Collateral vessels on magnetic resonance angiography in endovascular-treated acute ischemic stroke patients associated with clinical outcomes

Abstract

Results: Of 55 patients, Cases with insufficient collateral circulation at the Sylvian fissure and leptomeningeal convexity showed that the NIHSS score at arrival and preoperative infarct volume were significantly lower in mRS score of 0-2 (both P < 0.05) than mRS score of 3-6. Multivariate testing revealed age and collateral status at the leptomeningeal convexity were independent of the clinical outcome at 3 months after stroke (odds ratio (95% confidence interval): 1.094 (1.025-1.168); 9.542 (1.812-50.245) respectively). The change of infarct volume in the group with mRS score of 0-2 was smaller than that with mRS score of 3-6. While multivariate logistic models showed that postoperative infarct volume was non-significant in predicting the clinical outcome after stroke.Conclusions: The extent of collateral circulation at the leptomeningeal convexity may be useful for predicting the functional recovery while the relationship between postoperative infarct volume and clinical outcome still requires for further study.

Automatic segmentation, feature extraction and comparison of healthy and stroke cerebral vasculature

“…Using this algorithm, we performed a comparative study of the vascular geometry in stroke patients and healthy subjects to quantify the structural changes in the cerebral vasculature induced by ischemic stroke, which is the largest contributor to death and disability due to cerebrovascular disease. Performing a three-factor ANOVA test, we expected to find the average diameter, volume and total length in stroke patients to be smaller due to a major vessel being occluded with a higher tortuosity and fractality since these have been shown to be indicators of vascular pathology ( Gutierrez et al, 2015 , Kim et al, 2015 , Jiang et al, 2017 ). We also hypothesized that the number of branches would be smaller in the stroke data due to vessel occlusion but there is also contradictory information in literature regarding this as the vasculature tends to sprout additional smaller branches to compensate for the stroke ( Liu et al, 2014 , Shuaib et al, 2011 ).…”

“…We compared each extracted feature between the two groups using a paired t-test and ANOVA. We expected to find the average diameter, volume and total length in stroke patients to be smaller due to a major vessel being occluded with a higher tortuosity and fractality since these have been shown to be indicators of vascular pathology (6,9,58). We also hypothesized that the number of branches would be lesser in the stroke data due to vessel occlusion but there is also contradictory information in literature regarding this as the vasculature tends to sprout additional smaller branches to compensate for the stroke (11,59).…”

MR Angiography in Assessment of Collaterals in Patients with Acute Ischemic Stroke: A Comparative Analysis with Digital Subtraction Angiography

“…In fact, several scoring systems for the determination of collaterals have been developed on CTA, including the Tan score [ 14 ], Maas score [ 15 ], and a regional leptomeningeal score [ 3 ]. Assessment of collaterals by MRA has been limited to a handful of studies [ 16 , 17 , 18 , 19 ] due to the limited use of pretreatment MRIs in stroke patients. However, with extension of the treatment window of acute ischemic stroke to 24 h and with the increased value of MRI in this group of patients [ 20 , 21 ], more pretreatment MRI/MRA will be performed.…”

MRI investigation of vascular remodeling for heterogeneous edema lesions in subacute ischemic stroke rat models: Correspondence between cerebral vessel structure and function

“…As an investigation of vascular alterations after ischemic stroke, MR angiography (MRA) has shown morphological macrovascular remodeling at the brain surface region after ischemic stroke. [20][21][22] Microvascular remodeling in the inner brain region can be visualized by morphological mapping of the vessel size index (VSI) and microvessel density (MVD and Q), overcoming the spatial resolution limitation of MRA. [23][24][25][26][27][28] Dynamic susceptibility contrast MRI (DSC-MRI) can be used to estimate functional microvascular status, such as the cerebral blood volume (CBV), cerebral blood flow (CBF), and mean transit time (MTT) in lesions.…”