Application value of collateral circulation grading based on magnetic resonance DSC-PWI raw images in patients with acute anterior circulation large vessel occlusive cerebral infarction

YAN Da; XIE Jinlan; CHE Jinlian; MENG Yinying; CHEN Weihua

doi:10.3969/j.issn.1674-3806.2025.08.15

Abstract：Objective To explore the application value of collateral circulation grading based on magnetic resonance dynamic susceptibility contrast-enhanced perfusion-weighted imaging(DSC-PWI)raw images in patients with acute anterior circulation large vessel occlusive cerebral infarction.Methods The clinical data of 114 patients with acute cerebral infarction in the supplying area of the middle cerebral artery caused by unilateral anterior circulation large vessel occlusion who were admitted to Wuzhou Gongren Hospital from January 2020 to April 2024 were retrospectively analyzed.All the patients were diagnosed through head magnetic resonance angiography(MRA),among whom 76 patients received digital subtraction angiography(DSA)examination.The consistency of the results of collateral circulation grading obtained by two evaluators was analyzed.The consistency of the results of collateral circulation grading assessed by using DSC-PWI raw images and DSA was analyzed.The correlation between collateral circulation assessed by using DSC-PWI raw images with the perfusion deficit volume,infarct core volume,and ratio of the mismatch area between the perfusion deficit volume and the infarct core volume(mismatch ratio)was compared.Results There was good consistency in the assessment of collateral circulation grading results based on DSC-PWI raw images by 2 assessors(Kappa=0.821,P＜0.001).There was good consistency in the assessment of collateral circulation grading results based on DSC-PWI raw images and DSA(Kappa=0.801,P＜0.001).The perfusion deficit volume and infarct core volume in the good collateral circulation group were smaller than those in the poor collateral circulation group,and the mismatch ratio in the good collateral circulation group was greater than that in the poor collateral circulation group,with statistically significant differences between the two groups(P＜0.05).The results of Spearman rank correlation analysis showed that collateral circulation grading based on DSC-PWI raw images was negatively correlated with the infarct core volume(r,=-0.613,P＜0.001),perfusion deficit volume(r,=-0.382,P＜0.001),and was positively correlated with the mismatch ratio(r,=0.320,P＜0.001).Conclusion DSC-PWI raw images can be used to assess the collateral circulation of acute anterior circulation large vessel occlusive cerebral infarction.