[133Xe-DSPECT: significance of the cerebrovascular reserve capacity for the diagnosis and therapy of chronic cerebral ischemia].
Using 133Xe-DSPECT, measurements of regional cerebral blood flow (rCBF) were performed before and after stimulation with 1 g of Diamox in 55 patients with symptomatic occlusion of the internal carotid artery (ICA) and 26 patients without evidence of brain disease (normals). In normals, a negative correlation (r = -0.74) of the Diamox-induced increase of hemispheric blood flow (reserve capacity) and rCBF at rest was observed. In 48 of the 55 patients (87%) with ICA-occlusion a reduced reserve capacity was found. The extent of reduction, however, did not correlate with the findings of transmission CT, because 15 of 21 patients (71%) with normal CT-scans presented a moderate to severe reduction of reserve capacity. In contrast, reserve capacity corresponded to the extent of arterial collateralisation as documented by cerebral panangiography. In 31 patients EC/IC-bypass surgery was performed. In follow-up studies reserve capacity increased, especially in patients who had a severe reduction preoperatively. Therefore, the combined measurement of rCBF at rest and of reserve capacity is a sensitive, non-invasive method for the diagnosis of (even bilateral) cerebrovascular disease and can be helpful to identify patients with hemodynamic ischemia, who may benefit from EC/IC-bypass surgery.
Leinsinger
G
G
Radiologische Klinik, Universität München, Klinikum Grosshadern, BRD.
Schmiedek
P
P
Kreisig
T
T
Einhäupl
K
K
Bauer
W
W
Moser
E
E
D000328:Adult; D000368:Aged; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014055:Tomography, Emission-Computed; D014980:Xenon Radioisotopes
D014980:Xenon Radioisotopes
133Xe-DSPECT: Bedeutung der zerebrovaskulären Reservekapazität für Diagnostik und Therapie der chronischen zerebralen Ischämie.