J Korean Radiol Soc.  2005 Mar;52(3):153-160. 10.3348/jkrs.2005.52.3.153.

Prediction of Cerebrovascular Reserve by the MRI and Doppler Ultrasonography

• Lee HJ
• Kim YS

• KMID: 1834224
• DOI: http://doi.org/10.3348/jkrs.2005.52.3.153

Abstract

PURPOSE
We investigated acute stroke patterns on diffusion weighted images and with doppler ultrasonography studies of ICA and MCA steno-occlusive diseases in order to predict the cerbrovascular reserve (CVR), as was measured by acetazolamide (ACZ)-challenged Tc-99m ECD brain perfusion SPECT.
MATERIALS AND METHODS
A retrospective analysis was performed of 76 patients who underwent MRI/MRA, ACZ-challenged Tc-99m ECD brain perfusion SPECT, and carotid and vertebral artery Doppler sonography. After dividing these patients into four groups- MCA and ICA steno-occlusions, we analyzed the relationship between the CVR and topologic MR patterns and the flow volume, as was measured by Doppler sonography.
RESULTS
The CVRs were preserved in 26 of 76 patients. The CVRs were impaired in those cases of occlusion that were detected on MRA and also by the pattern of the territorial involvement on the diffusion weighted image (p < 0.05, x2 test). Yet in cases of preserved CVRs, the flow volume of the contralateral ICA, the anterior circulation, and the total cerebral flow volume were increased, as was checked by Doppler sonography (p < 0.05, t-test). As calculated by logistic regression analysis, the accuracy for predicting the preserved CVR by using the statistically significant variables was 78%.
CONCLUSION
We believe that the MRI-SPECT correlation study was helpful for understanding the hemodynamics and topographic patterns of ischemia in patients with ICA and MCA steno-occlusive disease, and that the flow volume measurement, which was done by using duplex US, was useful for predicting the CVR.

Keyword

Cerebral infarction; Cerebrovascular reserve; Middle cerebral artery; Internal carotid artery, SPECT

MeSH Terms

Acetazolamide
Brain
Cerebral Infarction
Diffusion
Hemodynamics
Humans
Ischemia
Logistic Models
Magnetic Resonance Imaging*
Middle Cerebral Artery
Perfusion
Retrospective Studies
Statistics as Topic
Stroke
Tomography, Emission-Computed, Single-Photon
Ultrasonography, Doppler*
Vertebral Artery
Acetazolamide