Vascular imaging techniques and tools have seen vast improvements in recent decades. In Vascular Imaging of the Central Nervous System, Dr. Castillo and Dr. Ramalho provide radiologists with a guide to choosing the most appropriate technique for each situation.

List of Contributors, vii Preface, ix Acknowledgments, x Part One Ultrasound Vascular Imaging (UVI), 1 1 Basic Principles of Ultrasound Sonography, 3 Ana Maria Braz, Jaime Leal Pamplona and Joana N. Ramalho 2 Clinical Applications of Ultrasound Vascular Imaging, 14 Ana Maria Braz, Maria Madalena Patricio, and Joana N. Ramalho Clinical Vignette #1 – Occlusive dissection of the proximal primitive carotid artery with extension to the ICA, 29 3 Novel Applications of Ultrasound Vascular Imaging, 33 Elsa Irene Azevedo and Pedro Miguel Castro Clinical Vignette #1 – Indirect signs of carotid dissection, 60 Clinical Vignette #2 – A case of severe perfusion deficit and lack of cerebral vasoreactivity in spite of normal neurologic examination and cranial CT, 61 Part Two Computed Tomography Angiography (CTA), 67 4 Basic Principles of Computed Tomography Angiography (CTA), 69 Margareth Kimura and Mauricio Castillo Clinical Vignette # 1 – Revascularization procedure evaluation by CTA, 81 5 Intracranial Computed Tomography Angiography (CTA), 83 Isabel R. Fragata and Joana N. Ramalho Clinical Vignette #1 – Acute stroke, 105 Clinical Vignette #2 – Acute intracerebral hematoma, 105 6 Extracranial Computed Tomography Angiography (CTA), 110 Tiago Baptista and João Lopes Reis Clinical Vignette #1 – Carotid stenosis, 118 Part Three Magnetic Resonance Vascular Imaging (MRV), 125 7 Basic Principles of Time-of-Flight Magnetic Resonance Angiography (TOF MRA) and MRV, 127 Hugo Alexandre Ferreira and Joana N. Ramalho 8 Basic Principles of Phase Contrast Magnetic Resonance Angiography (PC MRA) and MRV, 137 Hugo Alexandre Ferreira and Joana N. Ramalho 9 Time-of-Flight Magnetic Resonance Angiography (TOF MRA) and MRV: Clinical Applications, 146 Mauricio Castillo, Juan Camilo Márquez, and Francisco José Medina 10 Phase Contrast Magnetic Resonance Angiography (PC MRA) and Flow Analysis: Clinical Applications, 161 Pedro Vilela Clinical Vignette #1 – PC MRA, 171 11 Contrast-Enhanced Magnetic Resonance Angiography (MRA): Fundamentals and Clinical Applications, 176 Khurram Javed and Mauricio Castillo Clinical Vignette #1 – Internal carotid artery stenosis quantifi cation, 183 12 Intracranial Magnetic Resonance Angiography (MRA), 1.5 T versus 3 T: Advantages and Disadvantages, 186 Sara Safder, Benjamin Huang, and Mauricio Castillo Clinical Vignette #1 – Questionable middle cerebral artery stenosis, 192 13 Time-Resolved Techniques, Basic Principles, and Clinical Applications, 194 Nuno Almeida, David Silva Monteiro, and Daniela Seixas Clinical Vignette # 1 – Occipital arteriovenous malformation (AVM), 204 Part Four Digital Subtraction Angiography (DSA), 207 14 Digital Subtraction Angiography (DSA): Basic Principles, 209 Mauricio Castillo Clinical Vignette #1 – Use of DSA in seizure patient, 219 15 Digital Subtraction Angiography (DSA) in Clinical Practice, 221 Yueh Z. Lee and Mauricio Castillo 16 Advanced and Future Digital Subtraction Angiography (DSA) Applications, 229 Pedro Vilela Clinical Vignette #1 – Digital subtraction angiography, 247 Part Five Brain Perfusion Techniques: Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), 255 17 Computed Tomography (CT) Perfusion: Basic Principles and Clinical Applications, 257 Joana N. Ramalho and Isabel R. Fragata Clinical Vignette # 1 – Acute stroke, 272 18 Dynamic Susceptibility Contrast-Enhanced MRI Perfusion: Basic Principles and Clinical Applications, 275 Francisco José Medina, Mauricio Castillo, and Juan Camilo Márquez 19 Arterial Spin Labeling (ASL) Perfusion: Basic Concepts, Artifacts, and Clinical Applications, 294 Debora Bertholdo and Mauricio Castillo Part Six Plaque Imaging, 307 20 Imaging of Carotid Plaque, 309 Sangam G. Kanekar Clinical Vignette #1 – Case examples, 332 Part Seven Intravascular Imaging, 345 21 Basic Concepts and Clinical Applications of Intravascular Imaging, 347 Hideki Kitahara, Peter J. Fitzgerald, Paul G. Yock, and Yasuhiro Honda Clinical Vignette #1 – Right internal carotid artery stenosis and left internal carotid artery occlusion, 368 Part Eight Pediatric Vascular Imaging, 371 22 Pediatric Vascular Imaging Techniques and Clinical Applications, 373 Carla R. Conceição, Rita Lopes da Silva and Joana N. Ramalho Clinical Vignette #1 – Use of CT and MRI in a pediatric patient, 401 Index, 405

The first book-length reference to thoroughly describe diagnostic and therapeutic advances in the development of vascular radiology over the last decade The last ten years has seen vascular imaging of the central nervous system (CNS) evolve from fairly crude, invasive procedures to more advanced imaging methods that are safer, faster, and more precise—with computed tomographic (CT) and magnetic resonance (MR) imaging methods playing a special role in these advances. Vascular Imaging of the Central Nervous System is the first full-length reference text that shows radiologists—especially neuroradiologists—how to optimize the use of the many techniques available in order to increase the sensitivity and specificity of vascular imaging, thereby improving the diagnosis and treatment of individual patients. Each chapter is formatted carefully and divided into two essential parts: The first part describes the physical principles underlying each imaging technique, along potential associated artifacts and pitfalls; the second part addresses clinical applications and novel applications of each method. With a strong focus on the clinical application of each modality or technique in CNS radiology, this book provides in-depth chapter coverage of: • Ultrasound Vascular Imaging (UVI) • Computed Tomography Angiography (CTA) • Magnetic Resonance Vascular imaging (MRV) • Digital subtraction angiography (DSA) • Brain perfusion techniques: CT and MRI • Plaque imaging • Intravascular imaging • Pediatric vascular imaging Along with numerous illustrations and case studies, Vascular Imaging of the Central Nervous System: Physical Principles, Clinical Applications, and Emerging Techniques is an important book for those faced with choosing from the wide range of choices available for clinical practice.