Wang Wei MD, Presenter: Nothing to Disclose

Du Xianmao, Abstract Co-Author: Nothing to Disclose

Li Cheng, Abstract Co-Author: Nothing to Disclose

To quantitatively analyze the correlation between stenosis ratio and cerebral perfusion using a specific clinic model of solely symptomatic M1 stenosis of middle cerebral artery.

All the patients with solely symptomatic M1 stenosis of middle cerebral artery were selected strictly from consecutive 203 patients with elective stenting of symptomatic intracranial artery stenosis. CT, CT perfusion (CTP) and DSA examinations of the brain were performed in all cases. With the CTP results, the CTP parameters, including MTT, CBF and CBV, were measured in regions of interest (ROIs) including bilateral frontal lobe, anterior watershed, opercula of the insula, temporal lobe, posterior watershed and occipital lobe. Compared with the unaffected side, which is judged as normal, the CTP change and the relative CTP parameters including rMTT, rCBF and rCBV were determined. According to the DSA revelations, using a blind method, the ratio of M1 stenosis was measured manually, the collateral branch of compensative artery and the collateral branch flow grading were determined. Correlations were analyzed between the ratio of M1 stenosis and the CTP parameters including the absolute and the relative values.

Twenty patients were involved. Compared with the unaffected side, MTT and CBF were normal and CBV increased in frontal lobe; MTT prolonged, CBF was normal and CBV increased in anterior watershed and opercula of the insula; MTT prolonged, CBF and CBV had no significant difference in temporal lobe; MTT prolonged, CBF decreased and CBV had no significant difference in posterior watershed; MTT, CBF and CBV were normal in occipital lobe. The ratio of M1 stenosis was only positively correlated (r=0.66, p=0.002) with the rCBV in posterior watershed, there is no significant correlation between the ratio and any other CTP parameters in any regions(P＞0.05).

Affected by collateral compensative artery, tissue perfusion is at different level in different cerebral region and shows obviously spatial distribution. M1 stenosis ratio is positively correlated with rCBV in hemodynamic failure regions, and there is no correlation with tissue perfusion in hemodynamic compromise regions.

 Pre-operation evaluation of stenting for symptomatic middle cerebral artery stenosis.

Wei, W, Xianmao, D, Cheng, L, Symptomatic M1 Stenosis of Middle Cerebral Artery: The Correlation between Stenosis Ratio and CT Perfusion.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9002714.html