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Magnetic resonance perfusion imaging in acute ischemic stroke using continuous arterial spin labeling
J A Chalela1, D C Alsop, J B Gonzalez-Atavales
1Department of Neurology, University of Pennsylvania, Philadelphia 19104, USA.
Stroke
|March 4, 2000
Summary
Continuous arterial spin-labeled perfusion MRI (CASL-PI) rapidly images acute ischemic stroke, detecting perfusion deficits and mismatches. CASL-PI cerebral blood flow (CBF) predicts stroke severity and patient outcomes.
Area of Science:
- Neuroimaging
- Radiology
- Cerebrovascular disease
Background:
- Continuous arterial spin-labeled perfusion MRI (CASL-PI) noninvasively measures cerebral blood flow (CBF) using labeled arterial blood water.
- Acute ischemic stroke requires rapid assessment of perfusion deficits and potential for predicting outcomes.
Purpose of the Study:
- To evaluate CASL-PI's ability to detect perfusion deficits and perfusion/diffusion mismatches in acute ischemic stroke.
- To assess if CASL-PI can predict stroke severity and patient outcomes.
Main Methods:
- 15 acute ischemic stroke patients underwent a 6-minute CASL-PI and diffusion-weighted imaging protocol at 1.5T.
- Perfusion deficits, perfusion/diffusion mismatches, and delayed arterial transit effects were visually assessed.
- Regional CBF was quantified and correlated with NIHSS and Rankin Scale (RS) scores.
Main Results:
- CASL-PI provided interpretable images in all patients, consistent with clinical presentation and diffusion imaging.
- Perfusion deficits were observed in 11 patients; perfusion/diffusion mismatches in 8.
- CASL-PI derived CBF correlated significantly with NIHSS and RS scores, indicating predictive value.
Conclusions:
- CASL-PI is a rapid, noninvasive imaging technique for acute ischemic stroke.
- It effectively depicts perfusion abnormalities and predicts clinical severity and outcomes.
- Delayed arterial transit effects may suggest collateral circulation.