Purpose

This study aimed to verify the value of arterial spin labeling (ASL) collateral perfusion estimation for predicting functional outcomes in acute anterior circulation ischemic stroke.

Methods

This secondary analysis of an ongoing prospective observational study included data from participants with acute ischemic stroke due to steno-occlusion of the internal carotid artery and/or the middle cerebral artery within 8 h of symptom onset. We compared the collateral map, which is a 5-phase collateral imaging derived from dynamic contrast-enhanced magnetic resonance angiography, and ASL to validate the ASL collateral perfusion estimation. Multiple logistic regression analyses were conducted to identify independent predictors of favorable functional outcomes.

Results

One hundred forty-eight participants (68 ± 13 years, 96 men) were evaluated. The ASL collateral perfusion grade was positively correlated with the collateral perfusion grade of the collateral map (P < .001). Younger age (OR = 0.53, 95% CI = 0.36–0.78, P = .002), lower baseline NIHSS score (OR = 0.85, 95% CI = 0.78–0.92, P < .001), intermediate ASL collateral perfusion grade (OR = 4.02, 95% CI = 1.43–11.26, P = .008), good ASL collateral perfusion grade (OR = 26.37, 95% CI = 1.06–655.01, P = .046), and successful reperfusion (OR = 5.84, 95% CI = 2.08–16.42, P < .001) were independently associated with favorable functional outcomes.

Conclusion

ASL collateral perfusion estimation provides prognostic information, which can be helpful in guiding management decisions.