• Marc E Wolf, Vanessa Layer, Johannes Gregori, Martin Griebe, Kristina Szabo, Achim Gass, Michael G Hennerici, and Matthias Günther.
• J Neuroimaging. 2014 Sep 1;24(5):453-9.

Background And PurposeArterial spin labeling (ASL) MRI provides information on tissue perfusion by consecutive readout of labeled blood captured in arteries or the microvasculature without using contrast agents.MethodsWe used a single-shot 3D acquisition and readout technique for ASL with multiple inflow times (TI) to evaluate hemodynamic compromise and dynamics of arterial blood inflow expressed by the bolus arrival time (BAT). Thirty-six patients with ischemic stroke were examined with a standard multimodal MRI protocol including dynamic susceptibility contrast (DSC) and multi-TI ASL perfusion imaging. Time-to-peak maps were used to classify hemodynamic impairment as either hypo- or hyperperfusion.ResultsOverall there was a good agreement of ASL perfusion maps with DSC perfusion imaging on visual analysis. Correlations were found between ASL-BAT/(DSC-)Mean transit time (MTT) (r = .416; P < .01) and ASL-CBF/MTT (r = -.489; P < .01). Using ASL, BAT in ischemic territory was delayed by 55% (P = .001) in patients with hypoperfusion (n = 28); CBF was reduced by 39% (P<.001). All patients with hyperperfusion (n = 6) had higher CBF on ASL.ConclusionsThe use of ASL with multiple TI allows the contrast-free assessment of hemodynamic impairment in ischemic stroke patients. Quantitative ASL perfusion analysis reliably demonstrates areas of delayed BAT and reduced CBF matching findings of DSC.

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