Monitoring cerebral blood flow change through use of arterial spin labelling in acute ischaemic stroke patients after intra-arterial thrombectomy
- 338 Downloads
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.
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.
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.
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.
• 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.
KeywordsPerfusion Prognosis Reperfusion Stroke Thrombectomy
Asymmetrical index of cerebral blood flow
Acute ischaemic stroke
Arterial spin labelling perfusion-weighted imaging
Alberta Stroke Program Early CT Score
Cerebral blood flow
Dynamic susceptibility contrast-enhanced perfusion-weighted imaging
Fluid-attenuated inversion recovery
Internal carotid artery
Modified Treatment in Cerebral Ischemia Scale
National Institutes of Health Stroke Scale
Region of interest
The authors state that this work has not received any funding.
Compliance with ethical standards
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.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
• diagnostic or prognostic study
• performed at one institution
- 18.Yoo RE, Choi SH, Cho HR et al (2013) Tumor blood flow from arterial spin labeling perfusion MRI: a key parameter in distinguishing high-grade gliomas from primary cerebral lymphomas, and in predicting genetic biomarkers in high-grade gliomas. J Magn Reson Imaging 38:852–860CrossRefPubMedGoogle Scholar
- 24.Yu S, Ma SJ, Liebeskind DS et al (2017) ASPECTS-based reperfusion status on arterial spin labeling is associated with clinical outcome in acute ischemic stroke patients. J Cereb Blood Flow Metab. https://doi.org/10.1177/0271678X17697339:271678X17697339
- 26.Sung SM, Lee TH, Cho HJ et al (2017) Clinical predictors for favorable outcomes from endovascular recanalization in wake-up stroke. J Clin Neurosci. https://doi.org/10.1016/j.jocn.2017.02.021