Combining Computed Tomography Angiography and Computed Tomography Perfusion for Evaluating Patients With Middle Cerebral Artery Stenosis and Acute Cerebral Infarction.

Objective: Investigate the correlation between MCA stenosis severity and CTP parameter changes in ACI patients.

Methods: Sixty unilateral MCA stenosis-induced ACI patients (6 h-7 d post-onset) underwent CTA+CTP. Patients were stratified by stenosis degree: mild (<50%), moderate (50%-69%), severe (≥70%). CTP parameters were compared across groups. Patients with 50% to 100% stenosis were further analyzed by collateral circulation status (scores 2-3: good; 0-1: poor). Differences in CTP parameters and 90-day mRS were evaluated.

Results: (1) Good collateral circulation (scores 2-3) was associated with higher CBF/CBV, prolonged TTP/MTT, and lower NIHSS/90-day mRS compared with poor circulation (scores 0-1). (2) Mild stenosis showed increased CBF/CBV in unaffected hemisphere. Moderate stenosis demonstrated reduced CBV and prolonged TTP/MTT in affected hemisphere. Severe stenosis exhibited increased CBF/CBV in unaffected hemisphere.

Conclusions: (1) CBV and CBF reduction positively correlated with stenosis severity. (2) Adequate collateral circulation was associated with reduced early neurological damage and disability.