title: Multiphasic perfusion computed tomography as a predictor of collateral flow in acute ischemic stroke: comparison with digital subtraction angiography.
abstract: BACKGROUND
  Assessing collateral status is important in acute ischemic stroke. The purpose of this study was to compare multiphasic perfusion computed tomography (MPCT) with digital subtraction angiography (DSA) in predicting leptomeningeal collateral flow in acute middle cerebral artery (MCA) infarction.
  
  
  METHODS
  Consecutive patients underwent MPCT and DSA for acute MCA infarction that presented within 6 h of symptom onset. We included patients who showed MCA occlusion in the same location on both modalities and assessed the agreement rate and correlation between the MPCT and DSA collateral grades.
  
  
  RESULTS
  Of 54 patients, 44 (81.5%) had proximal MCA (M1) occlusions and 10 (18.5%) had distal MCA (M2) occlusions based on MPCT and DSA. The κ-coefficients were 0.87 and 0.81 in the MPCT and DSA collateral grade systems, respectively. Forty-four patients (81.5%) belonged to the same category in both collateral-grading systems. MPCT collateral grades correlated positively with those of DSA (Spearman's correlation coefficient 0.827, p < 0.001).
  
  
  CONCLUSIONS
  Our data show that MPCT can predict leptomeningeal collateral flow in acute ischemic stroke. Based on collateral status assessed by MPCT, different therapeutic approaches might be warranted.
authors.affiliation: Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Suk Jae
authors.initials: SJ
authors.lastname: Kim
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Noh
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Yoon
authors.forename: Keon Ha
authors.initials: KH
authors.lastname: Kim
authors.forename: Pyoung
authors.initials: P
authors.lastname: Jeon
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
authors.forename: Gyeong-Moon
authors.initials: GM
authors.lastname: Kim
authors.forename: Chin-Sang
authors.initials: CS
authors.lastname: Chung
authors.forename: Kwang Ho
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D002545:Brain Ischemia / Q000150:complications; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013223:Statistics as Topic; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed