Wang Chun-Min, Chang Yu-Ming, Sung Pi-Shan, Chen Chih-Hung
Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 704, Taiwan.
J Clin Med. 2021 Mar 21;10(6):1296. doi: 10.3390/jcm10061296.
This study was to evaluate the correlation of the hypoperfusion intensity ratio (HIR) with the collateral score from multiphase computed tomography angiography (mCTA) among patients with large vessel stroke.
From February 2019 to May 2020, we retrospectively reviewed the patients with large vessel strokes (intracranial carotid artery or proximal middle cerebral artery occlusion). HIR was defined as a Tmax > 10 s lesion volume divided by a Tmax > 6 s lesion volume, which was calculated by automatic software (Syngo.via, Siemens). The correlation between the HIR and mCTA score was evaluated by Pearson's correlation. The cutoff value predicting the mCTA score was evaluated by receiver operating characteristic analysis.
Ninety-four patients were enrolled in the final analysis. The patients with good collaterals had a smaller core volume (37.3 ± 24.7 vs. 116.5 ± 70 mL, < 0.001) and lower HIR (0.51 ± 0.2 vs. 0.73 ± 0.13, < 0.001) than those with poor collaterals. A higher HIR was correlated with a poorer collateral score by Pearson's correlation. (r = -0.64, < 0.001). The receiver operating characteristic (ROC) analysis suggested that the best HIR value for predicting a good collateral score was 0.68 (area under curve: 0.82).
HIR is a good surrogate of collateral circulation in patients with acute large artery occlusion.
本研究旨在评估大动脉卒中患者的低灌注强度比（HIR）与多期计算机断层血管造影（mCTA）侧支循环评分之间的相关性。
2019年2月至2020年5月，我们回顾性分析了大动脉卒中（颅内颈动脉或大脑中动脉近端闭塞）患者。HIR定义为Tmax>10秒的病变体积除以Tmax>6秒的病变体积，由自动软件（Syngo.via，西门子）计算得出。通过Pearson相关性评估HIR与mCTA评分之间的相关性。通过受试者工作特征分析评估预测mCTA评分的临界值。
94例患者纳入最终分析。侧支循环良好的患者与侧支循环不良的患者相比，梗死核心体积更小（37.3±24.7 vs. 116.5±70 mL，P<0.001），HIR更低（0.51±0.2 vs. 0.73±0.13，P<0.001）。Pearson相关性分析显示，HIR越高，侧支循环评分越差（r=-0.64，P<0.001）。受试者工作特征（ROC）分析表明，预测良好侧支循环评分的最佳HIR值为0.68（曲线下面积：0.82）。
HIR是急性大动脉闭塞患者侧支循环的良好替代指标。
