Nucl Med Mol Imaging.  2009 Aug;43(4):280-286.

Efficacy Assessment of Endovascular Stenting in Patients with Unilateral Middle Cerebral Artery Stenosis Using Statistical Probabilistic Anatomical Mapping Analysis of Basal/Acetazolamide Brain Perfusion SPECT

Affiliations
  • 1Department of Nuclear Medicine, Keimyung University, School of Medicine, Daegu, Korea. zeon@dsmc.or.kr
  • 2Department of Neurosurgery, Keimyung University, School of Medicine, Daegu, Korea.
  • 3Department of Brain Research Institute, Keimyung University, School of Medicine, Daegu, Korea.

Abstract

PURPOSE: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT.
MATERIALS AND METHODS
Eight patients (3 men and 5 women, 64.8+/-10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting.
RESULTS
After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1+/-2.2 ml/min/100 g and -2.1+/-2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3+/-2.9 ml/min/100 g, p=0.025 and 0.1+/-1.3%, p=0.036).
CONCLUSION
This study revealed that SPAM analysis of basal/ACZ brain perfusion SPECT would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.

Keyword

Tc-99m ECD; statistical probabilistic anatomical mapping; stents; middle cerebral artery; stenosis

MeSH Terms

Brain
Constriction, Pathologic
Cysteine
Female
Hemodynamics
Humans
Male
Middle Cerebral Artery
Organotechnetium Compounds
Perfusion
Stents
Stroke
Tomography, Emission-Computed, Single-Photon
Cysteine
Organotechnetium Compounds
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