Correlation of Angiographic Circulation Time and Cerebrovascular Reserve by Acetazolamide-Challenged Single Photon Emission CT
Shiro Yamamotoa,
Manabu Watanabeb,
Toshihiko Uematsub,
Kenichiro Takasawab,
Masaru Nukatab and
Naokazu Kinoshitab
a Department of Neurology, Kansai Rosai Hospital, Hyogo, Japan
b Division of Strokology, Department of Cardiovascular Medicine and Clinical Research, Osaka-Minami National Hospital, Osaka, Japan
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FIG 1. Angiogram and ACZ-challenged SPECT scans of patient 8, who had right internal carotid artery occlusion.
Left, Baseline and ACZ-challenged SPECT scans. Asymmetry index in right MCA territory of baseline scan is 0.78 (A/B) and of ACZ-challenged scan is 0.55 (A'/B'); therefore, regional reactivity index is 0.71 (0.55/0.78).
Right, Angiogram of right vertebral artery. Right MCA territory is perfused via the leptomeningeal artery from the right posterior cerebral artery (PCA). When the left PCA territory is in capillary phase, the right MCA territory is still in arteriole phase. Although the rACCT of left MCA territory is 3.9 s, that of right MCA territory is 8.8 s; therefore, the rACCT ratio is 2.3 (8.8/3.9).
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FIG 2. rACCT ratio of poor reserve group is larger than that of normal reserve group.
A, rACCT ratio and qualitative estimation on ACZ-challenged SPECT scan.
B, Correlation of rACCT ratio with regional reactivity index, calculated from ACZ asymmetry index/baseline asymmetry index.
C, Correlation of rACCT with asymmetry index of baseline study.
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