Periprocedural Arterial Spin Labeling and Dynamic Susceptibility Contrast Perfusion in Detection of Cerebral Blood Flow in Patients With Acute Ischemic Syndrome
- 1 March 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 44 (3), 664-670
- https://doi.org/10.1161/strokeaha.112.672956
Abstract
To compare the diagnostic performance of arterial spin-labeling (ASL) and dynamic susceptibility contrast (DSC) perfusion in detecting cerebral blood flow (CBF) changes before and after endovascular recanalization in acute ischemic syndrome. The inclusion criteria for this retrospective study were patients with acute ischemic syndrome who underwent endovascular recanalization and acquisition of both ASL and DSC before and after revascularization. ASL-CBF and multiparametric DSC maps were evaluated for image quality, location, and type of perfusion abnormality. Relative CBF (rCBF) was calculated in the infarction core and hypoperfused areas using coregistered ASL and DSC. Core and hypoperfused rCBF were used for paired pretreatment and posttreatment comparisons. Interobserver and intermodality agreement were evaluated by κ test, and t test was calculated for ASL and DSC rCBF values. Twenty-five patients met our inclusion criteria. Five studies were rated nondiagnostic, resulting in 45 pairs of DSC–ASL available for comparison. ASL and DSC agreed on type and location of the perfusion abnormality in 71% and 80% of cases, respectively. The image quality of ASL was lower than DSC, resulting in interobserver variability for the type (κ=0.45) and location (κ=0.56) of perfusion abnormality. ASL was unable to show any type of perfusion abnormality in 11% of patients. In successfully recanalized patients, hyperperfusion (rCBF >1) was detected in 100% on DSC and 47% on ASL. ASL is less sensitive than DSC for detecting rCBF changes in patients with acute ischemic syndrome, particularly with respect to hyperperfusion after successful recanalization.Keywords
This publication has 31 references indexed in Scilit:
- Whole-Brain Arterial Spin Labeling Perfusion MRI in Patients With Acute StrokeStroke, 2012
- The Value of Arterial Spin-Labeled Perfusion Imaging in Acute Ischemic StrokeStroke, 2012
- The Penumbra Pivotal Stroke TrialStroke, 2009
- Perfusion MRI (Tmax and MTT) correlation with xenon CT cerebral blood flow in stroke patientsNeurology, 2009
- Continuous flow‐driven inversion for arterial spin labeling using pulsed radio frequency and gradient fieldsMagnetic Resonance in Medicine, 2008
- The Interventional Management of Stroke (IMS) II StudyStroke, 2007
- ACR Guidance Document for Safe MR Practices: 2007American Journal of Roentgenology, 2007
- The Desmoteplase in Acute Ischemic Stroke Trial (DIAS)Stroke, 2005
- Trial Design and Reporting Standards for Intra-Arterial Cerebral Thrombolysis for Acute Ischemic StrokeStroke, 2003
- Apparent diffusion coefficient mapping of experimental focal cerebral ischemia using diffusion‐weighted echo‐planar imagingMagnetic Resonance in Medicine, 1993