With the ageing population, stroke has gradually become the leading cause of death and disability among adults. It is necessary to verify whether multi-delay pseudo-continuous arterial spin labelling (pCASL) MRI can be used as a standard neuroimaging protocol in the patients with ischemic stroke. We aimed to investigate the clinical utility of multi-delay pCASL for evaluating cerebral perfusion in ischemic stroke disease. Twenty-one ischemic stroke patients [18 men and 3 women; median age, 62 years (age range, 37-84 years)] were enrolled in this study. All patients underwent examinations, including the multi-delay pCASL protocol (using 6 PLDs between 1000-3500 ms) and computed tomography perfusion (CTP). The cerebral blood flow (CBF) and arterial transit time (ATT) maps were obtained by the multi-delay pCASL protocol, while CBF and mean transit time (MTT) maps were derived by CTP measurements. Based on the voxel level analysis, Pearson correlation coefficients were used to estimate the associations between the two modalities in the gray matter, white matter, and whole brain of each subject. Moderate to high positive associations between ASL-CBF and CTP-CBF were acquired by voxel level wise analysis in the gray matter, white matter, and whole brain of the enrolled patients (all P<0.005), and the average Pearson correlation coefficients were 0.647, 0.585 and 0.646, respectively. Highly significant positive correlations between ASL-ATT and CTP-MTT were obtained by voxel-level-wise associations in the gray matter, white matter, and whole brain (all P<0.005), and the average Pearson correlation coefficients were 0.787, 0.706 and 0.799, respectively. In addition, significant associations between ASL and CT perfusion were obtained in gray and white matter and whole brain, according to the subgroup analyses of patients’ age and disease stage. There is a correlation between perfusion parameters from multi-delay pCASL and CT perfusion imaging in patients with ischemic stroke. Multi-delay pCASL is radiation-free and non-invasive, and could be an alternative method to CT scans for assessing perfusion in ischemic stroke disease.

中文翻译：

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多延迟伪连续动脉自旋标记灌注MRI与CT灌注在缺血性脑卒中的对比研究

随着人口老龄化，中风逐渐成为成年人死亡和残疾的主要原因。有必要验证多延迟伪连续动脉自旋标记 (pCASL) MRI 是否可以作为缺血性卒中患者的标准神经影像学方案。我们旨在研究多延迟 pCASL 在评估缺血性中风疾病脑灌注方面的临床效用。21 名缺血性卒中患者 [18 名男性和 3 名女性；中位年龄 62 岁（年龄范围，37-84 岁）] 参加了这项研究。所有患者都接受了检查，包括多延迟 pCASL 协议（在 1000-3500 ms 之间使用 6 个 PLD）和计算机断层扫描灌注 (CTP)。通过多延迟 pCASL 协议获得脑血流 (CBF) 和动脉通过时间 (ATT) 图，而 CBF 和平均传输时间 (MTT) 地图是通过 CTP 测量得出的。基于体素水平分析，使用 Pearson 相关系数来估计每个受试者的灰质、白质和全脑中两种模式之间的关联。ASL-CBF 和 CTP-CBF 之间的中度至高度正相关是通过体素水平分析在入选患者的灰质、白质和全脑中获得的（均 P<0.005），平均 Pearson 相关系数为 0.647 ，分别为 0.585 和 0.646。ASL-ATT和CTP-MTT在灰质、白质和全脑中通过体素水平关联获得高度显着的正相关（均P<0.005），平均Pearson相关系数分别为0.787、0.706和0.706。分别为 0.799。此外，根据患者年龄和疾病分期的亚组分析，在灰质和白质以及全脑中获得了 ASL 和 CT 灌注之间的显着关联。缺血性卒中患者的多延迟 pCASL 灌注参数与 CT 灌注成像之间存在相关性。多延迟 pCASL 是无辐射和非侵入性的，可以作为 CT 扫描的替代方法，用于评估缺血性中风疾病的灌注。