title: Arterial Spin Labeling Magnetic Resonance Imaging Estimation of Antegrade and Collateral Flow in Unilateral Middle Cerebral Artery Stenosis.
abstract: OBJECTIVE
  Three-dimensional pseudocontinuous arterial spin labeling with multiple postlabeling delays has been used to assess cerebral blood flow (CBF). We used this modality to estimate antegrade and collateral flow in patients with unilateral middle cerebral artery stenosis.
  
  
  METHODS
  Consecutive patients with unilateral middle cerebral artery 50% to 99% stenosis at 2 centers underwent pseudocontinuous arterial spin labeling with a postlabeling delays of 1.5 and 2.5 s. Mean CBF of bilateral middle cerebral artery territory at the postlabeling delays 1.5 and 2.5 s was measured. Early-arriving flow proportion was defined as (CBF 1.5 s at lesion side/CBF 2.5 s at normal side)×100%. Late-arriving retrograde flow proportion was defined as ([CBF 2.5 s-CBF 1.5 s] at lesion side-[CBF 2.5 s-CBF 1.5 s] at normal side)/CBF 2.5 s at normal side×100%. Antegrade and collateral scales were evaluated in patients with conventional angiography. Spearman correlation coefficients were calculated between early-arriving flow and late-arriving retrograde flow proportions on arterial spin labeling and antegrade and collateral scales on conventional angiography, respectively.
  
  
  RESULTS
  Forty-one patients (46.0±12.0 years) were enrolled. The mean early-arriving flow proportion was 78.3±14.9%. The mean late-arriving retrograde flow proportion was 16.1±10.2%. In 21 patients with conventional angiography, Spearman correlation coefficient was 0.53 (95% confidence interval, 0.11-0.79) between antegrade grade and early-arriving flow proportion (P=0.01) and 0.81 (95% confidence interval, 0.56-0.92) between collateral grade and late-arriving retrograde flow proportion (P<0.0001).
  
  
  CONCLUSIONS
  Three-dimensional pseudocontinuous arterial spin labeling with 2 postlabeling delays may provide an empirical approach for estimating antegrade and collateral flow in patients with unilateral middle cerebral artery stenosis.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT02479243.
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Jinhao
authors.initials: J
authors.lastname: Lyu
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Ning
authors.initials: N
authors.lastname: Ma
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Danny J J
authors.initials: DJ
authors.lastname: Wang
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Yang
authors.initials: Y
authors.lastname: Xu
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.).
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.). louxin301@gmail.com zhongrongm@163.com.
authors.forename: Zhongrong
authors.initials: Z
authors.lastname: Miao
authors.affiliation: From the Department of Radiology, Chinese PLA General Hospital, Beijing, China (J.L., L.M., Y.X., T.W., X.L.); Department of Interventional Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, China National Clinical Research Center for Neurological Diseases, Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China (N.M., Z.M.); and Department of Neurology, UCLA Stroke Center, Los Angeles (D.S.L., D.J.J.W.). louxin301@gmail.com zhongrongm@163.com.
authors.forename: Xin
authors.initials: X
authors.lastname: Lou
mesh_terms: D000328:Adult; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D015331:Cohort Studies; D003097:Collateral Circulation; D003251:Constriction, Pathologic / Q000175:diagnosis; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology*; D012189:Retrospective Studies; D013113:Spin Labels; D014057:Tomography, X-Ray Computed
chemical_list: D013113:Spin Labels
keywords: atherosclerosis; collateral circulation; magnetic resonance imaging; middle cerebral artery; stroke