European Radiology

, Volume 28, Issue 11, pp 4890–4899 | Cite as

Correlation-based perfusion mapping using time-resolved MR angiography: A feasibility study for patients with suspicions of steno-occlusive craniocervical arteries

  • Yoonho Nam
  • Jinhee JangEmail author
  • Sonya Youngju Park
  • Hyun Seok Choi
  • So-Lyung Jung
  • Kook-Jin Ahn
  • Bum-soo Kim



To explore the feasibility of using correlation-based time-delay (CTD) maps produced from time-resolved MR angiography (TRMRA) to diagnose perfusion abnormalities in patients suspected to have steno-occlusive lesions in the craniocervical arteries.

Materials and methods

Twenty-seven patients who were suspected to have steno-occlusive lesions in the craniocervical arteries underwent both TRMRA and brain single-photon emission computed tomography (SPECT). TRMRA was performed on the supra-aortic area after intravenous injection of a 0.03 mmol/kg gadolinium-based contrast agent. Time-to-peak (TTP) maps and CTD maps of the brain were automatically generated from TRMRA data, and their quality was assessed. Detection of perfusion abnormalities was compared between CTD maps and the time-series maximal intensity projection (MIP) images from TRMRA and TTP maps. Correlation coefficients between quantitative changes in SPECT and parametric maps for the abnormal perfusion areas were calculated.


The CTD maps were of significantly superior quality than TTP maps (p < 0.01). For perfusion abnormality detection, CTD maps (kappa 0.84, 95% confidence interval [CI] 0.67-1.00) showed better agreement with SPECT than TTP maps (0.66, 0.46-0.85). For perfusion deficit detection, CTD maps showed higher accuracy (85.2%, 95% CI 66.3-95.8) than MIP images (66.7%, 46-83.5), with marginal significance (p = 0.07). In abnormal perfusion areas, correlation coefficients between SPECT and CTD (r = 0.74, 95% CI 0.34-0.91) were higher than those between SPECT and TTP (r = 0.66, 0.20-0.88).


CTD maps generated from TRMRA were of high quality and offered good diagnostic performance for detecting perfusion abnormalities associated with steno-occlusive arterial lesions in the craniocervical area.

Key Points

• Generation of perfusion parametric maps from time-resolved MR angiography is clinically useful.

• Correlation-based delay maps can be used to detect perfusion abnormalities associated with steno-occlusive craniocervical arteries.

• Estimation of correlation-based delay is robust for low signal-to-noise 4D MR data.


Magnetic resonance angiography Perfusion Stenosis Computer-assisted image processing Comparative study 



Alberta Stroke Program Early CT score


Confidence interval


Correlation-based time delay


Digital subtraction cerebral angiography


Gadolinium-based contrast agent


High-resolution contrast-enhanced MR angiography


Internal carotid artery


Intra-class coefficients


Interquartile range


Middle cerebral artery


Maximal intensity projection


Region of interest


Signal-to-noise ratio


Time-resolved, multiphasic MR angiography


Time to peak


Time-resolved angiography with stochastic trajectories



This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2017R1D1A1B03033829).

Compliance with ethical standards


The scientific guarantor of this publication is Bum-soo Kim.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• cross-sectional study

• performed at one institution

Supplementary material

330_2018_5468_MOESM1_ESM.docx (38 kb)
ESM 1 (DOCX 37.6 kb)


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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  1. 1.Department of Radiology, Seoul St. Mary’s Hospital, College of MedicineThe Catholic University of KoreaSeoulKorea

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