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February 2, 2026Stroke0 citations

Abstract WP267: Impact of Arterial Spin Labeling (ASL) on Etiological Work-up of Adult Spontaneous Intracerebral Hemorrhage (ICH)

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VCVictoria ChinMMMichael MlynashCVChitra Venkatasubramanian

Key Points

  • This study aims to evaluate the effectiveness of arterial spin labeling (ASL) in identifying arteriovenous shunts in adults with spontaneous intracerebral hemorrhage.
  • Retrospective analysis of patients with spontaneous intracranial hemorrhages from a prospective registry.
  • Comparison between pre-ASL (2006-2012) and post-ASL (2022-2023) groups based on diagnostic imaging outcomes.
  • Assessment of detection rates for arteriovenous malformations and related structures using CT angiography and MRI.
  • Culprit arteriovenous shunts were diagnosed in 8.1% (pre-ASL) and 11% (post-ASL) of cases.
  • CT angiography detection rates were 6.4% (pre-ASL) vs 8.5% (post-ASL), showing no significant difference.
  • MRI detection rates increased from 5.5% (pre-ASL) to 11% (post-ASL) but did not achieve statistical significance.
  • DSA recommendations decreased from 42% (pre-ASL) to 23% (post-ASL), with increased positivity rates in the post-ASL group (47.4% vs 17.4%).

Abstract

Background CTA yielded similar detection rates of 6.4% vs 8.5% ( p = 0.567 ); MRI detection rate increased from 5.5% vs 11% ( p = 0.159 ), though did not reach statical significance; DSAs were recommended less often, in 42% vs 23% of cases ( p = 0.007) and were associated with a higher rate of positivity in the post-ASL group, 47.4%, compared to 17.4% in the pre-ASL group ( p = 0.012 ) . Conclusions: These findings suggest that ASL imaging can be used as an effective adjunct to standard imaging techniques in the etiological work up for spontaneous ICH for the detection of arteriovenous shunting lesions. Future directions include comparing detection rates of arteriovenous shunting lesions and DSA practices in patients who underwent either CTA or MRI alone.

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Cite This Study

Chin et al. (2026) studied this question.

synapsesocial.com/papers/6980fc73c1c9540dea80e325https://doi.org/10.1161/str.57.suppl_1.wp267
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