| Whole-brain arterial spin labeling perfusion MRI in patients with acute stroke. | |
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MedLine Citation:
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PMID: 22426319 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: Perfusion MRI can be used to identify patients with acute ischemic stroke who may benefit from reperfusion therapies. The risk of nephrogenic systemic fibrosis, however, limits the use of contrast agents. Our objective was to evaluate the ability of arterial spin labeling (ASL), an alternative noninvasive perfusion technique, to detect perfusion deficits compared with dynamic susceptibility contrast (DSC) perfusion imaging. METHODS: Consecutive patients referred for emergency assessment of suspected acute stroke within a 7-month period were imaged with both ASL and DSC perfusion MRI. Images were interpreted in a random order by 2 experts blinded to clinical information for image quality, presence of perfusion deficits, and diffusion-perfusion mismatches. RESULTS: One hundred fifty-six patients were scanned with a median time of 5.6 hours (range, 3.0-17.7 hours) from last seen normal. Stroke diagnosis was clinically confirmed in 78 patients. ASL and DSC imaging were available in 64 of these patients. A perfusion deficit was detected with DSC in 39 of these patients; ASL detected 32 of these index perfusion deficits, missing 7 lesions. The median volume of the perfusion deficits as determined with DSC was smaller in patients who were evaluated as normal with ASL than in those with a deficit (median [interquartile range], 56 [10-116] versus 114 [41-225] mL; P=0.01). CONCLUSIONS: ASL can depict large perfusion deficits and perfusion-diffusion mismatches in correspondence with DSC. Our findings show that a fast 2½-minute ASL perfusion scan may be adequate for screening patients with acute stroke with contraindications to gadolinium-based contrast agents. |
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Authors:
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Reinoud P H Bokkers; Daymara A Hernandez; José G Merino; Raymond V Mirasol; Matthias J van Osch; Jeroen Hendrikse; Steven Warach; Lawrence L Latour; |
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Publication Detail:
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Type: Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't Date: 2012-03-15 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 43 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-04-24 Completed Date: 2012-08-16 Revised Date: 2013-05-20 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 1290-4 Citation Subset: IM |
Affiliation:
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Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands. r.p.h.bokkers@umcutrecht.nl |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Brain / blood supply* Cerebral Arteries / pathology* Cerebrovascular Circulation Contrast Media / contraindications Female Gadolinium / contraindications Humans Magnetic Resonance Angiography / methods* Male Mass Screening / methods Middle Aged Perfusion Imaging / methods Prospective Studies Spin Labels* Stroke / diagnosis, pathology* |
| Grant Support | |
ID/Acronym/Agency:
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Z99 NS999999/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Contrast Media; 0/Spin Labels; 7440-54-2/Gadolinium |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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