scholarly journals Collateral perfusion using arterial spin labeling in symptomatic versus asymptomatic middle cerebral artery stenosis

2017 ◽  
Vol 39 (1) ◽  
pp. 108-117 ◽  
Author(s):  
Xin Lou ◽  
Xiaoxiao Ma ◽  
David S Liebeskind ◽  
Ning Ma ◽  
Chenglin Tian ◽  
...  

The purpose was to assess the difference of collaterals in symptomatic versus asymptomatic patients with unilateral middle cerebral artery (MCA) stenosis by comparing cerebral blood flow (CBF) at two post labeling delays (PLD) using three-dimensional pseudo-continuous arterial spin labeling (3D pCASL). Eighty-one patients (49 symptomatic and 32 asymptomatic) with unilateral MCA stenosis ≥50% who underwent pCASL with two PLDs were included. Mean CBF and CBF subtraction images between two PLDs of MCA territories were compared in symptomatic and asymptomatic groups, respectively. Compared with the asymptomatic group, patients with symptomatic MCA stenosis had significantly lower CBF in the MCA territory of stenotic side at each PLD. The CBF of stenotic territory showed greater increase than that of normal side from PLD 1.5 to 2.5 s. The CBF of asymptomatic MCA territory increased similarly with that of symptomatic MCA territory from PLD of 1.5 to 2.5 s in stenotic side, while symptomatic patients experienced significantly slower antegrade flow. On CBF subtraction images, asymptomatic patients showed larger volume of differences between PLD of 1.5 and 2.5 s compared with those of symptomatic patients ( p = 0.037). The results suggest that more robust collateral perfusion on two-delay 3D pCASL is present in asymptomatic patients compared with symptomatic patients.

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Eric Lai ◽  
Raja Rizal Azman Raja Aman ◽  
Hui Zhang ◽  
Pui-Wai Chiu ◽  
Queenie Chan ◽  
...  

Purpose: Correlation of arterial stenosis with cortical and subcortical cerebral blood flow (CBF) in the middle cerebral artery (MCA) territory. Methods: 126 patients with acute cerebrovascular symptoms from March to June 2015 underwent MRI and MR Angiography (MRA) in a University hospital using a 3.0 Tesla scanner. Sequences included T1W, T2W, FLAIR, DWI, MRA, Pseudocontinuous Arterial Spin Labeling (pcASL, post-labeling delay 1.525 s). 13 patients (corrupted pcASL data) were excluded, with 113 patients (mean age: 67.74±14.19) evaluated (61 acute ischemic stroke, 52 patients transient ischemic attack). Institutionally developed software was used to determine CBF. MCA stenosis was graded into 4 categories by a neuroradiologist: 0 (no stenosis), 1 (mild <50%), 2 (moderate 50-70%) and 3 (severe >70%). Mean and standard deviation of MCA categories (leptomeningeal and perforating) CBF and corresponding degree of MCA stenosis were measured. Spearman correlation coefficients between CBF of cortical and subcortical regions and degree of MCA stenoses were calculated using SPSS (version 23.0). Results: The table showed the descriptive statistics. There was significant correlation between CBF of cortical region of MCA vascular territory and degree of stenosis of MCA in both left (r s = -0.296, p =0.001) and right (r s = -0.306, p =0.001) side. In the contrary, there was no correlation between subcortical CBF of MCA vascular territory and degree of stenosis of MCA in both sides. Conclusion: pcASL is a feasible non-invasive method to measure CBF in clinical setting. In MCA territory, the cortical blood flow correlated (fairly) with large vessel stenosis but not subcortical flow. We conclude that cortical CBF correlated with large artery stenosis, though being attenuated by collateral blood supply. No such relationship in subcortical CBF might be due to differential grey and white matter CBF flow, variable MCA stenotic location, and perforators originating from other territories.


2018 ◽  
Vol 81 (5) ◽  
pp. 3185-3191 ◽  
Author(s):  
Yuta Akamine ◽  
Makoto Obara ◽  
Osamu Togao ◽  
Shuhei Shibukawa ◽  
Masami Yoneyama ◽  
...  

2020 ◽  
Author(s):  
Yali Wu ◽  
jingjing li ◽  
wenqing wu

Abstract Objective This study aimed to identify the cerebral blood flow (CBF) in patients with general paralysis (GP). Methods Three-dimensional pseudo-continuous arterial spin labeling (3D-pCASL) imaging was performed to measure the CBF in twenty patients with GP and twenty healthy subjects(NC). CBF was normalized to reduce variations among subjects. CBF was compared between the groups. Results Compared with the healthy subjects, the patients with GP exhibited increased CBF in the frontal lobe, temporal lobe, insular lobe, limbic lobe, and parietal lobe(all P<0.05). There was no difference in CBF of the occipital lobe between the GP group and the NC group(all P>0.05). Conclusions Our results suggest that the patients with GP may exhibit regional increased CBF, which may be one of the pathogenesis of general paralysis.


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