Abstract: Objective　To investigate the values of CT angiography（CTA） collateral circulation score in evaluating the prognosis of patients with middle cerebral artery occlusion stroke.Methods　From September 2015 to November 2016，66 patients with middle cerebral artery occlusion stroke who were examined in Department of Radiology of Wuxi Second People's Hospital and met the inclusion criteria were selected as study subjects.The patients were followed up for 3 months.Four patients were lost in visits，and two patients died during the follow-up period.Patient prognosis was scored according to the National Institutes of Health Stroke Scale（NIHSS）．According to NIHSS scores，the patients were divided into good prognosis group（NIHSS score<16，n=32） and poor prognosis group（NIHSS score≥16，n=28）．Within 12 h after disease onset，CTA collateral circulation was scored，and magnetic resonance diffusion weighted imaging（DWI） infarct volume was calculated.Logistic regression was used to analyze the risk factors associated with patient prognosis.The correlation between DWI infarct volume and the CTA collateral circulation score was analyzed with Spearman rank correlation.The value of the DWI infarct volume and two CTA collateral circulation score in predicting the prognosis of the patients with middle cerebral artery occlusion stroke were assessed.Results　The DWI infarct volume in the poor prognosis group was greater than that in the good prognosis group，and the Maas and Tan scores were lower in the poor prognosis group than the good prognosis group（P<0.05）．The DWI infarct volume and two CTA collateral circulation scores were prognostic factors for the patients with middle cerebral artery occlusion stroke（P<0.05）．The DWI infarct volume showed a negative correlation with the Maas and Tan scores（rs=-0.886，-0.713，P<0.001）．DWI infarct volume predicted the prognosis of AUC=0.892 with a critical value of 30.2 cm2, sensitivity and specificity of 75.0%, and 100.0%, respectively, and the Maas score predicted AUC=0.852, the critical value was 3, the sensitivity and specificity were 64.3% and 75.0%, and the Tan score predicted the prognosis of AUC=0.815, with a critical value of 2, sensitivity and specificity were 71.4%, 78.1%，respectively .Conclusion　Both the Maas and Tan score have value in prognostic prediction in patients with acute middle cerebral artery occlusion stroke.The Tan score has higher sensitivity and specificity than the Mass score.

Key words: Infarction, middle cerebral artery；Arterial occlusive diseases；Collateral circulation scoring；Prognosis

摘要： 目的　探讨两种CT血管造影（CTA）侧支循环评分（Maas、Tan评分）评价大脑中动脉闭塞性脑卒中患者预后的价值。方法　选取2015年9月—2016年11月无锡市第二人民医院影像科诊治的符合纳入标准的大脑中动脉闭塞性脑卒中患者66例为研究对象。随访患者3个月，失访4例，死亡2例，采用美国国立卫生研究院卒中量表（NIHSS）对患者预后进行评分，根据NIHSS评分将患者分为预后较好组（NIHSS评分<16分，32例）和预后较差组（NIHSS评分≥16分，28例）。在发病12 h内，评估CTA侧支循环评分和计算磁共振弥散加权成像（DWI）梗死体积。采用Logistic回归分析分析患者预后的危险因素，Spearman秩相关分析评估DWI梗死体积和两种CTA侧支循环评分的相关性；分析DWI梗死体积及两种CTA侧支循环评分预测大脑中动脉闭塞性脑卒中患者预后的价值。结果　预后较差组患者的DWI梗死体积大于预后较好组，两种CTA侧支循环评分低于预后较好组（P<0.05）；DWI梗死体积、CTA侧支循环评分是大脑中动脉闭塞性脑卒中患者预后的影响因素（P<0.05）；DWI脑梗死体积与Maas、Tan评分均呈负相关（rs=-0.886、-0.713，P<0.001）。DWI梗死体积预测预后的AUC=0.892，临界值为30.2 cm2，灵敏度和特异度分别为75.0%和100.0%；Maas评分预测预估的AUC=0.852，临界值为3分，灵敏度和特异度分别为64.3%和75.0%；Tan评分预测预后的AUC=0.815，临界值为2分，灵敏度和特异度分别为71.4%和78.1%。结论　在大脑中动脉闭塞性脑卒中患者中，Maas、Tan评分均具有评估患者预后的价值，且Tan评分较Maas评分的灵敏度和特异度更高。

关键词: 梗死, 大脑中动脉；动脉闭塞性疾病；侧支循环评分；预后