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Abstract

Use of acetazolamide-challenge xenon CT in the assessment of cerebral blood flow dynamics in patients with arteriovenous malformations.

R W Tarr, D W Johnson, M Rutigliano, S T Hecht, S Pentheny, C A Jungreis, J A Horton and H Yonas
American Journal of Neuroradiology May 1990, 11 (3) 441-448;
R W Tarr
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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D W Johnson
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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M Rutigliano
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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S T Hecht
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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S Pentheny
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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C A Jungreis
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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J A Horton
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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H Yonas
Department of Radiology, University of Pittsburgh, Presbyterian-University Hospital, PA 15213.
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Abstract

Arteriovenous malformations (AVMs) may cause symptoms related to a reduction of cerebral blood flow (CBF) to surrounding brain parenchyma. To evaluate this compromise of hemodynamic reserve (commonly referred to as steal phenomenon), we used acetazolamide challenge and stable-xenon CT (Xe/CT). Baseline Xe/CT studies in 13 patients with AVMs were followed by an acetazolamide challenge to the vascular reserve. Blood flow maps were quantitated by using region-of-interest (ROI) software. ROI findings were categorized into four groups on the basis of the presence or absence of normal baseline CBF and presence or absence of normal augmentation of CBF. ROIs were designated as near site (within the vascular territory supplying the AVM) or far site (outside the vascular territory supplying the AVM). One patient had a normal baseline and normal augmentation of CBF (group 1). The other patients had a combination of one or more of the other three categories. Ten patients had parenchymal areas that exhibited either a normal or low baseline CBF with decreased augmentation; both conditions were interpreted as decreased vascular reserve (groups 2 and 3). Eleven patients had parenchymal areas that showed a low baseline CBF and normal augmentation with acetazolamide (group 4), interpreted as having a decreased demand for CBF but having a normal vascular reserve. Decreased vascular reserve was found in 27% of the nearsite areas and 17% of the far-site areas. No patients had only far-site abnormal vascular reserve. We believe that compromised vascular reserve can best be evaluated with a challenge study, such as this acetazolamide-challenge Xe/CT study.(ABSTRACT TRUNCATED AT 250 WORDS)

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American Journal of Neuroradiology
Vol. 11, Issue 3
1 May 1990
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Use of acetazolamide-challenge xenon CT in the assessment of cerebral blood flow dynamics in patients with arteriovenous malformations.
R W Tarr, D W Johnson, M Rutigliano, S T Hecht, S Pentheny, C A Jungreis, J A Horton, H Yonas
American Journal of Neuroradiology May 1990, 11 (3) 441-448;

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Use of acetazolamide-challenge xenon CT in the assessment of cerebral blood flow dynamics in patients with arteriovenous malformations.
R W Tarr, D W Johnson, M Rutigliano, S T Hecht, S Pentheny, C A Jungreis, J A Horton, H Yonas
American Journal of Neuroradiology May 1990, 11 (3) 441-448;
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