Abstract:

Objective

Early and accurate assessment of infarct core and ischemic penumbra volume is crucial for treatment decisions in acute ischemic stroke (AIS). This study aimed to compare the accuracy and consistency of multi-delay arterial spin labeling (ASL) and computed tomography perfusion(CTP) in evaluating the volumes of these lesion.

Methods

A retrospective analysis was conducted on 36 AIS patients who were admitted to Xuanwu Hospital of Capital Medical University between July 2021 and September 2023. All patients underwent both multi-delay ASL and CTP scans (with an interval of＜24 hours between the two examinations). The ASL and CTP images were analyzed, and the differences in infarct core and ischemic penumbra volumes measured by the two modalities were compared using the Wilcoxon signedrank test. Intraclass correlation coefficient (ICC) was used to assess the consistency of the two methods in measuring these volumes.

Results

The infarct core volumes measured by multi-delay ASL (12.56 [7.99,37.59]) and CTP (10.50 [6.00, 37.00]) showed no statistically significant difference (P＞0.05). Similarly,the ischemic penumbra volumes measured by multi-delay ASL (124.94 [94.67, 150.16]) and CTP (116.00[83.00, 151.00]) also showed no significant difference (P＞0.05). The ICC for measuring infarct core and ischemic penumbra volumes by the two methods were 0.967 and 0.949, respectively, indicating a high level of consistency.

Conclusion

Both multi-delay ASL and CTP demonstrate high diagnostic accuracy and good consistency in evaluating infarct core and ischemic penumbra volumes in AIS patients. Multi-delay ASL is a promising imaging method with potential for clinical application and further exploration.

Key words: Acute ischemic stroke, Multi-delay arterial spin labeling, CT perfusion imaging, Consistency