Abstract #2302

Quantifying early haemodynamic treatment effects in carotid stenosis using arterial transit artifacts and spatial CoV on ASL-MRI

Zhiyuan Lin¹, Mary Niroshinee Muthukumarasamy², Suk Fun Cheng³, John Gregson⁴, Martin Brown⁵, H Rolf Jäger^1,2, and Magdalena Sokolska⁶

¹Neuroradiology, UCL Queen Square Institute of Neurology, London, United Kingdom, ²Neuroradiology, National Hospital for Neurology and Neurosurgery, London, United Kingdom, ³Division of Surgery and Interventional Science, University College London Hospitals, London, United Kingdom, ⁴Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom, ⁵Stroke Research Centre, UCL Queen Square Institute of Neurology, London, United Kingdom, ⁶Department of Medical Physics and Biomedical Engineering, University College London Hospitals, London, United Kingdom

Synopsis

Keywords: Stroke, Perfusion, sCoV

Motivation: There is little understanding of how arterial transit artefacts (ATA) on ASL-MRI, which indicate regions of haemodynamic compromise, change in patients with carotid artery stenosis following optimised medical therapy versus surgical revascularisation.

Goal(s): To assess treatment effects using visually rated ATA severity and a spatial coefficient of variance before and after optimised medical therapy versus additional surgical revascularisation.

Approach: We visually rated ATAs using an established four-point grading system and computed the spatial coefficient of variance in corresponding regions.

Results: Both methods demonstrated only surgical revascularisation led to significant improvements in haemodynamics 1-month post-treatment, solely within the ipsilateral middle cerebral artery cortical territory.

Impact: A robust method of quantifying early haemodynamic treatment effects could be used to identify who truly benefits from surgical revascularisation in the long-term. Future work will correlate these measures to long-term clinical outcomes.

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