Multiphase CT angiography collateral score in acute stroke
Multiphase CT angiography (mCTA) collateral score is a simple scoring system that allows quick evaluation of collateral filling delay in acute ischemic stroke, and a better predictor of clinical outcome and eligibility for endovascular therapy than a decision based on single phase CT angiography1.
mCTA collateral score 2
A score on a scale of 0 to 5 is given, with 5 being the mildest and 0 the most severe:
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 below indicates a poor prognosis 1.
- 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