Department of Neurology, Shahe Hospital Changping District, Beijing 102206, China , ssamsca2024@163.com
Abstract: (19 Views)
Background:This study investigated the relationship between extracranial internal carotid artery (EICA) and extracranial carotid artery (ECA) tortuosity and clinical prognosis in acute anterior circulation ischemic stroke (AIS). Materials and Methods: We retrospectively analyzed 201 patients with anterior circulation AIS who underwent head and neck CT angiography (CTA) between January–December 2023.CTA was performed using a Discovery CT750 HD scanner (GE Medical Systems), with scanning extending from the aortic arch to the skull vertex. Iopromide contrast agent (37g iodine/100ml) was administered intravenously. Images were reconstructed at 0.63-mm slice thickness using multiplanar reformation (MPR) and 3D volume rendering (VR). Results: Tortuosity Index (TI) of EICA and ECA were independent predictors of poor 90-day prognosis (modified Rankin Scale [mRS] ≥3) in multivariate regression (Model I: EICA OR=1.038, P=0.007.ECA OR=1.052, P=0.015). ROC analysis showed ECA-TI≥12.5 predicted poor prognosis with higher specificity (AUC=0.623,sensitivity 55.6%,specificity 68.3%) than EICA-TI ≥14.5 (AUC=0.601,sensitivity 61.9%,specificity60.7%). Conclusions: Increased EICA/ECA tortuosity independently correlates with poor AIS outcomes, with ECA-TI being a superior prognostic indicator.