RT Journal Article
SR Electronic
T1 Simple Assessment of Cerebral Hemodynamics Using Single-Slab 3D Time-of-Flight MR Angiography in Patients with Cervical Internal Carotid Artery Steno-Occlusive Diseases: Comparison with Quantitative Perfusion Single-Photon Emission CT
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 559
OP 563
DO 10.3174/ajnr.A1389
VO 30
IS 3
A1 R. Hirooka
A1 K. Ogasawara
A1 T. Inoue
A1 S. Fujiwara
A1 M. Sasaki
A1 K. Chida
A1 D. Ishigaki
A1 M. Kobayashi
A1 H. Nishimoto
A1 Y. Otawara
A1 E. Tsushima
A1 A. Ogawa
YR 2009
UL http://www.ajnr.org/content/30/3/559.abstract
AB BACKGROUND AND PURPOSE: Visualization of the peripheral arteries on single-slab 3D time-of-flight (TOF) MR angiography (MRA) can reflect blood flow velocity. The velocity in the middle cerebral artery (MCA) may correlate with cerebrovascular reactivity (CVR) to acetazolamide, which can be used to assess hemodynamic impairment. The goal of this study was to compare the signal intensity of the MCA on MRA versus CVR quantified by perfusion single-photon emission CT (SPECT).MATERIALS AND METHODS: The signal intensity of the MCA on single-slab 3D time-of-flight MRA was graded according to the ability to visualize the MCA in 108 cerebral hemispheres of 87 patients with unilateral or bilateral cervical internal carotid artery (ICA) steno-occlusive diseases. SPECT-CVR was also calculated by measuring cerebral blood flow before and after acetazolamide challenge. Ten healthy subjects were studied to obtain control SPECT-CVR values. All subjects provided written informed consent before the study.RESULTS: CVR was significantly lower in cerebral hemispheres with reduced MCA signal intensity than in those with normal intensity (P < .05). When the reduced signal intensity of the MCA on MRA was defined as abnormal, and when a CVR less than the mean − 2 SD of healthy subjects was defined as reduced, MRA grading resulted in a 86.2% sensitivity and 69.6% specificity, with 51.0% positive-predictive and 93.2% negative-predictive values to detect reduced CVR.CONCLUSIONS: This simple MRA method can assess hemodynamic impairment with a high negative-predictive value.