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Published in: Neuroradiology 1/2019

01-01-2019 | Diagnostic Neuroradiology

Single-phase CT angiography: collateral grade is independent of scan weighting

Authors: Daniel-Alexandre Bisson, David Mahmoudian, Anwar S. Shatil, Ghouth Waggass, Liying Zhang, Christopher Levi, Neil J. Spratt, Longting Lin, David Liebeskind, Mark Parsons, Andrew Bivard, Richard I. Aviv

Published in: Neuroradiology | Issue 1/2019

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Abstract

Purpose

Collateral grading may vary on single-phase CTA (sCTA) depending on whether the CTA is arterial (A), arteriovenous (AV), or venous (V) weighted. We studied the impact of sCTA weighting on collateral grading using the Tan, MAAS, and Menon methods, and their ability to predict infarct and clinical outcome hypothesizing that AV-weighted sCTA should better predict these outcomes.

Methods

Multicenter retrospective analysis of 212 patients undergoing baseline CTP/sCTA. sCTA weighting was determined by comparing ICA to torcula AV ratios with those from concomitant CTP time-density curves at peak arterial or venous contrast attenuation. A generalized linear mixed model investigated the predictive value for infarct volume or 90-day mRS of the three collateral scores stratified by sCTA weighting and adjusting for age, sex, clot burden score (CBS), and NIHSS. Bayesian information criterion (BIC) differences were calculated between the null and fitted models.

Results

Mean age, baseline median NIHSS, ASPECTS, and onset to treatment time were 69.89 ± 14.45, 13 (6–18), 10 (8–10), and 128 (66–181) minutes. sCTA scans were AV-weighted in 137/212 (65%) and A-weighted in 73 (34%). No association was demonstrated between sCTA weighting, hospital site, and sCTA technique. All collateral scores were related to infarct volume irrespective of sCTA weighting, with greatest fit with the regional leptomeningeal score (BIC 18.29, p = 0.0001). No association was shown between sCTA weighting, collateral grade, and clinical outcome.

Conclusion

sCTA weighting did not significantly impact collateral grade using three common collateral scores or their ability to predict final infarct.
Appendix
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Metadata
Title
Single-phase CT angiography: collateral grade is independent of scan weighting
Authors
Daniel-Alexandre Bisson
David Mahmoudian
Anwar S. Shatil
Ghouth Waggass
Liying Zhang
Christopher Levi
Neil J. Spratt
Longting Lin
David Liebeskind
Mark Parsons
Andrew Bivard
Richard I. Aviv
Publication date
01-01-2019
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 1/2019
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-018-2105-2

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