Multimodal CT parameters in assessing collateral circulation status in acute cerebral infarction patients
Objective To analyze the clinical application value of multimodal CT parameters in assessing collat-eral circulation status in acute cerebral infarction(ACI)patients.Methods A retrospective analysis was conducted on the imaging features and clinical data of 150 ACI patients who underwent multimodal CT scanning at the Fifth People's Hospital of Huaian from January 2020 to August 2022.The patients were divided into a modeling set(n=105)and a val-idation set(n=45)in a 7∶3 ratio.The modeling set was divided into two groups based on collateral circulation outcome:the successful collateral circulation group(n=68)and the failure group(n=37).The CT perfusion(CTP)parameters and serum biomarkers including transforming growth factor beta(TGF-β)and homocysteine(Hey)were compared be-tween the two groups.Logistic regression models were developed to establish imaging models,clinical models,and a com-bined model incorporating both imaging features and clinical characteristics.Independent factors influencing collateral cir-culation status were identified,and a prediction model was constructed and validated with a nomogram.Results Univari-ate analysis showed significant differences in cerebral blood volume(CBV),cerebral blood flow(CBF),mean transit time(MTT),time to peak(TTP),TGF-β,Hey levels,and hypertension status between the two groups(P＜0.05).The collateral circulation successful group had significantly higher CBV,CBF,MTT,TTP,TGF-β levels,and hyperten-sion incidence compared to the failure group,with lower Hcy levels(P＜0.05).In the modeling set,the combined model incorporating imaging features and clinical characteristics had an area under the curve(AUC)of 0.978(95％CI:0.954-1.000),with a sensitivity of 91.9％and specificity of 95.6％.In the validation set,the AUC was 0.989(95％CI:0.966-1.000),with a sensitivity of 100％and specificity of 98.5％.The combined model had superior predictive value compared to the imaging model and clinical model alone.Conclusion The multimodal CT imaging model combined with clinical characteristics,incorporating CBV,CBF,MTT,TTP,TGF-β,Hcy,and hypertension status,has higher pre-dictive value for assessing collateral circulation in ACI patients and offers better evaluation efficacy.
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