Measurement of collateral perfusion in acute stroke: a vessel-encoded arterial spin labeling study

Sci Rep. 2019 Jun 3;9(1):8181. doi: 10.1038/s41598-019-44417-7.

Abstract

Collateral perfusion is important for sustaining tissue viability in acute ischemic stroke. Conventional techniques for its visualization are invasive, require contrast agents and demonstrate collateral vessels, rather than measuring perfusion directly. In this study we utilize a non-invasive, non-contrast magnetic resonance imaging (MRI)-based method to directly quantify collateral perfusion in acute stroke patients. Vessel-encoded multi-postlabeling delay arterial spin labeling (ASL) was used to separately quantify the blood flow and blood arrival time from four arteries supplying the brain in patients presenting within 18 hours of stroke onset. Twenty-nine acute ischemic stroke patients were scanned with a median time of onset to first MRI of 3 hours. Collateral perfusion at presentation was associated with tissue fate at 1-week. It sustained tissue prior to reperfusion, but was less effective than direct blood flow at maintaining tissue viability in patients who did not reperfuse. Delay in the blood arrival around the ischemic region was found at presentation and reduced over time but was not consistently associated with collateral perfusion. Vessel-encoded multi-postlabeling delay ASL provides a non-invasive tool for direct measurement of collateral perfusion and delayed blood arrival in acute stroke patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Arteries / diagnostic imaging
  • Arteries / pathology
  • Blood Vessels / diagnostic imaging*
  • Blood Vessels / pathology
  • Brain / diagnostic imaging*
  • Brain / pathology
  • Cerebrovascular Circulation / physiology
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Perfusion Imaging
  • Spin Labels
  • Stroke / diagnostic imaging*
  • Stroke / pathology

Substances

  • Spin Labels