128-slice Multidetector CT (MDCT) Whole Brain Perfusion Evaluation In Patients With Carotid Artery Stenosis Berfore And After Therapy

Objective:Carotid artery stenosis is one of the most primary pathogenic factors of ischemic encephalopathy, and it is of positive importance for active treatment on carotid artery stenosis to reduce or prevent ischemic encephalopathy. The aim of this study was to evaluate whole brain perfusion modifications by 128-MDCT(Siemens) in patients with severe carotid artery stenosis before and after undergoing carotid artery stent placement (CAS) or carotid endarterectomy (CEA).Materials and methods:Sixteen patients with unilateral (12/16) and bilateral (4/16) internal carotid artery stenosis(≥70%) were taken the whole brain perfusion by 128-MDCT within 1 week before and after treatment respectively. And meanwhile relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV) and relative mean transit time (rMTT) values were measured with different slice thickness and different reformatted images such as axial and coronal images.Results:Before treatment, it was found decreased rCBF and increased rMTT values in all 16 carotid artery stenosis cases, decreased rCBV values in 13 cases and slightly increased rCBV values in 3 cases. A marked normalization of the perfusion parameters was transferred after treatment of CAS or CEA. It was found increased rCBF(t=-4.57,P<0.01), rCBV(t=-5.06,P<0.01) and decreased rMTT (t=2.41,P <0.05) values in all 16 cases. There was no difference in evidence of rCBF, rCBV and rMTT values among different slice-thickness and reformatted images as well.Conclusions:128-MDCT whole brain perfusion is a useful technique for the assessment of the hemodynamic modifications in patients with severe carotid artery stenosis. The quantitative evaluation before and after treatment with whole brain perfusion makes it a relative reliable tool for the follow-up of patients performed with CAS or CEA.