Bright vessel appearance on arterial spin labeling (ASL) had been reported to be a useful marker for localizing arterial occlusion in acute ischemic stroke. But ischemia due to cerebral arterial occlusion did not always show bright vessel appearance on ASL. In the present study, we found that the presence of bright vessel appearance may associate with thrombus age and be able to specifically identify acute cerebral arterial occlusion. The findings may help to optimize current stroke protocols and facilitate the diagnosis of fresh thrombus, thus to support the treatment decision making in stroke patients with large vessel occlusion.
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