Spect Measurements of Regional Cerebral Perfusion and Carbondioxide Reactivity: Correlation with Cerebral Collaterals in Internal Carotid Artery Occlusive Disease

Overview

Journal J Neurol

Specialty Neurology

Date 2006 Oct 26

PMID 17063318

Citations 8

Authors

Michiel J de Boorder

Jeroen van der Grond

Alice J van Dongen

Catharina J M Klijn

L Jaap Kappelle

Peter P van Rijk

Jeroen Hendrikse

Affiliations

Soon will be listed here.

Abstract

Background: The aim of the present study was to assess the regional variation in cerebral perfusion, vasomotor reactivity (VMR) and the role of cerebral collaterals in patients with symptomatic internal carotid artery (ICA).

Methods: Seventeen functionally independent patients (60+/-9 years, mean+/-SD) with a unilateral symptomatic internal carotid artery occlusion and a <30% contralateral ICA stenosis were investigated. (99 m) Tc-hexamethyl propyleneamine oxime (HMPAO) single photon emission computed tomography (SPECT) was performed to study cerebral blood flow in rest and during a CO(2) challenge in the cerebellum, temporal lobe, occipital lobe, basal ganglia, frontal lobe and parietal lobe. Time of flight and phase contrast MRA were used to study collateral flow via circle of Willis.

Results: In rest, cerebral perfusion on the side ipsilateral to the ICA occlusion was decreased compared with the contralateral side in the basal ganglia (p<0.05), frontal lobe (p<0.01) and parietal lobe (p<0.01). During a CO(2) challenge only the ipsilateral frontal lobe demonstrated a perfusion decrease compared with the contralateral frontal lobe (p<0.05). Furthermore, in patients without collateral flow via the anterior circle of Willis the perfusion of the ipsilateral frontal lobe was significantly decreased (p<0.01) during the CO(2) challenge and crossed cerebellar diaschisis with a decreased perfusion on the contralateral cerebellar hemisphere was detected (p<0.05). No cerebral blood flow (CBF) differences were found for present/absent collateral flow via the posterior communicating artery.

Conclusion: Regional assessment of cerebral perfusion and VMR with SPECT demonstrated the heterogeneity of cerebral hemodynamics and the importance of collateral flow via the anterior circle of Willis.

Citing Articles

Influence of collateral circulation on cerebral blood flow and frontal lobe cognitive function in patients with severe internal carotid artery stenosis.

Wei W, Yi X, Ruan J, Duan X, Luo H, Lv Z BMC Neurol. 2019; 19(1):151.

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Genetic and Environmental Contributions to Variation in the Posterior Communicating Collaterals of the Circle of Willis.

Faber J, Zhang H, Rzechorzek W, Dai K, Summers B, Blazek C Transl Stroke Res. 2018; 10(2):189-203.

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Mismatch between TOF MR Angiography and CT Angiography of the Middle Cerebral Artery may be a Critical Sign in Cerebrovascular Dynamics.

Igase K, Igase M, Matsubara I, Sadamoto K Yonsei Med J. 2017; 59(1):80-84.

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Comparison of 3D Multi-inversion Time Arterial Spin Labeling and Digital Subtraction Angiography in the Evaluation of Cerebral Collateral Circulation.

Wu E, Liu X, Dornbos 3rd D, Pfeuffer J, Qian T, Qiao P CNS Neurosci Ther. 2016; 22(12):1009-1011.

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Impaired Cerebrovascular Reactivity Predicts Recurrent Symptoms in Patients with Carotid Artery Occlusion: A Hypercapnia BOLD fMRI Study.

Goode S, Altaf N, Munshi S, MacSweeney S, Auer D AJNR Am J Neuroradiol. 2016; 37(5):904-9.

PMID: 27012300 PMC: 7960300. DOI: 10.3174/ajnr.A4739.

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