Arterial Spin Labeling MRI In The Outcome Prediction Of Ischemic Stroke Patients

Objective:Ischemic stroke is a serious disease that threatens human health,The incidence rate of it is increasing year by year.The most common cause is cerebrovascular stenosis or occlusion.To explore the value of arterial transit artifact(ATA),a characteristic sign of arterial spin labeling perfusion imaging(ASL),in predicting the prognosis of patients with symptomatic cerebrovascular stenosis or occlusion;At the same tim,as a standard,to compare the consistency between arterial spin labeling perfusion imaging and DSC-PWI in the hemodynamic evaluation of these patients.Methods:A total of 40 patients with symptomatic cerebrovascular stenosis or occlusion who were treated at the Department of Neurology of the Jincheng General Hospital between September 2016 and December 2017 were recruited and confirmed by DSA,CTA or MRA.There were 26 males and 14 females,aged 36~81 years,with an average age of57±14 years.Record patient’s general information in detail,such as name,gender,whether there is a risk factor for stroke,etc.All patients completed routine MRI,DWI,MRA,and ASL scans.12 patients of those underwent DSC-PWI scan.Through follow-up of patients for one year,grouped these patients according to the follow-up results whether they had an ischemic event,compared baseline clinical and imaging indicators of two groups,and judged whether these indicators are related to the prognosis of patients.At the same time,compared the consistency of ASL and DSC-PWI on evaluating cerebral hemodynamics.The imaging indicators analysis was judged by two neuroimagingphysicians independently and blindly.When they had arguments about the same image,they gave same results by discussing.Results:In 40 patients,a total of 23 patients(57.5%)had high cortical bright signals in the ASL cerebral blood flow map.According to the results of follow-up,there were 12patients(30%)with recurrent ischemic events and 28 patients(70%)without recurrent ischemic events.Of these,there are 4 patients(33.3%)who had arterial transit artifacts in the ASL map with 12 patients with recurrent ischemic events and the remaining 8 cases did not show this sign;in patients with no recurrent ischemic events,there were 19patients(67.9%)with high signal in the ASL map.There was a significantly statistical difference between the two groups(P<0.05),This shows that arterial transit artifacts in the ASL cerebral blood flow map are more common in patients with good prognosis,indicating that arterial transit artifacts can help predict the prognosis of patients.Conclusion:Arterial transit artifacts,the characteristic signs of arterial spin labeling perfusion imaging,may serve as an indicator of prognosis in patients with ischemic stroke.