Perfusion Deficits Detected by Arterial Spin-Labeling in Patients with TIA with Negative Diffusion and Vascular Imaging

Representative cases from the TIA cohort. A, A 75-year-old woman with a history of hypertension and diabetes had an acute onset of transient blurry vision, slurred speech, dysarthria, and word-finding difficulties that lasted for 20–30 minutes. ABCD² score is 5. The standard MR imaging results demonstrate a few nonspecific T2/FLAIR hyperintensities in the cerebral white matter bilaterally. DWI and MRA study results are normal. ASL CBF map shows perfusion deficits in the right MCA region (arrow). ASL reading scores are rated 2, 2, 2 by 3 raters. B, A 57-year old woman with a history of hypertension had right facial droop and right arm numbness for 6 hours. ABCD² score is 3. Nonspecific T2/FLAIR hyperintensities are seen in the cerebral white matter. DWI and MRA study results are normal. ASL CBF map shows perfusion deficits in the regions of the left MCA and left posterior cerebral artery (arrow). ASL scores are rated 2, 2, 2 by 3 raters. C, A 80-year old woman with a history of hyperlipidemia had transient global amnesia, left-sided sensory deficit, and a positive Babinski sign on the left side for 6 hours. ABCD² score is 3. Scattered T2/FLAIR hyperintensities are seen in the periventricular and subcortical white matter on standard MR imaging. DWI and MRA study results are normal. ASL CBF map shows perfusion deficits in the right MCA region (arrow). ASL scores are rated 3, 3, 3 by 3 raters. D, A 57-year-old woman with a history of hypertension had right facial droop and slurred speech for more than 1 hour. ABCD² score was 4. The standard MR, DWI, and MRA study results are normal. ASL reading scores are rated 1, 1, 1 by 3 raters.