Open Access

ARTICLE

DSA-Based Quantitative Assessment of Cerebral Hypoperfusion in Patients with Asymmetric Carotid Stenosis

Xu Zhang^1,‡, Jie Gao^2,‡, Xinke Yao¹, Zhengze Dai^3,4, Gelin Xu^2,*, Yan Cai^1,*, Zhiyong Li^1,5,*

1 School of Biological Science and Medical Engineering, Southeast University, Nanjing, 201196, China.
2 Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing , 210002, China.
3 Department of Neurology, Nanjing Pukou Hospital, Nanjing, Jiangsu, China .
4 Department of Neurology, Jinling Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China .
5 School of Chemistry, Physics and Mechanical Engineering, Queensland University of Technology, Brisbane, QLD 4001, Australia.
‡ These authors contributed equally to this work.

* Corresponding Authors: Gelin Xu. Email: ;
  Yan Cai. Email: ;
  Zhiyong Li. Email: .

Molecular & Cellular Biomechanics 2019, 16(1), 27-39. https://doi.org/10.32604/mcb.2019.06140

Abstract

Digital subtraction angiography (DSA) is often used to evaluate the morphological and pathological changes of cerebral arteries in clinical practice. This study aims to explore the possibility of assessing cerebral hypoperfusion with DSA in patients with carotid stenosis. Thirty patients with a mild to severe stenosis on one side, and a mild stenosis on the other side of the carotid artery were recruited. Frontal, parietal, temporal and occipital lobes were chosen as regions of interest for measuring the quantitative perfusion parameters from their time-density curves (TDCs) of DSA images. The perfusion parameters were compared between the two hemispheres by using paired t-test. In addition, the bilateral asymmetry of these parameters was calculated and its correlation with the bilateral asymmetry in stenosis was analyzed. The parameters included mean transit time (MTT), time of contrast uptake (TU), time taken to the half peak value (1/2TMAX), area under the curve (AUC) were significantly prolonged at the severe stenosis side than those at the mild stenosis side in frontal lobe (P=0.013; P=0.041; P=0.009; P=0.027) and parietal lobe (P=0.008; P=0.041; P=0.002; P=0.012). The asymmetric ratios of MTT and AUC showed statistically significant correlations with stenosis asymmetry in all four lobes. MTT, TU, 1/2TMAX and AUC could reflect the bilateral asymmetry of the cerebral perfusion. These DSA parameters, therefore, may be used for the evaluation of cerebral hypoperfusion caused by carotid stenosis.

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