Objective To explore the application value of whole-brain computed tomographic perfusion (CTP) imaging in the assessment of collateral circulation status in acute ischemic stroke.

Method Clinical data were retrospectively collected from 92 patients with acute ischemic stroke, admitted to the Suqian First People’s Hospital between January 2021 and December 2023. All patients underwent whole-brain CTP examination within 12 h after symptom onset. The patients were divided into two groups based on their collateral circulation status: poor collateral circulation group (n=43) and good collateral circulation group (n=49). Emphasis was placed on the role of CTP in evaluating collateral circulation status in patients with acute ischemic stroke.

Results The time from onset to hospitalization in the poor collateral circulation group was longer than that in the good collateral circulation group, and the proportion of patients with hypertension and hyperlipidemia in the poor collateral circulation group was higher than that in the good collateral circulation group. In addition, among CTP parameters, cerebral blood volume (CBV) and cerebral blood flow (CBF) in the infarcted area of the poor collateral circulation group were lower than those in the good collateral circulation group, and the mean transit time (MTT) was longer than that in the good collateral circulation group. Multivariate logistic regression analysis showed that CBV, CBF, and MTT are all factors influencing collateral circulation status in patients with acute ischemic stroke. Receiver operating characteristic (ROC) curves were drawn, and the results showed that the area under the curve (AUC) values of CBV, CBF, and MTT in evaluating the collateral circulation status of patients with acute ischemic stroke were all greater than 0.7, which had a certain evaluation value. The AUC of the combined evaluation was higher at 0.961.

Conclusion The whole-brain CTP parameters CBV, CBF, and MTT are related to the collateral circulation status in acute ischemic stroke and can be used as effective imaging examination tools for the clinical evaluation of collateral circulation status.