Assessment of Variability in Cerebral Blood Flow and Cerebral Blood Volume in Cerebral Arteries of Ischemic Stroke...

Cerebral blood flow (CBF) and cerebral blood volume (CBV) are critical perfusion metrics in diagnosing ischemic stroke. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) enables the evaluation of these cerebral perfusion metrics; however, accurately assessing them remains challenging. This study aimed to: (1) assess CBF asymmetry by quantifying and comparing it between contralateral hemispheres (right vs. left) within the MCA, ACA, and PCA territories using paired t-tests, and describe pattern of CBV; (2) evaluate overall inter-territorial regional variations in CBF across the different cerebral arterial territories (MCA, ACA, PCA), irrespective of the hemisphere, using ANOVA; (3) determine the correlation between CBF and CBV using both Pearson's and Spearman's correlation analyses; and (4) assess the influence of age and gender on CBF using multiple regression analysis.

A cross-sectional study of 55 ischemic stroke patients was conducted. DCE-MRI was used to measure CBF and CBV. Paired t-tests compared contralateral hemispheric CBF in MCA, PCA, and ACA, one-way ANOVA assessed overall inter-territorial CBF variations, correlation analyses (Pearson/Spearman) evaluated the CBF-CBV relationship, and linear regression modeled demographic effects.

Significant contralateral asymmetries in CBF were observed for each cerebral pair of cerebral arteries using a paired t-test, with descriptive asymmetries noted in CBV. Separately, ANOVA revealed significant overall variability in CBF between the different cerebral arteries, irrespective of hemisphere. A strong positive correlation was found between CBF and CBV (Pearson r = 0.976; Spearman r = 0.928), with multiple regression analysis identifying age and gender as significant predictors of CBF.

This study highlights hemispheric asymmetry and inter-territorial variation, the impact of age, and gender on CBF. DCE-MRI provides perfusion metrics that can guide individualized stroke treatment, offering valuable insights for therapeutic planning, particularly in resource-limited settings.