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- Publisher
- American Journal of Neuroradiology
- Copyright
- © 2016 by American Journal of Neuroradiology
- ISSN
- 0195-6108
- eISSN
- 1936-959X
- DOI
- 10.3174/ajnr.A4878
- Publisher site
- See Article on Publisher Site
Abstract
ORIGINAL RESEARCH ADULT BRAIN Comparison of CTA- and DSA-Based Collateral Flow Assessment in Patients with Anterior Circulation Stroke X I.G.H. Jansen, X O.A. Berkhemer, X A.J. Yoo, X J.A. Vos, X G.J. Lycklama à Nijeholt, X M.E.S. Sprengers, X W.H. van Zwam, X W.J. Schonewille, X J. Boiten, X M.A.A. van Walderveen, X R.J. van Oostenbrugge, X A. van der Lugt, X H.A. Marquering, and X C.B.L.M. Majoie; on behalf of the MR CLEAN investigators (www.mrclean-trial.org) ABSTRACT BACKGROUND AND PURPOSE: Collateral flow is associated with clinical outcome after acute ischemic stroke and may serve as a parameter for patient selection for intra-arterial therapy. In clinical trials, DSA and CTA are 2 imaging modalities commonly used to assess collateral flow. We aimed to determine the agreement between collateral flow assessment on CTA and DSA and their respective associations with clinical outcome. MATERIALSANDMETHODS: PatientsrandomizedinMRCLEANwithmiddlecerebralarteryocclusionandbothbaselineCTAimagesand statistics complete DSA runs were included. Collateral flow on CTA and DSA was graded 0 (absent) to 3 (good). Quadratic weighted determined agreement between both methods. The association of both modalities with mRS at 90 days was assessed. Also, association between the dichotomized collateral score and mRS 0–2 (functional independence) was ascertained. RESULTS: Of45patientswithevaluableimagingdata,collateralflowwasgradedonCTAas0,1,2,3for3,10,20,and12patients,respectively, andonDSAfor12,17,10,and6patients,respectively.The -valuewas0.24(95%CI,0.16–0.32).Theoverallproportionofagreementwas24% (95%CI,0.12–0.38).TheadjustedoddsratioforfavorableoutcomeonmRSwas2.27and1.29forCTAandDSA,respectively.Therelationship
Journal
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Nov 1, 2016