Study on the value of cranial CT angiography combined with multimodal magnetic resonance imaging in acute ischemic stroke

JI Tingju; ZHU Wenwen; ZHANG Li

doi:10.12122/j.issn.1674-4500.2024.05.12

Abstract：Objective To explore the value of CT angiography(CTA)combined with multimodal MRI in evaluating the ischemic penumbra(IP)and collateral circulation in acute ischemic stroke(AIS)and its application in prognostic assessment.Methods Fifty-seven cases of AIS patients diagnosed from January 2019 to January 2022 at our hospital were retrospectively collected,with the age of 36-78(63.4±12.3)years old.All patients underwent multimodal MR combined with CTA examination,and the MRI data,CTA data and clinical data were collected.Cerebral collateral circulation and IP were diagnosed through CTA combined with 3D-TOF-MRA.The factors affecting IP,perfusion-diffusion mismatch and therapeutic efficacy were analyzed by intergroup comparison.Results 30 cases(52.6%)in the IP group,and 27 cases(47.4%)in the non-IP group.The difference was statistically significant(P<0.05).The grade of collateral circulation was negatively correlated with the volume of infarct area and hypoperfusion area on admission(r=-0.603,-0.331,P<0.01),and positively correlated with perfusion-diffusion mismatch(r=0.528,P<0.001).There were 37 patients(64.9%)with good collateral circulation and 20 patients(35.1%)with poor patency.The proportP<0.05).The improved value of NIHSS score,perfusion-diffusion mismatch,and collateral circulation grades in the significant effect group were significantly better than those in the insignificant effect group(P<0.05).Conclusion CTA combined with multimodal MRI is helpful to evaluate the changes of cerebral blood flow in patients with AIS,and the accurate assessment of collateral circulation and IP can effectively predict the short-term curative effect of AIS.