Clinical value of adenosine triphosphate stress cerebral blood flow perfusion SPECT imaging in patients with ischemic cerebrovascular disease

Abstract

Objective To investigate the value of ATP stress cerebral blood flow perfusion imaging (CBFPI) in diagnosis of ischemic cerebrovascular disease. Methods Thirty-two patients with cerebral ischemia and ischemic cerebral infarction (26 males, 6 females, average age: (63.0±8.7) years) in China-Japan Friendship Hospital from November 2016 to February 2017 were enrolled. All subjects underwent 99Tcm-ethylcysteinate dimer (ECD) rest and ATP stress CBFPI. Region of interest (ROI) was drawn in the symmetrical parts of the bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe and basal ganglia region, and the regional cerebral blood flow (rCBF) was automatically calculated. The images and rCBF of post- and pre-ATP stress CBFPI were analyzed and compared. Paired t test was used for statistical analysis. Results The positive rates of rest CBFPI, ATP stress CBFPI, and combination of both imaging were 53.1%(17/32), 65.6%(21/32), and 100%(32/32), respectively. In 16 cases with unilateral vascular stenosis, the average rCBF of diseased hemisphere was lower in stress imaging (62.7±13.3) ml·100 g-1·min-1 than that in rest imaging ((65.8±13.2) ml·100 g-1·min-1;t=3.07, P 0.05). In the other 16 patients with bilateral multivessel disease, the average rCBF of whole brain in rest imaging was higher than that in stress imaging: (62.5±13.9) vs (57.5±11.6) ml·100 g-1·min-1;t=3.50, P<0.05. There were 21 out of the 32 patients presented with a decreased cerebrovascular reserve. Conclusion ATP stress combined with rest CBFPI may improve positive rate remarkably and help to evaluate the cerebrovascular reserve. Key words: Brain ischemia; Tomography, emission-computed, single-photon; Adenosine triphosphate; Technetium; Cysteine