Contralateral Hemispheric Cerebral Blood Flow Measured With Arterial Spin Labeling Can Predict Outcome in Acute Stroke

作者：Thoralf Thamm, Jia Guo, Jarrett Rosenberg, Tie Liang, Michael P. Marks, Sören Christensen, Huy M., Stephanie Kemp, Emma Adair, Irina Eyngorn, Michael Mlynash, Tudor G. Jovin, Bart P. Keogh, Hui J. Chen, Maarten G. Lansberg, Gregory W. Albers, Greg Zaharchuk, on behalf of the iCAS Study Investigators · 发表于：Stroke · 年份：2019 · DOI：10.1161/strokeaha.119.026499 · 被引用次数：36 · 研究领域：Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases、Stroke Rehabilitation and Recovery

Background and Purpose— Imaging is frequently used to select acute stroke patients for intra-arterial therapy. Quantitative cerebral blood flow can be measured noninvasively with arterial spin labeling magnetic resonance imaging. Cerebral blood flow levels in the contralateral (unaffected) hemisphere may affect capacity for collateral flow and patient outcome. The goal of this study was to determine whether higher contralateral cerebral blood flow (cCBF) in acute stroke identifies patients with better 90-day functional outcome. Methods— Patients were part of the prospective, multicenter iCAS study (Imaging Collaterals in Acute Stroke) between 2013 and 2017. Consecutive patients were enrolled after being diagnosed with anterior circulation acute ischemic stroke. Inclusion criteria were ischemic anterior circulation stroke, baseline National Institutes of Health Stroke Scale score ≥1, prestroke modified Rankin Scale score ≤2, onset-to-imaging time <24 hours, with imaging including diffusion-weighted imaging and arterial spin labeling. Patients were dichotomized into high and low cCBF groups based on median cCBF. Outcomes were assessed by day-1 and day-5 National Institutes of Health Stroke Scale; and day-30 and day-90 modified Rankin Scale. Multivariable logistic regression was used to test whether cCBF predicted good neurological outcome (modified Rankin Scale score, 0–2) at 90 days. Results— Seventy-seven patients (41 women) met the inclusion criteria with median (interqua...