Title:Severity Evaluation of Regional Cerebrovascular Reactivity in Acute
Stroke Patients Using SPECT
Volume: 18
Author(s): Chang-Ki Kang, Min-Gyu Song, Jiwon Yang, Haejun Lee and Yeong-Bae Lee*
Affiliation:
- Neuroscience Research Institute, Gachon University, Incheon, 21565, Republic of Korea
- Department of Neurology,
Gil Medical Center, Gachon University College of Medicine, Incheon, 21565, Republic of Korea
Keywords:
SPECT, acetazolamide, cerebrovascular reactivity, PET, acute stroke, cerebral severity.
Abstract:
Background: Cerebrovascular Reactivity (CVR), as measured using perfusion Single
Photon Emission Computed Tomography (SPECT), is an important indicator for the treatment and
prognosis of cerebrovascular disease, but there are a few studies on acute stroke or small vascular
disease using SPECT.
Objective: This study evaluated the regional severity with quantitatively determined CVR in patients
with acute stroke.
Methods: Fifty-eight patients who took brain SPECT images were selected to localize quantitative
CVR values. The severity of the disease (Grade 1 to 4) was determined through image-based clinical
assessment in the absence and presence of a CVR map, and their results were compared.
Results: In 1st diagnosis without the map, the mean CVR values of Grades 2 and 3 were -6.07 %
and -9.12 %, respectively (P=0.034), while they were -4.78 % and -12.34 % in 2nd diagnosis with
the map, respectively (P<0.001), suggesting that the CVR difference with the map was much more
pronounced than without the map. Furthermore, in the ROC analysis, the diagnostic sensitivity between
Grades 2 and 3 in the 2nd diagnosis (AUC=0.899, P<0.001) was substantially greater than
the 1st diagnosis (AUC=0.646, P=0.048).
Conclusion: This study demonstrated that the quantitative CVR maps could reinforce the clinical
evaluation of cerebral severity by showing that they can provide statistically significant results between
severity and CVR. Furthermore, this study was the first to evaluate the effectiveness of quantitative
CVR by examining the difference in the presence or absence of CVR in patients with acute
stroke.
