Significant Slowed Cortical Venous Blood Flow in Patients with Acute Ischemic Stroke with Large Vessel Occlusion Suggests Poor Collateral Circulation and Prognosis

作者全名："Wang, Jingjie; Li, Jing; Liu, Jiayang; Wu, Jiajing; Gu, Sirun; Yao, Yunzhuo; Luo, Tianyou; Huang, Cheng; Huang, Fusen; Li, Yongmei"

作者地址："[Wang, Jingjie; Li, Jing; Liu, Jiayang; Gu, Sirun; Yao, Yunzhuo; Luo, Tianyou; Li, Yongmei] Chongqing Med Univ, Affiliated Hosp 1, Dept Radiol, RChina, Chongqing, Peoples R China; [Liu, Jiayang] Cent Hosp Shaoyang, Med Imaging Ctr, Shaoyang, Peoples R China; [Wu, Jiajing] 958th Hosp PLA Army, Dept Radiol, Chongqing, Peoples R China; [Huang, Cheng] Chongqing Med Univ, Affiliated Hosp 1, Dept Neurol, Chongqing, Peoples R China; [Huang, Fusen] Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Chongqing, Peoples R China"

通信作者："Huang, FS (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Anesthesiol, Chongqing, Peoples R China."

来源：ACADEMIC RADIOLOGY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001063942700001

JCR分区：Q1

影响因子：3.8

年份：2023

卷号：30

期号：9

开始页：1896

结束页：1903

文献类型：Article

关键词：Acute ischemic stroke; Crebral cortical vein; Large vessel occlusion; 4D-CTA; collateral circulation

摘要："Rationale and Objectives: To investigate the change of cortical venous flow in acute ischemic stroke patients with large vessel occlusion (LVO-AIS) and its clinical value. Materials and Methods: Baseline whole-brain 4D-CTA/CTP and clinical data of LVO-AIS and a control group were collected from June 2020 to October 2021. Venous inflow time (VIT), venous peak time (VPT), and venous outflow time (VOT) were analyzed on both sides of patients and normal controls. The VIT/VPT/VOT were statistically described and compared between the patient group and normal controls, then, in patients with different collateral circulation and prognoses. Next, the correlation between cortical venous drainage time and collateral circulation grading was analyzed. Finally, logistic regression analysis was used to explore the relationship between the three venous times and prognosis, and receiver operating characteristic (ROC) curves were plotted to assess the value of delayed cortical venous imaging in predicting prognosis. Results: 149 LVO-AIS and 73 normal controls were collected. VIT, VPT, and VOT were significantly delayed on the affected side in the patient group compared with the healthy side (p<0.05) and the controls (p<0.05); VIT and VPT were also significantly delayed on the healthy side of patients compared with the controls (p<0.05). Delayed VIT and VPT on the affected side in the patient group were more significant in patients with poor collateral circulation (p<0.05), and VIT and VPT on the affected side in the patient group were negatively correlated with arterial collateral scores. VIT and VPT were significantly delayed in both sides of patients in the poor prognosis group compared with the good prognosis group (p<0.05). logistic regression showed that patients' affected VPT, arterial collateral scores, and NIHSS were independent predictors of poor prognosis, with an accuracy of 79.6% in predicting poor prognosis. The affected VPT and NIHSS were independent predictors of poor prognosis for patients presenting within 24 hours, with an accuracy of 79.6% in predicting poor prognosis. Conclusion: Cortical venous flow was significantly slowed in both sides of LVO-AIS patients. delayed ipsilateral VPT in LVO-AIS patients can be used as an imaging indicator to determine poor collateral circulation and predict poor prognosis."

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