기저/아세타졸아미드 국소뇌혈류 SPECT의 확률 뇌지도 분석을 이용한 일측 중대뇌동맥 협착환자에서 시행한 스텐트 삽입술의 효용성 평가 (Efficacy Assessment of Endovascular Stenting in Patients with Unilateral Middle Cerebral Artery Stenosis Using Statistical Probabilistic Anatomical Mapping Analysis of Basal/Acetazolamide Brain Perfus)

서지정보

· 발행기관 : 대한핵의학회
· 수록지 정보 : Nuclear Medicine and Molecular Imaging / 43권 / 4호 / 280 ~ 286페이지
· 저자명 : 김해원, 원경숙, 전석길, 이창영

초록

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.

영어초록

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.

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