ArticleQuantitative imaging in medicine and surgery2026
The value of multiphase CT angiography in predicting hemorrhagic transformation after endovascular treatment: the arterial collaterals and venous drainage.
Article in Quantitative imaging in medicine and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Hemorrhagic transformation (HT) is a common and severe complication after endovascular treatment (EVT), especially the symptomatic intracerebral hemorrhage (sICH). This study aimed to explore the quantitative diagnostic value of multiphase computed tomography (CT) angiography (mCTA) in predicting HT and sICH in patients with anterior circulation acute ischemic stroke (AIS) after EVT. Methods: We retrospectively collected data of patients with anterior circulation AIS from Tianjin Huanhu Hospital from April 2020 to December 2023. We assessed the arterial collateral circulation (ACC), superficial venous drainage scores (SVS), and deep venous drainage scores (DVS) based on mCTA. SVS1, SVS2, and SVS3, as well as DVS1, DVS2, and DVS3, represented SVS and DVS in the arterial, venous, and late venous phases, respectively. Patients were divided into HT and non-HT groups based on the presence of an intracranial hemorrhage on a follow-up non-contrast CT. We conducted a subgroup analysis of HT patients, dividing them into sICH and asymptomatic intracerebral hemorrhage (aICH) subgroups. We analyzed and compared the clinical variables, ACC, SVS, and DVS in the non-HT and HT groups, as well as in the sICH and aICH subgroups. Multiparameter predictive models of HT and sICH were established using ACC (Model-HT1 and Model-sICH1), SVS and DVS (Model-HT2 and Model-sICH2), and comprehensive parameters (Model-HT3 and Model-sICH3). The performance of predictive models was evaluated and compared using the receiver operating characteristic (ROC) curve and the Delong test. Results: Finally, 127 patients were included, and 46 developed HT. The HT group had a higher ratio of poor ACC than the non-HT group (97.83% Conclusions: The ACC, SVS, and DVS based on mCTA were valuable for predicting the risk of HT and sICH after EVT, the combination of multiple parameters can improve the predictive efficacy.
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