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Sample records for abnormal perfusion regions

  1. Basal hyperaemia is the primary abnormality of perfusion in Takotsubo cardiomyopathy

    DEFF Research Database (Denmark)

    Christensen, Thomas Emil; Ahtarovski, Kiril Aleksov; Bang, Lia Evi

    2015-01-01

    AIMS: Takotsubo cardiomyopathy (TTC) is characterized by acute completely reversible regional left ventricle (LV) akinesia and decreased tracer uptake in the akinetic region on semi-quantitative perfusion imaging. The latter may be due to normoperfusion of the akinetic mid/apical area and basal...... hyperperfusion. Our aim was to examine abnormalities of perfusion in TTC, and we hypothesized that basal hyperperfusion is the primary perfusion abnormality in the acute state. METHOD AND RESULTS: Twenty-five patients were diagnosed with TTC due to (i) acute onset of symptoms, (ii) typical apical ballooning......-on follow-up. Patients initially had severe heart failure, mid/apical oedema but no infarction, and a rise in cardiac biomarkers. On initial perfusion PET imaging, eight patients appeared to have normal, whereas 17 patients had impaired LV perfusion. In the latter, flow in the basal region was increased...

  2. Reversible ventilation and perfusion abnormalities in unilateral obstructed lung

    International Nuclear Information System (INIS)

    Ward, H.E.; Jones, R.L.; King, E.G.; Sproule, B.J.; Fortune, R.L.

    1982-01-01

    An intraluminal carcinoid tumor obstructing the left mainstem bronchus produced hypoxemia through alteration in ventilation/perfusion matching. Studies of regional lung function using 133-xenon (/sup 133/Xe) and a multiprobe computerized instrumentation system documented a reduction of perfusion to 22 percent and ventilation to 6 percent of the total. There was negligible washout of intravenously injected /sup 133/Xe from the left lung consistent with air trapping. Four days after left mainstem bronchial sleeve resection, perfusion, ventilation and washout of injected xenon had significantly improved and by four months postresection, all measurements were virtually normal, although complete restoration of perfusion in relation to ventilation was delayed. Regional lung function studied with a multiprobe system in this patient provided a clinical model for the study of ventilation and perfusion inter-relationships in large airway obstruction and demonstrated that a prolonged time may be required for return of perfusion to normal

  3. Pediatric hemiplegic migraine: susceptibility weighted and MR perfusion imaging abnormality

    International Nuclear Information System (INIS)

    Altinok, Deniz; Agarwal, Ajay; Ascadi, Gyula; Luat, Aimee; Tapos, Daniela

    2010-01-01

    We report on an 11-year-old girl suffering from a typical attack of hemiplegic migraine with characteristic abnormalities in perfusion MR and susceptibility-weighted MR imaging findings. The imaging abnormalities were resolved 48 h after the attack. Susceptibility-weighted MR imaging findings correlated well with the MR perfusion, thus it can be used along with conventional MRI for evaluation of children with complex migraine attacks. Susceptibility-weighted MR imaging might have a diagnostic role in assessing the vascular events in hemiplegic migraine. (orig.)

  4. Abnormal perfusion on myocardial perfusion SPECT in patients with WPW syndrome: clinical implications

    International Nuclear Information System (INIS)

    Kang, Do Young; Cha, Kwang Soo; Kim, Moo Hyun; Kim, Young Dae; Kim, Duk Kyu

    2001-01-01

    Myocardial perfusion is altered significantly in patients with rhythm disturbances such as CLBBB and right ventricular pacing rhythm. Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on SPECT in patients with WPW syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial SPECT with or without coronary angiography were performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECG or electrophysiologic study. Small to large extent (11.0 8.5%, range: 0 35%) and mild to moderate severity (-71.8 42.7%, range: -217 0%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patient with right free wall AP showed normal. Other defect locations were as follows. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. It was not specifically correlated with location of accessory pathway, but most of all patients were abnormal perfusion pattern. Therefore myocardial perfusion SPECT was interpreted carefully in patients with WPW syndrome

  5. Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Hosenpud, J.D.; Montanaro, A.; Hart, M.V.; Haines, J.E.; Specht, H.D.; Bennett, R.M.; Kloster, F.E.

    1984-08-01

    Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.

  6. The diagnosis of renal perfusion abnormalities by sequential CT

    International Nuclear Information System (INIS)

    Treugut, H.; Andersson, I.; Hildell, J.; Nyman, U.; Weibull, H.

    1981-01-01

    Abnormalities of renal perfusion can be recognised more readily by sequential CT than by plain CT scan or after static enhancement with contrast medium. Haemodynamically significant stenoses of the renal arteries and total, or partial, infarcts can be diagnosed in this way. Intrarenal and capsular collaterals can be recognised by slow contrast accumulation in the infarcted area, or by the development of contrast in the sub-capsular portion of the cortex. Renal cortical necrosis is very well demonstrated by the absence of cortical perfusion; this is seen, for instance, in the DIC syndrome or during rejection after renal transplant. (orig.) [de

  7. Intelligence quotient-adjusted memory impairment is associated with abnormal single photon emission computed tomography perfusion.

    Science.gov (United States)

    Rentz, Dorene M; Huh, Terri J; Sardinha, Lisa M; Moran, Erin K; Becker, John A; Daffner, Kirk R; Sperling, Reisa A; Johnson, Keith A

    2007-09-01

    Cognitive reserve among highly intelligent older individuals makes detection of early Alzheimer's disease (AD) difficult. We tested the hypothesis that mild memory impairment determined by IQ-adjusted norms is associated with single photon emission computed tomography (SPECT) perfusion abnormality at baseline and predictive of future decline. Twenty-three subjects with a Clinical Dementia Rating (CDR) score of 0, were reclassified after scores were adjusted for IQ into two groups, 10 as having mild memory impairments for ability (IQ-MI) and 13 as memory-normal (IQ-MN). Subjects underwent cognitive and functional assessments at baseline and annual follow-up for 3 years. Perfusion SPECT was acquired at baseline. At follow-up, the IQ-MI subjects demonstrated decline in memory, visuospatial processing, and phonemic fluency, and 6 of 10 had progressed to a CDR of 0.5, while the IQ-MN subjects did not show decline. The IQ-MI group had significantly lower perfusion than the IQ-MN group in parietal/precuneus, temporal, and opercular frontal regions. In contrast, higher perfusion was observed in IQ-MI compared with IQ-MN in the left medial frontal and rostral anterior cingulate regions. IQ-adjusted memory impairment in individuals with high cognitive reserve is associated with baseline SPECT abnormality in a pattern consistent with prodromal AD and predicts subsequent cognitive and functional decline.

  8. Assessment of myocardial perfusion abnormalities in patients with apical hypertrophic cardiomyopathy using exercise [sup 201]Tl scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Taniguchi, Yoko; Ohtsuki, Katsuichi (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1993-11-01

    Regional myocardial perfusion abnormalities commonly occur during exercise in patients with hypertrophic cardiomyopathy (HCM). Exercise [sup 201]Tl myocardial scintigraphy has provided a noninvasive means of identifying myocardial perfusion abnormalities in patients with HCM. On the other hand, apical hypertrophic cardiomyopathy (APH) is reported as a subtype of HCM. Whether APH is essentially equal to HCM or not is controversial. To assess myocardial ischemia in patients with APH, we studied 28 patients with APH, with exercise [sup 201]Tl SPECT. Myocardial perfusion images were obtained immediately after submaximal exercise and again after a 3-hour delay. Regional perfusion defects during exercise were identified in 19 of the 28 patients (68%) with APH. Complete reversible defects were observed in 15 (79%) patients with APH. Although perfusion defects were present in all regions of the left ventricle in patients with HCM, they were present only in the apical region in patients with APH. Thus, reversible [sup 201]Tl perfusion abnormalities commonly occur during exercise in patients with APH as well as in patients with HCM. (author).

