Correlation of cerebrovascular reserve as measured by acetazolamide-challenged SPECT with angiographic flow patterns and intra- or extracranial arterial stenosis

Hasan T. Ozgur, T. Kent Walsh, Anthony Masaryk, Joachim F. Seeger, Walter Williams, Elizabeth A Krupinski, Miguel Melgar, Enrique Labadie

Research output: Contribution to journalArticle

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Abstract

BACKGROUND AND PURPOSE: The ability to identify patients at increased risk for stroke from cerebral hemodynamic ischemia may help guide treatment planning. We tested the correlation between regional cerebrovascular reserve (rCVR) on acetazolamide-challenged single-photon emission CT (SPECT) brain scans and intracranial collateral pathways as well as extra- or intracranial (EC-IC) arterial stenosis on cerebral angiography. METHODS: A retrospective analysis of 27 patients who underwent cerebral angiography and acetazolamide-challenged SPECT brain imaging was performed. With cerebral angiography, the anterior, middle, and posterior cerebral artery (ACA, MCA, PCA) territories were evaluated for patterns of flow, including the ipsilateral carotid or basilar arteries, the circle of Willis collaterals, the EC-IC collaterals, and the leptomeningeal collaterals. With acetazolamide-challenged SPECT, the ACA, MCA, and PCA territories were classified as either showing or not showing evidence of decreased rCVR. Statistical significance was determined by the X2 test. RESULTS: Patients with decreased rCVR had significantly greater dependence on either the EC-IC or leptomeningeal collaterals (42%) than did patients without decreased rCVR (7%). Similarly, the cerebral hemispheres with decreased rCVR showed a higher prevalence of 70% or greater stenosis or occlusion of the ipsilateral EC-IC arteries in the anterior circulation (74%) than did hemispheres with no evidence of decreased rCVR (16%), and this difference was also statistically significant. CONCLUSION: Acetazolamide-challenged SPECT brain scanning provides additional information regarding rCVR that is not reliably provided by cerebral angiography.

Original languageEnglish (US)
Pages (from-to)928-936
Number of pages9
JournalAmerican Journal of Neuroradiology
Volume22
Issue number5
StatePublished - May 2001

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Cerebral Angiography
Acetazolamide
Photons
Pathologic Constriction
Passive Cutaneous Anaphylaxis
Circle of Willis
Posterior Cerebral Artery
Anterior Cerebral Artery
Basilar Artery
Middle Cerebral Artery
Brain
Cerebrum
Single-Photon Emission-Computed Tomography
Brain Ischemia
Carotid Arteries
Neuroimaging
Arteries
Hemodynamics
Stroke
Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Correlation of cerebrovascular reserve as measured by acetazolamide-challenged SPECT with angiographic flow patterns and intra- or extracranial arterial stenosis. / Ozgur, Hasan T.; Walsh, T. Kent; Masaryk, Anthony; Seeger, Joachim F.; Williams, Walter; Krupinski, Elizabeth A; Melgar, Miguel; Labadie, Enrique.

In: American Journal of Neuroradiology, Vol. 22, No. 5, 05.2001, p. 928-936.

Research output: Contribution to journalArticle

Ozgur, Hasan T. ; Walsh, T. Kent ; Masaryk, Anthony ; Seeger, Joachim F. ; Williams, Walter ; Krupinski, Elizabeth A ; Melgar, Miguel ; Labadie, Enrique. / Correlation of cerebrovascular reserve as measured by acetazolamide-challenged SPECT with angiographic flow patterns and intra- or extracranial arterial stenosis. In: American Journal of Neuroradiology. 2001 ; Vol. 22, No. 5. pp. 928-936.
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AU - Ozgur, Hasan T.

AU - Walsh, T. Kent

AU - Masaryk, Anthony

AU - Seeger, Joachim F.

AU - Williams, Walter

AU - Krupinski, Elizabeth A

AU - Melgar, Miguel

AU - Labadie, Enrique

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