Relationships of metal artifacts and CT perfusion parameters with collateral circulation and prognosis in elderly patients with acute stroke in the late-time window
YANG Yuling
CHEN Guojuan
QIAN Qingqiang
LI Qian
ZHANG Zhiyue
CAO Yibin
LIU Jing
Abstract：Objective To analyze the relationships of metal artifact on plain CT scan and parameters of CT perfusion with collateral circulation in elderly patients with acute ischemic stroke(AIS)in late-time window and their prognostic value.Methods A total of 120 elderly AIS patients admitted to our department from January 2022 to November 2024 were retrospectively enrolled,and according to the score of modified Rankin scale(mRS)at 6 months of follow-up,they were divided into a good prognosis group(mRS score:0-2,n=42)and a poor prognosis group(mRS score:3-6,n=78).All patients underwent CT plaining scanning and CT perfusion imaging.Pearson correlation analysis was used to analyze the correlation of metal artifact on CT plain scan and CT perfusion parameters with collateral circulation as well as prognosis.Logistic regression analysis was adopted to screen the related factors affecting the prognosis,and then a prognostic prediction model was constructed based on the obtained factors.ROC curve analysis was applied to evaluate the predictive value of metal artifact and CT perfusion parameters for the prognosis of the elderly AIS patients.Results There was a statistical difference in the grade distribution of collateral circulation between the elderly AIS patients with positive and negative metal artifact on CT plain scan(P<0.01).Pearson correlation analysis showed that the metal artifact on CT scan was negatively correlated with the grade of collateral circulation(r=-0.456,P<0.05),and positively correlated with the mRS scores at 3 and 6 months of follow-up(r=0.356,r=0.421,P<0.05);the cerebral blood flow(CBF)and cerebral blood volume(CBV)were positively correlated with the grade of collateral circulation,and negatively correlated with the mRS score at 3 and 6 months of follow-up(P<0.05);the mean transit time(MTT)and time to peak(TTP)were negatively correlated with collateral circulation grade(P<0.05),and positively correlated with mRS scores at 3 and 6 months of follow-up(P<0.05).Multivariate logistic regression analysis revealed that metal artifact on CT plain scan,CBF,CBV,MTT and TTP were independent influencing factors for poor prognosis in the elderly AIS patients(P<0.05,P<0.01).ROC curve analysis suggested that the AUC value of the combined detection of metal artifact on CT plain scan and CT perfusion parameters was 0.894,which was significantly higher than that of metal artifact,CBV,CBF,MTT,TTP and other single indicator(P<0.01).Conclusion The metal artifact on CT plain scan and CT perfusion parameters are related to the collateral circulation in elderly AIS patients in late-time window,and the combined detection of these indicators can more accurately predict the prognosis.
Keywords：strokecollateral circulationprognosisCT perfusion imaging
Publication Date：2026-02-15
Online Publishing Date：2026-03-11(First online date of this platform, not the publication date of the document)
Pages：6( 156-161 )