Cortical Blood Flow during Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage: Three-Dimensional N-Isopropyl-p-[123I]Iodoamphetamine Single Photon Emission CT Findings
Hiroki Ohkumaa,
Shigeharu Suzukia,
Kanae Kudoa,
Shafiqul Islama and
Tomonari Kikkawaa
a From the Department of Neurosurgery, Hirosaki University School of Medicine, Japan
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FIG 1. Methods of rCBF assessment.
Top, 3D images were made by reconstructing the transaxial SPECT data.
Middle, The surface threshold value was set at 30 mL/100 g/min, and the image defects, which indicate the region with rCBF less than 30 mL/100 g/min, were outlined and calculated by using the image-analysis system (arrows).
Bottom, Transaxial images were obtained with the IMP-ARG method. ROIs of 30 x 15 mm were set in the lesion with decreased CBF along the cerebral cortex (arrows), and its value was measured.
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FIG 2. Characteristic findings in cases with DIND.
Top, Image shows widely decreased cortical rCBF at the left MCA region (arrows).
Bottom, Image shows widely decreased cortical rCBF at the left ACA region (arrows).
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FIG 3. CBF data in all cases compared according to the type of angiographic vasospasm.
Top, rCBF in the ROI on 2D images.
Middle, Mean hemispheric CBF calculated by using 2D images.
Bottom, The area of decreased cortical rCBF measured on 3D images.
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FIG 4. Serial changes in cortical rCBF in a case with DIND.
Top left, Six days after the onset of SAH, 3D images show multiple, patchy areas of decreased cortical rCBF.
Top right, cerebral angiography performed on the same day reveals no angiographic vasospasm.
Bottom left, Ten days after the onset of SAH, 3D images show the widely decreased cortical rCBF.
Bottom right, Diffuse angiographic vasospasm is seen on an cerebral angiogram obtained on the same day.
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