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European Radiology

, Volume 28, Issue 8, pp 3276–3284 | Cite as

Monitoring cerebral blood flow change through use of arterial spin labelling in acute ischaemic stroke patients after intra-arterial thrombectomy

  • Roh-Eul Yoo
  • Tae Jin YunEmail author
  • Dong Hyun Yoo
  • Young Dae Cho
  • Hyun-Seung Kang
  • Byung-Woo Yoon
  • Keun-Hwa Jung
  • Koung Mi Kang
  • Seung Hong Choi
  • Ji-hoon Kim
  • Chul-Ho Sohn
Neuro

Abstract

Objectives

To evaluate the ability of arterial spin labelling perfusion-weighted imaging (ASL-PWI) to identify reperfusion status and to predict the early neurological outcome of acute ischaemic stroke patients after intra-arterial (IA) thrombectomy.

Methods

A total of 51 acute ischaemic stroke patients who underwent IA thrombectomy were retrospectively reviewed. Asymmetrical index before and after IA thrombectomy (AICBFpre and AICBFpost) and volume ratio of the reperfused territory to the baseline perfusion abnormality (reperfusion volume ratio) were calculated on ASL-PWI. A paired t-test was used to compare AICBFpre and AICBFpost. Pearson correlation and multiple linear regression were performed to evaluate correlations between the imaging parameters and NIHSS scores.

Results

Mean AICBFpost was significantly higher than mean AICBFpre (0.923±0.352 vs. 0.312±0.191, p<0.001). AICBFpre had a significant correlation with NIHSSpre (pr=–0.430, p=.004). ∆AICBF had significant correlations with NIHSS24 h, NIHSS5-7 days and ∆NIHSS5-7 days (r=–0.356, p=0.028; r=–0.597, p<0.001; r=–0.346, p=0.033, respectively). ∆AICBF, reperfusion volume ratio and baseline infarct volume were significant independent predictors for NIHSS5-7 days.

Conclusions

ASL-PWI has the potential to serve as a non-invasive imaging tool to monitor the reperfusion status and predict the early neurological outcome of acute ischaemic stroke patients after IA thrombectomy.

Key Points

• CBF change on ASL-PWI after IA thrombectomy correlated with NIHSS scores.

• ASL-PWI can non-invasively monitor reperfusion in AIS patients after IA thrombectomy.

• ASL-PWI may predict early outcome of AIS patients after IA thrombectomy.

Keywords

Perfusion Prognosis Reperfusion Stroke Thrombectomy 

Abbreviations

3D

Three-dimensional

AICBF

Asymmetrical index of cerebral blood flow

AIS

Acute ischaemic stroke

ASL-PWI

Arterial spin labelling perfusion-weighted imaging

ASPECTS

Alberta Stroke Program Early CT Score

CBF

Cerebral blood flow

DSC-PWI

Dynamic susceptibility contrast-enhanced perfusion-weighted imaging

DWI

Diffusion-weighted imaging

FLAIR

Fluid-attenuated inversion recovery

IA

Intra-arterial

ICA

Internal carotid artery

IQR

Interquartile range

mTICI

Modified Treatment in Cerebral Ischemia Scale

NIHSS

National Institutes of Health Stroke Scale

ROI

Region of interest

SWI

Susceptibility-weighted imaging

TOF

Time-of-flight

Notes

Funding

The authors state that this work has not received any funding.

Compliance with ethical standards

Guarantor

The scientific guarantor of this publication is Tae Jin Yun.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

Supplementary material

330_2018_5319_MOESM1_ESM.docx (21 kb)
ESM 1 (DOCX 20 kb)

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Copyright information

© European Society of Radiology 2018

Authors and Affiliations

  • Roh-Eul Yoo
    • 1
    • 2
  • Tae Jin Yun
    • 1
    • 2
    Email author
  • Dong Hyun Yoo
    • 1
    • 2
  • Young Dae Cho
    • 1
    • 2
  • Hyun-Seung Kang
    • 3
  • Byung-Woo Yoon
    • 4
  • Keun-Hwa Jung
    • 4
  • Koung Mi Kang
    • 1
    • 2
  • Seung Hong Choi
    • 1
    • 2
  • Ji-hoon Kim
    • 1
    • 2
  • Chul-Ho Sohn
    • 1
    • 2
  1. 1.Institute of Radiation MedicineSeoul National University Medical Research CenterSeoulRepublic of Korea
  2. 2.Department of RadiologySeoul National University HospitalSeoulKorea
  3. 3.Department of NeurosurgerySeoul National University HospitalSeoulRepublic of Korea
  4. 4.Department of NeurologySeoul National University HospitalSeoulRepublic of Korea

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