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目的 探讨应用Faststroke软件生成的ColorViz融合图像对急性缺血性脑卒中（AIS）患者侧支循环状态的评估效能。方法 前瞻性纳入2023年2月—2024年7月我院收治的90例单侧大脑中动脉闭塞或重度狭窄的AIS患者，采集其影像学及临床数据。以数字减影血管造影（DSA）侧支评分为金标准，分别对单时相CT血管成像（sCTA）、多时相CT血管成像（mCTA）及ColorViz融合图进行侧支循环评分，采用Spearman秩相关分析比较三种方法评分与DSA评分的关联强度，并通过Steiger’s Z检验及加权Kappa系数评估相关系数差异及一致性。结果 ColorViz融合图、mCTA及sCTA与DSA侧支评分的Spearman相关系数分别为0.890、0.725和0.698(P均<0.001);Steiger’s Z检验显示，ColorViz融合图的相关系数显著高于mCTA(Z=3.412,P<0.001)及sCTA(Z=3.857,P<0.001)。加权Kappa系数显示，ColorViz融合图、mCTA及sCTA与DSA的一致性分别为κw=0.814(95%CI:0.742～0.886)、κw=0.652(95%CI:0.571～0.733)和κw=0.618(95%CI:0.529～0.707)。结论 相较于sCTA和mCTA，基于Faststroke软件的ColorViz融合图通过对对比剂充盈时序的显式彩色编码，与DSA评分呈现更优的相关性及一致性，能更精准、全面地反映前循环AIS患者的侧支循环代偿情况。
Abstract：Objective To investigate the efficacy of ColorViz fusion maps generated by Faststroke software for evaluating collateral circulation status in patients with acute ischemic stroke(AIS). Methods The clinical and imaging data of 90 patients,who were admitted to our hospital between February 2023 and July 2024 with unilateral middle cerebral artery occlusion or severe stenosis, were prospectively analyzed. Using the digital subtraction angiography(DSA) collateral grading as the reference standard,the collateral circulation was scored separately on single-phase CT angiography(sCTA), multiphase CTA(mCTA), and ColorViz fusion maps. Spearman's rank correlation analysis was used to compare the strength of association between each of the three methods and DSA grading. The differences between correlation coefficients and agreement levels were further evaluated using Steiger's Z test and weighted Kappa coefficients. Results Steiger's Z test demonstrated that the Spearman correlation coefficient of ColorViz(0.890)with DSA collateral grading was significantly higher than that of mCTA(0.725; Z=3.412, P<0.001)and that of sCTA(0.698; Z=3.857, P<0.001). The weighted Kappa coefficients for ColorViz versus DSA(0.814, 95%CI:0.742-0.886)were also higher than that of mCTA(0.652, 95% CI:0.571-0.733) and sCTA(0.618, 95% CI:0.529-0.707). Conclusion The Faststroke based ColorViz fusion map with time variant color encoding of contrast arrival timing has better correlation and agreement with DSA than sCTA and mCTA. It allows more accurate and comprehensive assessment of collateral compensatory status in anterior circulation AIS.
[1]《中国脑卒中防治报告2021》编写组.《中国脑卒中防治报告2021》概要[J].中国脑血管病杂志, 2023,20(11):783-792,封3.
[2]García-Tornel A, Carvalho V, Boned S, et al. Improving the evaluation of collateral circulation by multiphase computed tomography angiography in acute stroke patients treated with endovascular reperfusion therapies[J]. Interv Neurol , 2016 , 5(3-4):209-217.
[3]Ribo M, Flores A, Rubiera M, et al. Extending the time window for endovascular procedures according to collateral pial circulation[J]. Stroke, 2011,42(12):3465-3469.
[4]满术千,李旭丹,梁峰,等.大脑中动脉M1段闭塞后侧支循环状态与DWI-ASPECTS相关性研究[J].影像诊断与介入放射学, 2023,32(4):268-272.
[5]王市伟,赵霞,朱继兰,等. HR-VWI联合DWI-ASPECTS预测急性缺血性脑卒中短期预后的价值[J].影像诊断与介入放射学, 2023,32(3):194-200.
[6]Ospel J M, Volny O, Qiu W, et al. Displaying multiphase CT angiography using a time-variant color map:practical considerations and potential applications in patients with acute stroke[J]. Am J Neuroradiol, 2020,41(2):200-205.
[7]Ospel J M, Cimflova P, Volny O, et al. Utility of time-variant multiphase CTA color maps in outcome prediction for acute ischemic stroke due to anterior circulation large vessel occlusion[J]. Clin Neuroradiol, 2021,31(3):783-790.
[8]Menon B K, d’Esterre C D, Qazi E M, et al. Multiphase CT angiography:a new tool for the imaging triage of patients with acute ischemic stroke[J]. Radiology, 2015,275(2):510-520.
[9]王振华,马耀兴,王爱军,等. ColorViz融合图在急性缺血性脑卒中侧支循环评价中的应用[J].中国医学影像学杂志,2022,30(11):1095-1101.
[10]Lau A Y, Wong E H, Wong A, et al. Significance of good collateral compensation in symptomatic intracranial atherosclerosis[J]. Cerebrovasc Dis, 2012,33(6):517-524.
[11]李光硕,赵性泉.《中国急性缺血性卒中诊治指南2023》解读[J].中国卒中杂志, 2024,19(8):956-961.
[12]Nogueira R G, Jadhav A P, Haussen D C, et al. Thrombectomy6 to 24 hours after stroke with a mismatch between deficit and infarct[J]. N Engl J Med, 2018,378(1):11-21.
[13]Albers G W, Marks MP , Kemp S, et al. Thrombectomy for stroke at 6 to 16 hours with selection by perfusion imaging[J].N Engl J Med, 2018,378(8):708-718.
[14]李晗,胡春洪,郝光宇,等.基于FastStroke软件评估的急性缺血性脑卒中侧支循环与数字减影血管造影的对照研究[J].实用放射学杂志, 2021,37(5):695-698.
[15]陈莉. ColorViz mCTA在急性缺血性脑卒中的应用价值[J].临床医学进展, 2024,14(9):820-829.
[16]王强,许允发,李雪,等.多期CTA重建ColorViz融合图血管分级在急性缺血性脑卒中患者中的临床研究[J].中国临床医学影像杂志, 2024,35(6):381-385.
[17]关芬,王少帅,李常新. ColorViz在急性缺血性卒中患者侧支循环评价中的应用[J].国际脑血管病杂志, 2023,31(9):688-693.
[18]Maier I L, Scalzo F, Leyhe J R, et al. Validation of collateral scoring on flat-detector multiphase CT angiography in patients with acute ischemic stroke[J]. PLoS One, 2018,13(8):e0202592.
[19]Verdolotti T, Pilato F, Cottonaro S, et al. ColorViz, a new and rapid tool for assessing collateral circulation during stroke[J].Brain Sci, 2020,10(11):882.
[20]Liu H, Zhang J, Chen S, et al. Deep learning-based collateral scoring on multiphase CTA in patients with acute ischemic stroke in the MCA region[J]. Am J Neuroradiol, 2026,47(1):80-90.
基本信息:
中图分类号:R743.3
引用信息:
[1]唐亭,夏万泓,李姗,等.ColorViz融合图评估急性缺血性脑卒中侧支循环的价值[J].影像诊断与介入放射学,2026,35(04):291-296.
基金信息:
成都市卫健委医学科研课题立项项目（2022551）
2026-08-25
2026-08-25