Assessment of cerebrovascular reserve before and after STA-MCA bypass surgery by SPECT and SPM analysis.
OBJECTIVE
The purpose of this study was to objectively assess the efficacy of superficial temporal artery to middle cerebral artery (STA-MCA) bypass surgery using Technetium (Tc)-99m-ethyl cysteinate dimer (ECD) single photon emission computed tomography (SPECT) in patients who underwent STA-MCA bypass surgery.


METHODS
Brain perfusion SPECT images obtained at baseline and after the administration of acetazolamide were reconstructed using statistical parametric mapping in 23 patients, both before and after STA-MCA bypass surgery. The clinical outcomes of the surgery were also recorded and compared with the hemodynamic changes. A voxel with an uncorrected p-value of less than 0.001 was considered to be statistically significant.


RESULTS
SPECT images of the territory supplied by the bypass graft showed an increase in both cerebrovascular flow and reserve at baseline, and the increase was significantly higher following the administration of acetazolamide. All patients showed improvement of clinical symptoms and increased blood flow to the left temporal, parietal, and frontal cortices as well as the thalamus.


CONCLUSIONS
Brain SPECT effectively and objectively demonstrated the improved outcomes of STA-MCA bypass surgery, and thus may be used in postoperative analyses.
O
Joo-Hyun
JH
Department of Radiology, The Catholic University of Korea, Seoul, Korea.
Jang
Kyung-Sool
KS
Yoo
Ie-Ryung
IeR
Kim
Sung-Hoon
SH
Chung
Soo-Kyo
SK
Sohn
Hyung Sun
HS
Rha
Hyung-Kyun
HK
Park
Hae-Kwan
HK
Chung
Yong-An
YA
Jeong
Jaeseung
J
D000086:Acetazolamide; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D001931:Brain Mapping / Q000379:methods; D016893:Carotid Stenosis / Q000601:surgery; D002548:Cerebral Revascularization; D002560:Cerebrovascular Circulation; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002537:Intracranial Arteriosclerosis / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000601:surgery*; D015233:Models, Statistical; D015609:Organotechnetium Compounds; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D013699:Temporal Arteries / Q000601:surgery*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D016896:Treatment Outcome
D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine; D000086:Acetazolamide