Publication date: Feb 13, 2025

Perfusion imaging of the brain has important clinical applications in detecting neurological abnormalities in neonates. However, such tools have not been available to date. Although arterial-spin-labeling (ASL) MRI is a powerful noninvasive tool to measure perfusion, its application in neonates has encountered obstacles related to low signal-to-noise ratio (SNR), large-vessel contaminations, and lack of technical development studies. To systematically develop and optimize ASL perfusion MRI in healthy neonates under 1 week of age. Prospective. Thirty-two healthy term neonates (19 female; postnatal age 1. 9 +/- 0. 7 days). 3. 0 T; T-weighted half-Fourier single-shot turbo-spin-echo (HASTE) imaging, single-delay and multi-delay 3D gradient-and-spin-echo (GRASE) large-vessel-suppression pseudo-continuous ASL (LVS-pCASL). Three studies were conducted. First, an LVS-pCASL MRI sequence was developed to suppress large-vessel spurious signals in neonatal pCASL. Second, multiple post-labeling delays (PLDs) LVS-pCASL were employed to simultaneously estimate normative cerebral blood flow (CBF) and arterial transit time (ATT) in neonates. Third, an enhanced background-suppression (BS) scheme was developed to increase the SNR of neonatal pCASL. Repeated measure analysis-of-variance, paired t-test, spatial intraclass-correlation-coefficient (ICC), and voxel-wise coefficient-of-variation (CoV). P-value

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