Ces radiol. 2013, 67(3):181-187

Acetazolamide challenge test during perfusion computed tomography of the brainOriginal article

Jiří Ferda¹, Jan Baxa¹, Hynek Mírka¹, Jan Mraček², Vladimír Přibáň²

¹ Klinika zobrazovacích metod LF UK a FN, Plzeň

² Neurochirurgické oddělení FN, Plzeň

Aim: To assess the effectiveness of acetazolamide challenge perfusion CT of the brain in detection of cerebrovascular reserve.

Method: During twelve months, 10 examinations of volume perfusion CT of the brain was performed during acetazolamide challenge. The sample of patients consisted of 7 males and 3 females (mean age 54,4 years, range 28-72). The cerebrovascular reserve (CVR) was assessed using the comparison of perfusion maps during rest and challenge, cerebral blood volume (CBV) and mean transit time (MTT) were used.

Results: Significant decrease of CVR was not found in any of four patients with occlusion of internal carotid after spontaneous dissection. In four of six patients with atherosclerotic occlusion of internal carotid, the significant decrease of CVR was found; three of them underwent EC-IC bypass graft surgery. In remaining two patients was found no decrease of CVR.

Conclusion: Acetazolamide challenge test is useful test in detection of CVR, according tis test is possible to stratify the patients in whom the EC-IC surgery may improve the brain blood perfusion.

Keywords: brain CT perfusion, acetazolamide, extra-intracranial bypass

Grants and funding:

Podpořeno Projektem rozvoje Univerzity Karlovy P36 a projektem Koncepčního rozvoje výzkumné instituce 00669806 Fakultní nemocnice v Plzni.

Accepted: June 15, 2013; Published: September 1, 2013  Show citation