Evaluation of cerebral perfusion reserve using 5% CO2 and SPECT neuroperfusion imaging
- Nuclear Medicine Service, Hines VA Hospital, IL (USA)
Anatomic features of carotid artery stenosis, as defined angiographically, do not necessarily correlate with the hemodynamic significance of the narrowing. The concept of regional cerebral vasodilatory (or perfusion) reserve has been advocated as a means of defining the hemodynamic compromise associated with carotid lesions. We evaluated the feasibility of using SPECT imaging with 5% CO2 using I-123 IMP (N-isopropyl iodoamphetamine) or Tc-99m HMPAO (hexamethylpropylene amineoxime) to measure cerebral perfusion reserve. Imaging was performed on six asymptomatic subjects and one patient with a history of transient ischemic attacks but no evidence of carotid artery disease. A perfusion reserve index (PRI) was defined to represent the percent increase in blood flow during 5% CO2 breathing in regions supplied by the middle cerebral artery normalized for injected dose and changes in blood pressure. Significant increases in cerebral perfusion were seen in six of the seven subjects studied while breathing the 5% CO2 (P less than 0.01). The mean of the PRI values for the seven subjects was 32%, with a range of -5% to 58%. We conclude that SPECT imaging with IMP or HMPAO can be used to quantitatively measure the cerebral perfusion response to 5% CO2.
- OSTI ID:
- 5397809
- Journal Information:
- Clinical Nuclear Medicine; (United States), Journal Name: Clinical Nuclear Medicine; (United States) Vol. 16:4; ISSN CNMED; ISSN 0363-9762
- Country of Publication:
- United States
- Language:
- English
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62 RADIOLOGY AND NUCLEAR MEDICINE
AMINES
AMPHETAMINES
ANALEPTICS
ARTERIES
AUTONOMIC NERVOUS SYSTEM AGENTS
BETA DECAY RADIOISOTOPES
BLOOD FLOW
BLOOD PRESSURE
BLOOD VESSELS
BODY
BRAIN
CARBON COMPOUNDS
CARBON DIOXIDE
CARBON OXIDES
CARDIOVASCULAR SYSTEM
CAROTID ARTERIES
CENTRAL NERVOUS SYSTEM
CENTRAL NERVOUS SYSTEM AGENTS
CEREBRAL CORTEX
CEREBRUM
CHALCOGENIDES
COMPUTERIZED TOMOGRAPHY
COUNTING TECHNIQUES
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DISEASES
DRUGS
ELECTRON CAPTURE RADIOISOTOPES
EMISSION COMPUTED TOMOGRAPHY
FEASIBILITY STUDIES
HOURS LIVING RADIOISOTOPES
HYDROXY COMPOUNDS
INTERMEDIATE MASS NUCLEI
IODINE 123
IODINE ISOTOPES
ISOTOPES
NERVOUS SYSTEM
NUCLEI
ODD-EVEN NUCLEI
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
ORGANS
OXIDES
OXIMES
OXYGEN COMPOUNDS
PERFUSED ORGANS
RADIOISOTOPE SCANNING
RADIOISOTOPES
SCINTISCANNING
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
SYMPATHOMIMETICS
TOMOGRAPHY
VASCULAR DISEASES