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• Clinical Article •
3D-ASL of arterial transit artifact and the intra-arterial high-intensity signal in the evaluation of short-term clinical outcomes in patients with acute ischemic stroke
YANG Li  HE Yuanyan  LI Yanyao  ZHANG Pengfei  HE Yexin 

Cite this article as: YANG L, HE Y Y, LI Y Y, et al. 3D-ASL of arterial transit artifact and the intra-arterial high-intensity signal in the evaluation of short-term clinical outcomes in patients with acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2023, 14(10): 36-41. DOI:10.12015/issn.1674-8034.2023.10.007.


[Abstract] Objective To evaluate the short-term prognosis of acute ischemic stroke (AIS) patients with arterial transit artifact (ATA) and the intra-arterial high-intensity signal (IAS) in three dimensional arterial spin labeling (3D-ASL) imaging.Materials and Methods A total of 36 patients with AIS 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. They were divided into ATA (+) group and ATA (-) group according to whether ATA appeared. According to whether IAS appeared, ATA (+) group was divided into ATA (+) IAS (+) group and ATA (+) IAS (-) group. National Institute of Health Stroke Scale (NIHSS) scores difference (ΔNIHSS) were recorded for patient discharge and admission. ATA Alberta Stroke Program Early CT Score (ASPECTS) were developed and documented based on Alberta stroke program early CT score. Cerebral blood flow (CBF) in the ATA distribution area was measured , and relative cerebral blood flow (rCBF) was calculated. Compare whether there are differences in ΔNIHSS between the groups. The relationship between groups ATA ASPECTS, rCBF and ΔNIHSS.Results The post labeling delay (PLD) were 1525 ms and 2525 ms, the difference of ΔNIHSS in ATA (+) group and ATA (-) group was statistically significant (P＜0.05), and ΔNIHSS of the former fell more than the latter. The difference of ΔNIHSS between ATA (+) IAS (-) group and ATA (+) IAS (+) group was not statistically significant (P＞0.05), but ΔNIHSS of the former fell more than the latter. Spearman correlation analysis shows that PLD were 1525 ms and 2525 ms, there is negative correlation between ATA ASPECTS, rCBF and ΔNIHSS, and there was a positive correlation between rCBF and ATA ASPECTS. The results were statistically significant (P＜0.05).Conclusions Depending on the presence of ATA and IAS, the range of ATA distribution and the measured CBF in the distribution area are helpful for evaluating the open status of collateral circulation in patients with AIS, moreover, the accuracy of PLD used 2525 ms is higher. All these will provide an effective basis for extending the time window of endovascular therapy, evaluating patient's short-term prognosis and guiding clinical formulation of treatment plans.
[Keywords] stroke, acute ischemic；magnetic resonance imaging；arterial spin labeling, three-dimensional；post labeling delay；collateral circulation；arterial transit artifact；intra-arterial high-intensity signal

YANG Li1   HE Yuanyan1, 2   LI Yanyao1   ZHANG Pengfei1   HE Yexin3, 4*  

1 Department of Medical Imaging, Shanxi Medical University, Taiyuan 030012, China

2 Department of Imaging Medicine, Affiliated Hospital of Traditional Chinese Medicine of the Inner Mongolia Autonomous Region, Hohhot 010000, China

3 Department of MRI, Shanxi Provincial People's Hospital, Affiliate of Shanxi Medical University, Taiyuan 030012, China

4 Shanxi Key Laboratory of Brain Disease Control, Taiyuan 030012, China

Corresponding author: HE Y X, E-mail: heyexinty2000@sina.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Significant Research and Development Plan Program of Shanxi Province (No. 201903D321191).
Received  2023-02-10
Accepted  2023-09-11
DOI: 10.12015/issn.1674-8034.2023.10.007
Cite this article as: YANG L, HE Y Y, LI Y Y, et al. 3D-ASL of arterial transit artifact and the intra-arterial high-intensity signal in the evaluation of short-term clinical outcomes in patients with acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2023, 14(10): 36-41. DOI:10.12015/issn.1674-8034.2023.10.007.

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