  9. Impact of myocardial perfusion abnormality on prognosis in patients with non-ischemic dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Sobajima, Mitsuo; Nozawa, Takashi; Suzuki, Takayuki; Ohori, Takashi; Shida, Takuya; Matsuki, Akira; Inoue, Hiroshi

    2010-01-01

    Myocardial perfusion imaging shows various patterns in patients with non-ischemic dilated cardiomyopathy (DCM). However, influences of regional abnormalities of myocardial perfusion or ventricular wall motion on prognosis in DCM patients remains to be clarified. Accordingly, we investigated a relation between myocardial perfusion patterns and long-term prognosis in DCM patients. Sixty-two patients were divided into 2 groups according to patterns of 99m Tc-Tetrofosmin scintigraphy, id est (i.e.) large focal defects (focal) and minimally impaired perfusion or multiple small defects (non-focal). There were no differences between the 2 groups in left ventricular (LV) end-diastolic dimensions (63.4±9.1 and 63.8.4± 7.5 mm, respectively) and LV ejection fraction (30.3±9.2 and 27.9±7.8%, respectively), indicating LV systolic dysfunction was comparable between the groups. The focal group had a higher prevalence of brain natriuretic peptide ≥200 ng/dl and plasma norepinephrine ≥500 pg/ml than the non-focal group (p<0.05), and had longer QRS durations (p<0.05). The focal group had non-sustained ventricular tachycardia (VT) (p<0.05) on 24-h electrocardiogram recording and a history of VT/ventricular fibrillation more frequently (p<0.05), and had higher New York Heart Association functional class than the non-focal group (p<0.05). The mortality was significantly higher in the focal group (56.0%) than in the non-focal group (28.6%) and the survival curves revealed worse prognosis in the focal group during a follow-up period of 5.3±2.8 years. Non-ischemic DCM patients with focal defects are accompanied by more advanced heart failure and poor prognosis compared to those with minimally impaired perfusion or multiple small defects, despite comparable LV systolic dysfunction. (author)

  10. Regional cerebral perfusion in cardiovascular reflex syncope

    International Nuclear Information System (INIS)

    Toeyry, J.P.; Kuikka, J.T.; Laensimies, E.A.

    1997-01-01

    Little is known about the regional cerebral perfusion in subjects with presyncope or syncope, and the impact that autonomic nervous dysfunction has on it. Seven subjects with cardiovascular vasodepressor reflex syncope were studied. A baseline test was performed with the patients standing in the 70 upright position, while the passive head-up tilt table test with and without isoprenaline infusion was employed for provocation. Regional cerebral perfusion was assessed by means of single-photon emission tomography with technetium-99m labelled V-oxo-1,2-N,N 1 -ethylenedylbis-l-cysteine diethylester (baseline, and during blood pressure decline in the provocation test) and the autonomic nervous function by means of spectral analysis of heart rate variability (baseline, and before blood pressure decline in the provocation test). Every subject showed an abrupt decline in blood pressure in the provocation test (five with presyncope and two with syncope). The systolic and diastolic blood pressures decreased significantly (P<0.001) between the baseline and the provocation study time points (radiopharmaceutical injection and lowest systolic blood pressure). Mean cerebral perfusion as average count densities decreased upon provocation as compared with baseline (190±63 vs 307±90 counts/voxel, respectively, P=0.013). Hypoperfusion was most pronounced in the frontal lobe. These results suggest that cerebral perfusion decreases markedly during presyncope or syncope with systemic blood pressure decline in subjects with cardiovascular vasodepressor syncope. Furthermore, the autonomic nervous function remains unchanged before the systemic blood pressure decline. (orig.). With 3 figs., 2 tabs

  11. Electrocardiographic left ventricular hypertrophy without echocardiographic abnormalities evaluated by myocardial perfusion and fatty acid metabolic imaging

    International Nuclear Information System (INIS)

    Narita, Michihiro; Kurihara, Tadashi

    2000-01-01

    The pathophysiologic process in patients with electrocardiographic left ventricular hypertrophy with ST, T changes but without echocardiographic abnormalities was investigated by myocardial perfusion imaging and fatty acid metabolic imaging. Exercise stress 99m Tc-methoxy-isobutyl isonitrile (MIBI) imaging and rest 123 I-beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) imaging were performed in 59 patients with electrocardiographic hypertrophy including 29 without apparent cause including hypertension and echocardiographic hypertrophy, and 30 with essential hypertension. Coronary angiography was performed in 6 patients without hypertension and 4 with hypertension and biopsy specimens were obtained from the left ventricular apex from 6 patients without hypertension. Myocardial perfusion and 123 I-BMIPP images were classified into 3 types: normal, increased accumulation of the isotope at the left ventricular apex (high uptake) and defect. Transient perfusion abnormality and apical defect observed by 123 I-BMIPP imaging were more frequent in patients without hypertension than in patients with hypertension (32% vs. 17%, p=0.04671 in perfusion; 62% vs. 30%, p=0.0236 in 123 I-BMIPP). Eighteen normotensive patients with apical defect by 123 I-BMIPP imaging included 3 of 10 patients with normal perfusion at exercise, 6 of 10 patients with high uptake and 9 of 9 patients with perfusion defect. The defect size revealed by 123 I-BMIPP imaging was greater than that of the perfusion abnormality. Coronary stenoses were not observed and myocardial specimens showed myocardial disarray with hypertrophy. Moreover, 9 patients with hypertension and apical defects by 123 I-BMIPP showed 3 different types of perfusion. Many patients without hypertension show a pathologic process similar to hypertrophic cardiomyopathy. Perfusion and 123 I-BMIPP imaging are useful for the identification of these patients. (author)

  12. Electrocardiographic left ventricular hypertrophy without echocardiographic abnormalities evaluated by myocardial perfusion and fatty acid metabolic imaging

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Michihiro; Kurihara, Tadashi [Sumitomo Hospital, Osaka (Japan)

    2000-01-01

    The pathophysiologic process in patients with electrocardiographic left ventricular hypertrophy with ST, T changes but without echocardiographic abnormalities was investigated by myocardial perfusion imaging and fatty acid metabolic imaging. Exercise stress {sup 99m}Tc-methoxy-isobutyl isonitrile (MIBI) imaging and rest {sup 123}I-beta-methyl-p-iodophenyl pentadecanoic acid (BMIPP) imaging were performed in 59 patients with electrocardiographic hypertrophy including 29 without apparent cause including hypertension and echocardiographic hypertrophy, and 30 with essential hypertension. Coronary angiography was performed in 6 patients without hypertension and 4 with hypertension and biopsy specimens were obtained from the left ventricular apex from 6 patients without hypertension. Myocardial perfusion and {sup 123}I-BMIPP images were classified into 3 types: normal, increased accumulation of the isotope at the left ventricular apex (high uptake) and defect. Transient perfusion abnormality and apical defect observed by {sup 123}I-BMIPP imaging were more frequent in patients without hypertension than in patients with hypertension (32% vs. 17%, p=0.04671 in perfusion; 62% vs. 30%, p=0.0236 in {sup 123}I-BMIPP). Eighteen normotensive patients with apical defect by {sup 123}I-BMIPP imaging included 3 of 10 patients with normal perfusion at exercise, 6 of 10 patients with high uptake and 9 of 9 patients with perfusion defect. The defect size revealed by {sup 123}I-BMIPP imaging was greater than that of the perfusion abnormality. Coronary stenoses were not observed and myocardial specimens showed myocardial disarray with hypertrophy. Moreover, 9 patients with hypertension and apical defects by {sup 123}I-BMIPP showed 3 different types of perfusion. Many patients without hypertension show a pathologic process similar to hypertrophic cardiomyopathy. Perfusion and {sup 123}I-BMIPP imaging are useful for the identification of these patients. (author)

  13. Evaluation of MR perfusion abnormalities in organophosphorus poisoning and its correlation with SPECT

    OpenAIRE

    Bhanu, K Uday; Khandelwal, Niranjan; Vyas, Sameer; Singh, Paramjeet; Prabhakar, Anuj; Mittal, B R; Bhalla, Ashish

    2017-01-01

    Aim: Acute organophosphate (OP) pesticide poisoning causes substantial morbidity and mortality worldwide. Many imaging modalities, such as computerized tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT) of the brain, have been used for quantitative assessment of the acute brain insult caused by acute OP poisoning. Perfusion defects on SPECT in acutely poisoned patients with OPs have been described, however, MR perfusion abnormalities have...

  14. Cerebral perfusion abnormalities in therapy-resistant epilepsy in mentally retarded pediatric patients

    International Nuclear Information System (INIS)

    Abdel-Dayem, H.M.; Nawaz, K.; Hassoon, M.; Rahman, M.; Olofsson, O.E.

