1. Multi-Delay ASL can identify leptomeningeal collateral perfusion in endovascular therapy of ischemic stroke
- Author
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Lou, Xin, Yu, Songlin, Scalzo, Fabien, Starkman, Sidney, Ali, Latisha K, Kim, Doojin, Rao, Neal M, Hinman, Jason D, Vespa, Paul M, Jahan, Reza, Tateshima, Satoshi, Gonzalez, Nestor R, Duckwiler, Gary R, Saver, Jeffrey L, Yoo, Bryan, Salamon, Noriko, Lyu, Jinhao, Ma, Lin, Wang, Danny JJ, and Liebeskind, David S
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Brain Disorders ,Cerebrovascular ,Stroke ,Biomedical Imaging ,Neurosciences ,Aged ,Aged ,80 and over ,Brain Ischemia ,Cerebrovascular Circulation ,Female ,Humans ,Infarction ,Middle Cerebral Artery ,Magnetic Resonance Angiography ,Male ,Meninges ,Middle Aged ,Perfusion Imaging ,Spin Labels ,collateral circulation ,stroke ,perfusion imaging ,arterial spin-labeling ,cerebral blood flow ,Oncology and Carcinogenesis ,Oncology and carcinogenesis - Abstract
Background and purposeMulti-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 methodsASL 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 0-3) and poor outcome (mRS 4-6) and the regional collateral flow scores were compared.ResultsFifty-five AIS patients with unilateral MCA stroke (mean 73.95±14.82 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 (3.01±2.11 vs. 1.82±1.51, p=0.024) but no differences on scores on CBF (2.31±1.61 vs. 1.66±1.32, p=0.231) and ATT (2.67±2.33 vs. 3.42±3.37, p=0.593).ConclusionsHigher 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.
- Published
- 2017