Prognostic Utility of Arterial Spin Labeling Perfusion MRI in Common Pediatric Neurological Disorders

Abstract

Visualization of cerebral blood flow (CBF) has become an important part of neuroimaging for a wide range of diseases, especially in pediatrics. Arterial spin labeling (ASL) perfusion magnetic resonance imaging (MRI) sequences are increasingly being used to provide MR-based CBF quantification without the need for contrast administration and can be obtained in conjunction with a structural MRI study.

An accurate and early assessment of cerebral perfusion is essential in common pediatric neurological disorders as stroke for determining stroke site, extent, and prognosis. In addition, it aids in preoperative localization of seizure onset zones, particularly in cases of drug-resistant epilepsy. Moreover, ASL can differentiate between low- and high-grade pediatric brain tumors based on their blood flow, and it is used to monitor the effectiveness of treatment over time. This review explores the prognostic implications of ASL-derived parameters in common pediatric neurological disorders, summarizing recent advances in acquisition techniques, pathophysiological insights, and their translation into clinical prognosis.