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KMID : 1103720140700010001
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Journal of the Korean Society of Radiology
2014 Volume.70 No. 1 p.1 ~ p.12
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Correlation of Cerebrovascular Reserve as Measured by Acetazolamide-Challenged Perfusion CT with Collateral Circulation in Unilateral High Grade Carotid Stenosis
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Hong Do-Ran
Lee Young-Hun
Seo Hyung-Suk
Je Bo-Kyung
Suh Sang-Il
Seol Hae-Young
Lee Nam-Joon
Kim Jung-Hyuk
Yang Kyung-Sook
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Abstract
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Purpose: We correlated cerebrovascular reserve in unilateral high grade carotid artery stenosis or occlusion with a type of collateral circulation using acetazolamide-challenged perfusion CT (ACZ-PCT).
Materials and Methods: Among the patients who underwent ACZ-PCT in our institution, we retrospectively selected the patients with unilateral high grade internal carotid artery or middle cerebral artery stenosis (> 70%) or occlusion; we verified the types of their dominant collateral circulation by digital subtraction angiography or 3T MR-angiography; first, the primary collaterals flow through the circle of Willis; second, the secondary collaterals that flow through the opthalmic artery, the basal artery or other external carotid artery. Using ACZ-PCT, we measured the difference in percentage change of cerebral blood flow of the stenotic hemisphere against contralateral normal hemisphere and compared cerebrovascular reserves of lesional hemisphere, according to the type of collaterals.
Results: A total of 28 patients were included. The percentage changes of cerebral blood flow were significantly lower in the stenotic hemisphere than the contralateral hemisphere (14.34 ± 36.43% and 34.53 ± 47.82%, p < 0.001), and in the hemisphere predominantly supplied by secondary collaterals than primary (7.03 ± 32.71% and 24.37 ± 42.03%, p < 0.05), respectively.
Conclusion: Cerebrovascular reserves in the ipsilateral hemisphere predominantly supplied by secondary collaterals were more impaired than primary collaterals in patients with unilateral high grade carotid stenosis or occlusion.
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KEYWORD
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Carotid Stenosis, Cerebrovascular Insufficiency, Collateral Circulations, Perfusion Imaging
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