Dual-phase CT collateral score

A predictor of clinical outcome in patients with acute ischemic stroke

Na Young Shin, Kyung Eun Kim, Mina Park, Young Dae Kim, Dong Joon Kim, Sung Jun Ahn, Jihoe Heo, Seung Koo Lee

Research output: Contribution to journalArticle

9 Citations (Scopus)

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 (p = 0.744) showed higher correlation with TFCA collateral status than CTA collateral status (p = 0.596) and substantial interobserver agreement (weighted k = 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.

Original languageEnglish
Article numbere107379
JournalPLoS One
Volume9
Issue number9
DOIs
Publication statusPublished - 2014 Sep 1

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Cerebral Angiography
Angiography
stroke
carotid arteries
Stroke
Internal Carotid Artery
multivariate analysis
Multivariate Analysis
infarction
Middle Cerebral Artery
arteries
hypertension
hemorrhage
methodology
Databases
Hemorrhage
Hypertension
Computed Tomography Angiography
Defects

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Shin, N. Y., Kim, K. E., Park, M., Kim, Y. D., Kim, D. J., Ahn, S. J., ... Lee, S. K. (2014). Dual-phase CT collateral score: A predictor of clinical outcome in patients with acute ischemic stroke. PLoS One, 9(9), [e107379]. https://doi.org/10.1371/journal.pone.0107379
Shin, Na Young ; Kim, Kyung Eun ; Park, Mina ; Kim, Young Dae ; Kim, Dong Joon ; Ahn, Sung Jun ; Heo, Jihoe ; Lee, Seung Koo. / Dual-phase CT collateral score : A predictor of clinical outcome in patients with acute ischemic stroke. In: PLoS One. 2014 ; Vol. 9, No. 9.
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Dual-phase CT collateral score : A predictor of clinical outcome in patients with acute ischemic stroke. / Shin, Na Young; Kim, Kyung Eun; Park, Mina; Kim, Young Dae; Kim, Dong Joon; Ahn, Sung Jun; Heo, Jihoe; Lee, Seung Koo.

In: PLoS One, Vol. 9, No. 9, e107379, 01.09.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dual-phase CT collateral score

T2 - A predictor of clinical outcome in patients with acute ischemic stroke

AU - Shin, Na Young

AU - Kim, Kyung Eun

AU - Park, Mina

AU - Kim, Young Dae

AU - Kim, Dong Joon

AU - Ahn, Sung Jun

AU - Heo, Jihoe

AU - Lee, Seung Koo

PY - 2014/9/1

Y1 - 2014/9/1

N2 - 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 (p = 0.744) showed higher correlation with TFCA collateral status than CTA collateral status (p = 0.596) and substantial interobserver agreement (weighted k = 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.

AB - 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 (p = 0.744) showed higher correlation with TFCA collateral status than CTA collateral status (p = 0.596) and substantial interobserver agreement (weighted k = 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.

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