ASPECTS-based reperfusion status on arterial spin labeling is associated with clinical outcome in acute ischemic stroke patients. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Yu, Songlin; Ma, Samantha J; Liebeskind, David S; Yu, Dandan; Li, Ning; Qiao, Xin J; Shao, Xingfeng; Yan, Lirong; Yoo, Bryan; Scalzo, Fabien; Hinman, Jason D; Sharma, Latisha K; Rao, Neal; Jahan, Reza; Tateshima, Satoshi; Duckwiler, Gary R; Saver, Jeffrey L; Salamon, Noriko; Wang, Danny JJ
• Is Part Of: Journal of cerebral blood flow & metabolism. Volume 38:Issue 3(2018)
• Page Start: 382
• Page End: 392
• Publication Date: 2018-03
• Subjects: Acute ischemic stroke -- arterial spin labelling -- recanalization -- reperfusion -- reperfusion injury; Cerebral circulation -- Periodicals; Brain -- Metabolism -- Periodicals; Brain -- Blood-vessels -- Periodicals; Cerebrovascular disease -- Periodicals; 612.824
• DOI: 10.1177/0271678X17697339
• Languages: English
• ISSNs: 0271-678X

Abstract

The purpose of this study was to develop and evaluate a scoring system for assessing reperfusion status based on arterial spin labeled (ASL) perfusion MRI in acute ischemic stroke (AIS) patients receiving thrombolysis and/or endovascular treatment. Pseudo-continuous ASL with background suppressed 3D GRASE was acquired along with DWI in 90 patients within 24 h post-treatment. An automatic reperfusion scoring system (auto-RPS) was devised based on the Alberta Stroke Program Early CT Score (ASPECTS) template, and compared with manual RPS and DWI-ASPECTS. TICI (thrombolysis in cerebral infarction) scores were graded in 48 patients who received endovascular treatment. Favorable outcomes were defined by a modified Rankin Scale score of 0–2 at three months. Auto-RPS was positively correlated with DWI-ASPECTS (ρ = 0.6, P < 0.001) and was on average 1 point lower than DWI-ASPECTS ( P < 0.001). The area under the receiver operating characteristic curve for discriminating poor functional outcome (n = 90) was 0.75 (95% CI, 0.64–0.86) for manual RPS, 0.85 (95% CI, 0.76–0.94) for auto-RPS, and 0.81 (95% CI, 0.71–0.90) for DWI-ASPECTS. Multiple logistic regression analysis in the TICI-graded patients (n = 48) showed that auto-RPS is highly associated with functional outcome (OR = 25.2, 95% CI 4.02–496, P < 0.01). Post treatment auto-RPS within 24 h provides a useful tool to predict functional outcome in AIS patients.