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Published on: January 23, 2019
Assessment of collateral flow with multi-phasic CT: correlation with diffusion weighted MRI in MCA occlusion
So-Lyung Jung1, Youn-Joo Lee, Kook-Jin Ahn
1Department of Radiology, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Summary
Multiphasic contrast-enhanced CT effectively visualizes collateral flow in acute middle cerebral artery (MCA) infarction. This imaging method correlates with diffusion-weighted MRI findings, aiding in stroke assessment.
Area of Science:
- Neuroradiology
- Cerebrovascular Imaging
- Stroke Imaging
Background:
- Acute ischemic stroke requires prompt assessment of cerebral blood flow.
- Collateral circulation plays a critical role in determining infarct progression and patient outcomes.
- Evaluating collateral status non-invasively is crucial for guiding treatment decisions.
Purpose of the Study:
- To correlate collateral flow assessed by multiphasic contrast-enhanced computed tomography (CT) with ischemic changes on diffusion-weighted magnetic resonance imaging (MRI) in acute middle cerebral artery (MCA) infarction.
- To determine if multiphasic CECT can reliably assess collateral status in MCA occlusions.
Main Methods:
- Retrospective analysis of 11 patients with MCA occlusions.
- Diffusion-weighted images (DWIs) were graded using the Alberta Stroke Program Early CT Score (ASPECTS).
- Collateral flow on three-phasic contrast-enhanced CT (CECT) was quantified by counting enhancing MCA branches distal to the occlusion and calculating collateral ratios (CR1, CR2, CR3).
Main Results:
- Collateral ratios were CR1=0.48, CR2=0.73, and CR3=0.72.
- Significant correlations were found between collateral ratios in the second (CR2) and third (CR3) phases and ASPECTS scores (r=0.675, P=0.023 for CR2; r=0.664, P=0.026 for CR3).
Conclusions:
- The number of contrast-enhancing branches on later phase multiphasic CECT images reflects collateral flow status.
- Multiphasic CECT collateral assessment correlates with DWI-based ASPECTS grading in MCA infarction.
- This CT technique offers a valuable tool for evaluating collateral circulation in acute stroke.
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