Pseudo-continuous arterial spin labeling (pCASL) MRI involves labeling of flowing arterial blood water; therefore, the flow velocity of the blood water affects the efficiency of pCASL labeling. This effect has been quantified in healthy subjects but has not been examined in adults with sickle cell anemia (SCA). In this study, we illustrate that cervical flow velocities are elevated in adults with SCA, resulting in a reduced pCASL labeling efficiency of 0.72, and errors associated with this phenomenon are more than twice as large as those associated with bolus arrival time variability when long post-labeling delays times are used.
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