Derdeyn C P, Videen T O, Simmons N R, Yundt K D, Fritsch S M, Grubb R L, Powers W J
Section of Neuroradiology, Mallinckrodt Institute, St Louis, MO, USA.
Radiology. 1999 Aug;212(2):499-506. doi: 10.1148/radiology.212.2.r99au27499.
To test the ability of a count-based positron emission tomographic (PET) method, without arterial sampling, for the measurement of regional cerebral oxygen extraction fraction (OEF) to predict ischemic stroke in patients with symptomatic carotid arterial occlusion.
The outcome analysis of a blinded prospective study designed to determine if increased OEF was an independent predictor of stroke in patients with symptoms and with carotid occlusion was repeated by substituting a count-based method of OEF measurement for the original quantitative technique. The performance of the quantitative and count-based methods was assessed by using Kaplan-Meier cumulative survival functions (log-rank, [p < .05]). Receiver operating characteristic (ROC) curves for both methods were generated.
Thirteen ipsilateral strokes occurred during a mean follow-up of 3.1 years for 81 patients. All ipsilateral strokes occurred in 50 patients with increased count-based OEF (P = .002, sensitivity 100%, specificity 46%). Sixty-eight patients underwent complete quantitative studies, which allowed comparison of OEF methods. Both the count-based and the quantitative methods were predictive of stroke in this subgroup (P = .005 and .025, respectively). ROC analysis demonstrated a greater area under the curve for the count-based OEF method.
Count-based PET measurement of OEF without arterial sampling accurately predicts stroke in patients with carotid occlusion.
测试一种基于计数的正电子发射断层扫描（PET）方法在不进行动脉采样的情况下测量局部脑氧摄取分数（OEF）以预测有症状颈动脉闭塞患者发生缺血性卒中的能力。
通过用基于计数的OEF测量方法替代原始定量技术，重复一项盲法前瞻性研究的结果分析，该研究旨在确定OEF升高是否是有症状且有颈动脉闭塞患者发生卒中的独立预测因素。采用Kaplan-Meier累积生存函数（对数秩检验，[p <.05]）评估定量方法和基于计数的方法的性能。生成两种方法的受试者操作特征（ROC）曲线。
81例患者平均随访3.1年期间发生了13例同侧卒中。所有同侧卒中均发生在50例基于计数的OEF升高的患者中（P =.002，敏感性100%，特异性46%）。68例患者接受了完整的定量研究，这使得可以比较OEF测量方法。在该亚组中，基于计数的方法和定量方法均能预测卒中（分别为P =.005和.025）。ROC分析表明基于计数的OEF方法的曲线下面积更大。
不进行动脉采样的基于计数的PET测量OEF能准确预测颈动脉闭塞患者发生卒中。
