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Related Concept Videos

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Multiphase CTA vs. MRA collateral map for predicting functional outcomes after acute ischemic stroke.

Sang Bong Lee1, Hong Gee Roh2,3, Taek-Jun Lee1

  • 1Daejeon St. Mary'S Hospital, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea.

Neuroradiology
|February 28, 2025
PubMed
Summary

The multiphase MR angiography (MRA) collateral map shows superior prognostic ability compared to multiphase CT angiography (mCTA) for acute ischemic stroke patients. MRA collateral assessment aids in predicting patient outcomes more effectively.

Keywords:
CT angiographyCerebral infarctionCerebrovascular circulationMagnetic resonance angiographyStroke

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Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • Acute ischemic stroke due to anterior circulation steno-occlusion requires accurate assessment of collateral circulation for prognosis.
  • Multiphase CT angiography (mCTA) and multiphase MR angiography (MRA) are advanced imaging techniques used to evaluate collateral status.

Purpose of the Study:

  • To compare the prognostic capabilities of collateral maps generated by mCTA and MRA in patients with acute anterior circulation ischemic stroke.
  • To determine which imaging modality provides more reliable predictions of functional outcomes.

Main Methods:

  • A secondary analysis of a prospective observational study involving patients with acute ischemic stroke within 8 hours of symptom onset.
  • Analysis of intermethod agreement between collateral scores (CSs) from mCTA and collateral perfusion scores (CPSs) from MRA.
  • Logistic regression models were used to assess the prognostic value of both imaging modalities.

Main Results:

  • A moderate agreement was found between mCTA CSs and MRA CPSs (weighted kappa = 0.44).
  • Factors independently associated with favorable outcomes included younger age, lower NIHSS scores, higher MRA collateral perfusion scores (CPS 4 and 5), and successful reperfusion.
  • Only the MRA collateral map demonstrated significant clinical prognostic value.

Conclusions:

  • The MRA collateral map is a superior tool for assessing collateral status and predicting functional outcomes in acute anterior circulation ischemic stroke.
  • MRA-based collateral assessment offers greater clinical utility than mCTA in this patient population.