Hyperemia detection on dynamic susceptibility contrast versus arterial spin labeling MRI in stroke post-endovascular therapy

Motivation: Hyperemia, or increased relative cerebral blood flow (rCBF), is a potential sequalae following endovascular therapy (EVT) for large vessel occlusion stroke patients. Reliable hyperemia detection on 3T MRI post-EVT is warranted as it may have an impact on long term clinical outcomes. Goal(s): Our goal was to evaluate hyperemia detection on two perfusion MRI sequences. Approach: Hyperemia qualitative and quantitative assessments were compared on dynamic susceptibility contrast (DSC)-rCBF and arterial spin labeling (ASL)-rCBF in acute ischemic stroke patients at 24-hour and 5-day post-EVT. Results: The findings suggest hyperemia is more conspicuous on ASL-rCBF than DSC-rCBF in stroke patients post-EVT. Impact: Hyperemia detection by arterial spin labeling-relative cerebral blood flow compared to dynamic susceptibility contrast-relative cerebral blood flow may be more accurate in evaluating blood flow increases which can contribute to optimization of clinical care for stroke patients post-EVT.