, <span class="highwire-citation-author" data-delta="5">D. Zhang</span>, <span class="highwire-citation-author" data-delta="6">Y.L. Zhao</span>, <span class="highwire-citation-author" data-delta="7">Z.T. Zuo</span>, <span class="highwire-citation-author" data-delta="8">R. Xue</span>, <span class="highwire-citation-author" data-delta="9">D.J.J. Wang</span> and <span class="highwire-citation-author" data-delta="10">J.Z. Zhao</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">January 2014,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">65-71; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A3638 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-12647--6801954848" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S.L. Yu </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.L.%2BYu%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yu%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.L.%2BYu%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">R. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">R. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>State Key Laboratory of Brain and Cognitive Science (Rui Wang, Z.T.Z., R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>e</span>University of California, Los Angeles–Beijing Joint Center for Advanced Brain Imaging (R.X., Rui Wang, D.J.J.W.), Los Angeles, California and Beijing, China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">S. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AS.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Y.Q. Yao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Neurosurgery (Y.Q.Y.), Beijing Jishuitan Hospital, Peking University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.Q.%2BYao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Yao%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.Q.%2BYao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">D. Zhang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.%2BZhang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhang%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.%2BZhang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">Y.L. Zhao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Y.L.%2BZhao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhao%20Y&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AY.L.%2BZhao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">Z.T. Zuo </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>State Key Laboratory of Brain and Cognitive Science (Rui Wang, Z.T.Z., R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Z.T.%2BZuo%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zuo%20Z&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AZ.T.%2BZuo%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-8"><div class="author-tooltip-name">R. Xue </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>State Key Laboratory of Brain and Cognitive Science (Rui Wang, Z.T.Z., R.X.), Beijing MRI Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China</div><div class='author-affiliation'><span class='nlm-sup'>e</span>University of California, Los Angeles–Beijing Joint Center for Advanced Brain Imaging (R.X., Rui Wang, D.J.J.W.), Los Angeles, California and Beijing, China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BXue%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Xue%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AR.%2BXue%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-9"><div class="author-tooltip-name">D.J.J. Wang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurology (D.J.J.W.), University of California, Los Angeles, Los Angeles, California</div><div class='author-affiliation'><span class='nlm-sup'>e</span>University of California, Los Angeles–Beijing Joint Center for Advanced Brain Imaging (R.X., Rui Wang, D.J.J.W.), Los Angeles, California and Beijing, China.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=D.J.J.%2BWang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Wang%20D&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AD.J.J.%2BWang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-10"><div class="author-tooltip-name">J.Z. Zhao </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Department of Neurosurgery (S.L.Y., Rong Wang, S.W., D.Z., Y.L.Z., J.Z.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.Z.%2BZhao%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Zhao%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJ.Z.%2BZhao%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article abstract-view "><span class="highwire-journal-article-marker-start"></span><div class="section abstract" id="abstract-1"><h2>Abstract</h2>
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<p id="p-2"><strong>BACKGROUND AND PURPOSE:</strong> Identifying feeding arteries of intracranial AVMs is very important for preoperative evaluation. DSA remains the reference standard for diagnosis but is invasive. Our aim was to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling in identifying feeding arteries of intracranial AVMs by using DSA as the criterion standard.</p>
