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Perfusion MR Imaging Using a 3D Pulsed Continuous Arterial Spin-Labeling Method for Acute Cerebral Infarction
Y Shinohara1, A Kato2, K Kuya2
1From the Division of Radiology (Y.S., A.K., K.K., T.O.), Department of Pathophysiological and Therapeutic Science, Faculty of Medicine shino-y@olive.plala.or.jp.
Insights
3D arterial spin-labeling detects crossed cerebellar diaschisis in branch atheromatous disease, a stroke subtype. This imaging biomarker correlates with neurologic severity, aiding in stroke outcome prediction.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Branch atheromatous disease is a stroke subtype associated with early neurologic deterioration.
- Crossed cerebellar diaschisis is influenced by supratentorial perfusion abnormalities and impacts ischemic stroke outcomes.
Purpose of the Study:
- To evaluate the utility of whole-brain 3D pulsed continuous arterial spin-labeling (ASL) as an imaging biomarker.
- To predict neurologic severity in patients with branch atheromatous disease.
Main Methods:
- Twenty-three patients with branch atheromatous disease underwent MR imaging, including DWI, 3D-TOF-MRA, and 3D-ASL.
- Measured asymmetry indices of cerebral blood flow (CBF) in the affected area and contralateral cerebellum (crossed cerebellar diaschisis).
- Correlated these parameters and DWI infarct volume with the initial National Institutes of Health Stroke Scale (NIHSS) score.
Main Results:
- No correlation was found between NIHSS score and CBF asymmetry in the affected area (r = -0.027, P = .724).
- Significant correlations were observed between NIHSS score and crossed cerebellar diaschisis (r = 0.515, P = .012).
- DWI infarct volume also showed a significant correlation with NIHSS score (r = 0.664, P = .001).
Conclusions:
- 3D-arterial spin-labeling can effectively detect crossed cerebellar diaschisis in branch atheromatous disease.
- Crossed cerebellar diaschisis detected by 3D-ASL is a significant imaging biomarker correlated with neurologic severity.
Background And Purpose:
Branch atheromatous disease is a stroke subtype considered a risk factor for early neurologic deterioration. Meanwhile, crossed cerebellar diaschisis is thought to be influenced by the degree and location of supratentorial perfusion abnormalities and is associated with the clinical outcome in the case of an ischemic stroke. In this article, our aim was to clarify the utility of using a whole-brain 3D pulsed continuous arterial spin-labeling method as an imaging biomarker for predicting neurologic severity in branch atheromatous disease.
Materials And Methods:
Twenty-three patients with branch atheromatous disease in the lenticulostriate artery territory were enrolled. All patients underwent MR imaging, including DWI, 3D-TOF-MRA, and 3D-arterial spin-labeling. We measured the asymmetry index of CBF in the affected area (branch atheromatous disease), the asymmetry index of the contralateral cerebellar hemisphere (crossed cerebellar diaschisis), and the DWI infarct volume in the lenticulostriate artery territory. We also compared each parameter with the initial NIHSS score with the Pearson correlation coefficient.
Results:
Among the 23 patients, we found no correlation between NIHSS score and the asymmetry index of CBF in the affected area (branch atheromatous disease) (r = -0.027, P = .724), whereas the asymmetry index of the contralateral cerebellar hemisphere (crossed cerebellar diaschisis) and DWI infarct volumes were significantly correlated with NIHSS score (r = 0.515, P = .012; r = 0.664, P = .001, respectively).
Conclusions:
In patients with branch atheromatous disease, 3D-arterial spin-labeling can detect crossed cerebellar diaschisis, which is correlated with the degree of neurologic severity.
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