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Clinical Article
Application value of TWIST technique in evaluating collateral circulation in acute ischemic stroke
WANG Siyu  AI Zhongping  WU Qianqian  JIANG Hailong  JIANG Liang  CHEN Guozhong  YIN Xindao 

Cite this article as: Wang SY, Ai ZP, Wu QQ, et al. Application value of TWIST technique in evaluating collateral circulation in acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2022, 13(5): 11-16. DOI:10.12015/issn.1674-8034.2022.05.003.

[Abstract] Objective To evaluate the value of time-resolved with interleaved stochastic trajectories (TWIST) technology in the evaluation of collateral circulation in acute ischemic stroke.Materials and Methods The general clinical data of 28 patients with acute ischemic stroke treated in the Department of Neurology of Nanjing First Hospital from August 2020 to August 2021 were analyzed retrospectively. All patients underwent TWIST, perfusion weighted imaging and digital subtraction angiography (DSA). The collateral circulation classification of DSA and TWIST images refer to the classification system of American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR) and the modified ASITN/SIR score scale, respectively. Kappa coefficient was used to analyze the consistency of collateral circulation classification among different observers. χ2 test was used to analyze the inter group differences of collateral circulation classification results of TWIST and DSA images. The patients were divided into abundant collateral circulation group and insufficient collateral circulation group according to the collateral circulation classification of TWIST images, ASITN/SIR score 3-4 indicates abundant collateral circulation and score 0-2 indicates insufficient collateral circulation. The clinical data and hypoperfusion intensity ratio (HIR) of the two groups were compared. Spearman rank correlation coefficient was used to analyze the correlation between HIR and collateral circulation classification of TWIST images.Results The collateral circulation scores of TWIST (Kappa=0.826) and DSA (Kappa=0.856) images were both highly consistent among different observers. There was no significant difference in collateral circulation classification between TWIST and DSA images (χ2=0.865, P=0.929). The HIR in the abundant collateral circulation group (15 cases) was lower than that in the insufficient collateral circulation group (13 cases) (0.30±0.08 vs. 0.43±0.06, t=-5.156, P<0.001). Correlation analysis showed that HIR was negatively correlated with the classification of collateral circulation in TWIST images (r=-0.882, P<0.001).Conclusions Magnetic resonance TWIST can noninvasive evaluate collateral circulation of acute ischemic stroke. It has high value in collateral circulation diagnosis and can be used in clinic.
[Keywords] acute ischemic stroke;magnetic resonance imaging;time-resolved angiography with interleaved stochastic trajectories;collateral circulation;hypoperfusion intensity ratio

WANG Siyu1   AI Zhongping1   WU Qianqian2   JIANG Hailong1   JIANG Liang1   CHEN Guozhong1   YIN Xindao1*  

1 Department of Radiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

2 Clinical Medical Engineering Office, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China

YIN XD, E-mail:

Conflicts of interest   None.

Received  2021-10-27
Accepted  2022-04-29
DOI: 10.12015/issn.1674-8034.2022.05.003
Cite this article as: Wang SY, Ai ZP, Wu QQ, et al. Application value of TWIST technique in evaluating collateral circulation in acute ischemic stroke[J]. Chin J Magn Reson Imaging, 2022, 13(5): 11-16.DOI:10.12015/issn.1674-8034.2022.05.003

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