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      Interrogating the Functional Correlates of Collateralization in Patients with Intracranial Stenosis Using Multimodal Hemodynamic Imaging  
    	
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    The authors assessed correlations among baseline perfusion and arterial transit time artifacts, cerebrovascular reactivity, and the presence of collateral vessels on digital subtraction angiography. Arterial spin-labeling MRI and DSA were compared with BOLD MR imaging measures of hypercapnic cerebrovascular reactivity in 18 patients with symptomatic intracranial stenosis. In regions with normal-to-high signal on ASL, collateral vessel presence on DSA strongly correlated with declines in cerebrovascular reactivity (as measured on BOLD MRI). These data support the use of ASL MR imaging rather than invasive DSA to assess the presence of collateralization, even for patients with internal carotid stenosis from nonatherosclerotic etiologies. Also, collaterals identified on ASL with arterial transit artifacts correlated with decreased CVR compared with regions not perfused via collaterals.
    
  
  

    

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      Incidence of Radiologically Isolated Syndrome: A Population-Based Study  
    	
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    American Journal of Neuroradiology June 2016, 37 (6) 1017-1022; DOI: https://doi.org/10.3174/ajnr.A4660 
    
  
  
  

    

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    EDITOR'S CHOICEADULT BRAIN 
    
  
      
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      Clinical Feasibility of Synthetic MRI in Multiple Sclerosis: A Diagnostic and Volumetric Validation Study  
    	
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    SyMRI is a quantitative synthetic MR imaging method where a single saturation recovery TSE sequence is used to estimate the proton density, longitudinal relaxation rate, and transverse relaxation rate and allows for a free range of synthetic weightings. Twenty patients with MS and 20 healthy controls were enrolled and synthetic MR imaging was implemented on a Siemens 3T scanner. Diagnostic accuracy, lesion detection, and artifacts were assessed by blinded neuroradiologic evaluation, and CNR by manual tracing. Synthetic PD-, T1-, and T2-weighted images were of sufficient or good quality and were acquired in 7% less time than with conventional MRI. Synthetic FLAIR images suffered from artifacts. Also, synthetic MRI provided segmentations with the shortest processing time (16 seconds) and the lowest repeatability error for brain volume. Synthetic MRI can be an alternative to conventional MRI for generating diagnostic PD-, T1-, and T2-weighted images in patients with MS with fast and robust volumetric measurements.
    
  
  

    

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