TY - JOUR AU - Zhang, S AU - Chen, W AU - Tang, H AU - Han, Q AU - Yan, S AU - Zhang, X AU - Chen, Q AU - Parsons, M AU - Wang, S AU - Lou, M Y2 - 2020/12/17 Y1 - 2016 SN - 1932-6203 UR - http://hdl.handle.net/11343/254913 AB - OBJECTIVE: Leptomeningeal collaterals, which affects tissue fate, are still challenging to assess. Four-dimensional CT angiography (4D CTA) originated from CT perfusion (CTP) provides the possibility of non-invasive and time-resolved assessment of leptomeningeal collateral flow. We sought to develop a comprehensive rating system to integrate the speed and extent of collateral flow on 4D CTA, and investigate its prognostic value for reperfusion therapy in acute ischemic stroke (AIS) patients. METHODS: We retrospectively studied 80 patients with M1 ± internal carotid artery (ICA) occlusion who had baseline CTP before intravenous thrombolysis. The velocity and extent of collaterals were evaluated by regional leptomeningeal collateral score on peak phase (rLMC-P) and temporally fused intensity projections (tMIP) (rLMC-M) on 4D CTA, respectively. The cutoffs of rLMC-P and rLMC-M score for predicting good outcome (mRS score ≤ 2) were integrated to develop the collateral grading scale (CGS) (rating from 0-2). RESULTS: The CGS score was correlated with 3-months mRS score (non-recanalizers: ρ = -0.495, p = 0.01; recanalizers: ρ = -0.671, p < 0.001). Patients with intermediate or good collaterals (CGS score of 1 and 2) who recanalized were more likely to have good outcome than those without recanalization (p = 0.038, p = 0.018), while there was no significant difference in outcome in patients with poor collaterals (CGS score of 0) stratified by recanalization (p = 0.227). CONCLUSIONS: Identification of collaterals based on CGS may help to select good responders to reperfusion therapy in patients with large artery occlusion. LA - eng PB - Public Library of Science (PLoS) T1 - The Prognostic Value of a Four-Dimensional CT Angiography-Based Collateral Grading Scale for Reperfusion Therapy in Acute Ischemic Stroke Patients. DO - 10.1371/journal.pone.0160502 IS - PLoS One VL - 11 IS - 8 SP - e0160502- L1 - /bitstream/handle/11343/254913/PMC4978390.pdf?sequence=1&isAllowed=y ER -