Pseudo-continuous arterial spin labeling quantifies cerebral blood flow in patients with acute ischemic stroke and chronic lacunar stroke

ObjectiveWe employed non-invasive pseudo-continuous arterial spin labeling (pCASL) to quantify cerebral blood flow (CBF) in infarcted and nearby neural regions in patients with acute ischemic stroke (AIS) and chronic lacunar stroke (CLS). The results were compared with CBF in healthy individuals.MethodsAIS and CLS patients were imaged with ASL, diffusion-weighted imaging (DWI) and conventional MRI. CBF maps were created with 3DASL software. Two expert readers identified AIS and CLS lesions on conventional images, DWI images and CBF maps. A senior radiologist calculated CBF values for lesions and nearby regions. Lesion, nearby regions and normal corresponding region values were analyzed using a two-sample t-test.ResultsFifty-six stroke patients (21 with AIS and 35 with CLS) and 30 healthy subjects participated in this study. In the AIS group, AIS lesions appeared in the cortex/white matter, external/internal capsule (EC/IC), and basal ganglia. AIS lesions had lower CBF values than the normal corresponding regions (p < 0.05). The mean CBF values in AIS nearby regions were significantly higher than those in normal corresponding regions (p < 0.05). In the CLS group, the CBF values in white matter and EC/IC were lower than the CBF values in normal corresponding regions (p = 0.063 and 0.052, respectively). The CBF values in CLS nearby regions and normal corresponding regions were not significantly different (p > 0.05).ConclusionIn some regions of the brain, CLS lesions, AIS lesions, and their nearby regions have different perfusion statuses. In particular, the AIS nearby regions perfusion in our subjects was significantly higher than that previously reported. pCASL can be a robust imaging technique for diagnosing strokes in clinical practices.