Arterial Spin Labeling Identifies Tissue Salvage and Good Clinical Recovery After Acute Ischemic Stroke. Issue 3 (22nd August 2012)

• Record Type: Journal Article
• Authors: Bivard, Andrew; Stanwell, Peter; Levi, Christopher; Parsons, Mark
• Is Part Of: Journal of neuroimaging. Volume 23:Issue 3(2013)
• Page Start: 391
• Page End: 396
• Publication Date: 2012-08-22
• Subjects: Diagnostic imaging -- Periodicals; Nervous system -- Diseases -- Diagnosis -- Periodicals; Imagerie pour le diagnostic -- Périodiques; Système nerveux -- Maladies -- Diagnostic -- Périodiques; Imagerie médicale; Neuroimagerie; Neurologie; Système nerveux; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.804754
• DOI: 10.1111/j.1552-6569.2012.00728.x
• Languages: English
• ISSNs: 1051-2284

Abstract

<abstract abstract-type="main" xml:lang="en"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="abs1-1" sec-type="section"> <title>ABSTRACT</title> </sec> <sec id="abs1-2" sec-type="section"> <title>OBJECTIVE</title> <p>Arterial spin labeling (ASL) is a relatively new MR perfusion technique that requires validation.</p> </sec> <sec id="abs1-3" sec-type="section"> <title>METHODS</title> <p>One hundred patients with an acute hemispheric ischemic stroke were imaged within 6 hours of symptom onset with perfusion CT (CTP), and at 24 hours with MRI perfusion imaging, including ASL and bolus dynamic susceptibility contrast (DSC) imaging. Baseline CTP was used to define tissue at risk. This was used to determine persistent hypoperfusion, or hyperperfusion, on 24‐hour ASL maps.</p> </sec> <sec id="abs1-4" sec-type="section"> <title>RESULTS</title> <p>Using 24 hour ASL, 48 of 100 patients showed hyperperfusion, and 41 showed persistent hypoperfusion. None of the PWI maps identified hyperperfusion. Compared to patients with persistent hypoperfusion on ASL, patients with hyperperfusion had less progression of acute CTP mismatch tissue to infarction at 24 hours (<italic>P</italic>= .05). ASL hyperperfusion was also associated with improved early clinical improvement: mean reduction in acute to 24 hour National Institutes of Health Stroke Scale = 12 versus 4 for ASL hypoperfusion group (<italic>P</italic>= .05), as well as 90 day modified Rankin Score (mean 2 vs. 4 for hypoperfusion group, <italic>P</italic>= .01).</p> </sec> <sec id="abs1-5" sec-type="section"> <title>DISCUSSION</title> <p>Hyperperfusion of the initially ischemic area identified on ASL at 24 hours poststroke identifies patients with better tissue and clinical outcomes.</p> </sec> </abstract>