PREDICTIVE ROLE OF CEREBRAL BLOOD FLOW STRESS-TEST WITH ADENOSINTRIPHOSPHATE QUANTIFIED WITH 99m TC-HMPAO SPECT IN PATIENTS WITH CAROTID ATHEROSCLEROSIS

Introduction: Previously, a functional test with intravenous administration of adenosine triphosphate (ATP) was proposed to assess the reactivity cerebral circulation and significance internal carotid artery stenoses, evaluation by brain SPECT (neuroSPECT) 99mTc-HMPAO. The types reaction blood flow during it were identified, different ratios stenoses degree ischemic damage assessed according MRI data. However, prognostic value results ATP in relation disorders (NMC) remains unknown. Purpose: In retrospective study, we tried study risk subsequent circulation. Material methods: included 37 patients atherosclerotic stenosis arteries, who 2002–2005 underwent studies sample solution. Brain quantified data (Magnetom Open, Siemens) T2-weighted mode, previously developed technique. Denoting Iliq – intensity T2 signal from cerebrospinal fluid ventricles brain, Iinsult area affected ischemia, Inorm unaffected volume damaged tissue (VDT) calculated as sum taken all sections i, where is visible: VDT=Σid·Si∙[(Iinsult ‒ Inorm)/(Iliq Inorm)]i, d thickness slice, Si ischemia on slice i. quota physical lesion then obviously eqal : QD={Σid·Si∙[(Iinsult Inorm)]i}/{Σid·Si}. NeuroSPECT 99mTc-HMPAO (540 MBq) each patient carried out at rest solution (100 μg / kg weight, intravenously slowly for 1 min under ECG control). asymmetry evaluated accumulation index (AI) interhemispheric ratio average absorption score middle basin. Results: accordance presented classification, assigned one three groups stress ATP. 14 individuals (type 1), symmetrical distribution noted (AI=0.98±0.01), while caused an uptake (AI=0.91±0.04), due decrease side stenosis-dependent hemisphere (unilateral common and/or exceeding 55 %), without signs cortex. 11 previous injuries 2), proven MRI, arteries patent, including after endarterectomy (5 patients) or correction stent (three). Rest present (AI=0.92±0.03). increased supply injury if, area, QD<0.35. Due this, general, there significant (AI=0.96±0.03) test. 12 3) predominantly unilateral 50‒90 % stroke same (group III), hemispheric already (AI=0.96±0.03), (AI=0.93±0.03) When analyzing two-year follow-up, turned that frequent transient ishemic attacs, minor strokes only whom induced more than 5 four type reactivity, 3 Conclusions: Thus, perfusion neuroSPECT stress-test can be employed identify reduced reserve perfusion, have stroke. Quantitative analysis gives estimate proportion viable focus past which preserved.