The term “perfusion” is also used to emphasize contact with the tissue, or in other words, capillary blood flow. Perfusion is physiologically defined as the steady-state delivery of blood to an element of tissue. Question 2: Which Methods Are Currently Available to Assess Perfusion With MRI?-Overview of Technical Considerations In this article, we will also briefly address the technical requirements, including the use of contrast-enhanced techniques as well as the clinical applications in brain tumor imaging and acute stroke management. In this article, we will address five questions that radiologists and radiographers frequently ask when planning, performing, processing, and interpreting different perfusion MRI studies in diseases of the CNS. Today, we have several techniques to derive perfusion-related parameters using endogenous contrast methods or, more robustly and more widely used, exogenous gadolinium-based contrast agent dynamic methods. In this context, perfusion is one of the most important physiologic and pathophysiologic parameters and can be assessed non-invasively with MRI. Multiple studies have shown that the optimized use of high-quality contrast media in perfusion MRI can substantially improve detection, characterization, and monitoring of CNS diseases. The use of these functional imaging techniques has improved the differential diagnosis of CNS disease and the therapeutic management of patients and has enabled better assessment of treatment-related changes on follow-up. In recent years, however, there have been substantial improvements in MR protocols with a special focus on the assessment of functional tissue characteristics, such as perfusion or metabolism. Initially, most attention was focused on the improvement of visualization and resolution of morphologic characteristics. Since its introduction, MRI has been used in the assessment of a variety of CNS abnormalities, including tumors, metastases, infections, and vascular and degenerative diseases.
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