Role of Arterial Spin Labeling Perfusion MRI in recent ischemic cerebrovascular stroke

Articles in Press

Document Type : Original Article

Authors

1 Radio-diagnosis Department, Faculty of Medicine, Minia University, Minia, Egypt

2 Neuropsychiatry Department, Faculty of Medicine, Minia university, Minia, Egypt

Abstract

Background:

Recent cerebrovascular stroke requires prompt and accurate assessment of cerebral perfusion to guide therapeutic decisions and predict outcomes. Traditional perfusion imaging methods,such as dynamic susceptibility contrast (DSC) MRI and computed tomography perfusion (CTP), rely on exogenous contrast agents and may be limited in certain patient populations.

Objective:

To evaluate the added diagnostic value of Arterial Spin Labeling (ASL) perfusion MRI in the early detection and management of recent cerebrovascular stroke.

Methods:

This prospective clinical study was carried out on 50 patients, aged from 50 to 75 years, both sexes, with clinical symptoms of recent ischemic insult. All patients underwent conventional MRI and then ASL within two days of their onset of symptoms. 3months clinical follow up of the cases performed with correlation with MR imaging

Results:

The NIHSS scores categorized patients into mild (48%), moderate (30%), and severe (22%) stroke severity groups. The majority fell into the mild-to-moderate range, suggesting that the cohort had a mix of stroke severities

There is a strong positive association between diffusion/ASL mismatch and NIHSS favorable outcome after 3 months, A diffusion/ASL mismatch (indicating penumbra) was associated with favorable outcomes (96.1% vs. 8.3% in non-mismatch; p < 0.001). Though the kappa was mild (0.30), the high predictive accuracy supports the clinical utility of mismatch identification for guiding reperfusion therapies

Conclusion:

ASL metrics are valuable tool for the quantitative and qualitative evaluation of early detection of ischemic stroke when used in addition to conventional MRI

Its integration into stroke imaging protocols enhance tissue viability assessment

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Minia Journal of Medical Research

Articles in Press, Accepted Manuscript
Available Online from 27 July 2025

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