Analyzing the Role of Arterial Spin Labelling in Patients Undergoing Endovascular Thrombectomy for Large Vessel Occlusion—a Prospective Single Center Study

Acute stroke is one of the leading causes of death globally. Imaging remains the most common modality to diagnose and predict outcomes in patients with stroke. Conventionally, computed tomography (CT) was the preferred choice; however, imaging has expanded to include newer modalities such as Dynamic Susceptibility Contrast (DSC), Dynamic Contrast-Enhanced MRI (DCE), and Arterial Spin Labelling MRI. An alternative method of assessing perfusion, ASL uses the spins of endogenous water protons as a tracer rather than administering a contrast agent. In this manner, endogenous water in the arterial blood is labelled electromagnetically and employed as a freely diffusible tracer. ASL, as opposed to CT, DSC or DCE, allows estimation of cerebral blood flow without exposure to radiation or the administration of contrast material, which is advantageous for patients with impaired renal function or repetitive perfusion imaging. Thus a prospective study was conducted to explore the use of Arterial Spin Labelling MRI in the setting of acute ischemic stroke in both pre and post-thrombectomy patients. Our study is significant as there are no existing prospective studies comparing the cerebral perfusion measured using ASL with neurological outcomes.