Multiphase CT angiography collateral score in acute stroke
Citation, DOI & article data
Multiphase CT angiography (mCTA) collateral score is a simple scoring system that allows quick evaluation of collateral vessel filling delay in acute ischemic stroke. In some studies, it has been shown to be a better predictor of clinical outcomes and eligibility for endovascular therapy (ECT) than a decision based on single-phase CT angiography 1.
mCTA collateral score
A score on a scale of 0 to 5 is given, with 5 being the best and 0 the worst 2:
- 5: no filling delay compared to the asymptomatic contralateral hemisphere, normal pial vessels in the affected hemisphere
- 4: a filling delay of one phase in the affected hemisphere, but the extent and prominence of pial vessels is the same
- 3: a filling delay of two phases in the affected hemisphere, or a delay of one phase with a significantly reduced number of vessels in the ischemic territory
- 2: a filling delay of two phases in the affected hemisphere with a significantly reduced number of vessels in the ischemic territory, or one phase delay showing regions without visible vessels
- 1: only a few vessels are visible in the affected hemisphere in any phase
- 0: no vessels visible in the affected hemisphere in any phase
Generally, a score of 3 or less indicates a poor prognosis 1. Therefore, some investigators have dichotomized the scores such that 0-3 is "poor" and 4-5 is "good" collateral status 2.
- 1. Alvaro García-Tornel, Vanessa Carvalho, Sandra Boned, Alan Flores, David Rodríguez-Luna, Jorge Pagola, Marian Muchada, Estela Sanjuan, Pilar Coscojuela, Jesus Juega, Noelia Rodriguez-Villatoro, Bijoy Menon, Mayank Goyal, Marc Ribó, Alejandro Tomasello, Carlos A. Molina, Marta Rubiera. Improving the Evaluation of Collateral Circulation by Multiphase Computed Tomography Angiography in Acute Stroke Patients Treated with Endovascular Reperfusion Therapies. (2018) Interventional Neurology. 5 (3-4): 209. doi:10.1159/000448525 - Pubmed
- 2. Menon BK, d'Esterre CD, Qazi EM, Almekhlafi M, Hahn L, Demchuk AM, Goyal M. Multiphase CT Angiography: A New Tool for the Imaging Triage of Patients with Acute Ischemic Stroke. Radiology. 2015 May;275(2):510-20. doi:10.1148/radiol.15142256
- 3. García-Tornel A, Carvalho V, Boned S, Flores A, Rodríguez-Luna D, Pagola J, Muchada M, Sanjuan E, Coscojuela P, Juega J, Rodriguez-Villatoro N, Menon B, Goyal M, Ribó M, Tomasello A, Molina CA, Rubiera M. Improving the Evaluation of Collateral Circulation by Multiphase Computed Tomography Angiography in Acute Stroke Patients Treated with Endovascular Reperfusion Therapies. (2016) Interventional neurology. 5 (3-4): 209-217. doi:10.1159/000448525 - Pubmed