Identifying Patients for Carotid Artery Stenting : Feasibility of Acetazolamide - Challenged Dynamic CT Perfusion

To correlate quantitative cerebrovascular reserve calculated by acetazolamide - challenged CT perfusion with clinical symptoms in patients with high-grade (>70%) carotid stenosis and impaired cerebrovascular reserve who did not have evidence of embolic stroke. Thirty-seven patients diagnosed as unilateral severe carotid stenosis and 10 age-matched normal controls underwent acetazolamide - challenged CT perfusion from Nov. 2005 to Jun. 2006. For quantitative measurement, asymmetric index of cerebral blood flow, cerebral blood volume, and mean transit time were determined before and after acetazolamide challenge. Reactivity index was also calculated from asymmetric index of cerebral blood flow before and after acetazolamide challenge. On qualitative analysis, all of 14 asymptomatic patients and 4 of 23 symptomatic patients showed bilateral symmetric cerebrovascular reserve on CT perfusion, and 19 symptomatic patients showed decreased cerebrovascular reserve ipsilateral to carotid stenosis. On quantitative analysis, the reactivity index was significantly different between the symptomatic and the asymptomatic groups (-24% vs -8% in external border zone) but the resting parameters were not. Eleven patients with decreased cerebrovascular reserve who underwent carotid stent placement showed improved clinical symptoms and quantitative cerebrovascular reserve on follow up CT perfusion. Compared with resting hemodynamic parameters, quantitative cerebrovascular reserve calculated by CT perfusion is most significantly correlated with clinical symptoms in patients with high-grade carotid stenosis and impaired cerebrovascular reserve.

Author dc:creator

• 김, 준만

Contributors dc:contributor

• 김, 선용
• 대학원 의학과
• 200524165

• Perfusion CT
• Quantitative CVR
• Carotid Stenosis

Language dc:language

en

Identifier

http://dcoll.ajou.ac.kr:9080/dcollection/jsp/common/DcLoOrgPer.jsp?sItemId=000000006980
000000006980

OAI identifier oai:identifier

oai:repository.ajou.ac.kr:201003/1358