Evaluation of cerebrovascular reserve using xenon-enhanced CT scanning in patients with symptomatic middle cerebral artery stenosis.
Cerebrovascular reserve (CVR) is an important prognostic factor in patients with major cerebral arterial steno-occlusive disease. However, few studies have examined CVR in symptomatic intracranial stenosis without ipsilateral extracranial internal carotid artery stenosis. This study sought to evaluate CVR in patients with symptomatic middle cerebral artery (MCA) stenosis using xenon-enhanced computed tomography (Xe/CT) with acetazolamide (ACZ) challenge. Twelve patients with symptomatic MCA stenosis were recruited. All patients were examined by Xe/CT to quantitatively measure resting cerebral blood flow (CBF) and received ACZ challenge to evaluate CVR. For resting CBF, no significant differences were found between the sides in four regions of interest. After the ACZ challenge test, the CVR was significantly different between hemispheres (ipsilateral versus contralateral CVR: 12.9 ± 24.3% versus 28.0 ± 16.8%, respectively; p=0.005) and in the MCA territory (ipsilateral versus contralateral CVR: 8.7 ± 24.7% versus 29.3 ± 24%, respectively; p=0.003). However, no significant differences in CVR were detected between cortical comparisons and white matter comparisons from the two sides. Thus, ACZ-challenge Xe/CT is useful for the measurement of CBF and CVR in these patients. Impaired CVR is an important characteristic of patients with symptomatic MCA stenosis.
Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China.
Wenjie
W
Cao
Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China.
Xin
X
Cheng
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Haoxiong
H
Li
Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China.
Liang
L
Wang
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Xiaolong
X
Zhang
Department of Neurology and Institute of Neurology, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China; State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China. Electronic address: dongqiang2222@gmail.com.
Qiang
Q
Dong
D000086:Acetazolamide; D002317:Cardiovascular Agents; D002539:Cerebral Arterial Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000187:drug effects; D002560:Cerebrovascular Circulation; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000000981:diagnostic imaging; D003287:Contrast Media; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging / Q000187:drug effects; D009413:Nerve Fibers, Myelinated / Q000000981:diagnostic imaging / Q000187:drug effects; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014978:Xenon
D002317:Cardiovascular Agents; D003287:Contrast Media; D014978:Xenon; D000086:Acetazolamide
Acetazolamide; Cerebrovascular reserve; Intracranial stenosis; Symptomatic; Xenon-enhanced CT