Abstract
BACKGROUND AND PURPOSE: Arterial stroke is a rare-but-reported complication in patients with posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities (PHACE) syndrome. Currently, stroke risk is inferred by the severity of arterial anomalies identified on MRA, though no evidenced-based data exist. The purpose of our study was to determine whether arterial spin-labeling MR imaging perfusion can detect alterations in CBF in patients with PHACE syndrome.
MATERIALS AND METHODS: Records were reviewed from 3 institutions for all patients with PHACE syndrome who underwent arterial spin-labeling from 2000 to 2019. CBF was qualitatively investigated with arterial spin-labeling to determine whether there was decreased or normal perfusion. Arterial anomalies were characterized on MRA imaging, and parenchymal brain findings were evaluated on conventional MR imaging sequences.
RESULTS: Forty-one patients with PHACE syndrome had arterial spin-labeling imaging. There were 30 females and 11 males (age range, 7 days to 15 years). Of the 41 patients, 10 (24%) had decreased CBF signal corresponding to a major arterial territory. Ten of 10 patients had decreased CBF signal in the anterior circulation, 2/10 had decreased anterior and posterior circulation CBF signal, 2/10 had decreased bilateral anterior circulation CBF signal, and 1/10 had globally decreased CBF signal. Forty of 41 (97.5%) patients had at least 1 arteriopathy, and in those with decreased CBF signal, the arteriopathy corresponded to the CBF signal alteration in 10/10 patients.
CONCLUSIONS: Arterial spin-labeling can potentially characterize hemodynamic changes in patients with PHACE syndrome.
ABBREVIATIONS:
- ASL
- arterial spin-labeling
- PHACE
- posterior fossa brain malformations, hemangiomas, arterial anomalies, coarctation of the aorta and cardiac defects, and eye abnormalities
Footnotes
Paper previously presented as an abstract at: International Society and Study of Vascular Anomalies Workshop, May 14–15, 2020; Virtual.
Disclosures: Christopher P. Hess—UNRELATED: Consultancy: Focused Ultrasound Foundation, Comments: personal fees, Data and Safety Monitoring Board member; Expert Testimony: various legal firms, Comments: personal fees, medical expert witness; Payment for Lectures Including Service on Speakers Bureaus: EUROKONGRESS GmBH, Comments: professional conference travel; Travel/Accommodations/Meeting Expenses Unrelated to Activities Listed: Siemens, Comments: research travel; Other: GE Healthcare, Comments: personal fees, consultant.
- © 2020 by American Journal of Neuroradiology
Indicates open access to non-subscribers at www.ajnr.org