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  -