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Usefulness of 99mTc-ECD brain SPECT with voxel-based analysis in evaluation of perfusion changes early after carotid endarterectomy.
Nocun, Anna; Wilczynski, Marek; Wronski, Jacek; Chrapko, Beata.
Afiliación
  • Nocun A; Department of Nuclear Medicine, Medical University of Lublin, Lublin, Poland. ampolak@o2
Med Sci Monit ; 17(5): CR297-303, 2011 May.
Article en En | MEDLINE | ID: mdl-21525813
BACKGROUND: Association between preoperative perfusion pattern and reperfusion after carotid endarterectomy (CEA) is an important yet unexplored topic. Therefore, the aim of our study was to determine whether 99mTc-ECD single-photon emission computed tomography (SPECT) performed before carotid endarterectomy in patients with internal carotid artery (ICA) stenosis may be helpful in predicting early perfusion changes after revascularization. MATERIAL/METHODS: The examined group consisted of 30 patients (mean age 67.4±9.6 years) with ICA stenosis who underwent CEA. Infarction was demonstrated on computed tomography (CT) in 12 cases. Brain perfusion SPECT was performed 1-3 days before CEA and 3-5 days after the surgery. Voxel-based analysis was carried out with Brain SPECT Quantification software. For evaluation of preoperative interhemispheric asymmetry of perfusion, the percentage asymmetry index (AI) was calculated. For comparison of perfusion before and after CEA, the percentage relative difference (RD) was computed. RESULTS: Before CEA, cerebral hypoperfusion was seen in 26 cases, including 15 participants with normal CT. After CEA, the following changes of perfusion were observed: perfusion increase n=18 (ipsilateral and bilateral), deterioration n=1, mixed patterns n=2, no change n=9. In patients with preoperative ipsilateral hypoperfusion and perfusion increase after CEA, AI correlated significantly with RD (r=0.48, p=0.04). CONCLUSIONS: Our results suggest that perfusion increase 3-5 days after CEA is higher in patients with greater ipsilateral asymmetry index. Evaluation of preoperative AI may help to identify patients in whom rapid reperfusion is more likely.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encéfalo / Compuestos de Organotecnecio / Endarterectomía Carotidea / Cisteína Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Med Sci Monit Asunto de la revista: MEDICINA Año: 2011 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Encéfalo / Compuestos de Organotecnecio / Endarterectomía Carotidea / Cisteína Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Med Sci Monit Asunto de la revista: MEDICINA Año: 2011 Tipo del documento: Article País de afiliación: Polonia Pais de publicación: Estados Unidos