To study the predictive value of CT perfusion imaging (CTP) parameters for collateral circulation and functional outcomes after intravenous thrombolysis in patients with acute cerebral infarction (ACI).

A total of 100 patients with ACI admitted to the hospital from January 2021 to November 2024 were selected as the research subjects. All of them underwent CT perfusion imaging examination and received intravenous thrombolytic therapy after admission. The patients were divided into the good collateral group (46 cases) and the poor collateral group (54 cases) using digital subtraction angiography (DSA) as the gold standard. Compare the CTP parameters of the two groups of patients. According to the modified Rankin scale (mRS) score 90 days after the onset of the disease, the patients were divided into the good functional outcome group (65 cases) and the poor functional outcome group (35 cases). The predictive efficacy was analyzed using the receiver operating characteristic (ROC) curve.

Compared with the poor collateral group, the good collateral group had higher levels of cerebral blood flow (CBF) and cerebral blood volume (CBV) (P<0.05). The levels of mean transit time (MTT) and time to peak (TTP) were lower (P<0.05). The ROC curve results showed that CBF, CBV, MTT, TTP and the combined detection all had predictive efficacy for collateral circulation in patients (P<0.05), with AUC being 0.857, 0.800, 0.814, 0.713 and 0.931 respectively. Among the individual detections, CBF had the highest predictive efficacy but was still lower than the combined predictive efficacy. The Z values of CBF, CBV, MTT and TTP for the combined detection were calculated to be 1.37 (P>0.05), 2.21 (P<0.05), 1.71 (P>0.05) and 3.54 (P<0.05) respectively. The ROC curve results showed that CBF, CBV, MTT, TTP and the combined detection all had efficacy for the functional outcome of patients after intravenous thrombolysis (P<0.05), with AUC of 0.796, 0.811, 0.718, 0.784 and 0.902 respectively. Among the individual detects, CBV had the highest efficacy but was still lower than the combined predictive efficacy. The Z values of CBF, CBV, MTT and TTP for the combined detection were calculated to be 1.91 (P>0.05), 1.65 (P>0.05), 3.14 (P<0.05) and 2.13 (P<0.05) respectively.

In ACI patients, the levels of CBF and CBV in the good collateral circulation group were higher than those in the poor collateral circulation group, while the levels of MTT and TTP were lower. The CTP parameters in the good functional outcome group showed a similar trend to those in the good collateral circulation group. ROC analysis revealed that the CTP parameters had predictive efficacy for good collateral circulation and functional outcomes after intravenous thrombolysis.