Collateral Status in Ischemic Stroke: A Comparison of Computed Tomography Angiography, Computed Tomography Perfusion, and Digital Subtraction Angiography
| Autor: | Jeremy J Heit, Jan Willem Dankbaar, Max Wintermark, Fasco van Ommen, Blake W. Martin, Frans Kauw, Derek B. Boothroyd, Birgitta K. Velthuis, Victoria Y. Ding, L. Jaap Kappelle, Hugo W. A. M. de Jong |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Computed Tomography Angiography Perfusion scanning digital subtraction angiography Brain Ischemia Modified Rankin Scale Occlusion medicine Humans Radiology Nuclear Medicine and imaging collateral circulation brain infarction cardiovascular diseases Aged Retrospective Studies Computed tomography angiography Neuroradiology Aged 80 and over Observer Variation medicine.diagnostic_test endovascular procedure business.industry musculoskeletal neural and ocular physiology Angiography Digital Subtraction Brain computed tomography Digital subtraction angiography Cerebral Angiography Stroke Concordance correlation coefficient Angiography ComputingMethodologies_DOCUMENTANDTEXTPROCESSING Female prognosis Nuclear medicine business psychological phenomena and processes |
| Zdroj: | Journal of Computer Assisted Tomography |
| ISSN: | 1532-3145 0363-8715 |
| DOI: | 10.1097/rct.0000000000001090 |
| Popis: | Supplemental digital content is available in the text. Objective To compare assessment of collaterals by single-phase computed tomography (CT) angiography (CTA) and CT perfusion-derived 3-phase CTA, multiphase CTA and temporal maximum-intensity projection (tMIP) images to digital subtraction angiography (DSA), and relate collateral assessments to clinical outcome in patients with acute ischemic stroke. Methods Consecutive acute ischemic stroke patients who underwent CT perfusion, CTA, and DSA before thrombectomy with occlusion of the internal carotid artery, the M1 or the M2 segments were included. Two observers assessed all CT images and one separate observer assessed DSA (reference standard) with static and dynamic (modified American Society of Interventional and Therapeutic Neuroradiology) collateral grading methods. Interobserver agreement and concordance were quantified with Cohen-weighted κ and concordance correlation coefficient, respectively. Imaging assessments were related to clinical outcome (modified Rankin Scale, ≤ 2). Results Interobserver agreement (n = 101) was 0.46 (tMIP), 0.58 (3-phase CTA), 0.67 (multiphase CTA), and 0.69 (single-phase CTA) for static assessments and 0.52 (3-phase CTA) and 0.54 (multiphase CTA) for dynamic assessments. Concordance correlation coefficient (n = 80) was 0.08 (3-phase CTA), 0.09 (single-phase CTA), and 0.23 (multiphase CTA) for static assessments and 0.10 (3-phase CTA) and 0.27 (multiphase CTA) for dynamic assessments. Higher static collateral scores on multiphase CTA (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1–2.7) and tMIP images (OR, 2.0; 95% CI, 1.1–3.4) were associated with modified Rankin Scale of 2 or less as were higher modified American Society of Interventional and Therapeutic Neuroradiology scores on 3-phase CTA (OR, 1.5; 95% CI, 1.1–2.2) and multiphase CTA (OR, 1.7; 95% CI, 1.1–2.6). Conclusions Concordance between assessments on CT and DSA was poor. Collateral status evaluated on 3-phase CTA and multiphase CTA, but not on DSA, was associated with clinical outcome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|