The value of transcranial Doppler sonography and digital subtraction angiography in evaluating collateral circulation in ischemic stroke and its correlation with prognosis / 中国医师进修杂志

ABSTRACT

Objective:To explore the value of transcranial Doppler sonography (TCD) and digital subtraction angiography (DSA) in evaluating collateral circulation in ischemic stroke (IS) and its correlation with prognosis.Methods:The 350 IS patients admitted to Shaoxing People′s Hospital from January 2017 to December 2020 were selected as the research objects. According to the results of DSA, they were divided into collateral circulation group and non-collateral circulation group. According to the prognosis, they were divided into good prognosis group and poor prognosis group. The consistency between the evaluation results of collateral circulation on IS of TCD and DSA was analyzed, and its correlation with prognosis was analyzed.Results:The DSA results showed that among 350 patients, 118 had no collateral circulation and 232 had collateral circulation, including 130 cases of grade 1 collateral circulation and 102 cases of grade 2 collateral circulation. TCD results showed that there were 117 cases without collateral circulation and 233 cases with collateral circulation, including 131 cases with grade 1 collateral circulation and 102 cases with grade 2 collateral circulation. The consistency test showed that the evaluation results of TCD on collateral circulation was highly consistent with the gold standard DSA ( Kappa>0.9, P<0.05). Repeated measures analysis of variance showed that time-point effects, inter-group effects, time-point and inter-group interaction effects can significantly affect the changes in modified Rankin scale(mRS) scores ( P<0.05); and the mRS scores in the collateral circulation group were less than those in the non-collateral circulation group at admission the hospital, discharge of the hospital and 3 months after discharge the hospital: (1.89 ± 0.82) scores vs. (2.98 ± 0.98) scores, (1.13 ± 0.53) scores vs. (2.45 ± 0.80) scores, (0.50 ± 0.45) scores vs. (1.86 ± 0.80) scores, there were statistical differences ( P<0.05). The collateral circulation rate in the good prognosis group was higher than that in the poor prognosis group: 78.95%(150/190) vs. 47.50%(76/160), there was statistical difference ( P<0.05). Conclusions:The evaluation value of TCD for IS collateral circulation is high, and collateral circulation is closely related to prognosis.