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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Severity Evaluation of Regional Cerebrovascular Reactivity in Acute Stroke Patients Using SPECT

Author(s): Chang-Ki Kang, Min-Gyu Song, Jiwon Yang, Haejun Lee and Yeong-Bae Lee*

Volume 18, Issue 8, 2022

Published on: 25 March, 2022

Article ID: e030122199800 Pages: 8

DOI: 10.2174/1573405618666220103104726

Price: $65

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.

Keywords: SPECT, acetazolamide, cerebrovascular reactivity, PET, acute stroke, cerebral severity.

Graphical Abstract

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