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Updated: Jun 29, 2026

Optimized System for Cerebral Perfusion Monitoring in the Rat Stroke Model of Intraluminal Middle Cerebral Artery Occlusion
Published on: February 17, 2013
Perfusion-based Collaterals in Prediction of Infarct Growth in Patients with Acute Ischemic Stroke: A Multicenter
Mark McArthur1, Mona Asghariahmadabad1, Michael Thomas1
1From the Department of Radiological Sciences (M.M., E.T., A.I.), Neurology (M.B.-H., D.S.L.), David Geffen School of Medicine at UCLA, University of California, Los Angeles, Los Angeles, CA; Department of Radiology and Biomedical Imaging (M.M., M.A., M.T., C.W., S.S., K.N.), University of California, San Francisco, CA, USA; Department of Radiology (A.A.S., M.M.-B.), University of Washington, Seattle, WA, USA; Department of Radiology (M.M.-B.), University of Alabama at Birmingham, Birmingham, AL, USA; Department of Radiology (V.Y.), Johns Hopkins University, Baltimore, Maryland and Department of Neurology and Neurosurgery (H.S., J.M.), Icahn School of Medicine at Mount Sinai, New York City, NY, USA.
Perfusion indices integrating cerebral blood volume (CBV) like rCBV-Index and PCI better predict infarct growth in acute ischemic stroke (AIS) patients than delay-based HIR. These findings aid in treatment decisions and prognostication for AIS.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Robust collaterals in acute ischemic stroke (AIS) patients are linked to reduced infarct progression.
- Perfusion-based collateral indices, including hypoperfusion intensity ratio (HIR), relative cerebral blood volume index (rCBV-Index), and perfusion collateral index (PCI), are utilized to assess collateral status in AIS.
- The diagnostic performance of these indices in predicting infarct growth after successful reperfusion in AIS requires further evaluation.
Purpose of the Study:
- To evaluate and compare the diagnostic capabilities of perfusion-based collateral indices in predicting infarct growth in AIS patients post-reperfusion.
- To determine the association between collateral indices and infarct growth.
- To identify independent predictors of infarct growth in AIS.
Main Methods:
- A retrospective multicenter study included anterior circulation large vessel occlusion patients with pretreatment perfusion imaging, successful reperfusion (mTICI ≥2b), and follow-up MRI within 24-48 hours.
- Substantial infarct growth was defined as a final infarct volume ≥10 mL compared to the baseline ischemic core volume.
- Perfusion-based collateral indices (HIR, rCBV-Index, PCI) were calculated, and their association with infarct growth was analyzed using univariate and multivariable logistic regression.
Main Results:
- Of 116 patients, 50% experienced infarct growth (≥10 mL).
- Poor collaterals, as determined by PCI and rCBV-Index, were significantly associated with infarct growth (p<0.01), whereas HIR was not (p=0.83).
- Independent predictors of infarct growth identified were baseline NIHSS, rCBV-Index, and PCI.
Conclusions:
- Perfusion-based collateral indices incorporating cerebral blood volume (rCBV-Index and PCI) demonstrate superior performance over delay-based HIR in predicting substantial infarct growth in AIS patients.
- These findings suggest that rCBV-Index and PCI are valuable tools for treatment decision-making, patient transfer, and prognostication in AIS.
- Further research may refine the application of these indices in clinical practice.
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