Comparison of CT angiography collaterals for predicting target perfusion profile and clinical outcome in patients with acute ischemic stroke
| Autor: | Qiang-Hui Liu, Yue-Zhou Cao, Fei-Yun Wu, Xuan Zhang, Sheng Liu, Hai-Bin Shi, Lin Bo Zhao, Shan-Shan Lu, Xiao-Quan Xu |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Middle Cerebral Artery medicine.medical_specialty Computed Tomography Angiography Perfusion Imaging Collateral Circulation Perfusion scanning Sensitivity and Specificity Brain Ischemia 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine medicine.artery medicine Humans Radiology Nuclear Medicine and imaging Stroke Aged Neuroradiology medicine.diagnostic_test business.industry Penumbra General Medicine Middle Aged Collateral circulation medicine.disease Cerebral Angiography 030220 oncology & carcinogenesis Middle cerebral artery Angiography Female Radiology Internal carotid artery business Carotid Artery Internal |
| Zdroj: | European Radiology. 29:4922-4929 |
| ISSN: | 1432-1084 0938-7994 |
| DOI: | 10.1007/s00330-019-06027-9 |
| Popis: | To compare collateral status on single-phase CT angiography (sCTA) and multiphase CT angiography (mCTA) and their ability to predict a target mismatch on CT perfusion (CTP) and clinical outcome in patients with acute ischemic stroke (AIS).Seventy-three AIS patients with stroke onset between 5 and 15 h or with unclear onset time and occlusions in the M1/M2 segment of the middle cerebral artery and/or intracranial internal carotid artery underwent head non-contrast CT and CTP. Simulated sCTA and mCTA were reconstructed from CTP data and were compared for collaterals assessment. The ability to predict target mismatch on CTP (an ischemic core 70 ml, a mismatch ratio ≥ 1.8, and an absolute difference ≥ 15 ml) and 90-day modified Rankin Scale (mRS) score of 0-2 was compared between sCTA and mCTA by using receiver operating curve analysis.sCTA underestimated the collateral status when compared with mCTA (p 0.01). The ability of mCTA to predict target mismatch (AUC = 0.902, 95% confidence interval [CI] 0.809, 0.959) and clinical outcome (AUC = 0.771; 95% CI, 0.655, 0.864) was better than that of sCTA (p 0.05 overall). A mCTA collateral score of 3 best identified the target mismatch (sensitivity, 78.4%; specificity, 90.9%) and predicted 90-day mRS score of 0-2 (sensitivity, 84.8%; specificity, 69.4%).The collaterals were better estimated by mCTA compared with sCTA. A mCTA collateral score of 3 optimized the prediction of a target mismatch on CTP and a good clinical outcome in patients with AIS.• Collateral circulation is a key determinant of ischemic core and penumbra. Better collaterals are associated with smaller ischemic core volumes and larger mismatch ratios on CT perfusion. • The collaterals can be better estimated by multiphase CTA compared with single-phase CTA. • A collateral score of 3 on multiphase CTA best identifies patients with target mismatch on CT perfusion and predicts 90-day mRS score of 0-2. |
| Databáze: | OpenAIRE |
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