Comparison of perfusion signal acquired by arterial spin labeling–prepared intravoxel incoherent motion (IVIM) MRI and conventional IVIM MRI to unravel the origin of the IVIM signal

Purpose: Applications of intravoxel incoherent motion (IVIM) imaging in the brain are scarce, whereas it has been successfully applied in other organs with promising results. To better understand the cerebral IVIM signal, the diffusion properties of the arterial blood flow within different parts of the cerebral vascular tree (i.e., different generations of the branching pattern) were isolated and measured by employing an arterial spin labeling (ASL) preparation module before an IVIM readout. Methods: ASL preparation was achieved by T₁-adjusted time-encoded pseudo-continuous ASL (te-pCASL). The IVIM readout module was achieved by introducing bipolar gradients immediately after the excitation pulse. The results of ASL-IVIM were compared with those of conventional IVIM to improve our understanding of the signal generation process of IVIM. Results: The pseudo-diffusion coefficient D* as calculated from ASL-IVIM data was found to decrease exponentially for postlabeling delays (PLDs) between 883 ms and 2176 ms, becoming relatively stable for PLDs longer than 2176 ms. The fast compartment of the conventional IVIM-experiment shows comparable apparent diffusion values to the ASL signal with PLDs between 1747 ms and 2176 ms. At the longest PLDs, the observed D* values (4.0 ± 2.8 × 10⁻³ mm²/s) are approximately 4.5 times higher than the slow compartment (0.90 ± 0.05 × 10⁻³ mm²/s) of the conventional IVIM experiment. Conclusion: This study showed much more complicated diffusion properties of vascular signal than the conventionally assumed single D* of the perfusion compartment in the two-compartment model of IVIM (biexponential behavior). Magn Reson Med 79:723–729, 2018.