NEURORADIOLOGYAssessment of Cerebral Collateral Flow With Single-Phase Computed Tomography Angiography–Based Multimodal Scales in Patients With Acute Ischemic StrokeHe, Haoran MD∗; Qian, Zhong-Ming MD, PhD†; Sheng, Yuan PhD†; Liu, Yong MD, PhD∗Author Information From the ∗Department of Pain and Rehabilitation, The Second Affiliated (Xinqiao) Hospital, The Army (Third Military) Medical University, Chongqing †Institute of Translational & Precision Medicine, Nantong University, Nantong, China. Received for publication December 2, 2019; accepted March 8, 2020. Correspondence to: Zhong-Ming Qian, Institute of Translational & Precision Medicine, Nantong University, 5th Floor, Building No. 1, 19 Qi Xiu Road, Nantong, Jiangsu, China 226019 (e-mail: [email protected]); Yong Liu, Department of Pain and Rehabilitation, The Second Affiliated (Xinqiao) Hospital, The Army (Third Military) Medical University, 83 Xinqiao Street, Chongqing, China 400037 (e-mail: [email protected]). This study was supported by the Natural Science Foundation of China (81471108, 31571195). The authors declare no conflict of interest. Informed consent was obtained from all participants with approval from the Medical Ethics Committee of Xinqiao Hospital and conducted in accordance with the Declaration of Helsinki. ClinicalTrials.gov identifier: NCT02135783 (May 7, 2014). Authors' Contributions: Y.L. and Z.-M.Q. organized and supervised the study; H.H. and Y.S. performed data collection; Y.L. contributed to the analysis of data and double checking. H.H. prepared all figures. Y.L. and Z.-M.Q. prepared, wrote, and revised the manuscript. Journal of Computer Assisted Tomography: 9/10 2020 - Volume 44 - Issue 5 - p 708-713 doi: 10.1097/RCT.0000000000001030 Buy Metrics Abstract Objective Assessing collateral status is important in acute ischemic stroke (AIS). The purpose of this study was to establish an easy and rapid method for evaluating collateral flow. Methods A total of 60 patients with AIS were enrolled. The patients were aged 18 to 85 years with endovascular therapy treatment within 10 hours after the appearance of stroke symptoms, prestroke modified Rankin Scale ≤1, Alberta Stroke Program Early CT Score ≥6, and the occlusion of large vessels in anterior circulation. We reformed imaging strategies by conducting a small-dose group-injection test before normal computed tomography angiography (CTA) scanning and selected the visual collateral score and the regional leptomeningeal score scales as the single-phase CTA collateral flow assessment scales with the replacement of the parasagittal anterior cerebral artery territory by anterior cerebral artery regions adjacent to the longitudinal fissure and then verified, respectively, the consistencies between the 2 single-phase CTA-based collateral scales and the digital subtraction angiography (DSA)–based American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology scale and compared the prognosis of endovascular therapy between the AIS patients in the poor-collateral-flow group and the other patients' group assessed by 2 single-phase CTA-based collateral scales. Results There was a high consistency between the 2 single-phase CTA-based collateral flow scales with DSA-based American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology scale. The assessment by using CTA-based collateral flow assessment methods generated consistent results. Conclusion The single-phase CTA-based visual collateral score scale and regional leptomeningeal score scale can be used as the imaging evidence for the evaluation of collateral flow in AIS patients in the majority of grassroots hospitals where DSA is difficult to carry out. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.