Evaluation of carotid endarterectomy with sequential MR perfusion imaging: a preliminary 12-month follow up.
OBJECTIVE
The clinical benefit of carotid endarterectomy is partially determined by peri-operative mortality and morbidity. Post-operative abnormalities in cerebral perfusion may be a risk factor for cerebral haemorrhage, and may be estimated from Bolus Arrival Time (BAT) as demonstrated by MR perfusion imaging. We aimed to use MR perfusion imaging to determine the temporal extent of these changes.


METHODS
A single slice gradient recalled echo sequence was employed in five patients who underwent carotid endarterectomy. Sequential studies were undertaken pre-operatively, 3-5 days post carotid endarterectomy, and additionally at 3, 6 and 12 months.


RESULTS
Asymmetric BATs were demonstrated in 3/5 patients, changes occurring as late as 6 to 12 months after carotid endarterectomy. These changes were not associated with either clinical or conventional MR morphological complications.


CONCLUSIONS
MR perfusion imaging is able to demonstrate changes in BAT characteristics for up to 12 months after carotid endarterectomy. The clinical significance and underlying cause of these changes, including any association with post carotid endarterectomy hyperaemia, remains unknown.
Gillard
J H
JH
Department of Radiology, Addenbrooke's Hospital and University of Cambridge, UK.
Hardingham
C R
CR
Antoun
N M
NM
Freer
C E
CE
Kirkpatrick
P J
PJ
D000368:Aged; D000369:Aged, 80 and over; D002343:Carotid Artery, Internal; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000379:methods*; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D016896:Treatment Outcome