Correlation of infarct volume and hemorrhagic transformation in the acute ischemic group based on how miserable regional pial toilet paper assessment uan xing yan jiu

Abstract

Objective To explore the correlation and application value of regional leptomeningeal collateral assessment (rLMC) based on multi-mode CT with infarct volume and hemorrhagic transformation in acute ischemic stroke. Methods A retrospective analysis was performed on patients with acute large vessel occlusion ischemic stroke whose first onset was ≤6 hours in this hospital from October 2019 to October 2020. Brain CT was used to exclude hemorrhagic lesions and was divided into 2 regions using rLMC classification. : Anterior cerebral artery (ACA)-middle cerebral artery (MCA) area and posterior cerebral artery (PCA)-MCA area. Leptomeningeal artery grading uses a 6-point scale, and the CTA collateral score is the total score of the two regions (0 to 10 points). Within 3 days of admission, a DWI sequence was added to the conventional cranial MR sequence to determine the infarct volume and whether it was complicated by hemorrhagic transformation. Routine CT should be reviewed 10 to 14 days after admission or when the patient's condition worsens to see if there is hemorrhagic transformation. Results Compared with family history of stroke, coronary heart disease history, NIHSS score on admission, and fasting blood glucose between different rLMC grading and scoring groups, the differences were statistically significant (P<0.05). There was a significant negative correlation between rLMC grading score and cerebral infarction volume (γ=-0.735, P<0.001). There were statistically significant differences in infarct volume, incidence of symptomatic intracranial hemorrhage (sICH), and incidence of intracranial high-density lesions (PCHDs) between different rLMC grading and scoring groups (P<0.05). Multivariate logistic regression analysis showed that family history of stroke, blood sugar, and NIHSS score on admission were influencing factors of leptomeningeal collateral circulation. Conclusion rLMC is significantly negatively correlated with infarct volume and hemorrhagic transformation in acute ischemic stroke, and can effectively reflect the progression and severity of acute ischemic stroke. [International Journal of Neurology Neurosurgery, 2021, 48(6):521-525.]