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Comparative Study
. 2009 Apr;16(4):461-7.
doi: 10.1111/j.1468-1331.2008.02398.x.

Changes in cerebral blood flow after acetazolamide: an experimental study comparing near-infrared spectroscopy and SPECT

H W Schytz  1 , T Wienecke, L T Jensen, J Selb, D A Boas, M Ashina
Affiliations
Comparative Study

Changes in cerebral blood flow after acetazolamide: an experimental study comparing near-infrared spectroscopy and SPECT

H W Schytz et al. Eur J Neurol. 2009 Apr.

Abstract

Background and purpose: It is important to find a reliable and bedside method, which can estimate the cerebral blood flow (CBF) of patients in clinical settings. Estimation of CBF by calculating a blood flow index (BFI) using continuous wave near-infrared spectroscopy (CW-NIRS) and indocyanine green (ICG) as an i.v. tracer has been proposed to be a feasible and promising method. To validate if the BFI method can detect relative changes in CBF we compared data with the established method (133)Xenon single photon emission computer tomography ((133)Xe-SPECT).

Methods: Ten healthy subjects were investigated before and after a bolus of acetazolamide. NIRS data were obtained using a multi source detector separation configuration in order to assess a corrected BFI (BFI(corr)) value, which attempts to eliminate contamination of skin blood flow.

Results: Data obtained showed no significant correlation between CBF changes measured by (133)Xe-SPECT and BFI(corr) (0.133, P = 0.732). After acetazolamide, a 49% increase in CBF was detected using the (133)Xe-SPECT method, whereas no changes in any ICG variables were observed after acetazolamide.

Conclusion: The study shows that it is not possible to obtain reliable BFI data, which reflect changes in CBF after acetazolamide infusion, using the CW-NIRS and ICG method.

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Figures

Figure 1
Figure 1
Increase in per cent from baseline for CBFMCA (■), BFI (○), BFIcorr (□), ICGmax (▲) and rise time (formula image) after infusion of acetazolamide. A significant increase in CBFMCA was found 15 min (48.9 ± 6.6, *** P < 0.001) and 60 min (26.0 ± 6.8, ** P = 0.003) after acetazolamide bolus.
Figure 2
Figure 2
Changes over time for CBFMCA and BFIcorr (in optical density, OD/s) individual measurements. Thick grey bars shown mean values. ANOVA showed now changes over time for BFIcorr values (P = 0.319). CBFMCA showed changes from baseline after acetazolamide over time (P < 0.001). Post hoc analysis showed a 48.9 ± 6.8% increase in CBFMCA after the acetazolamide challenge at T15 (P < 0.001) and 26.0 ± 6.8% increase at T60 (P = 0.003).
Figure 3
Figure 3
Scatter diagram with changes of BFIcorr and CBFMCA from baseline in per cent 15 min after acetozolamide infusion. Correlation coefficient 0.133 (P = 0.732).
Figure 4
Figure 4
Optical density curve after an ICG bolus. Coloured lines show source detector of different distances. Y axis: ΔOD = delta optical density.
Figure 5
Figure 5
Example of corrected blood flow index (BFIcorr, in optical density, OD/s) at seven consecutive measurements calculated at source detector distances of 3, 4 and 5 cm. Acetozolamide bolus given at time = 0.
See this image and copyright information in PMC

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