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<p id="p-3"><strong>MATERIALS AND METHODS:</strong> Eighteen patients with AVMs were examined with vessel-encoded pseudocontinuous arterial spin-labeling and DSA. Three postlabeling delays (postlabeling delay = 1, 1.3, and 1.6 seconds) were applied in 6 patients, and a single postlabeling delay (1 second) was applied in the remainder. Perfusion-weighted images were decoded into individual vascular territories with standard and relative tagging efficiencies, respectively. The supply fraction of each feeding artery to the AVM was calculated. The within-subject ANOVA was applied to compare supply fractions acquired across 3 postlabeling delays. Receiver operating characteristic analysis curves were calculated to evaluate the diagnostic accuracy of vessel-encoded pseudocontinuous arterial spin-labeling for identifying the feeding arteries of AVMs.</p>
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<p id="p-4"><strong>RESULTS:</strong> There were no significant differences in supply fractions of the 3 major arteries to AVMs acquired with 3 postlabeling delays (<em>P</em> &gt; .05). For vessel-encoded pseudocontinuous arterial spin-labeling with standard labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.942. The optimal cutoff of the supply fraction for identifying feeding arteries was 15.17%, and the resulting sensitivity and specificity were 84.62% and 93.33%, respectively. For vessel-encoded pseudocontinuous arterial spin-labeling with relative labeling efficiencies, the area under the receiver operating characteristic analysis curve was 0.957. The optimal cutoff of the supply fraction was 11.73%, which yielded an 89.74% sensitivity and 93.33% specificity.</p>
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<p id="p-5"><strong>CONCLUSIONS:</strong> The contribution fraction of each feeding artery of the AVM can be reliably estimated by using vessel-encoded pseudocontinuous arterial spin-labeling. Vessel-encoded pseudocontinuous arterial spin-labeling with either standard or relative labeling efficiencies offers a high level of diagnostic accuracy compared with DSA for identifying feeding arteries.</p>
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</div><div class="section glossary" id="glossary-1"><h2>ABBREVIATIONS:</h2>
<dl id="def-list-1"><dt id="def-item-1">ASL<span class="def-item-dt-sep"></span></dt><dd>arterial spin-labeling<span class="def-item-dd-sep"></span></dd><dt id="def-item-2">AUC<span class="def-item-dt-sep"></span></dt><dd>area under the ROC curve<span class="def-item-dd-sep"></span></dd><dt id="def-item-3">LICA<span class="def-item-dt-sep"></span></dt><dd>left internal carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-4">PLD<span class="def-item-dt-sep"></span></dt><dd>postlabeling delay<span class="def-item-dd-sep"></span></dd><dt id="def-item-5">RICA<span class="def-item-dt-sep"></span></dt><dd>right internal carotid artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-6">ROC<span class="def-item-dt-sep"></span></dt><dd>receiver operating characteristic analysis<span class="def-item-dd-sep"></span></dd><dt id="def-item-7">VA<span class="def-item-dt-sep"></span></dt><dd>vertebral artery<span class="def-item-dd-sep"></span></dd><dt id="def-item-8">VE-PCASL<span class="def-item-dt-sep"></span></dt><dd>vessel-encoded pseudocontinuous arterial spin-labeling</dd></dl>
</div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2014 by American Journal of Neuroradiology</li></ul><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org">www.ajnr.org</a></p></div><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div><a href="http://ajnr-stage2.stage.highwire.org/content/35/1/65.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 35</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 1 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Jan 2014 </div></div>
      
      
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      <div class="highwire-cite-title">Accuracy of Vessel-Encoded Pseudocontinuous Arterial Spin-Labeling in Identification of Feeding Arteries in Patients with Intracranial Arteriovenous Malformations</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">S.L.</span> <span class="nlm-surname">Yu</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">S.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Y.Q.</span> <span class="nlm-surname">Yao</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">D.</span> <span class="nlm-surname">Zhang</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">Y.L.</span> <span class="nlm-surname">Zhao</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">Z.T.</span> <span class="nlm-surname">Zuo</span></span>, <span class="highwire-citation-author" data-delta="8"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Xue</span></span>, <span class="highwire-citation-author" data-delta="9"><span class="nlm-given-names">D.J.J.</span> <span class="nlm-surname">Wang</span></span>, <span class="highwire-citation-author" data-delta="10"><span class="nlm-given-names">J.Z.</span> <span class="nlm-surname">Zhao</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">65-71; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3638 </span></div>
  
  
  
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Jan 2014, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">35 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(1) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">65-71; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A3638 </span></div>
  
  
  
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