    1990-01-01

    This paper identifies sites of cerebral perfusion abnormalities in therapy-resistant epilepsy in mentally retarded pediatric patients (TREMRPP) using Tc-99m HMPAO and to compare it with the results of electroencephalography (EEG) and fluorographic CT. Thirteen children underwent Tc-99m HMPAO single photon emission CT (SPECT) studies; 11 had fluorographic CT, and 12 had EEG (four had EEG twice). All studies for same patients were within 2 weeks of each other. SPECT studies were reviewed twice by two nuclear medicine physicians without any knowledge of the results of other tests. Fluorographic CT results showed cerebral atrophy in only three and were normal in eight. EEG results were abnormal in all 12 patients examined. Epileptogenic spikes (EPS) were seen in eight patients only. Tc-99m HMPAO SPECT studies were abnormal in all patients; they showed 21 foci of decreased perfusion on nine patients and nine foci of increased perfusion in seven patients (three patients had mixed lesions)

  15. Myocardial perfusion abnormality and chest pain in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa (Sumitomo Hospital, Osaka (Japan))

    1991-02-01

    To investigate the role of myocardial ischemia in the development of chest pain in patients with hypertrophic cardiomyopathy (HCM), exercise stress (Ex) redistribution myocardial single photon emission CT's (SPECT's) with thallium-201 (Tl) were obtained in 27 patients with HCM. In all patients, coronary arteries were normal arteriographically. Patients were classified into NYHA Class I, II and III according to the frequency and severity of the chest pain during daily life. In these 3 groups, age, sex and intraventricular septal thickness measured by echocardiography were not different. Types of myocardial perfusion obtained by myocardial SPECT's were divided into 5: (1) normal perfusion, (2) no perfusion defect with abnormal myocardial Tl washout rate (WOR) during 3 hours (<30%) (Def(-)/WORabn), (3) reversible perfusion defect (RD), (4) fixed defect with abnormal WOR (FD/WORabn), and (5) fixed defect with normal WOR (FD/WORnl). In 14 patients of Class I, 9 patients (64%) showed normal perfusion but the rest showed perfusion abnormality (def(-)/WORabn in 3 and RD in 2). In Class II and III, all patients showed perfusion abnormalities of RD, FD/WORabn or FD/WORnl. As the functional class progressed from Class II to III, the ratio of fixed defect (both WORnl and WORabn) to RD increased, but it was not statistically significant. In 2 patients in whom Ex SPECT's were repeated because of the progression of the chest pain, the severity of the perfusion abnormality also progressed. Perfusion abnormalities were observed most frequently in anterior (35%), then inferior/posterior (20%) and septal wall (18%). The frequency of Ex induced ECG abnormalities (ST-depression or T wave changes) increased as the NYHA Class progressed (Class III vs I p<0.05). These findings suggested the following: chest pain in patients with HCM relates to the myocardial ischemia which may originate in the myocardial small arteries, and when the lesions progress myocardial necrosis

  16. Regional heterogeneity of myocardial perfusion in healthy human myocardium: assessment with magnetic resonance perfusion imaging.

    Science.gov (United States)

    Muehling, Olaf M; Jerosch-Herold, Michael; Panse, Prasad; Zenovich, Andrey; Wilson, Betsy V; Wilson, Robert F; Wilke, Norbert

    2004-01-01

    The knowledge of myocardial perfusion in healthy volunteers is fundamental for evaluation of patients with ischemic heart disease. The study was conducted to determine range, regional variability, and transmural gradient of myocardial perfusion in normal volunteers with Magnetic Resonance Perfusion Imaging (MRPI). Perfusion was assessed in 17 healthy volunteers (age: 20-47 yr, 11 males) at rest and adenosine-induced hyperemia using a 1.5 T MR scanner. Perfusion was quantified (mL/g/min) for the transmural myocardium and separately for the endo- and epimyocardium in the anterior, lateral, posterior, and septal left ventricular wall using the Fermi model for constrained deconvolution. Regional variabilities for resting, hyperemic perfusion, and perfusion reserve were 22 +/- 8%, 21 +/- 10%, and 35 +/- 18%. Mean resting, hyperemic perfusion, and perfusion reserve were 1.1 +/- 0.4 mL/g/min, 4.2 +/- 1.1 mL/g/min, and 4.1 +/- 1.4. Perfusion in the septum was higher at rest (1.3 +/- 0.3 mL/g/min vs. 1.0 +/- 0.3 mL/g/min, p < 0.05) and lower during hyperemia (3.6 +/- 0.8 mL/g/min vs. 4.5 +/- 1.1 mL/g/min, p < 0.03), resulting in a reduced perfusion reserve (PR) (3.2 +/- 0.9 vs. 4.5 +/- 1.4, p < 0.01) in the septum vs. the combined anterior, lateral, and posterior segments. Resting (0.9 +/- 0.3 mL/g/min vs. 1.4 +/- 0.5 mL/g/min, p < 0.01), but not hyperemic perfusion, was lower in the epi- vs. endomyocardium, resulting in a higher epimyocardial PR (4.8 +/- 1.8 vs. 3.5 +/- 1.4, p < 0.01) in all regions but the septum, where endo- and epimyocardial perfusion and perfusion reserve were not different. A considerable regional variability of myocardial perfusion was confirmed with MRPI. The exceptional anatomical position of the septum is reflected by the lack of a perfusion gradient, which was demonstrated in all other regions but the septum.

  17. Relation of global and regional left ventricular function to tomographic thallium-201 myocardial perfusion in patients with prior myocardial infarction

    International Nuclear Information System (INIS)

    Stratton, J.R.; Speck, S.M.; Caldwell, J.H.; Martin, G.V.; Cerqueira, M.; Maynard, C.; Davis, K.B.; Kennedy, J.W.; Ritchie, J.L.

    1988-01-01

    To determine the relation between regional myocardial perfusion and regional wall motion in humans, tomographic thallium-201 imaging and two-dimensional echocardiography at rest were performed on the same day in 83 patients 4 to 12 weeks after myocardial infarction. Myocardial perfusion and wall motion were assessed independently in five left ventricular regions (total 415 regions). Regional myocardial perfusion was quantitated as a percent of the region infarcted (range 0 to 100%) using a previously validated method. Wall motion was graded on a four point scale as 1 = normal (n = 266 regions), 2 = hypokinesia (n = 64), 3 = akinesia (n = 70), 4 = dyskinesia (n = 13) or not evaluable (n = 2). Regional wall motion correlated directly with the severity of the perfusion deficit (r = 0.68, p less than 0.0001). Among normally contracting regions, the mean perfusion defect score was only 2 +/- 4. Increasingly severe wall motion abnormalities were associated with larger perfusion defect scores (hypokinesia = 6 +/- 5, akinesia = 11 +/- 7 and dyskinesia = 18 +/- 5, all p less than 0.01 versus normal. Among regions with normal wall motion, only 3% had a perfusion defect score greater than or equal to 10. Conversely, among 68 regions with a large (greater than or equal to 10) perfusion defect, only 13% had normal motion whereas 87% had abnormal wall motion. The relation between perfusion and wall motion noted for the entire cohort was also present in subgroups of patients with anterior or inferior infarction. In patients with prior myocardial infarction, the severity of the tomographic thallium perfusion defect correlates directly with echocardiographically defined wall motion abnormalities, both globally and regionally

  18. Evaluation of MR perfusion abnormalities in organophosphorus poisoning and its correlation with SPECT

    Directory of Open Access Journals (Sweden)

    K Uday Bhanu

    2017-01-01

    Full Text Available Aim: Acute organophosphate (OP pesticide poisoning causes substantial morbidity and mortality worldwide. Many imaging modalities, such as computerized tomography (CT, magnetic resonance imaging (MRI, and single photon emission computed tomography (SPECT of the brain, have been used for quantitative assessment of the acute brain insult caused by acute OP poisoning. Perfusion defects on SPECT in acutely poisoned patients with OPs have been described, however, MR perfusion abnormalities have not been described in the literature. MR perfusion Imaging has the advantage of having higher spatial resolution, no radiation, and better availability. Materials and Methods: In this prospective study, 20 patients who ingested OP compounds were included. All the patients underwent brain SPECT on a dual head SPECT gamma camera and MRI brain on a 1.5T MR system. Neurocognitive tests were performed for all patients. Results: SPECT showed perfusion defects in 7 patients and total number of perfusion defects were 29. On MR perfusion, based on the cut-off values of normalized cerebral blood volume (nCBV ratios and normalized cerebral blood flow (nCBF ratios, the total number of patients showing perfusion defects were 6 and 8; and the total number of perfusion defects were 29 and 45, respectively. There was significant difference of the nCBV ratios and nCBF ratios between the control group (n = 20 and positive patients group (n = 6 and n = 8, respectively (P > 0.05. All the defects seen on SPECT were well appreciated on nCBF maps (MRI perfusion suggestive of 100% correlation. Conclusion: MR perfusion imaging can be used as an effective modality for evaluation in acute OP poisoning.

