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AJNR - American Journal of Neuroradiology

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Comparison of Technetium Tc 99m Hexamethylpropyleneamine Oxime Single-Photon Emission Tomograph with Stump Pressure During the Balloon Occlusion Test of the Internal Carotid Artery

Noriaki Tomura^a, Koichi Omachi^a, Satoshi Takahashi^a, Ikuo Sakuma^a, Takahiro Otani^a, Jiro Watarai^a, Kazuo Ishikawa^b, Hiroyuki Kinouchi^c and Kazuo Mizoi^c

^a Department of Radiology, Akita University School of Medicine, 1-1-1, Hondo, Akita City, Akita 010-8543, Japan
^b Department of Otorhinolaryngology, Akita University School of Medicine, 1-1-1, Hondo, Akita City, Akita 010-8543, Japan
^c Department of Neurosurgery, Akita University School of Medicine, 1-1-1, Hondo, Akita City, Akita 010-8543, Japan

View larger version (21K): [in a new window]   FIG 1. Graph shows the relationship between the minimum mean stump pressure and number of regions of interest (ROIs) with hypoperfusion. There was a significant correlation (P < .005 by Spearman rank correlation).

View larger version (22K): [in a new window]   FIG 2. Graph shows that the number of regions of interest (ROIs) with hypoperfusion was significantly (P < .001 by Mann–Whitney U test) greater in patients with a minMSP <40 mm Hg (31.5 ± 13.7) than in patients with minMSP 40 mm Hg (5.1 ± 4.0).

View larger version (144K): [in a new window]   FIG 3. In a 73-year-old man with hypopharyngeal carcinoma on the left side, the minMSP was 30 mm Hg during balloon test occlusion of the left internal carotid artery. SPECT using technetium Tc 99m HMPAO showed hypoperfusion of the cerebral hemisphere on the left side.

View larger version (156K): [in a new window]   FIG 4. In a 64-year-old man with meningioma invading the left internal carotid artery, the MSP was 64 mm Hg during balloon test occlusion of the left internal carotid artery. SPECT using technetium Tc 99m HMPAO showed no hypoperfusion areas of the cerebral hemisphere on the left side.

View larger version (20K): [in a new window]   FIG 5. Graph shows the relationship between the number of regions of interest (ROIs) with hypoperfusion and the pressure ratio of the minMSP to the minimum mean systemic pressure.

View larger version (21K): [in a new window]   FIG 6. Graph shows that the number of regions of interest (ROIs) with hypoperfusion was significantly (P < .001 by Mann–Whitney U test) greater in patients with a pressure ratio <0.5 (26.7 ± 15.8) than in patients with a pressure ratio 0.5 (4.5 ± 3.5)

View larger version (26K): [in a new window]   FIG 7. Graph shows the relationship between the minMSP and the mean L/n ratio (the radioactivity count of the occluded side / the radioactivity count of the contralateral normal side). There was a significant positive relationship (linear regression analysis; y = mean L/n ratio, x = minMSP; y = 0.71 + 0.005x; r = 0.497, P = .0084).