Perfusion computed tomography evaluation of cerebral hemodynamic impairment in patients with unilateral chronic steno-occlusive disease: a comparison with the acetazolamide challenge 99mTc-hexamethylpropyleneamine oxime single-photon emission computed tomography.
OBJECTIVE
The purpose of this study was to determine which pefusion computed tomography (PCT) parameter is the most valid predictor of cerebral vascular reserve (CVR) as determined by Tc-hexamethylpropyleneamine oxime single-photon emission computed tomography (SPECT).


METHODS
Single-photon emission computed tomography with acetazolamide challenge and PCT were used in 23 patients with unilateral steno-occlusive vascular disease. After coregistration of the PCT and SPECT images, we assessed the relationship between the PCT parameters and SPECT findings and the predictive values of the PCT parameters for decreased CVR.


RESULTS
All PCT parameters of cerebral blood flow, cerebral blood volume, and mean transit time (MTT) were significantly correlated with SPECT regional cerebral blood flow ratios (P < 0.01). The MTT values more strongly correlated with acetazolamide effect than with cerebral blood volume or cerebral blood flow (P < 0.001). The MTT difference (values in the pathological hemisphere minus the values in the contralateral hemisphere) was a threshold of 1.5 seconds, with a sensitivity of 88% and a specificity of 70% for predicting decreased CVR.


CONCLUSIONS
Mean transit time is the most predictive parameter for assessing decreased CVR in patients with unilateral steno-occlusive vascular disease.
Kim
Eunhee
E
Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Sohn
Chul-Ho
CH
Na
Dong Gyu
DG
Kim
Jeong Eun
JE
Chang
Kee-Hyun
KH
Kim
Ji-Hoon
JH
Jeon
Se Jeong
SJ
D000086:Acetazolamide; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001810:Blood Volume; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging; D002257:Carbonic Anhydrase Inhibitors; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging*; D002908:Chronic Disease; D003287:Contrast Media; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D010091:Oximes; D055420:Perfusion Imaging / Q000379:methods; D011237:Predictive Value of Tests; D011856:Radiographic Image Enhancement / Q000379:methods; D012039:Regional Blood Flow; D015203:Reproducibility of Results; D013667:Technetium; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods*
D002257:Carbonic Anhydrase Inhibitors; D003287:Contrast Media; D010091:Oximes; C068296:hexamethylpropyleneamine oxime; D007472:Iohexol; C038192:iopromide; D013667:Technetium; D000086:Acetazolamide