Single-photon emission computed tomography quantification of cerebral blood flow before and after carotid endarterectomy

Abstract

This study evaluated cerebral blood flow (CBF) by quantification and count profiles of hemispheric CBF using¹²³I-IMP SPECT 10 days before and after surgical removal of an unilateral carotid stenosis in eight selected patients. The endarterectomized carotid artery was stenosed 35–90% in diameter, whereas the contralateral carotid artery was virtually normal. Preoperative CBF in the cerebral hemisphere was lower on the stenosed carotid artery side than on the contralateral side in seven of eight cases. After endarterectomy, hemispheric CBF increased on the operated side in six cases, and on the contralateral side in five, although to a lesser degree. The postoperative increase was prominent in cases having carotid stenosis over approximately 80%. These results indicate that the present method is useful in evaluating the intracranial hemodynamics of cases with carotid stenosis, thereby confirming that endarterectomy is effective in improving CBF in cases with a high degree of stenosis.