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A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
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Relationship Between Collateral Status, Contrast Transit, and Contrast Density in Acute Ischemic Stroke
Hiroyuki Kawano1, Andrew Bivard1, Longting Lin1
1From the Department of Neurology, John Hunter Hospital, Hunter Medical Research Institute, and the University of Newcastle, Newcastle, New South Wales, Australia.
Stroke
|February 4, 2016
Summary
Good collateral circulation in acute ischemic stroke is linked to better outcomes. Contrast peak density on imaging is a reliable indicator of collateral status and predicts smaller infarcts, improving tissue fate.
Area of Science:
- Neurology
- Radiology
- Cardiovascular Research
Background:
- Collateral circulation significantly impacts the survival of brain tissue in acute ischemic stroke.
- Accurate quantification of collateral status using acute imaging remains an area of investigation.
Purpose of the Study:
- To evaluate the relationship between visual collateral assessment and quantitative measures.
- To determine the predictive value of these measures for perfusion deficits and infarct progression.
Main Methods:
- Sixty-six acute ischemic stroke patients with middle cerebral artery occlusion were analyzed.
- Visual collateral scoring was compared with contrast peak time delay and density.
- Predictive ability for perfusion lesion, infarct core, and final infarct volumes was assessed.
Main Results:
- Shorter contrast peak time delay and higher contrast peak density correlated with good collateral status.
- Higher contrast peak density independently predicted good collateral status.
- Higher contrast peak density was associated with smaller perfusion lesion and infarct core volumes, and reduced infarct growth.
Conclusions:
- Visual collateral status, contrast peak density, and time delay are interrelated.
- Contrast peak density is a strong indicator of collateral status and a predictor of tissue outcomes in acute ischemic stroke.
