Quantitative Evaluation of Mean Transit Times Obtained with Dynamic Susceptibility Contrast-Enhanced MR Imaging and with 133Xe SPECT in Occlusive Cerebrovascular Disease
Keiichi Kikuchi1,
Kenya Murase2,
Hitoshi Miki1,
Yoshifumi Yasuhara1,
Yoshifumi Sugawara1,
Teruhito Mochizuki1,
Junpei Ikezoe1 and
Shiro Ohue3
1 Department of Radiology, Ehime University School of Medicine, Shitsukawa,
Shigenobu-cho, Onsen-gun, Ehime, 791-0295 Japan.
2 Department of Medical Engineering, Division of Allied Health Sciences, Osaka
University Medical School, 1-7 Yamadaoka, Suita, Osaka, 565-0871 Japan.
3 Department of Neurological Surgery, Ehime University School of Medicine,
Ehime, 791-0295 Japan.
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Fig. 1. —For analysis of cerebral perfusion, regions of interest
(striped areas) are placed on middle cerebral artery territories of
each hemisphere. Settings for regions of interest are consistent with data
obtained from four slices of 133Xe SPECT images and with regional
mean transit time images generated from dynamic susceptibility
contrast-enhanced MR imaging.
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Fig. 2A. —75-year-old man with right internal carotid artery stenosis.
Concentration—time curve shows concentration change of arterial input
function and that obtained from bilateral middle cerebral artery territories.
Solid line = arterial input function; coarse-dotted line = right middle
cerebral artery territory; fine-dotted line = left middle cerebral artery
territory.
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Fig. 2B. —75-year-old man with right internal carotid artery stenosis.
Mean transit time image shows prolonged mean transit time (10.63 sec)
associated with poor cerebral perfusion reserve in right middle cerebral
artery territory. Mean transit time of left middle cerebral artery territory
(5.76 sec) is considered in normal range. R = right, L = left.
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Fig. 2C. —75-year-old man with right internal carotid artery stenosis.
133Xe SPECT image obtained with patient resting shows decreased
cerebral blood flow bilaterally. Cerebral blood flow values were 30 mL/100 g
per minute in right middle cerebral artery territory and 32 mL/100 g per
minute in left middle cerebral artery territory. Note that mean transit time
image (B) is superior to the 133Xe SPECT image in spatial
resolution. R = right, L = left.
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Fig. 2D. —75-year-old man with right internal carotid artery stenosis.
133Xe SPECT image obtained after administration of acetazolamide
shows no increase in cerebral blood flow in right middle cerebral artery
territory despite presence of acetazolamide. Cerebral blood flow values
changed to 26 mL/100 g per minute in right middle cerebral artery territory
and 44 mL/100 g per minute in left middle cerebral artery territory. Thus,
percentage of cerebral blood flow increase after administration of
acetazolamide is -13% in right and +38% in left middle cerebral artery
territories, respectively. Mean transit time and 133Xe SPECT images
represent impaired cerebral perfusion reserve in right middle cerebral artery
territory. R = right, L = left.
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Copyright © 2002 by the American Roentgen Ray Society.
= moderately decreased perfusion reserved 
= normal perfusion
reserve. Relationship between mean transit time and cerebral blood flow is
shown. We found significant correlation between mean transit time and cerebral
blood flow (r = -0.567, p = 0.0003).
0%),
moderately decreased (percentage of cerebral blood flow increase, > 0%
but