The value of multimodal CT in assessing collateral circulation and prognosis of acute cerebral infarction

Zheng Chunfeng; Wang Yaxin; Zhang Shengnan; Chen Lei

doi:10.3969/j.issn.1674-3245.2025.04.011

Abstract：Objective To evaluate the value of multimodal CT in assessing collateral circulation and the prognosis of acute cerebral infarction(ACI).Methods A total of 129 patients with ACI who received intravenous thrombolytic bridging endovascular therapy in Jinan second maternal and child health hospital from September 2021 to December 2022 were selected and divided into poor prognosis group(41 cases)and good prognosis group(88 cases)according to modified Rankin score(mRS)3 months after surgery.Multimodal CT scans,including preoperative plain CT scan(NCCT)and CT angiography(CTA),were performed in all patients.The relationship between multimodal CT scan index and collateral circulation and prognosis was analyzed.Results There were 122 patients with the same evaluation results of multi-mode CT and DSA on collateral circulation,and the evaluation consistency was high(Kappa=0.888,P＜0.05).The NIHSS score,mRS Score and 28d mortality after treatment in good collateral circulation group were lower than poor collateral circulation group(t=4.289,5.212,x2=4.404,P＜0.05).The proportion of NIHSS score on admission and mTICI grade 0-2a patients in the poor prognosis group were significantly higher than good prognosis group(t=6.991,x2=4.360,P＜0.05),and the scores of collateral circulation and ASPECTS in poor prognosis group were lower than good prognosis group(t=6.972,5.003,P＜0.05).The NIHSS,collateral circulation score and ASPECTS score were independent factors affecting the prognosis of ACI according the Logistic analysis(P＜0.05).The regression model equation is logit(P)=5.488+admission NIHSS score × 0.511-ASPECTS score ×1.366-collateral circulation score ×1.227.The regression model predicts poor prognosis in ACI patients.AUC was 0.887(95％CI:0.827～0.946),sensitivity was 82.9％,specificity was 78.4％.Conclusion Multimodal CT scan can effectively evaluate collateral circulation in ACI.NIHSS score,collateral circulation score and ASPECTS score are independent factors affecting the prognosis of ACI.The constructed model has high prognostic value for ACI patients.