PMC2782106_01
PCT was performed to determine if the patient was at risk for cerebral infarction and whether transluminal angioplasty should be performed or not (A-C) and was repeated after angioplasty to monitor treatment effects on cerebral perfusion (D-F). (A) Preangioplasty PCT CBV map demonstrates increased CBV values in the left hemisphere, consistent with ischemia-related activation of cerebral autoregulation (blue to red: CBV = 0 to 20 mL/100g). (B) Preangioplasty PCT MTT map demonstrates increased MTT values in the left hemisphere, consistent with ischemia-related activation of cerebral autoregulation (red to blue: MTT = 0 to 15 seconds). (C) Preangioplasty PCT CBF map demonstrates normal to decreased CBF values in the left hemisphere (blue to red: CBF = 0 to 100 mL per 100 g and per minute). (D) Postangioplasty PCT CBV map demonstrates normalized CBV values in the left hemisphere, symmetric to the normal right side. (E) Postangioplasty perfusion CT MTT map demonstrates normalized MTT values in the left hemisphere, symmetric to the normal right side. (F) Postangioplasty PCT CBF map demonstrates normalized CBF values in the left hemisphere, symmetric to the normal right side.
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PMC2782106_01_12028_2007_Article_6140_Fig1.jpg
Fig1
PCT showed areas of normal or decreased CBF and a large area of increased CBV and MTT in the MCA territory of the left hemisphere (Figure 1A-C), consistent with ischemia-related activation of autoregulation. PCT was repeated and showed symmetric, normalized CBV, CBF, and MTT values (Figure 1D-F).
DSA images in a 37-year-old woman who developed progressive aphasia 1 day after coiling of a ruptured left internal carotid arterytip aneurysm, despite optimal medical treatment. Transluminal balloon angioplasty was performed to treat the vasospasm. (A) Preangioplasty DSA demonstrates severe vasospasm in the M1 and M2 segments of left MCA. (B) Postangioplasty DSA shows return to normal caliber of the M1-segment of the left MCA.
12028_2007_Article_6140_Fig2.jpg
PMC2782106_01_12028_2007_Article_6140_Fig2.jpg
Fig2
Boston, MA) silicone balloon microcatheter (Sentry, Target Therapeutics/Boston Scientific, Fremont, CA), according to a technique described previously. Before angioplasty, DSA showed severe vasospasm of the M1 segment of the left MCA and of the proximal left M2 segments (Figure 2A). After angioplasty of the M1 segment of the left MCA a good angiographic result was obtained (Figure 2B).