• Hui Chen, Bing Wu, Nan Liu, Max Wintermark, Zihua Su, Ying Li, Jun Hu, Yongwei Zhang, Weiwei Zhang, and Guangming Zhu.
• From the Third Military Medical University, Chongqing, China (H.C.); Departments of Neurology (H.C., N.L., Y.L., W.Z., G.Z.) and Radiology (B.W.), Military General Hospital of Beijing PLA, Beijing, China; Department of Radiology, Neuroradiology Section, Stanford University, CA (M.W.); GE Healthcare, Beijing, China (Z.S.); Department of Neurology, Southwest Hospital, Third Military Medical University, Chongqing, China (J.H.); and Department of Neurology, Changhai Hospital, Second Military Medical University, Shanghai, China (Y.Z.).
• Stroke. 2015 Apr 1;46(4):961-7.

Background And PurposeThe study aims to determine whether volume transfer constant (K(trans)) maps calculated from first-pass perfusion computed tomographic data are a biomarker of cerebral collateral circulation and predict the clinical outcome in acute ischemic stroke caused by proximal arterial occlusion.MethodsConsecutive patients with acute occlusion of the middle cerebral artery who received endovascular treatment were enrolled. Digital subtraction angiography, computed tomographic angiography with maximum intensity projection, and K(trans) maps were used to assess their collateral circulation. Agreement between different methods was evaluated using the χ(2) tests. The correlations of various radiological and clinical outcomes with the collateral flow score, as determined from K(trans) maps, were calculated.ResultsSeventy-five patients were included, comprising 39 women and 36 men, with a mean age of 65.3±14.6 years. Collateral flow score on K(trans) maps had the highest correlation with digital subtraction angiography (κ=0.8101; P=0.9796). Twenty-five patients had poor collateral circulation on K(trans) maps, 25 had intermediate collateral flow, 20 had good collateral flow, and 5 had excellent collateral flow. Better collateral circulation was associated with better clinical outcome (P<0.0001).ConclusionsK(trans) maps extracted from standard first-pass perfusion computed tomography are correlated with collateral circulation status after acute proximal arterial occlusion and predictive of outcome.© 2015 American Heart Association, Inc.

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