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Super selective pseudocontinuous arterial spin-labeling with a circular labeling spot enabling selective vessel labeling was added to routine imaging in a prospective pilot study in 50 patients with extracranial steno-occlusive disease. The detected vessel occlusions/stenoses and perfusion patterns corresponded between cerebral DSA and super selective pseudocontinuous ASL maps in all cases. Perfusion deficits on DSC-CBF maps significantly correlated with those on super selective pseudocontinuous ASL maps. The authors conclude that superselectivepseudocontinuousASL is a robust technique for regional brain perfusion imaging, suitable for the noninvasive diagnostics of individual patient perfusion patterns.