Article Figures & Data
Figures
- FIG 1.
Illustrative case of good collaterals. MR imaging of a patient around 60 years of age obtained 108 minutes after stroke onset. Hyperintense lesions in the left MCA territory on admission DWI (A) and FVH on admission FLAIR (B), with FVHASPECTS of 5 and FVH-DWI mismatchASPECTS of 4. Grade 4 collaterals on early phase (C), mid phase (D), and late phase (E) of collateral flow maps (subtracted dynamic susceptibility contrast perfusion imaging). Note complete and rapid (from mid phase) collateral blood flow to the vascular bed in the entire ischemic territory by retrograde perfusion.
- FIG 2.
Illustrative case of poor collaterals. MR imaging of a patient around 70 years of age obtained 83 minutes after stroke onset. Hyperintense lesions in the left MCA territory on admission DWI (A) and FVH on admission FLAIR (B), with FVHASPECTS of 6 and FVH-DWI mismatchASPECTS of 1. Grade 2 collaterals on early phase (C), mid phase (D), and late phase (E) of collateral flow maps (subtracted dynamic susceptibility contrast perfusion imaging). Note rapid collaterals to the periphery of ischemic site with persistence of some of the defect (arrowheads).
- FIG 3.
ROC curves of FVH-DWI mismatchASPECTS (blue) and FVHASPECTS (red) to predict good (grades 3–4) collaterals. The area under the ROC curve was higher for FVH-DWI mismatchASPECTS (0.80; 95% CI, 0.74–0.87) than for FVHASPECTS (0.52; 95% CI, 0.44–0.60), P < .001 for comparison.
Tables
Baseline characteristics of the population and univariate relationships with collateral gradea
Whole Cohort (n = 209) Good Collaterals (Grades 3 and 4) (n = 133) Poor Collaterals (Grades 1 and 2) (n = 76) P Value Patient characteristics Age (yr) 72 (61–80) 72 (61–81) 71 (60–80) .39 Men 118 (56) 73 (55) 45 (59) .54 Hypertension 118 (56) 80 (60) 38 (50) .16 Diabetes mellitus 32 (15) 23 (17) 9 (12) .29 Current smoking 26 (12) 15 (11) 11 (14) .50 Pre-IVT characteristics NIHSS score 16 (9–19.5) 14 (7–18) 17 (14–21) <.001 Onset-to-IVT time (min) 160 (130–193.5) 158 (127–195) 161 (135–186) .67 Pre-IVT MRI Onset-to-MRI time (min) 123 (96–154) 122 (94–159) 124 (101–154) .74 Occlusion site .26 ICA-T/L 36 (17) 22 (17) 14 (18) M1 124 (60) 75 (56) 49 (65) M2 49 (23) 36 (27) 13 (17) DWI volume (mL) 12 (5–25) 8 (2–13) 33 (16–54) <.001 PWI volumes (mL) Tmax > 4 s 133 (83–187) 119 (70–168) 176 (114–209) <.001 Tmax > 6 s 83 (44–127) 64 (35–108) 119 (71–166) <.001 Tmax > 10 s 31 (13–63) 18 (8–44) 61 (34–95) <.001 HIR 0.43 (0.30–0.53) 0.36 (0.22–0.45) 0.53 (0.46–0.62) <.001 PWI-DWI mismatch profile 186 (91%) 127 (96%) 59 (81%) <.001 Mismatch ratio 5.6 (3.0–11.1) 8.2 (4.4–18.7) 3.2 (2.0–5.0) .001 FVH-DWI mismatchASPECTS 3 (2–5) 4 (3–5) 2 (0–2.75) <.001 FVHASPECTS 5 (4–5) 5 (4–5.5) 5 (4–5) .76 Note:—HIR indicates Tmax > 10-second/Tmax > 6-second volume; ICA-T/L, ICA T or L occlusion; Mismatch ratio, Tmax > 6-second volume/DWI volume; PWI-DWI mismatch profile, Tmax > 6-second volume >1.8 × DWI volume.
↵a Categoric variables are expressed as number (%), and continuous variables, as median (IQR). Four patients had missing PWI volume data (1 patient with good collaterals and 3 patients with poor collaterals).
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