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Neuroradiology

, Volume 59, Issue 6, pp 587–595 | Cite as

Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment

  • Shu Sogabe
  • Junichiro SatomiEmail author
  • Yoshiteru Tada
  • Yasuhisa Kanematsu
  • Kazuyuki Kuwayama
  • Kenji Yagi
  • Shotaro Yoshioka
  • Yoshifumi Mizobuchi
  • Hideo Mure
  • Izumi Yamaguchi
  • Takashi Abe
  • Nobuaki Yamamoto
  • Keiko T. Kitazato
  • Ryuji Kaji
  • Masafumi Harada
  • Shinji Nagahiro
Diagnostic Neuroradiology

Abstract

Purpose

Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment.

Methods

Our study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4).

Results

Of seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1–C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3–C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1–C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion.

Conclusion

High IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site.

Keywords

Magnetic resonance imaging Arterial spin labeling Internal carotid artery occlusion Occluded segment 

Notes

Acknowledgements

We thank the members of the Stroke Care Unit of Tokushima University Hospital for their contributions to this study.

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

Informed consent was obtained from all participants for whom identifying information is included in this article.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Shu Sogabe
    • 1
  • Junichiro Satomi
    • 1
    Email author
  • Yoshiteru Tada
    • 1
  • Yasuhisa Kanematsu
    • 1
  • Kazuyuki Kuwayama
    • 1
  • Kenji Yagi
    • 1
  • Shotaro Yoshioka
    • 1
  • Yoshifumi Mizobuchi
    • 1
  • Hideo Mure
    • 1
  • Izumi Yamaguchi
    • 1
  • Takashi Abe
    • 2
  • Nobuaki Yamamoto
    • 3
  • Keiko T. Kitazato
    • 1
  • Ryuji Kaji
    • 3
  • Masafumi Harada
    • 2
  • Shinji Nagahiro
    • 1
  1. 1.Department of NeurosurgeryTokushima University Graduate SchoolTokushimaJapan
  2. 2.Department of RadiologyTokushima University Graduate SchoolTokushimaJapan
  3. 3.Department of Clinical Neurosciences, Institute of Biomedical BiosciencesTokushima University Graduate SchoolTokushimaJapan

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