{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,15]],"date-time":"2025-11-15T04:05:25Z","timestamp":1763179525183,"version":"3.41.2"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T00:00:00Z","timestamp":1696896000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background and objectives<\/jats:title><jats:p>Magnetic resonance imaging with arterial spin labeling (ASL) perfusion imaging is a noninvasive method for quantifying cerebral blood flow (CBF). We aimed to evaluate the clinical utility of ASL perfusion imaging to aid in the diagnosis of Creutzfeldt\u2013Jakob disease (CJD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study enrolled 10 clinically diagnosed with probable sporadic CJD (sCJD) based on the National CJD Research &amp;amp; Surveillance Unit and EuroCJD criteria and 18 healthy controls (HCs). Diffusion-weighted images (DWIs), CBF images obtained from ASL, <jats:italic>N<\/jats:italic>-isopropyl-(<jats:sup>123<\/jats:sup>I)-<jats:italic>p<\/jats:italic>-iodoamphetamine (<jats:sup>123<\/jats:sup>IMP)-single-photon emission computed tomography (SPECT) images, and <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose (<jats:sup>18<\/jats:sup>FDG)-positron emission tomography (PET) images were analyzed. First, the cortical values obtained using volume-of-interest (VOI) analysis were normalized using the global mean in each modality. The cortical regions were classified into DWI-High (\u2265 +1\u2009SD) and DWI-Normal (&amp;lt; +1\u2009SD) regions according to the DWI-intensity values. The normalized cortical values were compared between the two regions for each modality. Second, each modality value was defined as ASL hypoperfusion (&amp;lt; \u22121\u2009SD), SPECT hypoperfusion (&amp;lt; \u22121\u2009SD), and PET low accumulation (&amp;lt; \u22121\u2009SD). The overall agreement rate of DWIs with ASL-CBF, SPECT, and PET was calculated. Third, regression analyses between the normalized ASL-CBF values and normalized SPECT or PET values derived from the VOIs were performed using a scatter plot.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean values of ASL-CBF (<jats:italic>N<\/jats:italic>\u2009=\u200910), <jats:sup>123<\/jats:sup>IMP-SPECT (<jats:italic>N<\/jats:italic>\u2009=\u20098), and <jats:sup>18<\/jats:sup>FDG-PET (<jats:italic>N<\/jats:italic>\u2009=\u20093) in DWI-High regions were significantly lower than those in the DWI-Normal regions (<jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001 for all); however, HCs (<jats:italic>N<\/jats:italic>\u2009=\u200918) showed no significant differences in ASL-CBF between the two regions. The overall agreement rate of DWI (high or normal) with ASL-CBF (hypoperfusion or normal) (81.8%) was similar to that of SPECT (85.2%) and PET (78.5%) in CJD. The regression analysis showed that the normalized ASL-CBF values significantly correlated with the normalized SPECT (<jats:italic>r<\/jats:italic>\u2009=\u20090.44, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) and PET values (<jats:italic>r<\/jats:italic>\u2009=\u20090.46, <jats:italic>p<\/jats:italic>\u2009&amp;lt;\u20090.001) in CJD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Patients with CJD showed ASL hypoperfusion in lesions with DWI hyperintensity, suggesting that ASL-CBF could be beneficial for the diagnostic aid of CJD.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2023.1242615","type":"journal-article","created":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T12:11:42Z","timestamp":1696939902000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Magnetic resonance imaging arterial spin labeling hypoperfusion with diffusion-weighted image hyperintensity is useful for diagnostic imaging of Creutzfeldt\u2013Jakob 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