Arterial spin labeling detects post-stroke collateral blood vessels to aid prognosis
medwireNews: Collateral blood vessels detected on arterial spin labeling (ASL) magnetic resonance imaging are significantly associated with good neurologic outcomes in patients after acute ischemic stroke.
“This novel association […] may help guide prognosis and management, particularly in patients who are unable to undergo contrast-based radiological studies,” write Jalal Andre (University of Washington, Seattle, USA) and colleagues in JAMA Neurology.
Collaterals, defined as curvilinear areas of hyperintensity along at least 10% of the border of an ASL hypoperfusion abnormality corresponding to a diffusion-weighted imaging lesion, were detected on graded ASL images from 25 (65.8%) of 38 patients.
These patients had a lower median modified Rankin Scale (mRS) score of 2 versus 4 at discharge and were fivefold more likely than those without ALS collaterals to have a 1-point decrease in mRS score at discharge, after adjustment for admission National Institutes of Health Stroke Scale score, premorbid mRS score, stroke parent artery status, and history of atrial fibrillation.
ASL collaterals were also indicative of a good neurologic outcome, with 60% of patients with them scoring 0–2 on the mRS, compared with 15.4% of those without them.
“Arterial spin labeling is underused for acute stroke, largely because of a lack of familiarity with the technique, and may eventually provide a safer standard of care for [acute ischemic stroke] imaging,” the team concludes.
By Lucy Piper
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