CC-BY-NC-ND 4.0 · J Clin Interv Radiol ISVIR 2017; 01(03): 144-149
DOI: 10.1055/s-0037-1603829
Original Article
Indian Society of Vascular and Interventional Radiology

Arterial Spin Labeling—Can Neurointerventionists Rely on This Novel Technique? A Case Series on Successful Use of Arterial Spin Labeling in Acute Stroke Imaging

K. R. Rahul
1  Division of Neuro and Vascular Interventional Radiology, Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
,
P. Santhosh
1  Division of Neuro and Vascular Interventional Radiology, Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
,
M. P. Dilip Kumar
2  Division of Interventional Radiology, Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
,
Pankaj Mehta
2  Division of Interventional Radiology, Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
,
Mathew Cherian
2  Division of Interventional Radiology, Department of Radiology, Kovai Medical Centre and Hospital, Coimbatore, Tamil Nadu, India
› Author Affiliations
Further Information

Publication History

16 January 2017

01 May 2017

Publication Date:
01 September 2017 (eFirst)

Abstract

Presence of ischemic penumbra is the principal factor that decides the need for mechanical thrombectomy in acute stroke patients with large vessel occlusion. Our objective was to evaluate the usefulness of arterial spin labeling (ASL) in detecting diffusion perfusion mismatch and directing patients into mechanical thrombectomy. We retrospectively studied all patients with acute nonhemorrhagic stroke in the anterior circulation, who had undergone stroke imaging with ASL followed by mechanical thrombectomy from July 2016 to November 2016. Area of diffusion perfusion mismatch was graded semiquantitatively into three grades: small, medium, and large. Mismatch was compared with 30-day modified Rankin scale (mRS) score. Interpretable PASL-perfusion images were obtained in all patients. Diffusion perfusion mismatches were present in all patients. Out of six patients with good mRS score, five patients had large diffusion perfusion mismatch. Two out of three patients with poor mRS were secondary to failed recanalization, in spite of large mismatch. One out of nine patients had poor outcome as well as a small area of mismatch. ASL is a rapid noninvasive imaging technique in acute stroke that has got the potential to detect ischemic penumbra.