Correlation of Cerebrovascular Reserve as Measured by Acetazolamide-Challenged Perfusion CT with Collateral Circulation in Unilateral High Grade Carotid Stenosis

홍도란; 이영흔; 서형석; 제보경; 서상일; 설혜영; 이남준; 김정혁; 양경숙
January 2014
Journal of the Korean Society of Radiology;Jan2014, Vol. 70 Issue 1, p1
Academic Journal
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土36.43% and 34.53土 47.82%, p <0.001), and in the hemisphere predominantly supplied by secondary collaterals than primary (7.03土32.71% and 24.37土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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