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Arterial Spin Labeling MRI to Measure Cerebral Blood Flow in Untreated Ischemic Stroke

Girolamo Crisi1, Silvano Filice2, Umberto Scoditti3

  • 1Neuroradiology Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.

Journal of Neuroimaging : Official Journal of the American Society of Neuroimaging
|October 11, 2018
PubMed
Abstract

Insights

Regional hyperperfusion (RH) in untreated stroke patients detected by arterial spin labeling (ASL) correlated with infarct volume. ASL imaging is valuable for assessing stroke and potential reperfusion effects.

Area of Science:

  • Neuroimaging
  • Stroke Research
  • Cerebrovascular Diseases

Background:

  • Acute stroke patient management requires timely and accurate assessment.
  • Arterial spin labeling (ASL) is an MRI technique for non-invasive cerebral blood flow (CBF) measurement.
  • Regional hyperperfusion (RH) is a potential indicator in acute ischemic stroke.

Purpose of the Study:

  • To investigate the significance of regional hyperperfusion (RH) detected by ASL in untreated stroke patients within 24-36 hours post-symptom onset.
  • To evaluate the relationship between RH volume and diffusion-weighted imaging (DWI) defined infarct core volume (DIV).

Main Methods:

  • Retrospective review of MRI studies (ASL and DWI) in 47 acute stroke patients ineligible for intravenous tissue plasminogen activator.
  • Coregistration of ASL-derived CBF maps to DWI images for RH and DIV volume calculation.
  • Comparison of RH and DIV volumes and evaluation of National Institutes of Health Stroke Scale (NIHSS) scores at various time points.

Main Results:

  • Twenty-two patients exhibited RH (CBF > 2x baseline), with complete overlap between RH and DWI infarct areas.
  • No significant difference was found between RH volume (7.2 ± 9.6 cm³ ) and DIV (9.0 ± 11.9 cm³ ) (P = .94).
  • A strong positive correlation (Pearson's r = .93) was observed between RH and DIV volumes.

Conclusions:

  • ASL perfusion is a valuable component of MRI in assessing untreated stroke patients within 24-36 hours.
  • Sustained RH in this cohort was associated with improved patient outcomes.
  • ASL may offer evidence for the beneficial effects of reperfusion therapies, such as recanalization treatment.
Keywords:
Cerebral blood flowarterial spin labelinghyperperfusionstroke

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