American Journal of Neuroradiology 22:928-936 (5 2001)
© 2001 American Society of Neuroradiology
ARTICLE
Correlation of Cerebrovascular Reserve as Measured by Acetazolamide-challenged SPECT with Angiographic Flow Patterns and Intra- or Extracranial Arterial Stenosis
a From the Departments of Radiology (H.T.O., A.M., J.F.S., E.K.), Nuclear Medicine (T.K.W., W.W.), Neurosurgery (M.M.), and Neurology (E.L.); University of Arizona Health Sciences Center and Veterans Administration Medical Center, Tucson.
BACKGROUND AND PURPOSE: The ability to identify patients at increased risk for stroke from cerebral hemodynamic ischemia may help guide treatment planning. We tested the correlation between regional cerebrovascular reserve (rCVR) on acetazolamide-challenged single-photon emission CT (SPECT) brain scans and intracranial collateral pathways as well as extra- or intracranial (EC-IC) arterial stenosis on cerebral angiography.
METHODS: A retrospective analysis of 27 patients who underwent cerebral angiography and acetazolamide-challenged SPECT brain imaging was performed. With cerebral angiography, the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA) territories were evaluated for patterns of flow, including the ipsilateral carotid or basilar arteries, the circle of Willis collaterals, the EC-IC collaterals, and the leptomeningeal collaterals. With acetazolamide-challenged SPECT, the ACA, MCA, and PCA territories were classified as either showing or not showing evidence of decreased rCVR. Statistical significance was determined by the 
2 test.
RESULTS: Patients with decreased rCVR had significantly greater dependence on either the EC-IC or leptomeningeal collaterals (42%) than did patients without decreased rCVR (7%). Similarly, the cerebral hemispheres with decreased rCVR showed a higher prevalence of 70% or greater stenosis or occlusion of the ipsilateral EC-IC arteries in the anterior circulation (74%) than did hemispheres with no evidence of decreased rCVR (16%), and this difference was also statistically significant.
CONCLUSION: Acetazolamide-challenged SPECT brain scanning provides additional information regarding rCVR that is not reliably provided by cerebral angiography.
This article has been cited by other articles:
 |
|
 |
|
  R. E. Latchaw, M. J. Alberts, M. H. Lev, J. J. Connors, R. E. Harbaugh, R. T. Higashida, R. Hobson, C. S. Kidwell, W. J. Koroshetz, V. Mathews, et al. Recommendations for Imaging of Acute Ischemic Stroke: A Scientific Statement From the American Heart Association Stroke, November 1, 2009; 40(11): 3646 - 3678. [Full Text] [PDF]
|
|
|
|
|
|
H. C. Schumacher, P. M. Meyers, R. T. Higashida, C. P. Derdeyn, S. D. Lavine, G. M. Nesbit, D. Sacks, P. Rasmussen, and L. R. Wechsler Reporting Standards for Angioplasty and Stent-Assisted Angioplasty for Intracranial Atherosclerosis Stroke, May 1, 2009; 40(5): e348 - e365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N.-J. Rim, H.S. Kim, Y.S. Shin, and S.Y. Kim Which CT Perfusion Parameter Best Reflects Cerebrovascular Reserve?: Correlation of Acetazolamide-Challenged CT Perfusion with Single-Photon Emission CT in Moyamoya Patients AJNR Am. J. Neuroradiol., October 1, 2008; 29(9): 1658 - 1663. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Yamamoto, M. Watanabe, T. Uematsu, K. Takasawa, M. Nukata, and N. Kinoshita Correlation of Angiographic Circulation Time and Cerebrovascular Reserve by Acetazolamide-Challenged Single Photon Emission CT AJNR Am. J. Neuroradiol., February 1, 2004; 25(2): 242 - 247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H.-Y. Lee, J. C. Paeng, D. S. Lee, J. S. Lee, C. W. Oh, M. J. Cho, J.-K. Chung, and M. C. Lee Efficacy Assessment of Cerebral Arterial Bypass Surgery Using Statistical Parametric Mapping and Probabilistic Brain Atlas on Basal/Acetazolamide Brain Perfusion SPECT J. Nucl. Med., February 1, 2004; 45(2): 202 - 206. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Uemura, T. O'uchi, Y. Kikuchi, N. Yashiro, N. Ihara, and K. Shoji Prominent Laterality of the Posterior Cerebral Artery at Three-Dimensional Time-of-Flight MR Angiography in M1-Segment Middle Cerebral Artery Occlusion AJNR Am. J. Neuroradiol., January 1, 2004; 25(1): 88 - 91. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ogasawara, T. Okuguchi, M. Sasoh, M. Kobayashi, H. Yukawa, K. Terasaki, T. Inoue, and A. Ogawa Qualitative versus Quantitative Assessment of Cerebrovascular Reactivity to Acetazolamide Using iodine-123-N-Isopropyl-p-Iodoamphetamine SPECT in Patients with Unilateral Major Cerebral Artery Occlusive Disease AJNR Am. J. Neuroradiol., June 1, 2003; 24(6): 1090 - 1095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. H.C. Bisschops, C. J.M. Klijn, L. J. Kappelle, A. C. van Huffelen, and J. van der Grond Collateral flow and ischemic brain lesions in patients with unilateral carotid artery occlusion Neurology, May 13, 2003; 60(9): 1435 - 1441. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ogasawara, H. Ito, M. Sasoh, T. Okuguchi, M. Kobayashi, H. Yukawa, K. Terasaki, and A. Ogawa Quantitative Measurement of Regional Cerebrovascular Reactivity to Acetazolamide Using 123I-N-Isopropyl-p-Iodoamphetamine Autoradiography with SPECT: Validation Study Using H215O with PET J. Nucl. Med., April 1, 2003; 44(4): 520 - 525. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Latchaw, H. Yonas, G. J. Hunter, W. T.C. Yuh, T. Ueda, A. G. Sorensen, J. L. Sunshine, J. Biller, L. Wechsler, R. Higashida, et al. Guidelines and Recommendations for Perfusion Imaging in Cerebral Ischemia: A Scientific Statement for Healthcare Professionals by the Writing Group on Perfusion Imaging, From the Council on Cardiovascular Radiology of the American Heart Association Stroke, April 1, 2003; 34(4): 1084 - 1104. [Full Text] [PDF]
|
|