title: Using standard first-pass perfusion computed tomographic data to evaluate collateral flow in acute ischemic stroke.
abstract: OBJECTIVE
  The study aims to determine whether volume transfer constant (K(trans)) maps calculated from first-pass perfusion computed tomographic data are a biomarker of cerebral collateral circulation and predict the clinical outcome in acute ischemic stroke caused by proximal arterial occlusion.
  
  
  METHODS
  Consecutive patients with acute occlusion of the middle cerebral artery who received endovascular treatment were enrolled. Digital subtraction angiography, computed tomographic angiography with maximum intensity projection, and K(trans) maps were used to assess their collateral circulation. Agreement between different methods was evaluated using the χ(2) tests. The correlations of various radiological and clinical outcomes with the collateral flow score, as determined from K(trans) maps, were calculated.
  
  
  RESULTS
  Seventy-five patients were included, comprising 39 women and 36 men, with a mean age of 65.3±14.6 years. Collateral flow score on K(trans) maps had the highest correlation with digital subtraction angiography (κ=0.8101; P=0.9796). Twenty-five patients had poor collateral circulation on K(trans) maps, 25 had intermediate collateral flow, 20 had good collateral flow, and 5 had excellent collateral flow. Better collateral circulation was associated with better clinical outcome (P<0.0001).
  
  
  CONCLUSIONS
  K(trans) maps extracted from standard first-pass perfusion computed tomography are correlated with collateral circulation status after acute proximal arterial occlusion and predictive of outcome.
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Hui
authors: H
authors: Chen
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Bing
authors: B
authors: Wu
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Nan
authors: N
authors: Liu
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Max
authors: M
authors: Wintermark
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Zihua
authors: Z
authors: Su
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Ying
authors: Y
authors: Li
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Jun
authors: J
authors: Hu
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
authors: Yongwei
authors: Y
authors: Zhang
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.). zhugmdc@aliyun.com Zhangvivian@vip.sina.com.
authors: Weiwei
authors: W
authors: Zhang
authors: From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.). zhugmdc@aliyun.com Zhangvivian@vip.sina.com.
authors: Guangming
authors: G
authors: Zhu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D015415:Biomarkers; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003097:Collateral Circulation / Q000502:physiology*; D003287:Contrast Media; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000150:complications; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D020521:Stroke / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D015415:Biomarkers; D003287:Contrast Media
keywords: perfusion; stroke