gms | German Medical Science

57th Annual Meeting of the German Society of Neurosurgery
Joint Meeting with the Japanese Neurosurgical Society

German Society of Neurosurgery (DGNC)

11 - 14 May, Essen

Quantitative assessment of hemodynamic impairment using cerebral blood volume measured by MR imaging in patients with major cerebral artery occlusive disease: Comparison with PET study

Meeting Abstract

  • corresponding author T. Inoue - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • H. Endo - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • K. Ogasawara - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • M. Kobayashi - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • T. Fukuda - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • Y. Kanbara - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan
  • A. Ogawa - Department of Neurosurgery, Iwate Medical University School of Medicine, Uchimaru, Morioka, Japan

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 57. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie. Essen, 11.-14.05.2006. Düsseldorf, Köln: German Medical Science; 2006. DocP 10.162

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2006/06dgnc379.shtml

Published: May 8, 2006

© 2006 Inoue et al.
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Outline

Text

Objective: Cerebrovascular reactivity (CVR) to acetazolamide can determine the severity of hemodynamic impairment in patients with major cerebral artery occlusive disease. On the other hand, perfusion-weighted magnetic resonance (PW MR) imaging can measure the cerebral blood volume (CBV) as an indicator of hemodynamic impairment. In the present study, CBV measured by PW MR imaging was compared with CVR measured by positron emission tomography (PET).

Methods: Twelve normal subjects and 17 patients with major cerebral artery occlusive disease underwent PW MR imaging and PET. The images were co-registered with three-dimensional spoiled gradient-recalled acquisition images. Quantitative PW MR imaging-CBV maps were generated using the indicator dilution method with arterial input function. One large cortical region of interest for each unilateral middle cerebral artery territory was determined on each image. PET-CVR was calculated by measuring cerebral blood flow before and after acetazolamide challenge.

Results: A significant negative correlation was observed between PW MR imaging-CBV and PET-CVR (r=-0.713, P<0.0001). PW MR imaging-CBV higher than the mean +2 SD obtained in normal subjects (15.2 mL/100 g) was defined as elevated and PET-CVR lower than the mean -2 SD obtained in normal subjects (15.1%) was defined as reduced. Assuming the PET-CVR as the true determinant of hemodynamic impairment, PW MR imaging-CBV provided 80.0% sensitivity and 91.7% specificity, with 80.0% positive predictive value for detecting patients with reduced CVR.

Conclusions: The PW MR imaging-CBV method can simply and accurately identify patients with hemodynamic impairment without exposure to ionizing radiation.