Anterior Borderzone Angle for Hemodynamic Collateral Metric in Patients with Symptomatic Middle Cerebral Artery Stenosis

作者：Li, Yongkun; Xiong, Yunyun; Cai, Qiankun; Liu, Dezhi; Dai, Qiliang; Liu, Wenhua; Huang, Zhixin; Sun, Wen; Liebeskind, David S.; Wang, Yinzhou^*; Liu, Xinfeng^*

来源：European Neurology, 2018, 79(1-2): 45-53.

DOI：10.1159/000484313

• Intracranial atherosclerotic diseases
• Middle cerebral artery stenosis
• Collateral circulation
• Leptomeningeal anastomosis
• Anterior borderzone angle

Background and Aims: We aimed to introduce a parameter of anterior borderzone angle (ABZA) to quantitatively evaluate the ACA-MCA leptomeningeal collaterals for middle cerebral artery stenosis (MCAS). Methods: Two hundred seventy-five patients with 50-100% MCAS and 100 controls were included. The 95% reference range of ABZA was obtained from the controls. ABZA(trans) was defined as "ABZA/the 95% upper limit." Relationships between ABZA and MCAS, ABZA(trans) and the TICI grade, the American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) collateral grade were analyzed. An ABZA grade model for the ACA leptomeningeal collaterals was tentatively developed. Results: The 95% reference range of ABZA was 0.0 degrees-23.0 degrees. ABZA was significantly associated with MCAS by a function of the fourth power (R-2 = 0.723, p < 0.001), and could predict hemodynamic MCAS (>= 70%) with an AUC of 0.928 (95% CI 0.903-0.953). ABZA(trans) was negatively correlated with the TICI grade (rho = -0.752, p < 0.001) and positively with the ASITN/SIR grade (rho = 0.921, p < 0.001). The ABZA grade was created by rounding ABZA(trans) to a nearest integer, and was closely associated with the ASITN/SIR grade (rho = 0.894, p < 0.001). Conclusions: ABZA can be used as a hemodynamic parameter to quantitatively evaluate ACA leptomeningeal collaterals.

• 出版日期2018
• 单位广东省第二人民医院; 华中科技大学; 福建省立医院; 福建医科大学; 南京大学