  19. Evaluation of MR perfusion abnormalities in organophosphorus poisoning and its correlation with SPECT.

    Science.gov (United States)

    Bhanu, K Uday; Khandelwal, Niranjan; Vyas, Sameer; Singh, Paramjeet; Prabhakar, Anuj; Mittal, B R; Bhalla, Ashish

    2017-01-01

    Acute organophosphate (OP) pesticide poisoning causes substantial morbidity and mortality worldwide. Many imaging modalities, such as computerized tomography (CT), magnetic resonance imaging (MRI), and single photon emission computed tomography (SPECT) of the brain, have been used for quantitative assessment of the acute brain insult caused by acute OP poisoning. Perfusion defects on SPECT in acutely poisoned patients with OPs have been described, however, MR perfusion abnormalities have not been described in the literature. MR perfusion Imaging has the advantage of having higher spatial resolution, no radiation, and better availability. In this prospective study, 20 patients who ingested OP compounds were included. All the patients underwent brain SPECT on a dual head SPECT gamma camera and MRI brain on a 1.5T MR system. Neurocognitive tests were performed for all patients. SPECT showed perfusion defects in 7 patients and total number of perfusion defects were 29. On MR perfusion, based on the cut-off values of normalized cerebral blood volume (nCBV) ratios and normalized cerebral blood flow (nCBF) ratios, the total number of patients showing perfusion defects were 6 and 8; and the total number of perfusion defects were 29 and 45, respectively. There was significant difference of the nCBV ratios and nCBF ratios between the control group ( n = 20) and positive patients group ( n = 6 and n = 8, respectively) ( P > 0.05). All the defects seen on SPECT were well appreciated on nCBF maps (MRI perfusion) suggestive of 100% correlation. MR perfusion imaging can be used as an effective modality for evaluation in acute OP poisoning.

  20. Brain perfusion studies in the evaluation of acute neurologic abnormalities.

    Science.gov (United States)

    Zuckier, Lionel S; Sogbein, O O

    2013-03-01

    Two categories of single-photon radiopharmaceuticals for brain perfusion exist, nonlipophilic and lipophilic compounds. The former are useful in performing simple flow examinations which today have application primarily in the determination of brain death. The latter also exhibit a parenchymal uptake phase that allows for evaluation of the distribution of blood flow within the brain. The lipophilic radiopharmaceuticals, therefore, have application in the evaluation of patients following catastrophic brain injury and traumatic brain injury (TBI) and in prognosticating the outcome following cerebral vascular accidents. Use of these agents to monitor therapy with thrombolytic agents, although theoretically helpful, is technically difficult due to the need to institute treatment rapidly, without undue delay. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Dynamic CT myocardial perfusion imaging identifies early perfusion abnormalities in diabetes and hypertension : Insights from a multicenter registry

    NARCIS (Netherlands)

    Vliegenthart, Rozemarijn; De Cecco, Carlo N.; Wichmann, Julian L.; Meinel, Felix G.; Pelgrim, Gert Jan; Tesche, Christian; Ebersberger, Ullrich; Pugliese, Francesca; Bamberg, Fabian; Choe, Yeon Hyeon; Wang, Yining; Schoepf, U. Joseph

    2016-01-01

    Background: To identify patients with early signs of myocardial perfusion reduction, a reference base for perfusion measures is needed. Objective: To analyze perfusion parameters derived from dynamic computed tomography perfusion imaging (CTPI) in patients with suspected coronary artery disease

  2. Multimodality imaging of abnormal vascular perfusion and morphology in preclinical 9L gliosarcoma model.

    Directory of Open Access Journals (Sweden)

    Moses M Darpolor

    2011-01-01

    Full Text Available This study demonstrates that a dynamic susceptibility contrast-magnetic resonance imaging (DSC-MRI perfusion parameter may indicate vascular abnormality in a brain tumor model and reflects an effect of dexamethasone treatment. In addition, X-ray computed tomography (CT measurements of vascular tortuosity and tissue markers of vascular morphology were performed to investigate the underpinnings of tumor response to dexamethasone.One cohort of Fisher 344 rats (N = 13, inoculated intracerebrally with 9L gliosarcoma cells, was treated with dexamethasone (i.p. 3 mg/kg/day for five consecutive days, and another cohort (N = 11 was treated with equal volume of saline. Longitudinal DSC-MRI studies were performed at the first (baseline, third and fifth day of treatments. Relative cerebral blood volume (rCBV was significantly reduced on the third day of dexamethasone treatment (0.65 ± .13 as compared to the fifth day during treatment (1.26 ±.19, p 0.05. In separate serial studies, microfocal X-ray CT of ex vivo brain specimens (N = 9 and immunohistochemistry for endothelial cell marker anti-CD31 (N = 8 were performed. Vascular morphology of ex vivo rat brains from micro-CT analysis showed hypervascular characteristics in tumors, and both vessel density (41.32 ± 2.34 branches/mm(3, p<0.001 and vessel tortuosity (p<0.05 were significantly reduced in tumors of rats treated with dexamethasone compared to saline (74.29 ± 3.51 branches/mm(3. The vascular architecture of rat brain tissue was examined with anti-CD31 antibody, and dexamethasone treated tumor regions showed reduced vessel area (16.45 ± 1.36 µm(2 as compared to saline treated tumor regions (30.83 ± 4.31 µm(2, p<0.001 and non-tumor regions (22.80 ± 1.11 µm(2, p<0.01.Increased vascular density and tortuosity are culprit to abnormal perfusion, which is transiently reduced during dexamethasone treatment.

  3. Cerebral abnormalities in cocaine abusers: Demonstration by SPECT perfusion brain scintigraphy. Work in progress

    International Nuclear Information System (INIS)

    Tumeh, S.S.; Nagel, J.S.; English, R.J.; Moore, M.; Holman, B.L.

    1990-01-01

    Single photon emission computed tomography (SPECT) perfusion brain scans with iodine-123 isopropyl iodoamphetamine (IMP) were obtained in 12 subjects who acknowledged using cocaine on a sporadic to a daily basis. The route of cocaine administration varied from nasal to intravenous. Concurrent abuse of other drugs was also reported. None of the patients were positive for human immunodeficiency virus. Brain scans demonstrated focal defects in 11 subjects, including seven who were asymptomatic, and no abnormality in one. Among the findings were scattered focal cortical deficits, which were seen in several patients and which ranged in severity from small and few to multiple and large, with a special predilection for the frontal and temporal lobes. No perfusion deficits were seen on I-123 SPECT images in five healthy volunteers. Focal alterations in cerebral perfusion are seen commonly in asymptomatic drug users, and these focal deficits are readily depicted by I-123 IMP SPECT

  4. Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    Energy Technology Data Exchange (ETDEWEB)

    Padua, Rodrigo Donizete Santana de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Div. de Cardiologia]. E-mail: rodrigo_dsp@hcrp.fmrp.usp.br; Oliveira, Lucas Ferrari de [Universidade Federal de Pelotas (UFPel), RS (Brazil). Inst. de Fisica e Matematica. Dept. de Tecnologia da Informacao; Marques, Paulo Mazzoncini de Azevedo [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Groote, Jean-Jacques Georges Soares de [Instituto de Ensino Superior COC, Ribeirao Preto, SP (Brazil). Lab. of Artifical Intelligence and Applications; Castro, Adelson Antonio de [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina; Ana, Lauro Wichert [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Centro de Ciencias das Imagens e Fisica Medica; Simoes, Marcus Vinicius [Universidade de Sao Paulo (USP), Ribeirao Preto, SP, (Brazil). Faculdade de Medicina. Divisao de Cardiologia

    2008-11-15

    To develop an atlas of myocardial perfusion scintigraphy and evaluating its applicability in computer-aided detection of myocardial perfusion defects in patients with ischemic heart disease. The atlas was created with rest-stress myocardial perfusion scintigraphic images of 20 patients of both genders with low probability of coronary artery disease and considered as normal by two experienced observers. Techniques of image registration and mathematical operations on images were utilized for obtaining template images depicting mean myocardial uptake and standard deviation for each gender and physiological condition. Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observe. The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended. (author)

  5. Comparison of brain perfusion SPECT abnormalities with anatomical imaging in mild traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Majid Asadi

    2007-02-01

    Full Text Available Background: Trauma is the most common cause of morbidity and mortality in industrialized countries and also in Iran. Anatomical imaging (AI CT and MRI is helpful in the diagnosis of acute traumatic complications however it is not efficient in the diagnosis of disabling injury syndrome. In contrast, brain perfusion SPECT (Single Photon Emission Computed Tomography can be more useful for evaluation of microvascular structure. This study was designed to compare these two diagnostic methods. Methods: A total of 50 patients who had been suffering from traumatic brain injury for more than 1 year, and were followed as mild traumatic brain injury group according to “the Brain Injury Interdisciplinary Special Interest Group of the Ameri can Congress of Rehabilitation Medicine” criteria, were examined by brain perfusion SPECT and AI. The common anatomical classification of the lobes of brain was used. Results: The male to female ratio was 3:2. The mean age was 32.32±11.8 years and mean post-traumatic time was 1.48±0.65 years. The most common symptoms were headache (60%, agusia (36% and anosmia (32%. Among 400 examined brain lobes in this study, brain perfusion SPECT revealed remarkable abnormality in 76 lobes (19%, but AI determined abnormalities in 38 lobes (9.5% therefore, SPECT was twice sensitive than AI in mild traumatic brain injury (P<0.001. The correlation between SPECT and AI findings was 84%. SPECT was more sensitive than AI in demonstrating brain abnormalities in frontal lobe it was more obvious in the male group however, there was no significant difference between more and less than 30 years old groups. Conclusion: According to the findings of this study, we recommend using brain perfusion SPECT for all patients with chronic complications of head trauma, particularly those who have signs and symptoms of hypofrontalism, even though with some abnormalities in AI.

