Neuroscience Research Institute, Gachon University, Incheon, 21565, Republic of Korea.
Department of Radiological Science, College of Health Science, Gachon University, Incheon, 21936, Republic of Korea.
Curr Med Imaging. 2022;18(8):837-844. doi: 10.2174/1573405618666220103104726.
Cerebrovascular Reactivity (CVR), as measured using perfusion Single Photon Emission Computed Tomography (SPECT), is an important indicator for the treatment and prognosis of cerebrovascular disease, but there are a few studies on acute stroke or small vascular disease using SPECT.
This study evaluated the regional severity with quantitatively determined CVR in patients with acute stroke.
Fifty-eight patients who took brain SPECT images were selected to localize quantitative CVR values. The severity of the disease (Grade 1 to 4) was determined through image-based clinical assessment in the absence and presence of a CVR map, and their results were compared.
In 1st diagnosis without the map, the mean CVR values of Grades 2 and 3 were -6.07 % and -9.12 %, respectively (P=0.034), while they were -4.78 % and -12.34 % in 2nd diagnosis with the map, respectively (P<0.001), suggesting that the CVR difference with the map was much more pronounced than without the map. Furthermore, in the ROC analysis, the diagnostic sensitivity between Grades 2 and 3 in the 2nd diagnosis (AUC=0.899, P<0.001) was substantially greater than the 1st diagnosis (AUC=0.646, P=0.048).
This study demonstrated that the quantitative CVR maps could reinforce the clinical evaluation of cerebral severity by showing that they can provide statistically significant results between severity and CVR. Furthermore, this study was the first to evaluate the effectiveness of quantitative CVR by examining the difference in the presence or absence of CVR in patients with acute stroke.
脑血管反应性（CVR），通过灌注单光子发射计算机断层扫描（SPECT）测量，是脑血管疾病治疗和预后的重要指标，但使用 SPECT 对急性中风或小血管疾病的研究较少。
本研究评估了急性中风患者使用定量 CVR 确定的区域性严重程度。
选择了 58 名接受脑部 SPECT 图像的患者来定位定量 CVR 值。通过图像的临床评估确定疾病严重程度（1 级至 4 级），并在没有和存在 CVR 图的情况下进行比较。
在没有地图的首次诊断中，等级 2 和 3 的平均 CVR 值分别为-6.07%和-9.12%（P=0.034），而在有地图的第二次诊断中，CVR 值分别为-4.78%和-12.34%（P<0.001），这表明地图与地图的 CVR 差异更为明显。此外，在 ROC 分析中，第二次诊断中等级 2 和 3 的诊断敏感性（AUC=0.899，P<0.001）明显高于首次诊断（AUC=0.646，P=0.048）。
本研究表明，定量 CVR 图可以通过显示它们可以在严重程度和 CVR 之间提供具有统计学意义的结果，从而增强对大脑严重程度的临床评估。此外，本研究首次通过检查急性中风患者 CVR 的存在与否来评估定量 CVR 的有效性。
