title: Arterial spin labeling perfusion MRI in pediatric arterial ischemic stroke: initial experiences.
abstract: OBJECTIVE
  To investigate the feasibility and utility of arterial spin labeling (ASL) perfusion MRI for characterizing alterations of cerebral blood flow (CBF) in pediatric patients with arterial ischemic stroke (AIS).
  
  
  METHODS
  Ten children with AIS were studied within 4 to 125 hours following symptom onset, using a pulsed ASL (PASL) protocol attached to clinically indicated MR examinations. The interhemisphere perfusion deficit (IHPD) was measured in predetermined vascular territories and infarct regions of restricted diffusion, which were compared with the degree of arterial stenosis and volumes of ischemic infarcts.
  
  
  RESULTS
  Interpretable CBF maps were obtained in all 10 patients, showing simple lesion in nine patients (five hypoperfusion, two hyperperfusion, and two normal perfusion) and complex lesions in one patient. Both acute and follow-up infarct volumes were significantly larger in cases with hypoperfusion than in either hyper- or normal perfusion cases. The IHPD was found to correlate with the degree of stenosis, diffusion lesion, and follow-up T(2) infarct volumes. Mismatch between perfusion and diffusion lesions was observed. Brain regions presenting delayed arterial transit effects were tentatively associated with positive outcome.
  
  
  CONCLUSIONS
  This study demonstrates the clinical utility of ASL in the neuroimaging diagnosis of pediatric AIS.
authors.affiliation: Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Juan
authors.initials: J
authors.lastname: Chen
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Licht
authors.forename: Sabrina E
authors.initials: SE
authors.lastname: Smith
authors.forename: Shannon C
authors.initials: SC
authors.lastname: Agner
authors.forename: Stefanie
authors.initials: S
authors.lastname: Mason
authors.forename: Sumei
authors.initials: S
authors.lastname: Wang
authors.forename: David W
authors.initials: DW
authors.lastname: Silvestre
authors.forename: John A
authors.initials: JA
authors.lastname: Detre
authors.forename: Robert A
authors.initials: RA
authors.lastname: Zimmerman
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Ichord
authors.forename: Jiongjiong
authors.initials: J
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001783:Blood Flow Velocity; D002545:Brain Ischemia / Q000473:pathology* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002648:Child; D002675:Child, Preschool; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011446:Prospective Studies; D013113:Spin Labels; D018709:Statistics, Nonparametric; D020521:Stroke / Q000473:pathology* / Q000503:physiopathology
chemical_list: D013113:Spin Labels