Ki Hee Jong, Roh Hong Gee, Kwak Jin Tae, Kim In Seong, Park Jeong Jin, Jeon Yoo Sung, Yang Hyun, Jung Sumin, Lee Ji Sung, Kim Hyun Jeong
Department of Neurosurgery, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
Radiol Med. 2025 Feb;130(2):235-247. doi: 10.1007/s11547-024-01941-5. Epub 2024 Dec 11.
To investigate the clinical feasibility of a CT collateral map compared with an MRA collateral map, focusing on collateral perfusion (CP) estimation and baseline lesion assessment in acute ischemic stroke (AIS).
This retrospective analysis used selected data from a prospectively collected database. We generated CT collateral maps derived from CT perfusion, encompassing images of arterial, capillary, early venous (CMEV), late venous, and delay phases. Three raters assessed CP scores from MRA and CT collateral maps and CMEV lesion volumes. Lesion volumes of baseline diffusion-weighted imaging (bDWI) and cerebral blood flow rate (CBF) < 30% were automatically measured by the software. The agreement between MRA and CT collateral maps in CP estimation and the correlation between lesion volumes with a CBF < 30% and the CMEV for bDWI lesion volumes were analyzed.
One-hundred ten patients (mean age ± standard deviation, 71 ± 14; 60 women) with AIS due to steno-occlusion of the internal carotid and/or middle cerebral arteries were included. The agreement between the MRA and CT collateral maps in CP grading was excellent (weighted κ = 0.93; 95% CI, 0.90-0.97). The concordance correlation coefficients (CCCs) of the CBF < 30% and CMEV for bDWI lesion volumes were 0.76 (95% CI, 0.60-0.91) and 0.97 (0.95-0.98), respectively.
The clinical feasibility of the CT collateral map is demonstrated by its significant correlation with the MRA collateral map in CP estimation and baseline lesion assessment.
研究CT侧支循环图与MRA侧支循环图相比的临床可行性，重点关注急性缺血性卒中（AIS）中的侧支循环灌注（CP）评估和基线病变评估。
本回顾性分析使用了前瞻性收集数据库中的选定数据。我们生成了源自CT灌注的CT侧支循环图，包括动脉期、毛细血管期、早期静脉期（CMEV）、晚期静脉期和延迟期的图像。三名评估者从MRA和CT侧支循环图以及CMEV病变体积评估CP评分。通过软件自动测量基线扩散加权成像（bDWI）的病变体积和脑血流率（CBF）<30%的情况。分析了MRA和CT侧支循环图在CP评估中的一致性，以及CBF<30%的病变体积与bDWI病变体积的CMEV之间的相关性。
纳入了110例因颈内动脉和/或大脑中动脉狭窄闭塞导致AIS的患者（平均年龄±标准差，71±14岁；60名女性）。MRA和CT侧支循环图在CP分级方面的一致性极佳（加权κ=0.93；95%CI，0.90-0.97）。CBF<30%和CMEV对于bDWI病变体积的一致性相关系数（CCC）分别为0.76（95%CI，0.60-0.91）和0.97（0.95-0.98）。
CT侧支循环图在CP评估和基线病变评估中与MRA侧支循环图具有显著相关性，证明了其临床可行性。
