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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 22:248-254 (2 2001)
© 2001 American Society of Neuroradiology

ARTICLE

Measurement of Cerebral Hemodynamics with Perfusion-weighted MR Imaging: Comparison with Pre- and Post-acetazolamide ¹³³Xe-SPECT in Occlusive Carotid Disease

Keiichi Kikuchi^,a, Kenya Murase^a, Hitoshi Miki^a, Takanori Kikuchi^a, Yoshifumi Sugawara^a, Teruhito Mochizuki^a, Junpei Ikezoe^a and Shiro Ohue^a

^a From the Departments of Radiology (K.K., K.M., H.M., T.K., Y.S., T.M., J.I.) and Neurological Surgery (S.O.), Ehime University School of Medicine, Ehime, Japan.

BACKGROUND AND PURPOSE: We generated regional cerebral blood volume (rCBV) and regional cerebral blood flow (rCBF) studies from dynamic susceptibility contrast-enhanced MR images after an intravenous bolus injection of contrast agent (perfusion-weighted imaging [PWI]) by applying indicator dilution theory. We used a multishot echo-planar imaging (EPI) sequence to obtain adequate arterial input function (AIF). Our purpose was to compare the cerebral hemodynamics measured by PWI with the rCBF values and cerebral perfusion reserve obtained by xenon-133 single-photon emission CT (¹³³Xe-SPECT).

METHODS: Eight patients with chronic internal carotid artery occlusion or stenosis were examined. PWI data were acquired using a multishot EPI sequence, and the AIF was determined automatically. Our procedure was based on indicator dilution theory and deconvolution analysis. To eliminate the effect of superficial vessels, the automatic threshold selection method was used.

RESULTS: AIF was adequate to generate rCBF and rCBV images. The rCBF and rCBV images by PWI were superior to ¹³³Xe-SPECT scans in spatial resolution, and the rCBF values obtained by PWI correlated well with those obtained by ¹³³Xe-SPECT. The regions with severely decreased perfusion reserve, which were determined by pre- and post-acetazolamide ¹³³Xe-SPECT, showed significantly lower rCBF and higher rCBV by PWI than did regions with normal and moderately decreased perfusion reserve.

CONCLUSION: The rCBF and rCBV images generated by our procedure using PWI data appear to provide important clinical information for evaluating the degree of cerebral perfusion reserve impairment in patients with chronic ischemia.

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