Academic radiology · 2026
Dual-Energy Computed Tomography Angiography Derived Lenticulostriate Arteries Morphology in Acute Branch Atheromatous Disease-Related Stroke: A Case-Control Study.
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Yin Yangyang, Wang Baoyi, Zhou Zixin, Liu Huan, Dai Lihui, Xu Zhihan, Wang Shaofang, Shao Haoyue, Zhai Linhan, Chen Yu, He Litong, Wang Qiuxia, Zhang Jing
Аннотация
RATIONALE AND OBJECTIVES: To quantitatively evaluate lenticulostriate artery (LSA) abnormalities on dual-energy CT angiography (DE-CTA) and examine their associations with branch atheromatous disease (BAD) and infarct burden.
MATERIALS AND METHODS: This case-control study included 110 patients with BAD and matched controls. Quantitative assessment of LSAs included branch count, maximum CT value, tortuosity, length and distance. Interhemispheric absolute differences and percentage interhemispheric differences (PIDs) were calculated. Associations of ipsilateral branch count and maximum CT value, together with their interhemispheric differences and PIDs, with BAD, number of diffusion-weighted imaging (DWI) layers, and maximum infarct diameter were analyzed.
RESULTS: Compared with the contralateral side in BAD and with control sides, ipsilateral sides showed fewer branches, lower maximum CT values, lower tortuosity, and shorter length and distance related parameters, whereas controls showed no significant interhemispheric differences (all P < 0.001). Interhemispheric differences and PIDs were greater in BAD group than in controls (all P < 0.01). In BAD group, ipsilateral branch count and maximum CT value, as well as their interhemispheric differences and PIDs, were associated with DWI infarct burden but not with ipsilateral MCA transcranial Doppler parameters. After multivariable adjustment, lower ipsilateral branch count and maximum CT value, together with greater absolute differences and PIDs of these metrics, remained independently associated with BAD, number of involved DWI layers, and maximum infarct diameter.
CONCLUSION: DE-CTA enables reliable quantification of LSAs morphology and identifies abnormalities associated with BAD and infarct burden, supporting its role as a novel imaging approach for assessing BAD-related perforator involvement.
MATERIALS AND METHODS: This case-control study included 110 patients with BAD and matched controls. Quantitative assessment of LSAs included branch count, maximum CT value, tortuosity, length and distance. Interhemispheric absolute differences and percentage interhemispheric differences (PIDs) were calculated. Associations of ipsilateral branch count and maximum CT value, together with their interhemispheric differences and PIDs, with BAD, number of diffusion-weighted imaging (DWI) layers, and maximum infarct diameter were analyzed.
RESULTS: Compared with the contralateral side in BAD and with control sides, ipsilateral sides showed fewer branches, lower maximum CT values, lower tortuosity, and shorter length and distance related parameters, whereas controls showed no significant interhemispheric differences (all P < 0.001). Interhemispheric differences and PIDs were greater in BAD group than in controls (all P < 0.01). In BAD group, ipsilateral branch count and maximum CT value, as well as their interhemispheric differences and PIDs, were associated with DWI infarct burden but not with ipsilateral MCA transcranial Doppler parameters. After multivariable adjustment, lower ipsilateral branch count and maximum CT value, together with greater absolute differences and PIDs of these metrics, remained independently associated with BAD, number of involved DWI layers, and maximum infarct diameter.
CONCLUSION: DE-CTA enables reliable quantification of LSAs morphology and identifies abnormalities associated with BAD and infarct burden, supporting its role as a novel imaging approach for assessing BAD-related perforator involvement.