Chatterjee D, Nagarajan K, Narayan Sunil K, Narasimhan R Lakshmi
Department of Radio-Diagnosis, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India.
Department of Neurology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Tamil Nadu, India.
Brain Circ. 2020 Jun 26;6(2):107-115. doi: 10.4103/bc.bc_55_19. eCollection 2020 Apr-Jun.
The aim of the study is to assess the correlation between regional leptomeningeal collateral (rLMC) Scores calculated on computed tomography (CT) angiography following acute anterior circulation ischemic stroke, with 3-month clinical outcome measured as modified Rankin Scale (mRS) and Barthel Index (BI).
A total of thirty patients were studied as per the exclusion and inclusion criteria and after informed consent. Multi-phase CT angiography was carried out within 24 h of stroke onset, and collateral scoring was done using rLMC score along with Alberta stroke programme early CT (ASPECT) scoring. At 3 months, patients were followed up to evaluate the clinical outcome using mRS and BI. Statistical analysis was performed to find out the correlation between rLMC score, ASPECT score, and clinical outcome and for association with demographic parameters and stroke risk factors.
A strong correlation was noted between ASPECT and rLMC scores ( < 0.001) and between rLMC scores and clinical outcome at 3 months (mRS and BI). Correlation with mRS ( < 0.001) was nearly as strong as that of BI on follow-up ( < 0.001). The ASPECT score also was a predictor of clinical outcome and showed correlation with mRS ( < 0.001) and BI ( < 0.001). No significant association was found between various stroke risk factors and demographic parameters with rLMC scores. The rLMC scoring system showed substantial inter-rater reliability with Kappa = 0.7.
rLMC score in CT angiography correlates with ASPECT Score and clinical outcome at 3 months. Hence, this scoring system can be used for collateral quantification as may be of use in predicting short-term clinical outcomes.
本研究旨在评估急性前循环缺血性卒中后计算机断层扫描（CT）血管造影计算的局部软脑膜侧支循环（rLMC）评分与以改良Rankin量表（mRS）和Barthel指数（BI）衡量的3个月临床结局之间的相关性。
按照排除和纳入标准，在获得知情同意后，共对30例患者进行了研究。在卒中发作后24小时内进行多期CT血管造影，并使用rLMC评分以及阿尔伯塔卒中项目早期CT（ASPECT）评分进行侧支循环评分。在3个月时，对患者进行随访，以使用mRS和BI评估临床结局。进行统计分析以找出rLMC评分、ASPECT评分与临床结局之间的相关性，以及与人口统计学参数和卒中危险因素的关联。
ASPECT评分与rLMC评分之间存在强相关性（<0.001），rLMC评分与3个月时的临床结局（mRS和BI）之间也存在强相关性。与mRS的相关性（<0.001）几乎与随访时BI的相关性（<0.001）一样强。ASPECT评分也是临床结局的预测指标，与mRS（<0.001）和BI（<0.001）均显示出相关性。未发现各种卒中危险因素和人口统计学参数与rLMC评分之间存在显著关联。rLMC评分系统显示出较高的评分者间信度，Kappa值为0.7。
CT血管造影中的rLMC评分与ASPECT评分以及3个月时的临床结局相关。因此，该评分系统可用于侧支循环量化，可能有助于预测短期临床结局。
