Snelling Brian M, Sur Samir, Shah Sumedh S, Wolfson Racheal I, Ambekar Sudheer, Yavagal Dileep R, Elhammady Mohamed S, Peterson Eric C
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA.
World Neurosurg. 2017 Jun;102:229-234. doi: 10.1016/j.wneu.2017.03.023. Epub 2017 Mar 16.
The purpose of this study is to evaluate the role of venous phase timing when compared with technetium-99m Single Photon Emission Computed Tomography (SPECT) during angiographic balloon test occlusion of the internal carotid artery (ICA) and subsequent sacrifice of the ICA.
Fifty-six patients underwent formal balloon test occlusion from April 2008 to February 2014 at our institution. Venous phase timing was calculated for each patient. SPECT imaging for each patient was interpreted by the nuclear medicine radiologist. Statistical analysis on the 3 groups (No Hypoperfusion, Mild Hypoperfusion, Moderate/Severe Hypoperfusion) was calculated using analysis of variance.
Twenty-six patients showed no hypoperfusion during SPECT. The average delay of venous phase for these patients was 0.65 seconds. Eight of the 26 patients went on to have vessel sacrifice, with none showing evidence of infarction at the time of discharge. Six patients showed evidence of mild hypoperfusion on SPECT. None of these patients went on to have vessel sacrifice. The average venous delay was 0.5 seconds. Twenty-four patients were found to have moderate or severe hypoperfusion. The average venous delay was 1.08 seconds. Analysis of variance among the 3 groups demonstrated no significant difference (P = 0.22).
Our study demonstrated no correlation between venous phase timing and SPECT. Future studies comparing multiple tests with patients who have had vessel occlusion are necessary to determine the best adjunctive measures to predict delayed ischemia following carotid occlusion.
本研究的目的是评估在颈内动脉（ICA）血管造影球囊试验闭塞及随后ICA牺牲过程中，与锝-99m单光子发射计算机断层扫描（SPECT）相比，静脉期时间的作用。
2008年4月至2014年2月，我院56例患者接受了正式的球囊试验闭塞。计算每位患者的静脉期时间。每位患者的SPECT成像由核医学放射科医生解读。使用方差分析对三组（无灌注不足、轻度灌注不足、中度/重度灌注不足）进行统计分析。
26例患者在SPECT检查中未出现灌注不足。这些患者静脉期的平均延迟为0.65秒。26例患者中有8例随后进行了血管牺牲，出院时均未显示梗死迹象。6例患者在SPECT检查中有轻度灌注不足的证据。这些患者均未进行血管牺牲。平均静脉延迟为0.5秒。24例患者被发现有中度或重度灌注不足。平均静脉延迟为1.08秒。三组之间的方差分析显示无显著差异（P = 0.22）。
我们的研究表明静脉期时间与SPECT之间无相关性。未来有必要对血管闭塞患者进行多项检查比较的研究，以确定预测颈动脉闭塞后延迟性缺血的最佳辅助措施。
