PT - JOURNAL ARTICLE AU - Lu, Shanshan AU - Su, Chunqiu AU - Cao, Yuezhou AU - Jia, Zhenyu AU - Shi, Haibin AU - He, Yining AU - Yan, Lirong TI - Assessment of Collateral Flow in Patients with Carotid Stenosis Using Random Vessel-Encoded Arterial Spin-Labeling: Comparison with Digital Subtraction Angiography AID - 10.3174/ajnr.A8100 DP - 2024 Feb 01 TA - American Journal of Neuroradiology PG - 155--162 VI - 45 IP - 2 4099 - http://www.ajnr.org/content/45/2/155.short 4100 - http://www.ajnr.org/content/45/2/155.full SO - Am. J. Neuroradiol.2024 Feb 01; 45 AB - BACKGROUND AND PURPOSE: Collateral circulation plays an important role in steno-occlusive internal carotid artery disease (ICAD) to reduce the risk of stroke. We aimed to investigate the utility of planning-free random vessel-encoded arterial spin-labeling (rVE-ASL) in assessing collateral flows in patients with ICAD.MATERIALS AND METHODS: Forty patients with ICAD were prospectively recruited. The presence and extent of collateral flow were assessed and compared between rVE-ASL and DSA by using Contingency (C) and Cramer V (V) coefficients. The differences in flow territory alterations stratified by stenosis ratio and symptoms, respectively, were compared between symptomatic (n = 19) and asymptomatic (n = 21) patients by using the Fisher exact test.RESULTS: Good agreement was observed between rVE-ASL and DSA in assessing collateral flow (C = 0.762, V = 0.833, both P < .001). Patients with ICA stenosis of ≥90% were more likely to have flow alterations (P < .001). Symptomatic patients showed a higher prevalence of flow alterations in the territory of the MCA on the same side of ICAD (63.2%), compared with asymptomatic patients (23.8%, P = .012), while the flow alterations in the territory of anterior cerebral artery did not differ (P = .442). The collateral flow to MCA territory was developed primarily from the contralateral internal carotid artery (70.6%) and vertebrobasilar artery to a lesser extent (47.1%).CONCLUSIONS: rVE-ASL provides comparable information with DSA on the assessment of collateral flow. The flow alterations in the MCA territory may be attributed to symptomatic ICAD.ACAanterior cerebral arteryAcomAanterior communicating arteryASLarterial spin-labelingECAexternal carotid arteryICADinternal carotid artery diseasepCASLpseudocontinuous ASLPcomAposterior communicating arteryrVE-ASLrandom vessel-encoded arterial spin-labelingSSsuper-selectiveVBAvertebrobasilar arteryVEvessel-encoded