title: [Evaluation of cerebral blood perfusion in patients undergoing carotid endarterectomy using densitometric analysis of conventional cranial CT].
abstract: OBJECTIVE
  To evaluate the efficacy of densitometric analysis of cranial CT imaging in the measurement of areas with low cerebral blood flow and lack of hemodynamic reserve in patients undergoing carotid endarterectomy.
  
  
  METHODS
  40 consecutive patients undergoing carotid endarterectomy have been included in the study. All of them had preoperative cranial CT, pre and postoperative basal and acetazolamide SPECT. Cranial CT imaging after digitalization and computer processing were obtained with 4 densitometric patterns: 1). normal cerebral blood perfusion; 2). ischemic or low brain blood perfusion (patron I); 3). parenchyma without cerebral hemodynamic reserve (patron nR), and 4). brain infarction.
  
  
  RESULTS
  32 out of 40 (80 %) patients had abnormal densitometric patterns: 19 nR patterns (47.5 %), 11 I pattern (27.5 %) and 2 established brain infarction. The correlation between densitometric cranial TC imaging and SPECT was 92% when analyzing areas with hypoperfusion (S: 96.5 %; E: 82 %). Cranial CT detected 12/13 of patients who lacked cerebral hemodynamic reserve in the SPECT analysis (S: 74 %; E: 92 %; Vpp: 95 %).
  
  
  CONCLUSIONS
  There is a good correlation between analysis of densitometric cranial TC imaging and SPECT in determining low cerebral blood flow areas and lack of cerebral hemodynamic reserve. This method could help to improve carotid surgery indications in patients with carotid stenosis.
authors.affiliation: Servicos de Andiologia y Cirugia Vascular II, Hospital Universitario Central de Asturias Oviedo.
authors.forename: L A
authors.initials: LA
authors.lastname: Camblor
authors.forename: J M
authors.initials: JM
authors.lastname: Gutiérrez
authors.forename: V
authors.initials: V
authors.lastname: Mateos
authors.forename: F
authors.initials: F
authors.lastname: Vaquero
authors.forename: J M
authors.initials: JM
authors.lastname: Llaneza
authors.forename: A
authors.initials: A
authors.lastname: Perez
authors.forename: I
authors.initials: I
authors.lastname: Fernandez-Solares
authors.forename: B
authors.initials: B
authors.lastname: Llana
authors.forename: P
authors.initials: P
authors.lastname: Raigoso
authors.forename: C
authors.initials: C
authors.lastname: Roiz
authors.forename: M A
authors.initials: MA
authors.lastname: Menendez
authors.forename: J A
authors.initials: JA
authors.lastname: Carreno
authors.forename: L J
authors.initials: LJ
authors.lastname: Alvarez
authors.forename: J
authors.initials: J
authors.lastname: Rodriguez-Olay
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000378:metabolism; D016893:Carotid Stenosis / Q000503:physiopathology / Q000601:surgery; D016894:Endarterectomy, Carotid / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed