A Study on the Correlation between Low Perfusion Intensity Ratio and CTA Collateral Status in Acute Ischemic Stroke with Large Vessel Occlusion
Objective This study aims to evaluate whether the low perfusion intensity ratio derived from CTP testing is related to the collateral circulation status of CTA,and whether there is a threshold low perfusion intensity ratio for predicting poor collateral circulation in CTA.Methods Retrospective analysis of imaging and clinical data of patients with acute ischemic stroke with large vessel occlusion who were admitted consecutively.Two specialist doctors used TAN,MAAS,and Calgary/Menon methods to perform single and multiple phase CTA scores.Use Rapid Processing Perfusion and Diffusion Software(RAPID)to process CTP.Low perfusion intensity ratio=ratio of brain volume to maximum time＞10 seconds/ratio of maximum volume＞6 seconds.Use Pearson correlation method to calculate the correlation between CTA collateral circulation score and low perfusion rate.Determine the optimal threshold for predicting the low perfusion intensity ratio of poor collateral circulation through the analysis of subject work characteristic curves.Results 52 patients with acute ischemic stroke with large vessel occlusion were included.Multi stage CTA scores showed better consistency among evaluators(k=0.813)compared to single stage CTA(TAN,k=0.587;MAAS,k=0.273).Low perfusion rate is correlated with CTA collateral circulation score(multiphase CTA:0.55;95％CI,0.67-0.40;P＜0.001).The optimal threshold for predicting poor multiphase CTA collateral circulation status is a low perfusion intensity ratio of 0.45(sensitivity 78％;specificity 76％;area under the curve 0.86).Patients with lower perfusion intensity compared to those with higher/poorer collateral circulation have lower/larger infarcts,higher NIHSS scores,and greater hypoperfusion volume.Conclusion The low perfusion intensity ratio in patients with acute ischemic stroke with large vessel occlusion is related to the collateral circulation status of CTA.For clinical and future stroke trials,low perfusion intensity ratio is an automated and quantitative alternative to the CTA collateral circulation scoring method.
万方数据
维普
