Highlight
This prospective multicenter study demonstrates the high diagnostic accuracy of arterial spin labeling (ASL) MRI for detecting arteriovenous shunts (AVSs) in patients presenting with nontraumatic intracerebral hemorrhage (ICH). With a near-perfect negative predictive value, ASL reliably excludes AVSs such as arteriovenous malformations (AVMs) and dural arteriovenous fistulas (dAVFs), potentially serving as a noninvasive gatekeeper to digital subtraction angiography (DSA). The study reports excellent interobserver agreement and identifies ASL-positive shunts sometimes occult on initial DSA, highlighting its diagnostic strength and clinical utility in acute stroke etiologic workup.
Study Background
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For clinical reference; use professional judgment.
