Cao Ruoyao, Qi Peng, Jiang Yun, Hu Shen, Ye Gengfan, Zhu Yaxin, Li Ling, You Zilong, Chen Juan
Graduate School of Peking Union Medical College, Beijing, China.
Department of Radiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China.
Front Neurol. 2021 Dec 23;12:714313. doi: 10.3389/fneur.2021.714313. eCollection 2021.
To develop an efficient and quantitative assessment of collateral circulation on time maximum intensity projection CT angiography (tMIP CTA) in patients with acute ischemic stroke (AIS). Eighty-one AIS patients who underwent one-stop CTA-CT perfusion (CTP) from February 2016 to October 2020 were retrospectively reviewed. Single-phase CTA (sCTA) and tMIP CTA were developed from CTP data. Ischemic core (IC) volume, ischemic penumbra volume, and mismatch ratio were calculated. The Tan scale was used for the qualitative evaluation of collateral based on sCTA and tMIP CTA. Quantitative collateral circulation (CCq) parameters were calculated semi-automatically with software by the ratio of the vascular volume (V) on both hemispheres, including tMIP CTA V and sCTA V Spearman correlation analysis was used to analyze the correlation of collateral-related parameters with final infarct volume (FIV). ROC and multivariable regression analysis were calculated to compare the significance of the above parameters in clinical outcome evaluation. The analysis time of the observers was also compared. tMIP CTA V ( = 0.61, < 0.01), IC volume ( = 0.66, < 0.01), Tan score on tMIP CTA ( = 0.52, < 0.01) and mismatch ratio ( = 0.60, < 0.01) showed moderate negative correlations with FIV. tMIP CTA V showed the best prognostic value for clinical outcome (AUC = 0.93, < 0.001), and was an independent predictive factor of clinical outcome (OR = 0.14, = 0.009). There was no difference in analysis time of tMIP CTA V among observers ( = 0.079). The quantitative evaluation of collateral circulation on tMIP CTA is associated with clinical outcomes in AIS patients with endovascular treatments.
开发一种对急性缺血性卒中（AIS）患者进行时间最大密度投影CT血管造影（tMIP CTA）时侧支循环的高效定量评估方法。回顾性分析了2016年2月至2020年10月期间接受一站式CTA-CT灌注（CTP）检查的81例AIS患者。从CTP数据中生成单相CTA（sCTA）和tMIP CTA。计算缺血核心（IC）体积、缺血半暗带体积和错配率。基于sCTA和tMIP CTA，使用Tan量表对侧支进行定性评估。使用软件通过计算双侧半球血管体积（V）的比值半自动计算定量侧支循环（CCq）参数，包括tMIP CTA V和sCTA V。采用Spearman相关分析分析侧支相关参数与最终梗死体积（FIV）的相关性。计算ROC和多变量回归分析以比较上述参数在临床结局评估中的意义。还比较了观察者的分析时间。tMIP CTA V（r = 0.61，P < 0.01）、IC体积（r = 0.66，P < 0.01）、tMIP CTA上的Tan评分（r = 0.52，P < 0.01）和错配率（r = 0.60，P < 0.01）与FIV呈中度负相关。tMIP CTA V对临床结局显示出最佳的预后价值（AUC = 0.93，P < 0.001），并且是临床结局的独立预测因素（OR = 0.14，P = 0.009）。观察者之间tMIP CTA V的分析时间无差异（P = 0.079）。tMIP CTA上侧支循环的定量评估与接受血管内治疗的AIS患者的临床结局相关。
