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Brain Perfusion Imaging Under Acetazolamide Challenge for Detection of Impaired Cerebrovascular Reserve Capacity: Positive Findings with 15O-Water PET in Patients with Negative 99mTc-HMPAO SPECT Findings
The Journal of Nuclear Medicine ( IF 9.1 ) Pub Date : 2018-02-01 , DOI: 10.2967/jnumed.117.195818
Güliz Acker , Catharina Lange , Imke Schatka , Andreas Pfeifer , Marcus A. Czabanka , Peter Vajkoczy , Ralph Buchert

Cerebrovascular reserve capacity (CVRC) is an important parameter for treatment decisions in chronic cerebrovascular diseases. It can be assessed by measuring the acetazolamide-induced change in regional cerebral blood flow using SPECT with 99mTc-labeled hexamethylpropyleneamine oxime (99mTc-HMPAO) or PET with 15O-water. Methods: Our database was searched for patients with moyamoya vasculopathy or atherosclerotic cerebrovascular disease who had undergone 15O-water PET after normal 99mTc-HMPAO SPECT results with respect to CVRC. 15O-water PET was analyzed visually and quantitatively. Quantitative analysis was based on parametric CVRC maps generated by voxelwise image subtraction. Results: The search identified 18 patients (43 ± 15 y, 12 moyamoya vasculopathy). PET revealed impaired CVRC in 8 patients (44%). Quantitative analysis confirmed the positive visual findings in 15O-water PET and the negative findings in 99mTc-HMPAO SPECT. Conclusion: 15O-water PET enables detection of impaired CVRC in a considerable fraction of symptomatic patients with stenoocclusion and negative 99mTc-HMPAO SPECT.



中文翻译:

乙酰唑胺挑战下的脑灌注成像检测受损的脑血管储备能力:阴性99m Tc-HMPAO SPECT结果为15 O-Water PET的阳性结果

脑血管储备能力(CVRC)是慢性脑血管疾病治疗决策的重要参数。可以通过使用99m Tc标记的六甲基丙烯胺肟(99m Tc-HMPAO)的SPECT或15 O-水的PET来测量乙酰唑胺诱导的局部脑血流变化来进行评估。方法:在我们的数据库中搜索关于CVRC的99m Tc-HMPAO SPECT结果正常后经历15 O-water PET的烟雾病血管病或动脉粥样硬化性脑血管疾病的患者。15目视和定量分析O-水PET。定量分析基于通过体素图像减法生成的参数CVRC图。结果:该搜索确定了18例患者(43±15岁,烟雾病12例)。PET显示8例患者(44%)的CVRC受损。定量分析证实了15 O-水PET的阳性视觉结果和99m Tc-HMPAO SPECT的阴性结果。结论: 15 O-水PET能够在相当一部分有狭窄闭塞和99m Tc-HMPAO SPECT阴性的症状患者中检测CVRC受损。

更新日期:2018-02-01
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