Regional resting state perfusion variability and delayed cerebrovascular uniform reactivity in subjects with chronic carotid artery stenosis

• Authors: Arkadiusz Szarmach , Mariusz Kaszubowski , Agnieszka Sabisz , Andrzej Frydrychowski , Grzegorz Halena , Maciej Piskunowicz , Jarosław Dzierzanowski , Michał Studniarek , Edyta Szurowska , Pawel Winklewski
• Languages of publication: EN

Abstracts

EN

The aim of this study was to assess regional perfusion at baseline and regional cerebrovascular resistance (CVR) to delayed acetazolamide challenge in subjects with chronic carotid artery stenosis. Sixteen patients (ten males) aged 70.94±7.71 with carotid artery stenosis ≥ 90% on the ipsilateral side and ≤ 50% on the contralateral side were enrolled into the study. In all patients, two computed tomography perfusion examinations were carried out; the first was performed before acetazolamide administration and the second 60 minutes after injection. The differences between mean values were examined by paired two-sample t-test and alternative nonparametric Wilcoxon's test. Normality assumption was examined using W Shapiro-Wilk test. The lowest resting-state cerebral blood flow (CBF) was observed in white matter (ipsilateral side: 18.4±6.2; contralateral side: 19.3±6.6) and brainstem (ipsilateral side: 27.8±8.5; contralateral side: 29.1±10.8). Grey matter (cerebral cortex) resting state CBF was below the normal value for subjects of this age: frontal lobe - ipsilateral side: 30.4±7.0, contralateral side: 33.7±7.1; parietal lobe - ipsilateral side: 36.4±11.3, contralateral side: 42.7±9.9; temporal lobe - ipsilateral side: 32.5±8.6, contralateral side: 39.4±10.8; occipital lobe - ipsilateral side: 24.0±6.0, contralateral side: 26.4±6.6). The highest resting state CBF was observed in the insula (ipsilateral side: 49.2±17.4; contralateral side: 55.3±18.4). A relatively high resting state CBF was also recorded in the thalamus (ipsilateral side: 39.7±16.9; contralateral side: 41.7±14.1) and cerebellum (ipsilateral side: 41.4±12.2; contralateral side: 38.1±11.3). The highest CVR was observed in temporal lobe cortex (ipsilateral side: +27.1%; contralateral side: +26.1%) and cerebellum (ipsilateral side: +27.0%; contralateral side: +34.6%). The lowest CVR was recorded in brain stem (ipsilateral side: +20.2%; contralateral side: +22.2%) and white matter (ipsilateral side: +18.1%; contralateral side: +18.3%). All CBF values were provided in milliliters of blood per minute per 100 g of brain tissue (ml/100g/min). Resting state circulation in subjects with carotid artery stenosis is low in all analysed structures with the exception of insula and cerebellum. Acetazolamide challenge yields relatively uniform response in both hemispheres in the investigated population. Grey matter is more reactive to acetazolamide challenge than white matter or brainstem.

Keywords

EN

chronic carotid artery stenosis; computed tomography perfusion; acetazolamide test; cerebral blood flow; cerebral blood volume; mean transit time; time to peak

• Publisher: Polish Biochemical Society
• Journal: Acta Biochimica Polonica
• Year: 2018
• Volume: 65
• Issue: 1
• Pages: 151-162

Dates

published

2018

received

2018-02-27

revised

2018-02-28

accepted

2018-02-28

(unknown)

2018-03-12

Contributors

author

Arkadiusz Szarmach

• 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland

author

Mariusz Kaszubowski

• Department of Economic Sciences, Faculty of Management and Economics, Gdansk University of Technology, Gdańsk, Poland

author

Agnieszka Sabisz

• 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland

author

Andrzej Frydrychowski

• Department of Human Physiology, Medical University of Gdansk, Gdańsk, Poland

author

Grzegorz Halena

• Department of Cardiovascular Surgery, Medical University of Gdansk, Gdańsk, Poland

author

Maciej Piskunowicz

• 1-st Department of Radiology, Medical University of Gdansk, Gdańsk, Poland

author

Jarosław Dzierzanowski

• Department of Neurosurgery, Medical University of Gdansk, Gdańsk, Poland

author

Michał Studniarek

• 1-st Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
• Department of Diagnostic Imaging, Medical University of Warsaw, Warsaw, Poland

author

Edyta Szurowska

• 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland

author

Pawel Winklewski

• 2nd Department of Radiology, Medical University of Gdansk, Gdańsk, Poland
• Department of Human Physiology, Medical University of Gdansk, Gdańsk, Poland
• Faculty of Health Sciences, Pomeranian University of Slupsk, Słupsk, Poland

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Identifiers

DOI

10.18388/abp.2018_2581