  6. Quantification of reversible perfusion abnormality using exercise-stress thallium SPECT before and after coronary revascularization

    International Nuclear Information System (INIS)

    Nagao, Kazuhiko; Nakata, Tomoaki; Tsuchihashi, Kazufumi

    1994-01-01

    Reversible myocardial perfusion abnormality was quantified by bull's eye and unfolded surface mapping methods in exercise thallium SPECT before and after coronary revascularization in 47 patients with angina pectoris, including 34 patients with previous myocardial infarction (PMI) and 13 with effort angina (AP). There was no difference in the incidence or extent of myocardial ischemia between the 2 groups before revascularization. However, the ischemic scores were significantly smaller in PMI group preoperatively than the reductions of the ischemic scores after revascularization. The ischemic scores, preoperatively estimated reversible perfusion abnormality was 32%, 69% and 48% of the improvement of the ischemic score (extent score, severity score, and ischemic area, respectively). Using the 3 ischemic scores, the improvement of perfusion abnormality was well predicted in 70-89% of AP patients but 35-57% of PMI patients. Thus, quantitative analysis in stress thallium SPECT is useful for detecting myocardial ischemia and evaluating the effect of coronary revascularization. However, about a half of myocardial viability was underestimated in one third of PMI patients by the conventional exercise-stress thallium SPECT study. (author)

  7. Comparison of Regional Brain Perfusion Levels in Chronically Smoking and Non-Smoking Adults

    Directory of Open Access Journals (Sweden)

    Timothy C. Durazzo

    2015-07-01

    Full Text Available Chronic cigarette smoking is associated with numerous abnormalities in brain neurobiology, but few studies specifically investigated the chronic effects of smoking (compared to the acute effects of smoking, nicotine administration, or nicotine withdrawal on cerebral perfusion (i.e., blood flow. Predominately middle-aged male (47 ± 11 years of age smokers (n = 34 and non-smokers (n = 27 were compared on regional cortical perfusion measured by continuous arterial spin labeling magnetic resonance studies at 4 Tesla. Smokers showed significantly lower perfusion than non-smokers in the bilateral medial and lateral orbitofrontal cortices, bilateral inferior parietal lobules, bilateral superior temporal gyri, left posterior cingulate, right isthmus of cingulate, and right supramarginal gyrus. Greater lifetime duration of smoking (adjusted for age was related to lower perfusion in multiple brain regions. The results indicated smokers showed significant perfusion deficits in anterior cortical regions implicated in the development, progression, and maintenance of all addictive disorders. Smokers concurrently demonstrated reduced blood flow in posterior brain regions that show morphological and metabolic aberrations as well as elevated beta amyloid deposition demonstrated by those with early stage Alzheimer disease. The findings provide additional novel evidence of the adverse effects of cigarette smoking on the human brain.

  8. Dual vessel arterial spin labeling scheme for regional perfusion imaging.

    Science.gov (United States)

    Zimine, Ivan; Petersen, Esben Thade; Golay, Xavier

    2006-11-01

    Regional perfusion imaging (RPI) based on pulsed arterial spin labeling and angulated inversion slabs has been recently proposed. The technique allows mapping of individual brain perfusion territories of the major feeding arteries and could become a valuable clinical tool for evaluation of patients with cerebrovascular diseases. Here we propose a new labeling scheme for RPI where lateral and posterior circulations are labeled simultaneously. Two scans instead of three are sufficient to obtain the same perfusion territories as in the original approach, allowing for a 33% reduction in the total RPI protocol time. Moreover, the position of the inversion slabs with respect to vascular anatomy facilitates the planning and allows potentially better labeling efficiency. The new approach was tested on seven healthy volunteers and compared to the original labeling scheme. The results showed that the same perfusion territories and regional CBF values can be obtained. (c) 2006 Wiley-Liss, Inc.

  9. Reclassification of cardiovascular risk by myocardial perfusion imaging in diabetic patients with abnormal resting electrocardiogram.

    Science.gov (United States)

    Petretta, M; Acampa, W; Evangelista, L; Daniele, S; Zampella, E; Assante, R; Nappi, C; Cantoni, V; Fiumara, G; Cuocolo, A

    2014-06-01

    Despite an extensive use of stress myocardial perfusion single-photon emission computed tomography (MPS), no study addressed the role of perfusion imaging in diabetic patients with abnormal resting electrocardiogram (ECG). We compared analytical approaches to assess the added value of stress MPS variables in estimating coronary heart disease outcomes in diabetic patients with abnormal resting ECG. A total of 416 patients with diabetes and abnormal resting ECG who underwent stress MPS were prospectively followed up after the index study. The end point was the occurrence of a major cardiac event, including cardiac death and nonfatal myocardial infarction. At the end of follow-up (median 58 months), 42 patients experienced events. MPS data increased the predictive value of a model including traditional cardiovascular risk factors and left ventricular (LV) ejection fraction (likelihood ratio χ² from 17.54 to 24.15, p patients were reclassified to a lower risk category, with a 5-year event rate of 3.5%, and 40 patients were reclassified to a higher risk category, with a 5-year event rate of 20%. The addition of MPS findings to a model based on traditional cardiovascular risk factors and LV ejection fraction improves risk classification for incident cardiac events in diabetic patients with abnormal resting ECG. Copyright © 2013 Elsevier B.V. All rights reserved.

  10. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    International Nuclear Information System (INIS)

    Perani, D.; Di Piero, V.; Vallar, G.

    1988-01-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([/sup 99m/Tc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data

  11. Radiation-induced myocardial perfusion abnormalities in breast cancer patients following external beam radiation therapy

    Directory of Open Access Journals (Sweden)

    Mohammad Eftekhari

    2015-01-01

    Full Text Available Objective(s: Radiation therapy for breast cancer can induce myocardial capillary injury and increase cardiovascular morbidity and mortality. A prospective cohort was conducted to study the prevalence of myocardial perfusion abnormalities following radiation therapy of left-sided breast cancer patients as compared to those with right–sided cancer. Methods: To minimize potential confounding factors, only those patients with low 10-year risk of coronary artery disease (based on Framingham risk scoring were included. All patients were initially treated by modified radical mastectomy and then were managed by postoperative 3D Conformal Radiation Therapy (CRT to the surgical bed with an additional 1-cm margin, delivered by 46-50 Gy (in 2 Gy daily fractions over a 5-week course. The same dose-adjusted chemotherapy regimen (including anthracyclines, cyclophosphamide and taxol was given to all patients. Six months after radiation therapy, all patients underwent cardiac SPECT for the evaluation of myocardial perfusion. Results: A total of 71 patients with a mean age of 45.3±7.2 years [35 patients with leftsided breast cancer (exposed and 36 patients with right-sided cancer (controls] were enrolled. Dose-volume histogram (DVH [showing the percentage of the heart exposed to >50% of radiation] was significantly higher in patients with left-sided breast cancer. Visual interpretation detected perfusion abnormalities in 42.9% of cases and 16.7% of controls (P=0.02, Odds ratio=1.46. In semiquantitative segmental analysis, only apical (28.6% versus 8.3%, P=0.03 and anterolateral (17.1% versus 2.8%, P=0.049 walls showed significantly reduced myocardial perfusion in the exposed group. Summed Stress Score (SSS of>3 was observed in twelve cases (34.3%, while in five of the controls (13.9%,(Odds ratio=1.3. There was no significant difference between the groups regarding left ventricular ejection fraction. Conclusion: The risk of radiation induced myocardial

  12. Prevalence and predictors of an abnormal stress myocardial perfusion study in asymptomatic patients with type 2 diabetes mellitus

    Energy Technology Data Exchange (ETDEWEB)

    Scholte, Arthur J.H.A.; Schuijf, Joanne D.; Wall, Ernst E. van der; Bax, Jeroen J. [Leiden University Medical Center, Department of Cardiology, Albinusdreef 2, PO Box 9600, Leiden (Netherlands); Kharagjitsingh, Antje V. [Medisch Centrum Haaglanden, Department of Internal Medicine, The Hague (Netherlands); Dibbets-Schneider, Petra; Stokkel, Marcel P. [Leiden University Medical Center, Department of Nuclear Medicine, Leiden (Netherlands)

