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


Journal

Journal of neuroimaging : official journal of the American Society of Neuroimaging
ISSN: 1552-6569
Titre abrégé: J Neuroimaging
Pays: United States
ID NLM: 9102705

Informations de publication

Date de publication:
Mar 2019
Historique:
received: 04 07 2018
revised: 21 09 2018
accepted: 25 09 2018
pubmed: 12 10 2018
medline: 7 3 2020
entrez: 11 10 2018
Statut: ppublish

Résumé

This study aims to investigate the significance of regional hyperperfusion (RH) detected by arterial spin labeling (ASL) in a group of untreated stroke patients, within 24-36 hours after symptom onset. The relationship between RH volume and infarcted volume (DIV) as defined on diffusion weighted images (DWIs) was evaluated. Of the 346 consecutive acute stroke patients who attended our center, we retrospectively reviewed MRI studies of 47 patients who were ineligible for standard treatment with intravenous tissue plasminogen activator. The MRI study included ASL and DWI. The ASL-derived cerebral blood flow (CBF) maps were coregistered on the DWI images. RH volume and DIV were calculated and compared. Patient NIHSS scores were also evaluated at admission, discharge, and after 1 and 6-month follow-up. Twenty-two patients showed RH with CBF twice than baseline. In all 22 patients, RH overlaps with DWI infarcted area. No significant difference (P = .94) between RH volume and DIV was found (7.2 ± 9.6 and 9.0 ± 11.9 cm The study showed that ASL perfusion could be an integral part of the MRI examination in the assessment of 24-36 hours not-treated stroke patients as sustained RH group had improved outcomes. More importantly, ASL perfusion may provide evidence of beneficial effects of reperfusion induced by recanalization treatment.

Sections du résumé

BACKGROUND AND PURPOSE OBJECTIVE
This study aims to investigate the significance of regional hyperperfusion (RH) detected by arterial spin labeling (ASL) in a group of untreated stroke patients, within 24-36 hours after symptom onset. The relationship between RH volume and infarcted volume (DIV) as defined on diffusion weighted images (DWIs) was evaluated.
METHODS METHODS
Of the 346 consecutive acute stroke patients who attended our center, we retrospectively reviewed MRI studies of 47 patients who were ineligible for standard treatment with intravenous tissue plasminogen activator. The MRI study included ASL and DWI. The ASL-derived cerebral blood flow (CBF) maps were coregistered on the DWI images. RH volume and DIV were calculated and compared. Patient NIHSS scores were also evaluated at admission, discharge, and after 1 and 6-month follow-up.
RESULTS RESULTS
Twenty-two patients showed RH with CBF twice than baseline. In all 22 patients, RH overlaps with DWI infarcted area. No significant difference (P = .94) between RH volume and DIV was found (7.2 ± 9.6 and 9.0 ± 11.9 cm
CONCLUSIONS CONCLUSIONS
The study showed that ASL perfusion could be an integral part of the MRI examination in the assessment of 24-36 hours not-treated stroke patients as sustained RH group had improved outcomes. More importantly, ASL perfusion may provide evidence of beneficial effects of reperfusion induced by recanalization treatment.

Identifiants

pubmed: 30302863
doi: 10.1111/jon.12569
doi:

Substances chimiques

Spin Labels 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

193-197

Informations de copyright

© 2018 by the American Society of Neuroimaging.

Auteurs

Girolamo Crisi (G)

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

Silvano Filice (S)

Medical Physics Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.

Umberto Scoditti (U)

Neurology Unit, Azienda Ospedaliero-Universitaria of Parma, Parma, Italy.

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Classifications MeSH