Objective
Perfusion CT (PCT) has the ability to measure quantitative value and produce maps of mean transit time (MTT), cerebral blood flow (CBF), and cerebral blood volume (CBV). We assessed cerebral hemodynamics by using these parameters and acetazolamide challenge for the pre- and post-procedural evaluation in patients with unilateral cerebrovascular stenotic disease.
Methods
Thirty patients underwent pre-procedural PCT with acetazolamide challenge, and 24 patients (80%) did post-proceduralPCT with same protocol. Comparison of mean MTT, CBF, and CBV was determined between both middle cerebral arterial territories and before and after acetazollamide challenge. Bilateral ratio and percent change due to acetazollamide challenge were calculated before and after angioplasty.
Results
The mean stenosis rate was 76.6 %. Significant increases in MTT(32.6 %,p=0.000) and significant decreases in CBF (-14.2 %,p=o.ooo) was found in stenotic side MCA territories. After acetazolamide challenge, significant changes in MTT (37.4%, p=0.000), CBF (-13.1%, p=0.000), and CBV (-10.5%,p=0.001) in pre-procedural perfusion study. However,there were no significant increases in MTT, and decreases in CBF and CBV in post-procedural study. And no significant change after acetazolamide challenge also. Furthermore, most of these parameters (pre- andpost-Acetazolamide challenge) were highly correlated with the stenotic degree in pre-procedural perfusion study.
Conclusion
Perfusion CT with acetazolamide challenge can be used to assess the cerebral perfusion and might be useful in the treatment decision in patients with cerebrovascular stenosis.