Assessment of collateral flow in patients with carotid stenosis using random vessel-encoded arterial spin labeling

Motivation: The ability to characterize collateral flows is crucial for evaluating patients with steno-occlusive internal carotid artery disease (ICAD). A random vessel-encoded ASL (rVE-ASL) has been introduced as a non-invasive approach for mapping vascular territories. Goal(s): In this study, we evaluated the feasibility of using a planning-free rVE-ASL to assess collateral flows in patients with ICAD by taking DSA as the golden standard. Approach: Prospective, case-control study. Results: rVE-ASL provides comparable information with DSA in determining the presence and the extent of collateral flows. The presence of flow alterations in the territory of middle cerebral artery may be attributed to symptomatic ICAD. Impact: Our study emphasized the clinical utility of a planning-free random vessel-encoded ASL (rVE-ASL) as a non-invasive tool for characterizing individual collateral pathways and its potential role in predicting and managing symptomatic patients with ICAD.