{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T05:47:08Z","timestamp":1785217628699,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T00:00:00Z","timestamp":1739404800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000070","name":"National Institute of Biomedical Imaging and Bioengineering","doi-asserted-by":"publisher","award":["P41 EB031771"],"award-info":[{"award-number":["P41 EB031771"]}],"id":[{"id":"10.13039\/100000070","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"National Institute of Neurological Disorders and Stroke","doi-asserted-by":"publisher","award":["R01 NS109029"],"award-info":[{"award-number":["R01 NS109029"]}],"id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"published-print":{"date-parts":[[2025,9]]},"abstract":"Background<\/jats:title>Perfusion imaging of the brain has important clinical applications in detecting neurological abnormalities in neonates. However, such tools have not been available to date. Although arterial\u2010spin\u2010labeling (ASL) MRI is a powerful noninvasive tool to measure perfusion, its application in neonates has encountered obstacles related to low signal\u2010to\u2010noise ratio (SNR), large\u2010vessel contaminations, and lack of technical development studies.<\/jats:p><\/jats:sec>Purpose<\/jats:title>To systematically develop and optimize ASL perfusion MRI in healthy neonates under 1\u2009week of age.<\/jats:p><\/jats:sec>Study Type<\/jats:title>Prospective.<\/jats:p><\/jats:sec>Subjects<\/jats:title>Thirty\u2010two healthy term neonates (19 female; postnatal age 1.9\u2009\u00b1\u20090.7\u2009days).<\/jats:p><\/jats:sec>Field Strength\/Sequence<\/jats:title>3.0\u2009T<\/jats:styled-content>; T2<\/jats:sub>\n<\/jats:styled-content>\u2010weighted half\u2010Fourier single\u2010shot turbo\u2010spin\u2010echo (HASTE<\/jats:styled-content>) imaging, single\u2010delay and multi\u2010delay 3D<\/jats:styled-content> gradient\u2010and\u2010spin\u2010echo (GRASE<\/jats:styled-content>) large\u2010vessel\u2010suppression pseudo\u2010continuous ASL<\/jats:styled-content> (LVS<\/jats:styled-content>\u2010pCASL<\/jats:styled-content>).<\/jats:p><\/jats:sec>Assessment<\/jats:title>Three studies were conducted. First, an LVS\u2010pCASL MRI sequence was developed to suppress large\u2010vessel spurious signals in neonatal pCASL. Second, multiple post\u2010labeling delays (PLDs) LVS\u2010pCASL were employed to simultaneously estimate normative cerebral blood flow (CBF) and arterial transit time (ATT) in neonates. Third, an enhanced background\u2010suppression (BS) scheme was developed to increase the SNR of neonatal pCASL.<\/jats:p><\/jats:sec>Statistical Tests<\/jats:title>Repeated measure analysis\u2010of\u2010variance, paired t<\/jats:italic>\u2010test, spatial intraclass\u2010correlation\u2010coefficient (ICC), and voxel\u2010wise coefficient\u2010of\u2010variation (CoV). P<\/jats:italic>\u2010value <0.05 was considered significant.<\/jats:p><\/jats:sec>Results<\/jats:title>LVS\u2010pCASL reduced spurious ASL signals, making the CBF images more homogenous and significantly reducing the temporal variation of CBF measurements by 58.0% when compared to the standard pCASL. Multi\u2010PLD ASL yielded ATT and CBF maps showing a longer ATT and lower CBF in the white matter relative to the gray matter. The highest CBF was observed in basal ganglia and thalamus (10.4\u2009\u00b1\u20091.9\u2009mL\/100\u2009g\/min). Enhanced BS resulted in significantly higher test\u2013retest reproducibility (ICC\u2009=\u20090.90\u2009\u00b1\u20090.04, CoV\u2009=\u20098.4\u2009\u00b1\u20091.2%) when compared to regular BS (ICC\u2009=\u20090.59\u2009\u00b1\u20090.12, CoV\u2009=\u200923.6\u2009\u00b1\u20093.8%).<\/jats:p><\/jats:sec>Data Conclusion<\/jats:title>We devised an ASL method that can generate whole\u2010brain CBF images in 4\u2009minutes with a test\u2013retest image ICC of 0.9. This technique holds potential for studying neonatal brain diseases involving perfusion abnormalities.<\/jats:p><\/jats:sec>Plain Language Summary<\/jats:title>MR imaging of cerebral blood flow in neonates remains a challenge due to low blood flow rates and confounding factors from large blood vessels. This study systematically developed an advanced MRI technique to enhance the reliability of perfusion measurements in neonates. The proposed method reduced signal artifacts from large blood vessels and improved the signal\u2010to\u2010noise ratio of brain perfusion images. With this approach, whole\u2010brain neonatal perfusion can be measured in 4\u2009minutes with excellent reproducibility. This technique may provide a useful tool for studying neonatal brain maturation and detecting perfusion abnormalities in diseases.<\/jats:p><\/jats:sec>Evidence Level<\/jats:title>2<\/jats:p><\/jats:sec>Technical Efficacy<\/jats:title>Stage 1<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmri.29740","type":"journal-article","created":{"date-parts":[[2025,2,13]],"date-time":"2025-02-13T08:54:30Z","timestamp":1739436870000},"page":"737-748","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["High\u2010Fidelity MRI<\/scp> Assessment of Cerebral Perfusion in Healthy Neonates Less Than 1\u2009Week of Age"],"prefix":"10.1002","volume":"62","author":[{"given":"Zhiyi","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Johns Hopkins University School of Medicine Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3843-1020","authenticated-orcid":false,"given":"Dengrong","family":"Jiang","sequence":"additional","affiliation":[{"name":"The Russell H. 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