    2009-04-15

    The purpose of this study was to evaluate the prevalence of an abnormal stress myocardial perfusion study in a cohort of truly asymptomatic patients with type 2 diabetes mellitus using myocardial perfusion imaging by means of single photon emission computed tomography (SPECT). Secondly, we determined which clinical characteristics may predict an abnormal stress myocardial perfusion study in this population. A total of 120 asymptomatic patients (mean age 53{+-}10 years) with type 2 diabetes mellitus and one or more risk factors for coronary artery disease were prospectively recruited from an outpatient diabetes clinic. All patients underwent myocardial perfusion imaging by means of adenosine {sup 99m}Tc sestamibi SPECT. Images were evaluated for the presence of perfusion abnormalities as well as other nonperfusion abnormalities that may indicate extensive ischaemia, including left ventricular dysfunction (defined as a left ventricular ejection fraction <45%), transient ischaemic dilatation and adenosine-induced ST segment depression. Multivariable analysis was performed using a backward selection strategy to identify potential predictors for an abnormal stress myocardial perfusion study. Finally, all patients were followed up for 12 months to determine the occurrence of cardiovascular events: (1) cardiac death, (2) nonfatal myocardial infarction, (3) unstable angina requiring hospitalization, (4) revascularization, or (5) stroke. Of the 120 patients, 40 (33%) had an abnormal stress study, including myocardial perfusion abnormalities in 30 patients (25%). In 10 patients (8%), indicators of extensive (possibly balanced ischaemia) were observed in the absence of abnormal perfusion. The multivariable analysis identified current smoking, duration of diabetes and the cholesterol/high-density lipoprotein (HDL) ratio as independent predictors of an abnormal stress study. During a follow-up period of 12 months six patients (5%) had a cardiovascular event. The current study

  13. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    International Nuclear Information System (INIS)

    Dowdle, S.C.; Human, D.G.; Mann, M.D.

    1990-01-01

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis

  14. Pulmonary ventilation and perfusion abnormalities and ventilation perfusion imbalance in children with pulmonary atresia or extreme tetralogy of Fallot

    Energy Technology Data Exchange (ETDEWEB)

    Dowdle, S.C.; Human, D.G.; Mann, M.D. (Univ. of Cape Town (South Africa))

    1990-08-01

    Xenon-133 lung ventilation and perfusion scans were done preoperatively after cardiac catheterization and cineangiocardiography in 19 children; 6 had pulmonary atresia with an intact ventricular septum and hypoplastic right ventricle, 4 pulmonary atresia with associated complex univentricular heart, and 9 extreme Tetralogy of Fallot. The four patients with discrepancies in the sizes of the left and right pulmonary arteries on angiography had marked asymmetry of pulmonary perfusion and ventilation-perfusion imbalance on scintigraphy. Similar degrees of asymmetry and imbalance were present in 6 of the 15 children with equal-size pulmonary vessels. Asymmetry of pulmonary perfusion and ventilation-perfusion imbalance were associated with a poor prognosis.

  15. Magnetic resonance imaging in familial hypertrophic cardiomyopathy associated with abnormal thallium perfusion and cardiac enzymes

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Nagata, Seiki; Sakakibara, Hiroshi

    1988-01-01

    Gated magnetic resonance imaging (MRI) was performed in 6 patients with familial hypertrophic cardiomyopathy associated with abnormal thallium perfusion, and 12 patients with ordinary hypertrophic cardiomyopathy. The patients with ordinary hypertrophic cardiomyopathy and abnormal thickening of the septal wall and normal left ventricular dimensions, while the patients with familial hypertrophic cardiomyopathy had focal wall thinning (usually involving the apical-septal wall) and dilated left ventricle in addition to hypertrophied heart. The quantitative measurement for cardiac dimensions using MRI was similar to that found on echocardiography in all cases. In addition, inhomogeneous signal intensities at left ventricular wall were observed in 3 cases of familial hypertrophic cardiomyopathy, which may suggest the existence of myocardial fibrosis. Gated MRI should be performed for early detection and follow-up of hypertrophic cardiomyopathy, since some patients will progress from hypertrophic cardiomyopathy to dilated cardiomyopathy. (author)

  16. Prognostic estimation of coronary artery disease risk with resting perfusion abnormalities and stress ischemia on myocardial perfusion SPECT.

    Science.gov (United States)

    Shaw, Leslee J; Hendel, Robert C; Heller, Gary V; Borges-Neto, Salvador; Cerqueira, Manuel; Berman, Daniel S

    2008-01-01

    The extent and severity of stress ischemia are strong predictors of coronary artery disease (CAD) events. Prognosis associated with myocardial perfusion single photon emission computed tomography (MPS) abnormalities on the resting scan as it relates to stress ischemia has been incompletely described. The Myoview Prognosis Registry was a prospective consecutive series of 7849 outpatients enrolled from 5 geographically diverse centers. Patients were followed up for the occurrence of CAD events (nonfatal myocardial infarction [MI] or death related to MI, heart failure, or sudden cardiac death). Time to CAD event (n = 545) was estimated by use of univariable and multivariable Cox proportional hazards models (risk adjusted by symptoms, risk factors, and comorbid conditions). For patients with no resting defects, overall CAD event rates were 1.2%, 8%, and 10% for patients with 0% ischemic myocardium, 1% to 4.9% ischemic myocardium, and 5% ischemic myocardium or greater, respectively (P ischemic myocardium, there was a 7% increased risk of CAD events (P disease, and MPS with provocative ischemia.

  17. Lack of dystrophin results in abnormal cerebral diffusion and perfusion in vivo.

    Science.gov (United States)

    Goodnough, Candida L; Gao, Ying; Li, Xin; Qutaish, Mohammed Q; Goodnough, L Henry; Molter, Joseph; Wilson, David; Flask, Chris A; Yu, Xin

    2014-11-15

    Dystrophin, the main component of the dystrophin-glycoprotein complex, plays an important role in maintaining the structural integrity of cells. It is also involved in the formation of the blood-brain barrier (BBB). To elucidate the impact of dystrophin disruption in vivo, we characterized changes in cerebral perfusion and diffusion in dystrophin-deficient mice (mdx) by magnetic resonance imaging (MRI). Arterial spin labeling (ASL) and diffusion-weighted MRI (DWI) studies were performed on 2-month-old and 10-month-old mdx mice and their age-matched wild-type controls (WT). The imaging results were correlated with Evan's blue extravasation and vascular density studies. The results show that dystrophin disruption significantly decreased the mean cerebral diffusivity in both 2-month-old (7.38 ± 0.30 × 10(-4)mm(2)/s) and 10-month-old (6.93 ± 0.53 × 10(-4)mm(2)/s) mdx mice as compared to WT (8.49 ± 0.24 × 10(-4), 8.24 ± 0.25 × 10(-4)mm(2)/s, respectively). There was also an 18% decrease in cerebral perfusion in 10-month-old mdx mice as compared to WT, which was associated with enhanced arteriogenesis. The reduction in water diffusivity in mdx mice is likely due to an increase in cerebral edema or the existence of large molecules in the extracellular space from a leaky BBB. The observation of decreased perfusion in the setting of enhanced arteriogenesis may be caused by an increase of intracranial pressure from cerebral edema. This study demonstrates the defects in water handling at the BBB and consequently, abnormal perfusion associated with the absence of dystrophin. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Prevalence of myocardial perfusion abnormalities in end-stage liver disease

    International Nuclear Information System (INIS)

    Fathala, Ahmed; Safar, Bander; Al Muhaideb, Ahmed

    2011-01-01

    The prevalence of coronary artery disease (CAD) in end-stage liver disease (ESLD) being evaluated for orthotopic liver transplantation (OLT) is unclear based on variable definition used for CAD. The aim of this study to investigate the prevalence of abnormal stress myocardial perfusion single-photon emission computed tomography (MPS) imaging, as a marker for CAD, among patients with ESLD who were referred for stress MPS imaging as a routine work up before OLT. This was a single-center, retrospective study. We reviewed data on 167 patients who were referred for MPS as a routine work up before OLT over the last 2 years. All patients underwent evaluation for CAD risk factors [age, hypercholesterolemia, diabetes mellitus (DM), hypertension (HTN), and smoking], and stress MPS as per standard protocol. The total number of patients referred for stress MPS was 167. Seven patients (4% of total study population) were excluded from the study due to poor and/or nondiagnostic studies. 147 patients (92%) had normal, but only 13 patients (8%) had abnormal MPS scans. DM and male gender were the most independent risk factors for abnormal MPS with P value of 0.046, and 0.26, respectively. There was no significant association between the abnormal MPS result and HTN, hypercholesterolemia, smoking, age or etiology of the liver disease. Based on our data, the prevalence of abnormal MPS and left ventricular ejection fraction in patients with ESLD was found to be 8%. DM and male gender were the most independent predictor factors for abnormal MPS. True prevalence of CAD and usefulness of MPS in patients with ESLD can only be studied using a very large and randomized prospective study

