# Multidelay ASL of the pediatric brain

## TL;DR

This paper explains how multidelay arterial spin labeling (MDASL) improves cerebral blood flow measurements in children using multiple timing delays.

## Contribution

The paper introduces MDASL as a novel approach to enhance cerebral blood flow accuracy in pediatric MRI.

## Key findings

- MDASL improves cerebral blood flow calculations by accounting for arterial transit time.
- MDASL is particularly useful in young subjects and slow-flow conditions.
- The paper provides practical clinical applications of MDASL in various pediatric brain conditions.

## Abstract

Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for
evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is
the choice of postlabel delay (PLD), which refers to the timing between the
labeling of arterial free water and measurement of flow into the brain.
Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF
calculations using arterial transit time (ATT) correction. This approach is
particularly helpful in situations where ATT is unknown, including young
subjects and slow-flow conditions. In this article, we discuss the technical
considerations for MDASL, including labeling techniques, quantitative metrics,
and technical artefacts. We then provide a practical summary of key clinical
applications with real-life imaging examples in the pediatric brain, including
stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor,
infection, and metabolic disease.