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Interventions and functional brain imaging
A P Yudd1, R L Van Heertum, J C Masdeu
1Department of Radiology, St. Vincent's Hospital Medical Center, New York, NY 10011.
Seminars in Nuclear Medicine
|April 1, 1991
Summary
Assessing regional cerebral blood flow (rCBF) with acetazolamide-augmented SPECT helps differentiate vascular issues from neuronal loss in cerebrovascular disease. This stress test reveals diminished flow reserve missed by resting studies.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Regional cerebral blood flow (rCBF) assessment is crucial for evaluating cerebrovascular disease.
- Resting rCBF studies have limitations, potentially missing diminished vascular reserve or showing decreased flow due to diaschisis/neuronal loss with intact vasculature.
Purpose of the Study:
- To review the utility of stress single photon emission computed tomography (SPECT) using vasodilatory stimuli.
- Specifically, to discuss acetazolamide-augmented SPECT in evaluating cerebrovascular disease.
Main Methods:
- Review of studies utilizing acetazolamide (Diamox) as a vasodilatory stimulus.
- Application of single photon emission computed tomography (SPECT) for rCBF measurement under stress conditions.
Main Results:
- Acetazolamide-augmented SPECT can differentiate between diminished cerebrovascular reserve and conditions like diaschisis or selective neuronal loss.
- This stress-testing approach provides a more comprehensive evaluation than resting rCBF studies alone.
Conclusions:
- Acetazolamide-augmented SPECT is a valuable tool for assessing cerebrovascular disease.
- It enhances the diagnostic capability of SPECT by unmasking cerebrovascular dysfunction not evident at rest.