Contralateral Hemispheric Cerebral Blood Flow Measured With Arterial Spin Labeling Can Predict Outcome in Acute...

Area of Science:

• Neurology
• Medical Imaging
• Stroke Research

Background:

• Intra-arterial therapy selection for acute stroke relies on imaging.
• Arterial spin labeling MRI enables noninvasive quantitative cerebral blood flow (cCBF) measurement.
• Contralateral hemisphere blood flow may influence collateral capacity and patient outcomes.

Purpose of the Study:

• To investigate if higher contralateral cerebral blood flow (cCBF) in acute stroke patients correlates with improved 90-day functional outcomes.
• To assess the predictive value of cCBF for neurological recovery.

Main Methods:

• Prospective, multicenter iCAS study (2013-2017) included patients with anterior circulation acute ischemic stroke.
• Arterial spin labeling MRI and diffusion-weighted imaging were used.
• Patients were grouped by median cCBF; outcomes assessed using NIH Stroke Scale and modified Rankin Scale.
• Multivariable logistic regression analyzed cCBF as a predictor of good 90-day outcome (mRS 0-2).

Main Results:

• Seventy-seven patients met inclusion criteria.
• Median cCBF was 38.9 mL/100g/min.
• Higher cCBF significantly predicted good 90-day neurological outcome (OR 4.6, P=0.01), independent of stroke severity, lesion volume, and treatment.

Conclusions:

• Elevated quantitative cCBF at baseline is a significant predictor of favorable neurological outcomes at 90 days post-stroke.
• cCBF measurements can potentially enhance acute stroke triage, treatment strategies, and prognosis.
• Further research into cCBF's role in stroke recovery is warranted.