Multi-delay ASL can identify leptomeningeal collateral perfusion in endovascular therapy of ischemic stroke

Background and Purpose Multi-delay arterial spin-labeling (ASL) perfusion imaging has been used as a promising modality to evaluate cerebral perfusion. Our aim was to assess the association of leptomeningeal collateral perfusion scores based on ASL parameters with outcome of endovascular treatment in patients with acute ischemic stroke (AIS) in the middle cerebral artery (MCA) territory. Materials and Methods ASL data at 4 post-labeling delay (PLD) times (PLD = 1.5, 2, 2.5, 3 s) were acquired during routine clinical magnetic resonance examination on AIS patients prior to endovascular treatment. A 3-point scale of leptomeningeal collateral perfusion grade on 10 anatomic regions was determined based on arterial transit times (ATT), cerebral blood flow (CBF), and arterial cerebral blood volume (CBV), estimated by the multi-delay ASL protocol. Based on a 90-day modified Rankin Scale (mRS), the patients were dichotomized to moderate/good (mRS 03) and poor outcome (mRS 46) and the regional collateral flow scores were compared. Results Fifty-five AIS patients with unilateral MCA stroke (mean 73.9514.82 years) including 23 males were enrolled. Compared with poor outcome patients, patients with moderate to good outcomes had a significantly higher leptomeningeal collateral perfusion scores on CBV (3.012.11 vs. 1.821.51, p=0.024) but no differences on scores on CBF (2.311.61 vs. 1.661.32, p=0.231) and ATT (2.672.33 vs. 3.423.37, p=0.593). Conclusions Higher leptomeningeal collateral perfusion scores on CBV images by ASL may be a specific marker of clinical outcome after endovascular treatment in patients with acute MCA ischemic stroke. Further study with larger sample size is warranted.

• Publication year

  2016

• Venue

  OncoTarget

• Publication date

  2016-12-10

• Fields of study

  Medicine

• Identifiers
  DOI 10.18632/oncotarget.13898PMID 27974692PMCID 5356813
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

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