title: Acetazolamide-challenged perfusion magnetic resonance imaging for assessment of cerebrovascular reserve capacity in patients with symptomatic middle cerebral artery stenosis: comparison with technetium-99m-hexamethylpropyleneamine oxime single-photon emission computed tomography.
abstract: OBJECTIVE
  Acetazolamide-challenged perfusion magnetic resonance imaging (MRI) has been shown as a method for assessment of cerebrovascular reserve (CVR) capacity in patients with atherosclerotic steno-occlusive disease of internal carotid artery. We have assessed the feasibility of the acetazolamide-challenged perfusion MRI for evaluating CVR in symptomatic patients with severe middle cerebral artery (MCA) stenosis (≥70%) by comparison with the acetazolamide-challenged technetium-99m-hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT).
  
  
  METHODS
  Seventeen prospectively enrolled patients with symptomatic unilateral MCA stenosis underwent technetium-99m-hexamethylpropyleneamine oxime SPECT and perfusion MRI without and with acetazolamide challenge, respectively. Acetazolamide-challenged SPECT and perfusion MRI were compared quantitatively by Region of interest (ROI) analysis.
  
  
  RESULTS
  At all ROIs, there were no significant differences in percent change between SPECT and perfusion MRI. Patients with impaired CVR showed significant decreases in the percent changes of respective cerebral blood flow (P=.016) and respective cerebral blood volume (P=.029).
  
  
  CONCLUSIONS
  Acetazolamide-challenged perfusion MRI is feasible for evaluating CVR in symptomatic patients with severe MCA stenosis quantitatively.
authors: Department of Radiology, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon, Republic of Korea.
authors: Hyun Jeong
authors: HJ
authors: Kim
authors: Tae Woo
authors: TW
authors: Kim
authors: Seon-Young
authors: SY
authors: Ryu
authors: Po Song
authors: PS
authors: Yang
authors: Min Jeong
authors: MJ
authors: Kwon
authors: Ji Chang
authors: JC
authors: Kim
authors: Yeon Soo
authors: YS
authors: Lee
authors: Hyung Jin
authors: HJ
authors: Lee
authors: Ji Ho
authors: JH
authors: Yang
authors: Jae Kyun
authors: JK
authors: Kim
authors: Yong-An
authors: YA
authors: Chung
authors: Eun-Young
authors: EY
authors: Oh
authors: Sang Bong
authors: SB
authors: Lee
mesh_terms: D000086:Acetazolamide; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002257:Carbonic Anhydrase Inhibitors; D002560:Cerebrovascular Circulation; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000473:pathology; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D002257:Carbonic Anhydrase Inhibitors; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D000086:Acetazolamide