Evaluation of cerebral perfusion from bypass arteries using selective intraarterial microsphere tracer after vascular reconstructive surgery.
OBJECTIVE
To detect areas of cerebral perfusion from bypass arteries after vascular reconstruction, we administered selective intraarterial microsphere tracer into the external carotid arteries and determined (via single-photon emission computed tomography [IA-SPECT]) whether the distribution of radiotracer matched the arteriographic distribution of contrast material as shown on external carotid angiograms.


METHODS
We compared the extent of regional distribution of tracer after external carotid artery injection of 20 to 40 MBq of 99mTc-HMPAO or 99mTc-ECD with that of contrast medium on the external carotid angiograms in 582 cortical regions in 12 patients with atherosclerotic occlusive disease and in 18 patients with moyamoya disease.


RESULTS
Marked accumulation of tracer was found only in the expected, specific, newly developed areas of cerebral perfusion from bypass arteries. The regional distribution of tracer corresponded to that of contrast medium in 523 regions (90%) and did not correspond in 59 regions (10%). Significant overestimation of the distribution of contrast material relative to that of tracer was observed in the patients with moyamoya disease.


CONCLUSIONS
SPECT showed slightly different distribution of tracer from that predicted by conventional angiography. IA-SPECT should enhance the analysis of newly developed areas of cerebral perfusion from the bypass arteries.
Nochide
I
I
Department of Neurological Surgery, Ehime University, School of Medicine, Japan.
Ohta
S
S
Ueda
T
T
Shiraishi
M
M
Watanabe
H
H
Sakaki
S
S
Ikezoe
J
J
D000328:Adult; D001161:Arteriosclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002536:Cerebral Arteries / Q000503:physiopathology; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D009072:Moyamoya Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D015609:Organotechnetium Compounds; D011184:Postoperative Period; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; C059659:technetium Tc 99m bicisate; D003545:Cysteine