  19. The clinical significance of abnormal 99Tcm-MIBI myocardial perfusion tomography in patients with hypertension

    International Nuclear Information System (INIS)

    Yang Yongzhen; Li Zhaoping; Liu Yimin; Zhang Weifang; Zhang Yanyan; Zhang Songlin; Wang Xin; Mao Yuan

    2000-01-01

    Objective: To evaluate the clinical significance of abnormal myocardial perfusion tomography in the hypertensive patients with normal coronary angiography. Methods: Qualitative diagnosis, the average counts ratio of lateral to septal segments (L/S) and the ratio of stress L/S to rest L/S from stress and rest 99 Tc m -sestamibi myocardial perfusion tomography (MPT), and every clinical characteristic and the results from other examinations were compared between hypertensive patients (HP) and normotensive controls (NC). Every risk factor leading to coronary artery disease and related indexes in patients with positive MPT were compared with the results of patients with negative MPT. Results: 1) The positive rate of MPT in HP was obviously higher than that of NC,which was 61.9% vs 9.1%, respectively. Most focuses of MPT were reversible defects (RD), a few of them accompanied by reverse reversible defects (RRD). There were many more angina pectoris and heart arrhythmia attacks in HP than in NC. 2) The ratio of stress L/S to rest L/S of HP was lower than that of NC (P<0.05). 3) The ratio of stress L/S to rest L/S of the patients with positive MPT in HP significantly decreased compared with that of the patients with negative MPT (P<0.01). There were more patients being addicted to smoking and drinking in those with a positive than in those with a negative MPT (53.8% versus 12.5%, P<0.05). 4) The abnormal defects of MPT in HP were almost seen in any segment of left ventricle and most of the patients had no left ventricular hypertrophy, but did smoke and drink. Conclusions: 1)Abnormal MPT exist in the HP with normal coronary angiography and not necessarily with left ventricular hypertrophy. 2)The long-term addiction of smoking and drinking was one of the risk factors leading to arouse myocardial ischemia in HP

  20. The value of MR perfusion weighted imaging in normal and abnormal kidneys

    International Nuclear Information System (INIS)

    Shi Hao; Ding Hongyu; Duan Ruiping; Sun Yongping; Xing Yiyong

    2008-01-01

    Objective: To explore the characteristics and the clinical application of MR perfusion weighted imaging (PWI) in the normal kidneys and the renal diseases. Methods: Thirty-one subjects including 9 cases without urinary diseases, 14 cases with renal carcinoma, 6 cases with renal cyst and 2 cases with renal tuberculosis who had been examined with T 1 WI, T 2 WI and PWI were analyzed retrospectively. All the data were processed by a workstation to obtain time-signal intensity curves, color perfusion maps and relative perfusion value. The relative renal blood volume (RBV), relative renal blood flow (RBF), mean transition time (MTY) and the time to peak (TTP) in the normal renal cortex and medulla and the renal lesions were calculated. Comparisons between the right and the left normal kidneys, and between the cortex and the medulla of the normal kidneys were performed using t test, and comparisons between the normal and the abnormal kidneys were performed using q test. Results: Relative RBV and relative RBF of the cortex were 1.33±0.08 and 1.44±0.09 respectively, and for medulla were 0.58± 0.05 and 0.78±0.13 respectively (t=9.2241 and 5.0336, P 0.05). The values of relative RBF of the renal carcinoma (1.35±0.34) were significantly higher than that of the normal tissues (1.02±0.06) (q=3.0882, P< 0.01). Conclusion: PWI is able to demonstrate the hemodynamic change of the normal renal tissues and the renal lesions, and it maybe an ideal method for showing the functional changes of the kidney and for differentiating the renal diseases. (authors)

  1. Effects of diltiazem on myocardial perfusion abnormalities during exercise in patients with hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Sugihara, Hiroki; Taniguchi, Yoko; Ito, Kazuki [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1998-12-01

    The effect of diltiazem on myocardial ischemia in patients with hypertrophic cardiomyopathy (HCM) was evaluated by exercise myocardial {sup 201}Tl single photon emission computed tomography (SPECT). Exercise myocardial SPECT was performed before and 8 weeks after oral administration of diltiazem (180 mg/day) in 20 patients with HCM who showed transient perfusion defects on exercise myocardial {sup 201}Tl SPECT under control conditions. SPECT images were divided into 17 segments. The {sup 201}Tl perfusion defects were visually scored and evaluated as the defect score. The transient dilation index was calculated as an index of subendocardial ischemia. Improvement of the defect score was demonstrated in 15 patients after the administration of diltiazem. The mean defect score decreased significantly from 9.90{+-}5.17 to 5.50{+-}4.89 (p<0.0001). Although 16 of 20 patients showed an abnormal transient dilation index before diltiazem treatment, 16 showed improvement and 13 of these normalized after diltiazem therapy. The mean transient dilation index decreased from 1.16{+-}0.10 to 1.02{+-}0.09 (p<0.0001). In conclusion, diltiazem prevents or diminishes myocardial ischemia in patients with HCM. (author)

  2. Regional assessment of treatment in lung cancer using lung perfusion and ventilation images

    Energy Technology Data Exchange (ETDEWEB)

    Horikoshi, Masaki; Teshima, Takeo; Yanagimachi, Tomohiro; Ogata, Yuuko [Sendai Kohsei Hospital (Japan); Nukiwa, Toshihiro

    2000-11-01

    In 30 patients with lung cancer undergoing non-surgical treatment, we performed perfusion lung imaging using {sup 99m}Tc-MAA and inhalation lung studies using Technegas before and after treatment and evaluated regional perfusion and ventilation status in the lung regions where bronchogenic carcinoma was located. Regional ventilation status was preserved rather than perfusion counterpart (V>P) in 18 patients (18/30=60.0%) before treatment, while the former was better than the latter in 27 patients (27/30=90.0%) after treatment, indicating that regional ventilation status improved more significantly than regional perfusion counterpart after treatment (P=0.005). We also classified the therapeutic effect for regional perfusion and ventilation status as improved, unchanged, or worsened, respectively; improvement in regional perfusion status was observed in 17 patients (56.7%) and that in regional ventilation status in 24 patients (80.0%). There was a statistically significant correlation between improved regional perfusion and ventilation status (P=0.0018) when therapeutic effect was recognized. The patients who showed improvement in regional perfusion status after treatment always showed improved regional ventilation status, but 7 patients showed either unchanged or worsened regional perfusion status after treatment, although regional ventilation status was improved. In conclusion the pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and improvement in regional perfusion status was revealed to be more difficult than that in regional ventilation status after treatment. (author)

  3. Regional assessment of treatment in lung cancer using lung perfusion and ventilation images

    International Nuclear Information System (INIS)

    Horikoshi, Masaki; Teshima, Takeo; Yanagimachi, Tomohiro; Ogata, Yuuko; Nukiwa, Toshihiro

    2000-01-01

    In 30 patients with lung cancer undergoing non-surgical treatment, we performed perfusion lung imaging using 99m Tc-MAA and inhalation lung studies using Technegas before and after treatment and evaluated regional perfusion and ventilation status in the lung regions where bronchogenic carcinoma was located. Regional ventilation status was preserved rather than perfusion counterpart (V>P) in 18 patients (18/30=60.0%) before treatment, while the former was better than the latter in 27 patients (27/30=90.0%) after treatment, indicating that regional ventilation status improved more significantly than regional perfusion counterpart after treatment (P=0.005). We also classified the therapeutic effect for regional perfusion and ventilation status as improved, unchanged, or worsened, respectively; improvement in regional perfusion status was observed in 17 patients (56.7%) and that in regional ventilation status in 24 patients (80.0%). There was a statistically significant correlation between improved regional perfusion and ventilation status (P=0.0018) when therapeutic effect was recognized. The patients who showed improvement in regional perfusion status after treatment always showed improved regional ventilation status, but 7 patients showed either unchanged or worsened regional perfusion status after treatment, although regional ventilation status was improved. In conclusion the pulmonary vascular beds seem more vulnerable to bronchogenic carcinoma and improvement in regional perfusion status was revealed to be more difficult than that in regional ventilation status after treatment. (author)

  4. SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury.

    Science.gov (United States)

    Abdel-Dayem, H M; Abu-Judeh, H; Kumar, M; Atay, S; Naddaf, S; El-Zeftawy, H; Luo, J Q

    1998-05-01

    The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time. Therefore, the authors feel that Tc-99m HMPAO is preferable to Tc-99m ECD. Recommendations regarding standardizing intravenous injection, the acquisition, processing parameters, and interpretation of scans using a ten grade color scale, and use of the cerebellum as the reference organ are presented. SPECT images of 228 patients (age range, 11 to 88; mean, 40.8 years) with mild or moderate TBI and no significant medical history that interfered with the results of the SPECT BP were reviewed. The etiology of the trauma was in the following order of frequency: motor vehicle accidents (45%) followed by blow to the head (36%) and a fall (19%). Frequency of the symptoms was headache (60.9%), memory problems (27.6%), dizziness (26.7%), and sleep disorders (8.7%). Comparison between patients imaged early (3 months) from the time of the accident, showed that early imaging detected more lesions (4.2 abnormal lesions per study compared to 2.7 in those imaged more than 3 months after the accident). Of 41 patients who had mild traumatic injury without loss of consciousness and had normal CT, 28 studies were abnormal. Focal areas of hypoperfusion were seen in 77% (176 patients, 612 lesions) of the group of 228 patients. The sites of abnormalities were in the following order: basal ganglia and thalami, 55.2%, frontal lobes, 23.8%, temporal lobes, 13%, parietal, 3.7%, insular and occipital lobes together, 4.6%.

