In major ischemic stroke caused by a large artery occlusion, neuronal loss varies considerably across individuals without revascularization. This study aims to identify which patient characteristics are most highly associated with this variability. Demographic and clinical information were retrospectively collected on a registry of 878 patients. Imaging biomarkers including Alberta Stroke Program Early CT score, noncontrast head computed tomography infarct volume, perfusion computed tomography infarct core and penumbra, occlusion site, collateral score, and recanalization status were evaluated on the baseline and early follow-up computed tomography images. Infarct growth rates were calculated by dividing infarct volumes by the time elapsed between the computed tomography scan and the symptom onset. Collateral score was graded into four levels (0, 1, 2, and 3) in comparison with the normal side. Correlation of perfusion computed tomography and noncontrast head computed tomography infarct volumes and infarct growth rates were estimated with the nonparametric Spearman's rank correlation. Conditional inference trees were used to identify the clinical and imaging biomarkers that were most highly associated with the infarct growth rate and modified Rankin Scale at 90 days. Two hundred and thirty-two patients met the inclusion criteria for this study. The median infarct growth rates for perfusion computed tomography and noncontrast head computed tomography were 11.2 and 6.2 ml/log(min) in logarithmic model, and 18.9 and 10.4 ml/h in linear model, respectively. Noncontrast head computed tomography and perfusion computed tomography infarct volumes and infarct growth rates were significantly correlated (rho=0.53; P < 0.001). Collateral status was the strongest predictor for infarct growth rates. For collateral=0, the perfusion computed tomography and noncontrast head computed tomography infarct growth rate were 31.56 and 16.86 ml/log(min), respectively. Patients who had collateral >0 and penumbra volumes>92 ml had the lowest predicted perfusion computed tomography infarct growth rates (6.61 ml/log(min)). Collateral status was closely related to the diversity of infarct growth rates, poor collaterals were associated with a faster infarct growth rates and vice versa.

中文翻译：

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使用计算机断层摄影术评估大动脉闭塞的急性中风患者的梗塞生长影响因素，包括侧支状态。

在由大动脉闭塞引起的严重缺血性中风中，未经血运重建的个体之间神经元损失差异很大。这项研究旨在确定哪些患者特征与此变异性最相关。回顾性收集了878例患者的人口统计学和临床​​信息。在基线和早期计算机断层扫描图像上评估了包括阿尔伯塔省卒中计划早期CT评分，非对比头计算机断层扫描梗死体积，灌注计算机断层扫描梗死核心和半影，闭塞部位，侧支评分和再通状态的成像生物标志物。通过将梗塞体积除以计算机断层扫描和症状发作之间的时间来计算梗塞增长率。附带分数分为四个等级（0，1、2和3）与正常端相比。用非参数Spearman等级相关性估计灌注计算机断层扫描和非对比头计算机断层扫描的梗死体积和梗死增长率的相关性。使用条件推断树来鉴定与90天时梗死生长率和改良的Rankin量表最相关的临床和影像生物标志物。232名患者符合本研究的纳入标准。对数模型中，灌注计算机断层扫描和非对比头计算机断层扫描的中位梗塞生长率在对数模型中分别为11.2和6.2 ml / log（min），在线性模型中分别为18.9和10.4 ml / h。非对比头计算机断层扫描和灌注计算机断层扫描显着相关的梗死体积和梗死增长率（rho = 0.53； P <0.001）。抵押品状态是梗死增长率的最强预测指标。对于侧支= 0，灌注计算机断层扫描和非对比头计算机断层扫描梗塞生长率分别为31.56和16.86 ml / log（min）。侧支> 0且半影量> 92 ml的患者的预测灌注计算机断层扫描梗死增长率最低（6.61 ml / log（min））。抵押品状况与梗死增长率的多样性密切相关，不良抵押品与梗死增长率更快相关，反之亦然。灌注计算机断层扫描和非对比头计算机断层扫描的梗死增长率分别为31.56和16.86 ml / log（min）。侧支> 0且半影量> 92 ml的患者的预测灌注计算机断层扫描梗死增长率最低（6.61 ml / log（min））。抵押品状况与梗死增长率的多样性密切相关，不良抵押品与梗死增长率更快相关，反之亦然。灌注计算机断层扫描和非对比头计算机断层扫描的梗死增长率分别为31.56和16.86 ml / log（min）。侧支> 0且半影量> 92 ml的患者的预测灌注计算机断层扫描梗死增长率最低（6.61 ml / log（min））。抵押品状况与梗死增长率的多样性密切相关，不良抵押品与梗死增长率更快相关，反之亦然。