Simultaneous Hemodynamic and Structural Imaging of Ischemic Stroke With Magnetic Resonance Fingerprinting Arterial Spin Labeling. Issue 6 (16th March 2022)

• Record Type: Journal Article
• Authors: Fan, Hongli; Su, Pan; Lin, Doris Da May; Goldberg, Emily B.; Walker, Alexandra; Leigh, Richard; Hillis, Argye E.; Lu, Hanzhang
• Is Part Of: Stroke. Volume 53:Issue 6(2022)
• Page Start: 2016
• Page End: 2025
• Publication Date: 2022-03-16
• Subjects: hemodynamics -- ischemic stroke -- magnetic resonance imaging -- perfusion -- tissues; Cerebrovascular disease -- Periodicals; Cerebral circulation -- Periodicals; 616.81
• DOI: 10.1161/STROKEAHA.121.037066
• Languages: English
• ISSNs: 0039-2499

Abstract

Abstract : Background: Perfusion and structural imaging play an important role in ischemic stroke. Magnetic resonance fingerprinting (MRF) arterial spin labeling (ASL) is a novel noninvasive method of ASL perfusion that allows simultaneous estimation of cerebral blood flow (CBF), bolus arrival time (BAT), and tissue T1 map in a single scan of <4 minutes. Here, we evaluated the utility of MRF-ASL in patients with ischemic stroke in terms of detecting hemodynamic and structural damage and predicting neurological deficits and disability. Methods: A total of 34 patients were scanned on 3T magnetic resonance imaging. MRF-ASL, standard single-delay pseudo-continuous ASL, T2 -weighted, and diffusion magnetic resonance imaging were performed. Regions of interest of lesion and contralateral normal tissues were manually delineated. CBF (with 2 different compartmental models), BAT, and tissue T1 parameters were quantified. Cross-sectional linear regression analyses were performed to examine the relationship between MRF-ASL parameters and National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale. Receiver operating characteristic analyses were performed to determine the utility of MRF-ASL in the classification of stroke lesion voxels. Results: MRF-ASL derived parameters revealed a significant difference between stroke lesion and contralateral normal regions of interest, in that lesion regions manifested a lower CBF1-compartment ( P <0.001), lower CBF2-compartment ( P <0.001), longer BAT ( P =0.002), and longer T1 ( P <0.001) compared with normal regions of interest. NIHSS scores at acute stage revealed a strong association with lesion-normal differences in CBF1-compartment, diff (β=−0.11, P =0.008), CBF2-compartment, diff (β=−0.16, P =0.003), and T1, diff (β=0.008, P =0.001). MRF-ASL parameters were also predictive of NIHSS score and modified Rankin Scale scale measured at a later stage, although the degree of the associations was weaker. These associations tended to be even stronger when the MRF-ASL data were acquired at the acute/subacute stage. Compared with standard pseudo-continuous ASL, the multiparametric capability of MRF-ASL yielded higher area under curve values in the receiver operating characteristic analyses of stroke voxel classifications. Conclusions: MRF-ASL may provide a new approach for quantitative hemodynamic and structural imaging in ischemic stroke.