Three-Dimensional Arterial Spin Labeling Of Arterial Transit Artifact And The Intra-Arterial High-Intensity Signal Evaluate The Short-Term Clinical Outcomes In Patients With Acute Ischemic Stroke

Objective:To investigate the value of arterial transit artifact(ATA)and the intra-arterial high-intensity signal(IAS)of three-dimensional Arterial spin labeling(3D-ASL)in evaluating the short-term prognosis of patients with acute ischemic stroke.Methods:A total of 36 patients with acute ischemic stroke due to severe stenosis or occlusion of intracranial segment of unilateral internal carotid artery or middle cerebral artery admitted to the Department of Neurology of Shanxi Provincial People’s Hospital from July 2018 to October 2022 were collected for study.National Institute of Health stroke scale(NIHSS)scores difference(ΔNIHSS)were recorded for patient discharge and admission.Refering to Alberta stroke program early CT score(ASPECTS),the seven regions(Insula and M1-M3 at the nuclear mass level,M4-M6 above the nuclear)are supplied by the middle cerebral artery.Patients were divided into group of ATA(+)and group of ATA(-)according to whether they had ATA in the 7 areas in 3D-ASL PLD uses 1525 ms or 2525 ms.Group of ATA(+)was divided into group of ATA(+)IAS(+)and group of ATA(+)IAS(-)depending on whether IAS was present.ATA Alberta stroke program early CT score(ATA ASPECTS)scoring was performed for the ATA emergence level,and subtracted 1 point from the total score of IAS.Cerebral blood flow and relative cerebral blood flow were measured in the area where ATA was present.For multiple regions,finding the average of all regions.Compare whether there are differences in ΔNIHSS between the groups,the relationship between groups ATA ASPECTS,rCBF and ΔNIHSS.Results:Of all the patients,23 were ATA(+)and 13 were ATA(-).18 were ATA(+)IAS(-)and 5 were ATA(+)IAS(+).No matter PLD uses 1525 ms or 2525 ms,the difference ofΔNIHSS in ATA(+)and ATA(-)was statistically significant.The ΔNIHSS decline of ATA(+)is greater than that of group ATA(-).Although the difference between ATA(+)IAS(-)and ATA(+)IAS(+)was not statistically significant.The ΔNIHSS decline of ATA(+)IAS(-)is greater than that of group ATA(+)IAS(+).According to Spearman correlation analysis results,whether PLD uses 1525 ms or 2525 ms,ATA ASPECTS,rCBF are negatively correlated with ΔNIHSS.There is positive correlation between rCBF and ATA.No matter PLD uses 1525 ms or 2525 ms,CBF and rCBF of group ATA(+)IAS(-)are all higher than those of group ATA(+)IAS(+).However,only when PLD uses 1525 ms,the difference of CBF between the two groups was statistically significant.None of the others were statistically significant.Conclusion:Depending on the presence of ATA and IAS,the range of ATA distribution and the measured blood flow in the distribution area can estimate the patient’s short-term clinical outcomes.