Crossed cerebellar diaschisis and cerebral perfusion reserve in unilateral occlusive cerebrov ascular diseases
- Ehime Univ. School of Medicine (Japan); and others
The purpose of this study was to investigate the relationship between crossed cerebellar diaschisis (CCD) and cerebral perfusion reserve in patients with unilateral occlusive cerebrovascular diseases using SPECT and acetazolamide (ACZ) enhancement. We studied 14 patients who had reduced cerebral cortical blood flow on SPECT but only subcortical abnormalities on CT or MRI. Cerebral perfusion reserve was evaluated with the change of rCBF and rCBF ratio (affected/nonaffected cerebral cortex) measured by Xe-133 gas inhalation method at rest and after ACZ enhancement. The presence and the degree of CCD was evaluated visually and semiquantitatively with the count ratio of the cerebellar cortex (contralateral/ipsilateral) using Tc-99m HMPAO SPECT. Eight patients showed CCD, while 6 did not. At rest, no difference in the degree of cerebral blood flow asymmetry was observed between the two patient groups (the rCBF ratio as follows; 0.76{plus_minus}0.08 in the CCD(+) vs 0.73{plus_minus}0.14 in the CCD(-)). After ACZ enhancement, however, the rCBF ratio of the CCD(-) group was significantly lower than that of the CCD(+) group (the rCBF ratio as follows; 0.63{plus_minus}0.18 in the CCD(+) vs 0.46{plus_minus}0.14 in the CCD(-), p<0.05). The degree of the change of the rCBF ratio before and after ACZ correlated significantly with the degree of CCD (r=-0.63, p<0.05). Furthermore, after bypass surgery (9 patients), marked improvement of rCBF and perfusion reserve of the affected cortex was achieved in the CCD (-) group (3 patients), while that was poor in the CCD(+) group (6 patients). Thus, CCD had a close relationship with cerebral perfusion reserve, and it was a useful finding in management of the patients with unilateral occlusive cerebrovascular diseases.
- OSTI ID:
- 198055
- Report Number(s):
- CONF-940605--
- Journal Information:
- Journal of Nuclear Medicine, Journal Name: Journal of Nuclear Medicine Journal Issue: Suppl.5 Vol. 35; ISSN JNMEAQ; ISSN 0161-5505
- Country of Publication:
- United States
- Language:
- English
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