AbstractPurposeTo investigate high‐resolution hyperpolarized (HP) ¹³C pyruvate MRI for measuring cerebral perfusion in the human brain.MethodsHP [1‐¹³C]pyruvate MRI was acquired in five healthy volunteers with a multi‐resolution EPI sequence with 7.5 × 7.5 mm² resolution for pyruvate. Perfusion parameters were calculated from pyruvate MRI using block‐circulant singular value decomposition and compared to relative cerebral blood flow calculated from arterial spin labeling (ASL). To examine regional perfusion patterns, correlations between pyruvate and ASL perfusion were performed for whole brain, gray matter, and white matter voxels.ResultsHigh resolution 7.5 × 7.5 mm² pyruvate images were used to obtain relative cerebral blood flow (rCBF) values that were significantly positively correlated with ASL rCBF values (r = 0.48, 0.20, 0.28 for whole brain, gray matter, and white matter voxels respectively). Whole brain voxels exhibited the highest correlation between pyruvate and ASL perfusion, and there were distinct regional patterns of relatively high ASL and low pyruvate normalized rCBF found across subjects.ConclusionAcquiring HP ¹³C pyruvate metabolic images at higher resolution allows for finer spatial delineation of brain structures and can be used to obtain cerebral perfusion parameters. Pyruvate perfusion parameters were positively correlated to proton ASL perfusion values, indicating a relationship between the two perfusion measures. This HP ¹³C study demonstrated that hyperpolarized pyruvate MRI can assess cerebral metabolism and perfusion within the same study.