Positron emission tomography (PET) uses ISOlabeled carbon dioxide, carbon monoxide and oxygen to obtain quantitative maps of CBF, cerebral blood volume, oxygen extraction fraction and cerebral metabolic rate. PET has been used extensively in experimental studies of stroke, to define the ischemic penumbra and the effects of early reperfusion/hyperperfusion. Clinical uses are less common. Recently, a study of patients with carotid occlusion demonstrated that patients with high oxygen extraction fractions as determined by PET were at significantly higher risk of future ipsilateral stroke . This may potentially identify a subset of patients who would benefit from extracranial-intracranial bypass surgery, and could imply an increased clinical role for PET scanning in the future.
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