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Selective Neuronal Damage and Borderzone Infarction in Carotid Artery Occlusive Disease: A ¹¹C-Flumazenil PET Study

¹ Research Institute, Shiga Medical Center, Moriyama, Japan

View larger version (63K): [in a new window]   FIGURE 1. Examples of PET images on 2 different levels show parallel decrease of FMZ-BP, CBF, CMRO2, and an increase of OEF in patient with right ICA occlusion who showed internal borderzone infarction (red arrow) with cortical extension (green arrow) on corresponding MR images. In addition to markedly reduced FMZ-BP in region with small cortical infarcts, a decrease of FMZ-BP was found in normal-appearing cerebral cortex beyond borderzone infarcts. Mean hemispheric values of ipsilateral/contralateral hemisphere: FMZ-BP ratio, 1.00/1.16; CBF, 20.4/26.1 mL/100 g/min; CMRO2, 2.37/2.87 mL/100 g/min; OEF, 61.9%/58.3%.

View larger version (66K): [in a new window]   FIGURE 2. Examples of PET images show distribution of decrease of FMZ-BP in patient with right ICA occlusion (patient in Fig. 1). Although decreases of FMZ-BP predominated in frontoparietal region near borderzone infarction, an extensive decrease of FMZ-BP was found in MCA distribution.

View larger version (18K): [in a new window]   FIGURE 3. Scatter diagrams plot CBF (A), CMRO2 (B), and OEF (C) against cerebral/cerebellar FMZ-BP ratio in 62 hemispheres with carotid artery disease. The lines were generated by simple linear regression. Ext = solitary external borderzone infarct; Int = solitary internal borderzone infarct; Both = both borderzone infarct; None = no borderzone infarct.