TY - JOUR
T1 - Multiphase MR angiography collateral map
T2 - Functional outcome after acute anterior circulation ischemic stroke
AU - Kim, Hyun Jeong
AU - Lee, Sang Bong
AU - Choi, Jin Woo
AU - Jeon, Yoo Sung
AU - Lee, Hyung Jin
AU - Park, Jeong Jin
AU - Kim, Eung Yeop
AU - Kim, In Seong
AU - Lee, Taek Jun
AU - Jung, Yu Jin
AU - Ryu, Seon Young
AU - Chun, Young Il
AU - Lee, Ji Sung
AU - Roh, Hong Gee
N1 - Funding Information:
Supported by the National Research Foundation of Korea (2017R1A2B1008020).
Publisher Copyright:
© RSNA, 2020.
PY - 2020
Y1 - 2020
N2 - Background: Collateral circulation determines tissue fate and affects treatment result in acute ischemic stroke. A precise method for collateral estimation in an optimal imaging protocol is necessary to make an appropriate treatment decision for acute ischemic stroke. Purpose: To verify the value of multiphase collateral imaging data sets (MR angiography collateral map) derived from dynamic contrast material–enhanced MR angiography for predicting functional outcomes after acute ischemic stroke. Materials and Methods: This secondary analysis of an ongoing prospective observational study included data from participants with acute ischemic stroke due to occlusion or stenosis of the unilateral internal carotid artery and/or M1 segment of the middle cerebral artery who were evaluated within 8 hours of symptom onset. Data were obtained from March 2016 through August 2018. The collateral grading based on the MR angiography collateral map was estimated by using six-scale MR acute ischemic stroke collateral (MAC) scores. To identify independent predictors of favorable functional outcomes, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline diffusion-weighted imaging (DWI) lesion volume, site of steno-occlusion, collateral grade, mode of treatment, and early reperfusion were evaluated with multiple logistic regression analyses. Results: One hundred fifty-four participants (mean age 6 standard deviation, 69 years 6 13; 99 men) were evaluated. Younger age (odds ratio [OR], 0.45; 95% confidence interval [CI]: 0.29, 0.70; P , .001), lower baseline NIHSS score (OR, 0.85; 95% CI: 0.78, 0.94; P , .001), MAC score of 3 (OR, 27; 95% CI: 4.0, 179; P , .001), MAC score of 4 (OR, 17; 95% CI: 2.1, 134; P = .007), MAC score of 5 (OR, 27; 95% CI: 2.5, 306; P = .007), and successful early reperfusion (OR, 7.5; 95% CI: 2.6, 22; P , .001) were independently associated with favorable functional outcomes in multivariable analysis. There was a linear negative association between collateral perfusion grades and functional outcomes (P , .001). Conclusion: An MR angiography collateral map was clinically reliable for collateral estimation in patients with acute ischemic stroke. This map provided patient-specific pacing information for ischemic progression.
AB - Background: Collateral circulation determines tissue fate and affects treatment result in acute ischemic stroke. A precise method for collateral estimation in an optimal imaging protocol is necessary to make an appropriate treatment decision for acute ischemic stroke. Purpose: To verify the value of multiphase collateral imaging data sets (MR angiography collateral map) derived from dynamic contrast material–enhanced MR angiography for predicting functional outcomes after acute ischemic stroke. Materials and Methods: This secondary analysis of an ongoing prospective observational study included data from participants with acute ischemic stroke due to occlusion or stenosis of the unilateral internal carotid artery and/or M1 segment of the middle cerebral artery who were evaluated within 8 hours of symptom onset. Data were obtained from March 2016 through August 2018. The collateral grading based on the MR angiography collateral map was estimated by using six-scale MR acute ischemic stroke collateral (MAC) scores. To identify independent predictors of favorable functional outcomes, age, sex, risk factors, baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline diffusion-weighted imaging (DWI) lesion volume, site of steno-occlusion, collateral grade, mode of treatment, and early reperfusion were evaluated with multiple logistic regression analyses. Results: One hundred fifty-four participants (mean age 6 standard deviation, 69 years 6 13; 99 men) were evaluated. Younger age (odds ratio [OR], 0.45; 95% confidence interval [CI]: 0.29, 0.70; P , .001), lower baseline NIHSS score (OR, 0.85; 95% CI: 0.78, 0.94; P , .001), MAC score of 3 (OR, 27; 95% CI: 4.0, 179; P , .001), MAC score of 4 (OR, 17; 95% CI: 2.1, 134; P = .007), MAC score of 5 (OR, 27; 95% CI: 2.5, 306; P = .007), and successful early reperfusion (OR, 7.5; 95% CI: 2.6, 22; P , .001) were independently associated with favorable functional outcomes in multivariable analysis. There was a linear negative association between collateral perfusion grades and functional outcomes (P , .001). Conclusion: An MR angiography collateral map was clinically reliable for collateral estimation in patients with acute ischemic stroke. This map provided patient-specific pacing information for ischemic progression.
UR - https://www.scopus.com/pages/publications/85082147330
U2 - 10.1148/radiol.2020191712
DO - 10.1148/radiol.2020191712
M3 - Article
C2 - 32068506
AN - SCOPUS:85082147330
SN - 0033-8419
VL - 295
SP - 192
EP - 201
JO - Radiology
JF - Radiology
IS - 1
ER -