Role of Arterial Spin Labeling Perfusion MRI in recent ischemic cerebrovascular stroke | ||||
| Minia Journal of Medical Research | ||||
| Articles in Press, Accepted Manuscript, Available Online from 27 July 2025 | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/mjmr.2025.402816.2024 | ||||
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| Authors | ||||
Aya Gaber Taha Seddik  1; Moustafa Abdel Kader1; Rasha Nady Saleh2; Sara Mahmoud Ragaee Mohamed 1
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| 1Radio-diagnosis Department, Faculty of Medicine, Minia University, Minia, Egypt | ||||
| 2Neuropsychiatry 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 | ||||
| Keywords | ||||
| Recent ischemic cerebrovascular stroke; ASL; Perfusion MRI; CBF; Non-contrast imaging | ||||
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