CJRTP

Chinese Journal of Rehabilitation Theory and Practice >

2020 , Vol. 26 >Issue 7: 745 - 748

DOI: https://doi.org/10.3969/j.issn.1006-9771.2020.07.001

Application of 13N-Ammonia PET/CT Cerebral Blood Perfusion Imaging Combined with Methazolamide Challenge in Ischemic Cerebrovascular Diseases

  • Yu-sheng SU ,
  • Hong-yan WANG ,
  • Xun-ming JI ,
  • Zhi-gang LIANG ,
  • Jie LU ,
  • Chun-lei CUI
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  • 1. a. Department of Nuclear Medicine; b. Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
    2. Department of Nuclear Medicine, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China

Received date: 2019-08-06

  Revised date: 2020-06-11

  Online published: 2020-07-24

Supported by

Beijing Municipal Commission of Science and Technology Capital Clinical Application Research Program(Z161100000516085)

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Abstract

Objective To apply 13N-ammonia PET/CT cerebral blood perfusion imaging combined with methazolamide challenge for cerebrovascular reserve (CVR) evaluation in ischemic cerebrovascular diseases. Methods From January, 2014 to December, 2016, 56 ischemic stroke patients with serious stenosis of unilateral internal carotid artery or middle cerebral artery accepted basal and stress PET/CT with methazolamide challenge. The patients were divided into normal-CVR group (n = 29) and reduced-CVR group (n = 27) according to the results of CVR, and followed up for 24 months. The ischemic cerebrovascular events and cerebral blood flow were observed. Results The incidence of transient ischemic attack was more in the reduced-CVR group than in the normal-CVR group (χ2 = 4.389, P < 0.05), while the incidence of ischemic stroke increased a little with no significant difference between the two groups ( P > 0.05). The CBF was improved in normal-CVR group after treatment ( t = 2.409, P < 0.05), and the improvement was not significant in reduced-CVR group ( t = 0.648, P > 0.05). Conclusion 13N-ammonia PET/CT cerebral blood flow perfusion imaging combined with methazolamide challenge can be used to evaluate CVR to predict the outcome for patients with cerebral ischemic disease, which is helpful for early intervention.

Key words： ischemic cerebrovascular diseases; cerebrovascular reserve; nitrogen radioisotopes; methazolamide; positronemission tomography; computerized tomography; ischemic preconditioning

Cite this article

Yu-sheng SU , Hong-yan WANG , Xun-ming JI , Zhi-gang LIANG , Jie LU , Chun-lei CUI . Application of 13N-Ammonia PET/CT Cerebral Blood Perfusion Imaging Combined with Methazolamide Challenge in Ischemic Cerebrovascular Diseases[J]. Chinese Journal of Rehabilitation Theory and Practice, 2020 , 26(7) : 745 -748 . DOI: 10.3969/j.issn.1006-9771.2020.07.001

References

[1] Pandya A, Gupta A, Kamel H, et al. Carotid artery stenosis: cost effectiveness of assessment of cerebrovascular reserve to guide treatment of asymptomatic patients[J]. Radiology, 2015, 274(2): 455-463.
[2] Wang Y, Zhao X, Liu L, et al. Prevalence and outcomes of symptomatic intracranial large artery stenoses and occlusions in China: the Chinese Intracranial Atherosclerosis (CICAS) Study[J]. Stroke, 2014, 45(3): 663-669.
[3] Gorelick P B, Wong K S, Bae H J, et al. Large artery intracranial occlusive disease: a large worldwide burden but a relatively neglected frontier[J]. Stroke, 2008, 39(8): 2396-2399.
[4] Gupta A, Chazen J L, Hartman M, et al. Cerebrovascular reserve and stroke risk in patients with carotid stenosis or occlusion: a systematic review and meta-analysis[J]. Stroke, 2012, 43(11): 2884-2891.
[5] Gasecki D, Kwarciany M, Nyka W, et al. Hypertension, brain damage and cognitive decline[J]. Curr Hypertens Rep, 2013, 15(6): 547-558.
[6] Kim K M, Watabe H, Hayashi T, et al. Quantitative mapping of basal and vasareactive cerebral blood flow using split-dose 123I-iodoamphetamine and single photon emission computed tomography[J]. Neuroimage, 2006, 33(4): 1126-1135.
[7] Hartkamp N S, Bokkers R P, van Osch M J, et al. Cerebrovascular reactivity in the caudate nucleus, lentiform nucleus and thalamus in patients with carotid artery disease[J]. J Neuroradiol, 2017, 44(2): 143-150.
[8] King A, Serena J, Bornstein N M, et al. Does impaired cerebrovascular reactivity predict stroke risk in asymptomatic carotid stenosis? A prospective substudy of the asymptomatic carotid emboli study[J]. Stroke, 2011, 42(6): 1550-1555.
[9] Chaer R A, Shen J, Rao A, et al. Cerebral reserve is decreased in elderly patients with carotid stenosis[J]. J Vasc Surg, 2010, 52(3): 569-574.
[10] You S H, Jo S M, Kim Y J, et al. Pre-and post-angioplasty perfusion CT with acetazolamide challenge in patients with unilateral cerebrovascular stenotic disease[J]. J Korean Neurosurg Soc, 2013, 54(4): 280-288.
[11] Buratti L, Viticchi G, Falsetti L, et al. Thresholds of impaired cerebral hemodynamics that predict short-term cognitive decline in asymptomatic carotid stenosis[J]. J Cereb Blood Flow Metab, 2016, 36(10): 1804-1812.
[12] Reinhard M, Schwarzer G, Briel M, et al. Cerebrovascular reactivity predicts stroke in high-grade carotid artery disease[J]. Neurology, 2014, 83(16): 1424-1431.
[13] Zhang W, Yin Y, Zhang Y, et al. Influence of cerebrovascular reactivity on outcome of the patients with ≥ 50% symptomatic unilateral middle cerebral artery stenosis[J]. Int J Neurosci, 2018, 128(1): 42-47.
[14] Donnelly J, Czosnyka M, Harland S, et al. Cerebral haemodynamics during experimental intracranial hypertension[J]. J Cereb Blood Flow Metab, 2017, 37(2): 694-705.
[15] 苏玉盛, 王红艳, 梁志刚, 等. 13N-Ammonia PET/CT脑血流灌注显像结合醋甲唑胺负荷试验对单侧大脑中动脉或颈内动脉狭窄患者脑血管储备的评定[J]. 中国康复理论与实践, 2016, 22(11): 1304-1309.
[15] Su Y S, Wang H Y, Liang Z G, et al. Cerebrovascular reserve in patients with unilateral internal carotid artery or middle cerebral artery stenosis: study with 13N-ammonia PET/CT combined with methazolamide [J]. Chin J Rehabil Theory Pract, 2016, 22(11): 1304-1309.
[16] Rebrova N V, Anisimova E A, Sarkisova O L, et al. Cerebrovascular reactivity in patients with rheumatoid arthritis concurrent with and without hypertension[J]. Ter Arkh, 2015, 87(4): 24-29.
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