Abstract
Identification of increased stroke risk in a population of symptomatic patients with occlusive vascular disease (OVD) is presently accomplished by measurement of oxygen extraction fraction (OEF) or cerebrovascular reserve (CVR). However, many regions identified by compromised CVR are not identified by OEF. Our aim was to determine whether the response of OEF to acetazolamide, namely, oxygen extraction fraction response (OEFR) would identify those hemispheres in hemodynamic compromise with normal OEF. Nine patients symptomatic with transient ischemic attacks and strokes, and with occlusive vascular disease were studied. Anatomical MRI scans and T2-weighted images were used to identify and grade subcortical white matter infarcts. PET cerebral blood flow (CBF) and OEF were measured after acetazolamide. The relationship between CVR and oxygen extraction fraction response (OEFR) showed that positive OEFR occurred after acetazolamide despite normal baseline OEF values. The two hemispheres with positive OEFR were also associated with severe (> 3 cm) subcortical white matter infarcts. We found that the OEFR was highly correlated with CVR and identified hemispheres that were hemodynamically compromised despite normal baseline OEF.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
E. M. Nemoto, H. Yonas, H. Kuwabara, R. Pindzola, D. Sashin, C. C. Meltzer, J. C. Price, and Y. F. Change, Detection of stage II compromised cerebrovascular reserve by Xenon-CT cerebral blood flow with acetazolamide and oxygen extraction fraction by positron emission tomography, in: Brain Imaging Using PET, edited by M. Senda, Y. Kimura, and P. Herscovitch (Academic Press, New York, 2002), pp. 259–267.
R. P. Woods, S. R. Cherry, and J. C. Mazziotta, Rapid automated algorithm for aligning and reslicing PET images, J. Comp. Assist. Tomog. 16, 620–633 (1992).
S. Ohta, E. Meyer, H. Fujita, D. C. Reutens, A. Evans, and A. Gjedde, Cerebral [15O] water clearance in humans determined by PET: I. Theory and normal values, J. Cereb. Blood Flow Metab. 16, 765–780 (1966).
H. Iida, I. Kanno, S. Miura, M. Murakami, K. Takahashi, and K. Uemura, Error analysis of a quantitative cerebral blood flow measurement using H2 15O autoradiography and positron emission tomography with respect to the dispersion of the input function, J. Cereb. Blood Flow Metab. 6, 536–545 (1986).
M. A. Mintun, M. E. Raichle, W. R. Martin, and P. Herscovitch, Brain oxygen utilization measured with O-15 radiotracers and positron emission tomography, J. Nucl. Med. 25, 177–187 (1983).
S. Ohta, E. Meyer, and C. J. Thompson, Oxygen consumption of the living human brain measured after a single inhalation of positron emitting oxygen, J. Cereb. Blood Flow Metab. 12, 179–192 (1992).
E. M. Nemoto, H. Yonas, H. Kuwabara, R. R. Pindzola, D. Sashin, C. C. Meltzer, J. C. Price, Y. Chang, and D. W. Johnson, Identification of hemodynamic compromise by CVR and OEF in occlusive vascular disease, J. Cereb. Blood Flow Metab. (In press, October 2004).
I. Kanno, K. Uemura, S. Higano, M. Murakami, H. Iida, S. Miura, F. Shishido, A. Inugami, and I. Sayama, Oxygen extraction fraction at maximally vasodilated tissue in the ischemic brain estimated from the regional CO2 responsiveness measured by positron emission tomography, J. Cereb. Blood Flow Metab. 8(2), 227–235 (1988).
T. Nariai, R. Suzuki, K. Hirakawa, T. Maehara, K. Ishii, and M. Senda, Vascular reserve in chronic cerebral ischemia measured by the acetazolamide challenge test: comparison with positron emission tomography, Am. J. Neuroradiol. 16(3), 563–570 (1995).
M. Imaizumi, K. Kitagawa, K. Hashikawa, N. Oku, T. Teratani, M. Takasawa, T. Yoshikawa, P. Rishu, T. Ohtsuki, M. Hori, M. Matsumoto, and T. Nishimura, Detection of misery perfusion with split-dose 123I-iodoamphetamine single-photon emission computed tomography in patients with carotid occlusive diseases, Stroke 33(9), 2217–2223 (2002).
H. Yamauchi, H. Fukuyama, Y. Nagahama, H. Nabatame, M. Ueno, S. Nishizawa, J. Konishi, and H. Shio, Significance of increased oxygen extraction fraction in five-year prognosis of major cerebral arterial occlusive diseases, J. Nucl. Med. 40, 1992–1998 (1999).
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2005 Springer Science+Business Media, Inc.
About this paper
Cite this paper
Nemoto, E.M. et al. (2005). Differentiating Hemodynamic Compromise by the OEF Response to Acetazolamide in Occlusive Vascular Disease. In: Okunieff, P., Williams, J., Chen, Y. (eds) Oxygen Transport to Tissue XXVI. Advances in Experimental Medicine and Biology, vol 566. Springer, Boston, MA. https://doi.org/10.1007/0-387-26206-7_19
Download citation
DOI: https://doi.org/10.1007/0-387-26206-7_19
Publisher Name: Springer, Boston, MA
Print ISBN: 978-0-387-25062-5
Online ISBN: 978-0-387-26206-2
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)