Related Experiment Video
Updated: Mar 29, 2026
Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
Published on: September 25, 2019
Associations Among CTA Collateral Scores, Multimodal MRI Lesion Volumes, and Clinical Severity in Acute Middle
Halil Gulluoglu1, Hasan Armagan Uysal2, Fatma Gulhan Sahbaz1
1Department of Neurology, Medicalpoint İzmir Hospital, Faculty of Medicine, Izmir University of Economics, 35330 İzmir, Türkiye.
Abstract:
Background/objectives: In this study, we aimed to investigate acute infarct volume on magnetic resonance diffusion-weighted imaging (MRI DWI), chronic infarct volume on FLAIR (fluid-attenuated inversion recovery), hypoperfused area volume on PWI (perfusion-weighted imaging), stenosis locations and rates on CT (computerized tomography) angiography, CT angiography collateral scoring, and correlation of background data and etiological factors with neurological clinical findings in patients with acute middle cerebral infarction. Methods: A total of 117 patients with MCA (middle cerebral artery) infarction were hospitalized for diagnosis and treatment after undergoing CT angiography within 9 h of symptom onset. Comparative results of Souza's collateral score system, MRI parameters, and clinical outcomes were determined. Results: According to the Souza CS system, 23 patients were in the malignant profile and 94 in the good profile. There was a statistically significant difference between the malignant and benign profiles in terms of DWI volume, hypoperfused area volume on PWI sequence, white matter assessment using the Fazekas scale, and supratentorial and infratentorial chronic infarct volume on the FLAIR sequence (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p < 0.001). Conclusions: Patients with a malignant profile on CTA may have a larger infarct volume and worse functional outcome. This should be recognized, and these patients should be followed up more carefully and attentively than those with good collateral scores.
Insights
Patients with a malignant profile on CT angiography (CTA) may experience larger infarct volumes and poorer outcomes. Careful monitoring is crucial for these individuals, distinguishing them from those with good collateral scores.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Acute middle cerebral artery (MCA) infarction presents a significant clinical challenge.
- Accurate assessment of infarct volume, perfusion, and collateral status is vital for prognosis.
Purpose of the Study:
- To investigate acute infarct volume (MRI DWI), chronic infarct volume (FLAIR), hypoperfused area (PWI), and stenosis (CTA).
- To evaluate the correlation between imaging findings, collateral status (Souza CS), and clinical outcomes in acute MCA infarction.
Main Methods:
- 117 patients with acute MCA infarction underwent CT angiography (CTA) within 9 hours of symptom onset.
- Comparative analysis of Souza's collateral score system, MRI parameters (DWI, FLAIR, PWI), and clinical outcomes.
Main Results:
- 23 patients had a malignant profile, and 94 had a good profile according to the Souza CS system.
- Significant differences (p < 0.001) were observed between malignant and benign profiles in DWI volume, PWI hypoperfused area, Fazekas scale, and chronic infarct volumes (FLAIR).
Conclusions:
- A malignant profile on CTA may indicate larger infarct volume and worse functional outcomes.
- Patients with malignant profiles require closer monitoring and more attentive follow-up compared to those with good collateral scores.
