J Stroke.
2018 Sep;20(3):362-372. 10.5853/jos.2018.00605.
Outcome Prediction Using Perfusion Parameters and Collateral Scores of Multi-Phase and Single-Phase CT Angiography in Acute Stroke: Need for One, Two, Three, or Thirty Scans?
- Affiliations
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- 1Institute of Neuroradiology, University Medical Center Goettingen, Goettingen, Germany. m.psychogios@med.uni-goettingen.de
- 2Department of Medical Statistics, University Medical Center Goettingen, Goettingen, Germany.
- 3Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
- 4Department of Neurology, University Medical Center Goettingen, Goettingen, Germany.
- KMID: 2428771
- DOI: http://doi.org/10.5853/jos.2018.00605
Abstract
- BACKGROUND AND PURPOSE
Collateral status is an important factor determining outcome in acute ischemic stroke (AIS). Hence, different collateral scoring systems have been introduced. We applied different scoring systems on single- and multi-phase computed tomography (CT) angiography (spCTA and mpCTA) and compared them to CT perfusion (CTP) parameters to identify the best method for collateral evaluation in patients with AIS.
METHODS
A total of 102 patients with AIS due to large vessel occlusion in the anterior circulation who underwent multimodal CT imaging and who were treated endovascularly were included. Collateral status was assessed on spCTA and mpCTA using four different scoring systems and compared to CTP parameters. Logistic regression was performed for predicting favorable outcome.
RESULTS
All collateral scores correlated well with each other and with CTP parameters. Comparison of collateral scores stratified by extent of perfusion deficit showed relevant differences between groups (P < 0.01 for each). An spCTA collateral score discriminated best between favorable and unfavorable outcome as determined using the modified Rankin Scale 3 months after stroke.
CONCLUSIONS
Collateral status evaluated on spCTA may suffice for outcome prediction and decision making in AIS patients, potentially obviating further imaging modalities like mpCTA or CTP.
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