Diffusion-prepared pseudocontinuous ASL (DP-pCASL) is a more recent ASL variant sequence that magnetically labels water molecules and measures their movement across the blood-brain barrier complex, which allows for the calculation of the water exchange rate (kw). kw is used as a surrogate for BBB function and permeability. Water exchange across the BBB is mediated by a number of processes, including passive diffusion, active co-transport through the endothelial membrane, and predominantly by facilitated diffusion through the dedicated water channel aquaporin-4 (AQP4). Several studies have investigated the use of DP-pCASL in cerebrovascular diseases, including acute ischemic stroke, CADASIL, hereditary cerebral small vessel disease   as well as in animal models.