Pseudo-continuous arterial spin labeling quantifies cerebral blood flow in patients with acute ischemic stroke and chronic lacunar stroke

Guo, Lingfei; Zhang, Qun; Ding, Linda; Li, Kai; Ding, Kevin; Jiang, Chunmiao; Liu, Cheng; Cui, Li

doi:10.1016/j.clineuro.2014.08.017

Cited by 15 publications

(13 citation statements)

References 46 publications

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“…Second, prescribing postlabel delay based on arterial blood velocity may help to distinguish aspects of arterial transit time that separate slower flow velocity from collateral or tortuous pathways. The GM-CBF values observed here are consistent with those in other studies involving younger adults, 27 healthy older adults, 28 and individuals with chronic stroke. 29 Older adults with WMH, however, exhibited lower GM-CBF than previously reported.…”

Section: Discussionsupporting

confidence: 82%

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity

Robertson

Matta

Basile

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:The relationship between extracranial large-artery characteristics and arterial spin-labeling MR imaging may influence the quality of arterial spin-labeling-CBF images for older adults with and without vascular pathology. We hypothesized that extracranial arterial blood velocity can explain between-person differences in arterial spin-labeling data systematically across clinical populations.

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Section: Discussionsupporting

confidence: 82%

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity

Robertson

Matta

Basile

et al. 2017

AJNR Am J Neuroradiol

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“…However, current sequences on 3T systems are consistently able to reproduce excellent quality perfusion images using ASL technique. 12,13 Noncontrast magnetic resonance perfusion studies in all our patients were of good interpretable quality, and the final outcome in all of them corresponded closely to the expected recovery based on the penumbra whenever the vessel was recanalized and corresponded to the studies performed by Hartkamp et al and Bivard et al 14,15 This study demonstrates that ASL is successful in demonstrating the ischemic penumbra. In our study, 66.6% (six out of nine) of our patients had functional independence as shown by mRS score of 0 to 2.…”

Section: Discussionsupporting

confidence: 79%

Arterial Spin Labeling—Can Neurointerventionists Rely on This Novel Technique? A Case Series on Successful Use of Arterial Spin Labeling in Acute Stroke Imaging

Rahul

Santhosh

Kumar

et al. 2017

J Clin Interv Radiol ISVIR

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IntroductionConventional imaging of stroke was mainly dependent on computed tomography (CT), which included noncontrast imaging that assessed the ASPECTS (Alberta Stroke Program Early CT Score), contrast CT angiography, and CT perfusion. Though these techniques continue to be the mainstay in stroke imaging, there are certain disadvantages such as high radiation dose and need of contrast administration. Further, interpretation of the images can be difficult and, at times, impossible if the patient becomes noncooperative during the contrast study. Considering these issues, there is a need for an alternative imaging technique that gives the same information without contrast administration or radiation. Magnetic resonance imaging (MRI) sequences that include diffusion imaging, noncontrast perfusion arterial spin labeling (ASL) can probably have a distinct advantage. We present the successful use of ASL perfusion imaging in selecting patients for mechanical thrombectomy and the outcome. Keywords► arterial spin labeling ► perfusion imaging ► diffusion perfusion mismatch ► modified Rankin scale score AbstractPresence of ischemic penumbra is the principal factor that decides the need for mechanical thrombectomy in acute stroke patients with large vessel occlusion. Our objective was to evaluate the usefulness of arterial spin labeling (ASL) in detecting diffusion perfusion mismatch and directing patients into mechanical thrombectomy. We retrospectively studied all patients with acute nonhemorrhagic stroke in the anterior circulation, who had undergone stroke imaging with ASL followed by mechanical thrombectomy from July 2016 to November 2016. Area of diffusion perfusion mismatch was graded semiquantitatively into three grades: small, medium, and large. Mismatch was compared with 30-day modified Rankin scale (mRS) score. Interpretable PASL-perfusion images were obtained in all patients. Diffusion perfusion mismatches were present in all patients. Out of six patients with good mRS score, five patients had large diffusion perfusion mismatch. Two out of three patients with poor mRS were secondary to failed recanalization, in spite of large mismatch. One out of nine patients had poor outcome as well as a small area of mismatch. ASL is a rapid noninvasive imaging technique in acute stroke that has got the potential to detect ischemic penumbra.

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“…In addtion, the inversion labeling rate of PASL is greatly improving ( 12 ). With the development of MR software and hardware and increasing investigations of ASL technology, the ASL sequence is also improving continuously, such as FAIREST technology performing the third imaging on imaging layer after saturation based on core sequence (FAIR sequence), which is able to effectively separate blood oxygen level-dependent (BOLD) weight and perform quantitative CBF measurement ( 13 ). BOLD and T1-weighted imaging can subsequently be obtained to reflect blood perfusion and metabolic status of brain tissue more accurately ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Application of 3.0T magnetic resonance arterial spin labeling (ASL) technology in mild and moderate intracranial atherosclerotic stenosis

et al. 2016

Experimental and Therapeutic Medicine

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The application value of 3.0T magnetic resonance arterial spin labeling (ASL) technology in mild and moderate intracranial atherosclerotic stenosis was evaluated. A total of 58 cases of transient ischemic attack (TIA) and 60 cases of ischemic cerebral apoplexy cases were selected. The cases were analysed using a GE Healthcare Signa HDx 3.0T superconducting whole-body magnetic resonance scan within 24 h of attack. Eight-channel head phased array coils and conventional sequence were used to create T1-weighted images (T1WI), T2WI, diffusion-weighted imaging, magnetic resonance angiography (MRA) and ASL imaging, which were generated into ASL pseudo-color images (blue was hypoperfusion area) through post-processing in order to compare and analyze the correlation and differences between ASL and conventional imaging in terms of lesion location, size, blood perfusion situation and signal range of relative cerebral blood flow (rCBF). The results showed that, 13 TIA cases of abnormal signal in conventional magnetic resonance imaging (MRI) can also be found through ASL technology. Diameter stenosis beyond 30% in MRA can also be tested in ASL. A positive rate in ASL was significantly higher than that of conventional MRI (χ2=29.078, P<0.001) and hypoperfusion area was greatly increased (t=32.526, P<0.001). The rCBF value was positively correlated with the degree of diameter stenosis shown in MRA (r=0.524, P=0.012). Additionally, the positive rate of ASL was positively correlated with the attack times of TIA (r=0.352, P=0.027). A total of 39 cerebral apoplexy cases of abnormal signal in conventional MRI were also found through ASL technology. A positive rate in ASL was significantly higher than that of conventional MRI (χ2=7.685, P=0.006) and hypoperfusion area was greatly increased (t=9.425, P<0.001). The rCBF value was positively correlated with the degree of diameter stenosis (r=0.635, P=0.009). In conclusion, 3.0T ASL correlated with early diagnosis of TIA and mild and moderate intracranial arterial stenosis of cerebral apoplexy.

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Pseudo-continuous arterial spin labeling quantifies cerebral blood flow in patients with acute ischemic stroke and chronic lacunar stroke

Cited by 15 publications

References 46 publications

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity

Temporal and Spatial Variances in Arterial Spin-Labeling Are Inversely Related to Large-Artery Blood Velocity

Arterial Spin Labeling—Can Neurointerventionists Rely on This Novel Technique? A Case Series on Successful Use of Arterial Spin Labeling in Acute Stroke Imaging

Application of 3.0T magnetic resonance arterial spin labeling (ASL) technology in mild and moderate intracranial atherosclerotic stenosis

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