The application value of the quantitative parameters of collateral circulation in evaluating the clinical prognosis of patients with acute ischemic stroke
10.3969/j.issn.1002-1671.2024.10.003
- VernacularTitle:侧支循环定量参数评估急性缺血性卒中患者临床预后的应用价值
- Author:
Xian FAN
1
;
Tianle WANG
;
Li ZHU
;
Xiaolong LI
;
Xiwu RUAN
;
Han WANG
Author Information
1. 南通大学第二附属医院影像科,江苏 南通 226000
- Keywords:
collateral circulation;
quantitative parameter;
computed tomography perfusion;
acute ischemic stroke
- From:
Journal of Practical Radiology
2024;40(10):1587-1591
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the application value of the quantitative parameters of collateral circulation based on computed tomography perfusion(CTP)in evaluating the clinical prognosis of patients with acute ischemic stroke(AIS).Methods A total of 126 patients with AIS caused by middle cerebral artery occlusion were enrolled,collateral circulation were reconstructed and scored via multiphase computed tomography angiography(mCTA)based on CTP.The hypoperfusion intensity ratio(HIR)and collateral vessel density(CVD)were calculated.All patients were divided into good prognosis group(72 cases)and poor prognosis group(54 cases)based on 90 d modified Rankin scale(mRS)scores.Differences in cardiovascular risk factors,National Institutes of Health Stroke Scale(NIHSS)scores,Albert stroke program early CT(ASPECT)scores,Tmax＞10 s volume,Tmax＞6 s volume,core infarct area volume,and final infarct volume between the two groups were compared.Binary logistic regression was employed to identify independent predictors of the clinical prognosis,and the DeLong test was used to compare the efficacy of different predictors in predicting clinical prognosis.Results The good prognosis group had significantly higher ASPECT scores,mCTA scores,and CVD,but significantly lower HIR,Tmax＞10 s volume,and baseline NIHSS scores compared to the poor prognosis group(P＜0.05).Binary logistic regression analysis showed that ASPECT scores[odds ratio(OR)=0.780],mCTA scores(OR=0.669),CVD(OR=0.595),and HIR(OR=28.968)were independent predictors of clinical prognosis(P＜0.05).DeLong test found no significant difference in area under the curve(AUC)values between mCTA scores,CVD and HIR in predicting the clinical prognosis of AIS patients(P＞0.05).Conclusion Quantitative parameters such as CVD and HIR related to collateral circulation have a strong diagnostic efficacy in predicting the 90 d clinical prognosis in patients with AIS.
