Hypoxic Viable Tissue in Human Chronic Cerebral Ischemia Because of Unilateral Major Cerebral Artery Steno-Occlusive Disease

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Bibliographische Detailangaben
Zeitschriftentitel:	Stroke
Personen und Körperschaften:	Saura, Hiroaki, Ogasawara, Kuniaki, Beppu, Takaaki, Yoshida, Koji, Kobayashi, Masakazu, Yoshida, Kenji, Terasaki, Kazunori, Takai, Yoshihiro, Ogawa, Akira
In:	Stroke, 46, 2015, 5, S. 1250-1256
Format:	E-Article
Sprache:	Englisch
veröffentlicht:	Ovid Technologies (Wolters Kluwer Health)
Schlagwörter:	Advanced and Specialized Nursing Cardiology and Cardiovascular Medicine Neurology (clinical)

Details
Zusammenfassung:	<jats:sec> <jats:title>Background and Purpose—</jats:title> <jats:p> Positron emission tomography (PET) with radiolabeled 2-nitroimidazoles directly detects hypoxic but viable tissue present in an acute ischemic area in the human brain. This study using PET with 1-(2- <jats:sup>18</jats:sup> F-fluoro-1-[hydroxymethyl]ethoxy) methyl-2-nitroimidazole ( <jats:sup>18</jats:sup> F-FRP170) aimed to determine whether tissue with an abnormally elevated uptake of <jats:sup>18</jats:sup> F-FRP170 exists in human chronic cerebral ischemia because of unilateral atherosclerotic major cerebral artery steno-occlusive disease. </jats:p> </jats:sec> <jats:sec> <jats:title>Methods—</jats:title> <jats:p> <jats:sup>18</jats:sup> F-FRP170 PET was performed, and cerebral blood flow and metabolism were assessed using <jats:sup>15</jats:sup> O-gas PET in 20 healthy subjects and 52 patients. A region of interest (ROI) was automatically placed in 3 segments of the middle cerebral artery territory in both cerebral hemispheres with a 3-dimensional stereotaxic ROI template using SPM2, and each PET value was determined in each ROI. The ratio of values in the affected versus contralateral hemispheres was calculated for the <jats:sup>18</jats:sup> F-FRP170 PET image. </jats:p> </jats:sec> <jats:sec> <jats:title>Results—</jats:title> <jats:p> A significant correlation was observed between oxygen extraction fraction and <jats:sup>18</jats:sup> F-FRP170 ratios ( <jats:italic>ρ</jats:italic> =0.509; <jats:italic>P</jats:italic> <0.0001) in a total of 156 ROIs in 52 patients. The specificity and positive-predictive value for a combination of an elevated oxygen extraction fraction and a moderately reduced cerebral oxygen metabolism for detection of an abnormally elevated <jats:sup>18</jats:sup> F-FRP170 ratio (19 ROIs: 12%) were significantly greater than those for the individual categories (elevated oxygen extraction fraction, moderately reduced cerebral oxygen metabolism, or reduced cerebral blood flow). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p> Tissues with abnormally elevated uptake of <jats:sup>18</jats:sup> F-FRP170 exist in human chronic cerebral ischemia characterized by a combination of misery perfusion and moderately reduced oxygen metabolism because of unilateral atherosclerotic major cerebral artery steno-occlusive disease. </jats:p> </jats:sec>
Umfang:	1250-1256
ISSN:	1524-4628 0039-2499
DOI:	10.1161/strokeaha.114.008238