Purpose

Despite, currently, “state-of-the-art” magnetic resonance imaging (MRI) protocols for head and neck (H&N) lesion assessment incorporate perfusion sequences, these acquisitions require the intravenous injection of exogenous gadolinium-based contrast agents (GBCAs), which may have potential risks. Alternative techniques such as arterial spin labeling (ASL) can provide quantitative microvascular information similar to conventional perfusion sequences for H&N lesions evaluation, as a potential alternative without GBCA administration.

Methods

We review the existing literature and analyze the latest evidence regarding ASL in H&N area highlighting the technical adjustments needed for a proper ASL acquisition in this challenging region for lesion characterization, treatment monitoring, and tumor recurrence detection.

Results

ASL techniques, widely used for central nervous system lesions evaluation, can be also applied to the H&N region. Technical adjustments, especially regarding post-labeling delay, are mandatory to obtain robust and reproducible results. Several studies have demonstrated the feasibility of ASL in the H&N area including the orbits, skull base, paranasal sinuses, upper airway, salivary glands, and thyroid.

Conclusion

ASL is a feasible technique for the assessment of H&N lesions without the need of GBCAs. This manuscript reviews ASL’s physical basis, emphasizing the technical adjustments necessary for proper ASL acquisition in this unique and challenging anatomical region, and the main applications in evaluating H&N lesions.

中文翻译：

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用于头颈部病变评估的动脉自旋标记：技术调整和临床应用

目的

尽管目前用于头颈部 (H&N) 病变评估的“最先进”磁共振成像 (MRI) 协议包含灌注序列，但这些采集需要静脉注射外源性钆造影剂 (GBCA)，这可能有潜在的风险。动脉自旋标记 (ASL) 等替代技术可以提供类似于传统灌注序列的定量微血管信息，用于 H&N 病变评估，作为无需 GBCA 管理的潜在替代方案。

方法

我们回顾了现有文献并分析了 H&N 地区有关 ASL 的最新证据，重点介绍了在这个具有挑战性的地区正确获取 ASL 所需的技术调整，以进行病变表征、治疗监测和肿瘤复发检测。

结果

ASL 技术广泛用于中枢神经系统病变评估，也可应用于 H&N 区域。技术调整，特别是关于标签后延迟的技术调整，对于获得稳健和可重复的结果是强制性的。多项研究证明了 ASL 在 H&N 区域的可行性，包括眼眶、颅底、鼻窦、上呼吸道、唾液腺和甲状腺。

结论

ASL 是一种无需 GBCA 即可评估 H&N 病变的可行技术。这份手稿回顾了 ASL 的物理基础，强调了在这个独特且具有挑战性的解剖区域中正确获取 ASL 所需的技术调整，以及评估 H&N 病变的主要应用。