title: Multimodal CT: favorable outcome factors in acute middle cerebral artery stroke with large artery occlusion.
abstract: BACKGROUND
  We investigated which parameters of multimodal computed tomography (CT) or their combinations might be useful as additional imaging predictors for favorable outcomes in acute stroke patients with large artery occlusion.
  
  
  METHODS
  The parameters of multimodal CT, including non-enhanced CT, CT angiography, perfusion CT parameters, CT angiography source image (CTA-SI), and collateral flow, were analyzed in 66 consecutive patients with acute middle cerebral artery stroke with large artery occlusion. For favorable outcomes at the 3-month follow-up, odds ratios of multimodal CT parameters with an optimum predictive cut-off Alberta Stroke Program Early CT Score (ASPECTS) were assessed.
  
  
  RESULTS
  Cerebral blood volume (CBV) ASPECTS ≥6, CTA-SI ASPECTS ≥7, and good collateral flow were associated with a favorable outcome. The combination of those parameters had better predictive validity compared to a single parameter only: CBV (p = 0.039), CTA-SI (p = 0.038), and collateral flow (p < 0.001).
  
  
  CONCLUSIONS
  Among the various parameters of multimodal CT, CBV ASPECTS ≥6, CTA-SI ASPECTS ≥7, and good collateral flow might be the most reliable predictors for favorable outcomes in acute stroke patients with large artery occlusion. Moreover, considering these parameters simultaneously might improve the predictive validity of multimodal CT for functional outcome.
authors: Department of Neurology, Center for Geriatric Neuroscience Research, Institute of Biomedical Science and Technology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Republic of Korea.
authors: Joon Hwa
authors: JH
authors: Lee
authors: Young Jin
authors: YJ
authors: Kim
authors: Jin Woo
authors: JW
authors: Choi
authors: Hong Gee
authors: HG
authors: Roh
authors: Young Il
authors: YI
authors: Chun
authors: Hyun-Ji
authors: HJ
authors: Cho
authors: Hahn Young
authors: HY
authors: Kim
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D020244:Infarction, Middle Cerebral Artery / Q000000981:diagnostic imaging*; D008297:Male; D064847:Multimodal Imaging / Q000379:methods*; D011379:Prognosis; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome