Quantitative Evaluation of Cerebral Metabolites and Cerebral Blood Flow in Patients With Carotid Stenosis

Neurol Res. 2001 Sep;23(6):573-80. doi: 10.1179/016164101101199036.

Abstract

We examined the metabolic and hemodynamic status of patients with severe carotid stenosis and evaluated the effectiveness of carotid endarterectomy (CEA) by comparing pre- and post-operative results of quantitative proton magnetic resonance spectroscopy (1H-MRS) and single-photon emission computed tomography (SPECT). Quantitative 1H-MRS and SPECT were performed in 17 patients with severe carotid stenosis before CEA; in 10 patients the examinations were repeated after CEA. There was a significant correlation between the degree of internal carotid artery (ICA) stenosis and the N-acetyl-aspartate (NAA) concentration, and between CBFand NAA in the basal ganglia. In 10 of the 17 patients (58.8%) we noted a decrease of NAA on 1H-MRS. After CEA in these patients, NAA was significantly increased, and in 7 of 8 patients whose pre-operative SPECT had indicated impairment of cerebral vasoreactivity, it was improved. Quantitative 1H-MRS and CBF measurements can indicate the severity of metabolic and hemodynamic impairment in patients with severe carotid stenosis, and can help to assess the effectiveness of CEA.

MeSH terms

  • Adult
  • Aged
  • Aging / metabolism
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / metabolism
  • Basal Ganglia / diagnostic imaging
  • Basal Ganglia / metabolism
  • Basal Ganglia / physiopathology
  • Brain Ischemia / diagnostic imaging*
  • Brain Ischemia / metabolism*
  • Brain Ischemia / physiopathology
  • Carotid Stenosis / diagnostic imaging*
  • Carotid Stenosis / metabolism
  • Carotid Stenosis / physiopathology
  • Cerebral Cortex / diagnostic imaging*
  • Cerebral Cortex / metabolism*
  • Cerebral Cortex / physiopathology
  • Cerebrovascular Circulation / physiology*
  • Choline / metabolism
  • Creatine / metabolism
  • Endarterectomy, Carotid
  • Energy Metabolism / physiology*
  • Female
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Middle Aged
  • Recovery of Function / physiology
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome

Substances

  • Aspartic Acid
  • N-acetylaspartate
  • Creatine
  • Choline