The value of arterial spin-labeled perfusion imaging in acute ischemic stroke: comparison with dynamic susceptibility contrast-enhanced MRI.
OBJECTIVE
The purpose of this study was to evaluate the potential clinical value of arterial spin-labeled (ASL) perfusion MRI in acute ischemic stroke (AIS) through comparison with dynamic susceptibility contrast (DSC) enhanced perfusion MRI.


METHODS
Pseudocontinuous ASL with 3-dimensional background-suppressed gradient and spin echo readout was applied with DSC perfusion MRI on 26 patients with AIS. ASL cerebral blood flow and multiparametric DSC perfusion maps were rated for image quality and lesion severity/conspicuity. Mean ASL cerebral blood flow and DSC perfusion values were obtained in main vascular territories. Kendall coefficient of concordance was calculated to evaluate the reliability of ratings. Spearman correlation coefficients were calculated to compare ratings and quantitative perfusion values between ASL and DSC perfusion maps.


RESULTS
ASL cerebral blood flow and DSC perfusion maps provided largely consistent results in delineating hypoperfused brain regions in AIS. Hyperemic lesions, which also appeared frequently in the AIS cases studied, were more conspicuous on ASL cerebral blood flow than on DSC cerebral blood flow, mean transit time and time to the maximum of the tissue residual function maps.


CONCLUSIONS
As a rapid, noninvasive, and quantitative technique, ASL has clinical use in detecting blood flow abnormalities in patients with AIS.
Department of Neurology, University of California Los Angeles, 660 Charles E. Young Drive South, Los Angeles, CA 90095, USA. jwang71@gmail.com
Danny J J
DJ
Wang
Jeffry R
JR
Alger
Joe X
JX
Qiao
Qing
Q
Hao
Samuel
S
Hou
Rana
R
Fiaz
Matthias
M
Gunther
Whitney B
WB
Pope
Jeffrey L
JL
Saver
Noriko
N
Salamon
David S
DS
Liebeskind
D000368:Aged; D000369:Aged, 80 and over; D001783:Blood Flow Velocity; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D011859:Radiography; D013113:Spin Labels; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology*
D003287:Contrast Media; D013113:Spin Labels