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Dual-Phase CT Collateral Score: A Predictor of Clinical Outcome in Patients with Acute Ischemic Stroke

Authors
 Na-Young Shin  ;  Kyung-eun Kim  ;  Mina Park  ;  Young Dae Kim  ;  Dong Joon Kim  ;  Sung Jun Ahn  ;  Ji Hoe Heo  ;  Seung-Koo Lee 
Citation
 PLOS ONE, Vol.9(9) : e107379, 2014 
Journal Title
 PLOS ONE 
Issue Date
2014
MeSH
Aged ; Aged, 80 and over ; Brain Infarction/diagnostic imaging* ; Carotid Artery, Internal/diagnostic imaging ; Cerebral Angiography ; Female ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery/diagnostic imaging ; Prognosis ; Retrospective Studies ; Severity of Illness Index ; Stroke/diagnostic imaging* ; Stroke/therapy ; Tomography, X-Ray Computed ; Treatment Outcome
Abstract
BACKGROUND AND PURPOSE: The presence of good collaterals on CT angiography (CTA) is a well-known predictor for favorable outcome in acute ischemic stroke. Recently, multiphase CT has been introduced as a more accurate method in assessing collaterals. The aim of this study was to assess the ability of dual-phase CT to evaluate collateral status and predict clinical outcome. METHODS: Forty-three patients who underwent both dual-phase CT and transfemoral cerebral angiography (TFCA) for occluded intracranial internal carotid artery (ICA) and/or middle cerebral artery (M1 segment) were recruited from a prospectively collected database. The collateral status on dual-phase CT was graded by using a 4-point scale: grade 0 = no collaterals; 1 = some collaterals with persistence of some defects; 2 = slow but complete collaterals; and 3 = fast and complete collaterals. Univariate and multivariate analysis were performed to define the independent predictors for favorable outcome at 3 months. RESULTS: Dual-phase CT collateral status (ρ = 0.744) showed higher correlation with TFCA collateral status than CTA collateral status (ρ = 0.596) and substantial interobserver agreement (weighted κ = 0.776). In the univariate analysis, age, history of hypertension, collateral scores on CTA, dual-phase CT, and TFCA, occlusion in intracranial ICA, final infarct volume, and symptomatic hemorrhage were significantly associated with outcome. Among them, only the dual-phase CT collateral score was an independent predictor for favorable outcome (OR = 26.342 (2.788-248.864); P = 0.004) in the multivariate analysis. CONCLUSIONS: The collateral status on dual-phase CT can be a useful predictor for clinical outcome in acute stroke patients, especially when advanced CT techniques are not available in emergent situations.
Files in This Item:
T201402887.pdf Download
DOI
10.1371/journal.pone.0107379
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Eun(김경은)
Kim, Dong Joon(김동준) ORCID logo https://orcid.org/0000-0002-7035-087X
Kim, Young Dae(김영대) ORCID logo https://orcid.org/0000-0001-5750-2616
Park, Mina(박미나) ORCID logo https://orcid.org/0000-0002-2005-7560
Shin, Na Young(신나영)
Ahn, Sung Jun(안성준) ORCID logo https://orcid.org/0000-0003-0075-2432
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Heo, Ji Hoe(허지회) ORCID logo https://orcid.org/0000-0001-9898-3321
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/99627
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