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Eur Radiol. 2018 Aug;28(8):3276-3284. doi: 10.1007/s00330-018-5319-0. Epub 2018 Feb 23.

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

Yoo RE1,2, Yun TJ3,4, Yoo DH1,2, Cho YD1,2, Kang HS5, Yoon BW6, Jung KH6, Kang KM1,2, Choi SH1,2, Kim JH1,2, Sohn CH1,2.

Author information

1
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea.
2
Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea.
3
Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea. radiologyyun@gmail.com.
4
Department of Radiology, Seoul National University Hospital, 101, Daehangno, Jongno-gu, Seoul, 110-744, Korea. radiologyyun@gmail.com.
5
Department of Neurosurgery, Seoul National University Hospital, Seoul, Republic of Korea.
6
Department of Neurology, Seoul National University Hospital, Seoul, Republic of Korea.

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

PMID:
29476217
DOI:
10.1007/s00330-018-5319-0
[Indexed for MEDLINE]

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