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Assessment of Perfusion Deficits in Ischemic Stroke Using 3D‐GRASE Arterial Spin Labeling Magnetic Resonance Imaging with Multiple Inflow Times
Author(s) -
Wolf Marc E.,
Layer Vanessa,
Gregori Johannes,
Griebe Martin,
Szabo Kristina,
Gass Achim,
Hennerici Michael G.,
Günther Matthias,
Kern Rolf
Publication year - 2013
Publication title -
journal of neuroimaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.822
H-Index - 64
eISSN - 1552-6569
pISSN - 1051-2284
DOI - 10.1111/jon.12064
Subject(s) - medicine , perfusion , magnetic resonance imaging , hemodynamics , arterial spin labeling , perfusion scanning , cerebral blood flow , blood flow , stroke (engine) , nuclear medicine , cardiology , radiology , mechanical engineering , engineering
BACKGROUND AND PURPOSE Arterial spin labeling (ASL) MRI provides information on tissue perfusion by consecutive readout of labeled blood captured in arteries or the microvasculature without using contrast agents. METHODS We used a single‐shot 3D acquisition and readout technique for ASL with multiple inflow times (TI) to evaluate hemodynamic compromise and dynamics of arterial blood inflow expressed by the bolus arrival time (BAT). Thirty‐six patients with ischemic stroke were examined with a standard multimodal MRI protocol including dynamic susceptibility contrast (DSC) and multi‐TI ASL perfusion imaging. Time‐to‐peak maps were used to classify hemodynamic impairment as either hypo‐ or hyperperfusion. RESULTS Overall there was a good agreement of ASL perfusion maps with DSC perfusion imaging on visual analysis. Correlations were found between ASL‐BAT/(DSC‐)Mean transit time (MTT) ( r = .416; P < .01) and ASL‐CBF/MTT ( r = –.489; P < .01). Using ASL, BAT in ischemic territory was delayed by 55% ( P = .001) in patients with hypoperfusion ( n = 28); CBF was reduced by 39% ( P <.001). All patients with hyperperfusion ( n = 6) had higher CBF on ASL. CONCLUSIONS The use of ASL with multiple TI allows the contrast‐free assessment of hemodynamic impairment in ischemic stroke patients. Quantitative ASL perfusion analysis reliably demonstrates areas of delayed BAT and reduced CBF matching findings of DSC.