Perioperative changes in cerebral perfusion territories assessed by arterial spin labeling magnetic resonance imaging are associated with postoperative increases in cerebral blood flow in patients with carotid stenosis

Abstract Objective MRI technique known as Territorial ASL (TASL) allows for noninvasive visualization of their perfusion territories. The objective of this study was to use TASL to assess the relationship between perioperative changes in the perfusion territories of ICA and CBF after carotid revascularization. Methods In 32 patients, ICA perfusion volume (PV) and CBF were measured before and after CEA/CAS using TASL and SPECT, respectively. ICA flow was measured during CEA before and after reconstruction, using an electromagnetic flowmeter. Eleven healthy volunteers, as the normal control group, underwent TASL evaluation. Results We classified patients into the following two groups: the normal PV group (ICA PV≥mean-2SD of healthy volunteers, n=13) and the reduced PV group (ICA PV