Arterial spin labeling combined with territory arterial spin labeling technology for evaluating collateral compensation in patients with severe stenosis or occlusion of unilateral middle cerebral artery
Objective To observe the value of arterial spin labeling(ASL)combined with territory ASL(t-ASL)technology for evaluating collateral compensation in patients with severe stenosis or occlusion of unilateral middle cerebral artery(MCA).Methods Data of 52 patients with severe stenosis or occlusion of unilateral MCA(lesion group)were retrospectively analyzed.The patients were divided into poor collateral circulation subgroup(n=23)or good subgroup(n=29)based on relative cerebral blood flow(rCBF).Meawhile,55 healthy subjects were taken as controls(control group).Based on ASL(post labeling delay[PLD]=1 525,2 525 ms)and t-ASL images,cerebral blood flow(CBF),rCBF and CBF difference(CBF in PLD 2 525 ms-CBF in PLD 1 525 ms)were compared between groups and subgroups within lesion group,and the source of collateral compensation was observed.The correlations of the above parameters and compensation status were explored using Kendall correlation analysis.Results Significant differences of CBF and CBF difference were found between the affected side of lesion group and the left side of control group,as well as of rCBF between groups(all P＜0.001).In both groups,CBF on PLD=2 525 ms images were greater than that on PLD=1 525 ms images(both P＜0.05),and CBF in the affected side was smaller than that in the opposite side in lesion group(all P＜0.05).Significant differences of CBF and rCBF in the affected side,also of CBF difference(all P＜0.001),as well as of the proportion of non collateral compensation and contralateral internal carotid arteria(ICA)+vertebral basilar artery(VBA)compensation were found between subgroups within lesion group(both P＜0.05).In lesion group,rCBF(PLD=2 525 ms)had low positive correlation with the presence of VBA collateral compensation(r=0.397,P=0.004).Conclusion ASL combined with t-ASL were helpful for evaluating collateral compensation in patients with unilateral MCA stenosis or occlusion.
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