Reduced Cerebral Blood Flow in Benign Oligemia Relates to Poor Clinical Outcome in Acute Ischemic Stroke Patients.

Abstract

The imaging of cerebral blow flow (CBF) has shown great promise in predicting the tissue outcome or functional outcome of acute ischemic stroke patients. Arterial spin labeling (ASL) provides a noninvasive tool for quantitative CBF measurement and does not require a contrast agent, which makes it an attractive technology for perfusion imaging in clinical settings. Previous studies have shown the feasibility of using ASL for acute stroke imaging and its potential in stroke outcome prediction. However, the relationship between the tissue-level CBF reduction in hypoperfused region and clinical outcome in acute stroke patients remains not well understood. In this study, we obtained the quantitative measurements of CBF in acute ischemic stroke patients (N = 18) using pseudocontinuous ASL (pCASL) perfusion imaging technology. The tissue-level CBF changes were evaluated and their correlations with patient clinical outcome were explored. Our results showed different CBF values between hypoperfused tissues recruited into infarction and those that survived. Moreover, a significant correlation was found specifically between the CBF reduction in benign oligemia area and patient neurological deficit severity. These findings showed the validity of pCASL perfusion imaging in the assessment of tissue-level CBF information in acute stroke. The association of CBF with patient clinical outcome might provide useful insights in early diagnosis of acute stroke patients.