Efficacy Assessment of Endovascular Stenting in Patients with Unilateral Middle Cerebral Artery Stenosis Using Statistical Probabilistic Anatomical Mapping Analysis of Basal/Acetazolamide Brain Perfusion SPECT / 핵의학분자영상

ABSTRACT

PURPOSE: The aim of this study was to evaluate the hemodynamic changes after endovascular stenting in patients with unilateral middle cerebral artery (MCA) stenosis using statistical probabilistic anatomical mapping (SPAM) analysis of basal/acetazolamide (ACZ) Tc-99m ECD brain perfusion SPECT. MATERIALS AND METHODS: Eight patients (3 men and 5 women, 64.8+/-10.5 years) who underwent endovascular stenting for unilateral MCA stenosis were enrolled. Basal/ACZ Tc-99m ECD brain perfusion SPECT studies were performed by one-day protocol before and after stenting. Using SPAM analysis, we compared basal cerebral perfusion (BCP) counts and cerebrovascular reserve (CVR) index of the MCA territory before stenting with those after stenting. RESULTS: After stenting, no patient had any complication nor additional stroke. In SPAM analysis, 7 out of the 8 patients had improved BCP counts of the MCA territory and 7 out of the 8 patients had improved CVR index of the MCA territory after stenting. Before stenting, the mean BCP counts and CVR index in the affected MCA territory were 47.1+/-2.2 ml/min/100 g and -2.1+/-2.9%, respectively. After stenting, the mean BCP counts and CVR index in the affected MCA territory were improved significantly (48.3+/-2.9 ml/min/100 g, p=0.025 and 0.1+/-1.3%, p=0.036). CONCLUSION: This study revealed that SPAM analysis of basal/ACZ brain perfusion SPECT would be helpful to evaluate hemodynamic efficacy of endovascular stenting in unilateral MCA stenosis.