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OtherClinical Investigations

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

Hiroshi Yamauchi, Takashi Kudoh, Yoshihiko Kishibe, Jinei Iwasaki and Shinya Kagawa
Journal of Nuclear Medicine December 2005, 46 (12) 1973-1979;
Hiroshi Yamauchi
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Takashi Kudoh
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Yoshihiko Kishibe
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Jinei Iwasaki
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Shinya Kagawa
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  • FIGURE 1.
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    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%.

  • FIGURE 2.
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    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.

  • FIGURE 3.
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    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.

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    TABLE 1

    Characteristics of Patients

    CharacteristicAsymptomaticTIAStroke
    No. of patients211229
    ICA occlusion/stenosis8/135/716/13
        Asymptomatic contralateral carotid stenosis >50% (n)226
        Asymptomatic vertebral artery stenosis >50% (n)421
    Type of lesion (n)
        External borderzone infarcts0012
        Territorial infarcts1010
        Internal borderzone infarcts0112
        Other white matter infarcts447
        Striatocapsular infarcts005
        Lacunar infarcts8212
    • TIA = transient ischemic attack.

    • View popup
    TABLE 2

    Ischemic Lesions and Cerebral/Cerebellar FMZ BP Ratio in Hemisphere with Carotid Artery Disease

    Type of lesionYesNo
    External borderzone infarcts (n = 12)1.02 ± 0.07*1.31 ± 0.16
    Territorial infarcts (n = 11)1.22 ± 0.121.26 ± 0.20
    Internal borderzone infarcts (n = 13)1.13 ± 0.14*1.29 ± 0.19
    Other white matter infarcts (n = 15)1.29 ± 0.171.24 ± 0.19
    Striatocapsular infarcts (n = 5)1.20 ± 0.161.26 ± 0.19
    Lacunar infarcts (n = 22)1.22 ± 0.171.27 ± 0.20
    • ↵* P < 0.008 (0.05/6) vs. corresponding value in No group (Student t test).

    • View popup
    TABLE 3

    Multiple Linear Regression Analysis with Cerebral/Cerebellar FMZ BP Ratio in Hemisphere with Carotid Artery Disease as Dependent Variable

    ParameterCoefficientSEtP value
    External borderzone infarcts (no = 0, yes = 1)−0.2850.056−5.11<0.0001
    Age (y)−0.0030.003−1.060.292
    Territorial infarcts (no = 0, yes = 1)−0.0760.053−1.430.157
    Internal borderzone infarcts (no = 0, yes = 1)−0.0580.054−1.060.293
    Other white matter infarcts (no = 0, yes = 1)0.0110.0460.240.809
    Striatocapsular infarcts (no = 0, yes = 1)−0.1370.072−1.900.062
    Lacunar infarcts (no = 0, yes = 1)−0.0450.043−1.040.299
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Journal of Nuclear Medicine: 46 (12)
Journal of Nuclear Medicine
Vol. 46, Issue 12
December 1, 2005
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Selective Neuronal Damage and Borderzone Infarction in Carotid Artery Occlusive Disease: A 11C-Flumazenil PET Study
Hiroshi Yamauchi, Takashi Kudoh, Yoshihiko Kishibe, Jinei Iwasaki, Shinya Kagawa
Journal of Nuclear Medicine Dec 2005, 46 (12) 1973-1979;

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Selective Neuronal Damage and Borderzone Infarction in Carotid Artery Occlusive Disease: A 11C-Flumazenil PET Study
Hiroshi Yamauchi, Takashi Kudoh, Yoshihiko Kishibe, Jinei Iwasaki, Shinya Kagawa
Journal of Nuclear Medicine Dec 2005, 46 (12) 1973-1979;
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