  5. Regional blood perfusion in childhood partial seizure using N-isopropyl-p-[I-123]iodoamphetamine and single photon emission CT

    International Nuclear Information System (INIS)

    Michihiro, Narumi; Kurosawa, Yumiko; Hibio, Shuichi; Ishihara, Hiroaki; Ariizumi, Motomizu

    1989-01-01

    Single photon emission CT (SPECT) with N-isopropyl-p-[I-123]iodoamphetamine was performed in 20 pediatric patients with partial seizure to examine regional blood perfusion. In detecting location of abnormality, SPECT and EEG were concordant in 13 patients (65%) and discordant in 4 patients (20%). In 7 patients undergoing SPECT one to 4 years after seizure onset, decreased blood perfusion corresponded to focal abnormality on EEG. In other 9 patiets in whom SPECT was performed within one year, however, location of abnormality on SPECT did not necessarily concur with that on EEG. These findings suggest that brain lesions are not focal but extensive at the early stage of partial seizure and that they are becoming focal with the mature of the central nervous system. (Namekawa, K)

  6. Regional distribution of ventilation-perfusion ratio in patients with interstitial pneumonia using Kr-81m

    International Nuclear Information System (INIS)

    Sekine, Hiroshi; Kawakami, Kenji; Shimada, Takao

    1983-01-01

    In order to know the pathophysiological change of interstitial pneumonia, it is important to detect the morphological change of vascular and air way systems in the lung. The study group consisted of 12 patients of interstitial pneumonia including IIP, PSS, RA, sarcoidosis, and hypersensitive pneumonia. The Kr-81m bolus inhalation from 3 different lung volumes were analyzed to detect regional ventilation abnormalities. The regional distribution of ventilation-perfusion ratio (V/Q) in the lung was obtained from the continuous inhalation and infusion Kr-81 m. In 7 patients, regional distribution of V/Q was also measured at rest and during exercise. In advanced stage of interstitial pneumonia, radioactivity in lower lung fields was decreased in bolus inhalation from TLC-400 ml lung volume, and present in lower lung in bolus inhalation from RV level. These findings are representing air way rigidity especially in lower lung fields. However, in early stage or reversible cases, it is difficult to detect the abnormal distribution of radioactivity in lung, in spite of decreased PO 2 . So it seems impossible to screen early stage or reversible cases of interstitial pneumonia by bolus inhalation method alone. At rest for normal subjects in the upright position, the apical zone had a high V/Q, but in the lower parts two third of V/Q distribution was relatively homogeneous. During exercise at 50W, the distribution became more uniform. In most cases of the disease, weak exercise (less than 40W) produced the same uniform V/Q distribution. It should be noted that in the disease not only was perfusion in upper lung fields increased, but that perfusion of lower lung fields was reduced. So late in the cource of extension of the disease, pulmonary vascular bed in the lower lung fields is restricted.(J.P.N.)

  7. Unexpected reductions in regional cerebral perfusion during prolonged hypoxia.

    Science.gov (United States)

    Lawley, Justin S; Macdonald, Jamie H; Oliver, Samuel J; Mullins, Paul G

    2017-02-01

    Cognitive performance is impaired by hypoxia despite global cerebral oxygen delivery and metabolism being maintained. Using arterial spin labelled (ASL) magnetic resonance imaging, this is the first study to show regional reductions in cerebral blood flow (CBF) in response to decreased oxygen supply (hypoxia) at 2 h that increased in area and became more pronounced at 10 h. Reductions in CBF were seen in brain regions typically associated with the 'default mode' or 'task negative' network. Regional reductions in CBF, and associated vasoconstriction, within the default mode network in hypoxia is supported by increased vasodilatation in these regions to a subsequent hypercapnic (5% CO 2 ) challenge. These results suggest an anatomical mechanism through which hypoxia may cause previously reported deficits in cognitive performance. Hypoxia causes an increase in global cerebral blood flow, which maintains global cerebral oxygen delivery and metabolism. However, neurological deficits are abundant under hypoxic conditions. We investigated regional cerebral microvascular responses to acute (2 h) and prolonged (10 h) poikilocapnic normobaric hypoxia. We found that 2 h of hypoxia caused an expected increase in frontal cortical grey matter perfusion but unexpected perfusion decreases in regions of the brain normally associated with the 'default mode' or 'task negative' network. After 10 h in hypoxia, decreased blood flow to the major nodes of the default mode network became more pronounced and widespread. The use of a hypercapnic challenge (5% CO 2 ) confirmed that these reductions in cerebral blood flow from hypoxia were related to vasoconstriction. Our findings demonstrate steady-state deactivation of the default network under acute hypoxia, which become more pronounced over time. Moreover, these data provide a unique insight into the nuanced localized cerebrovascular response to hypoxia that is not attainable through traditional methods. The observation of reduced

  8. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Perani, D.; Di Piero, V.; Vallar, G.; Cappa, S.; Messa, C.; Bottini, G.; Berti, A.; Passafiume, D.; Scarlato, G.; Gerundini, P.

    1988-09-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ((/sup 99m/Tc)HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data.

  9. Cerebral blood flow is an earlier indicator of perfusion abnormalities than cerebral blood volume in Alzheimer's disease

    OpenAIRE

    Lacalle-Aurioles, María; Mateos-Pérez, José M; Guzmán-De-Villoria, Juan A; Olazarán, Javier; Cruz-Orduña, Isabel; Alemán-Gómez, Yasser; Martino, María-Elena; Desco, Manuel

    2014-01-01

    The purpose of this study was to elucidate whether cerebral blood flow (CBF) can better characterize perfusion abnormalities in predementia stages of Alzheimer's disease (AD) than cerebral blood volume (CBV) and whether cortical atrophy is more associated with decreased CBV or with decreased CBF. We compared measurements of CBV, CBF, and mean cortical thickness obtained from magnetic resonance images in a group of healthy controls, patients with mild cognitive impairment (MCI) who converted t...

  10. Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Schillaci, O.; Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L.; Danieli, R.; Scopinaro, F.

    1999-01-01

    In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with 99m Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (''reverse redistribution pattern''). Coronary angiography was performed in eight patients with positive 99m Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that 99m Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole 99m Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.)

  11. Technetium-99m sestamibi single-photon emission tomography detects subclinical myocardial perfusion abnormalities in patients with systemic lupus erythematosus

    Energy Technology Data Exchange (ETDEWEB)

    Schillaci, O. [Nuclear Medicine, University of l`Aquila (Italy); Lagana, B.; Gentile, R.; Tubani, L.; Baratta, L. [Department of Clinical Medicine, University ``La Sapienza``, Rome (Italy); Danieli, R.; Scopinaro, F. [Section of Nuclear Medicine, Department of Experimental Medicine and Pathology, University ``La Sapienza``, Rome (Italy)

    1999-07-01

    In patients with systemic lupus erythematosus, involvement of the cardiovascular system is the third leading cause of death. However, although autopsy studies have demonstrated a high incidence of abnormalities in both the myocardium and coronary vessels, clinical manifestations have been reported in only a small percentage of cases. The aim of this study was to evaluate myocardial perfusion in asymptomatic lupus patients using technetium-99m sestamibi single-photon emission tomography (SPET). Twenty-eight patients without overt cardiac involvement and risk factors were studied with {sup 99m}Tc-sestamibi SPET at rest and after dipyridamole infusion. Perfusion abnormalities were detected in 18 cases: six had persistent defects, three had reversible defects, seven had both persistent and reversible defects, and two showed rest defects which normalized on dipyridamole images (``reverse redistribution pattern``). Coronary angiography was performed in eight patients with positive {sup 99m}Tc-sestamibi SPET, and showed normal epicardial vessels in all the cases. These results indicate that {sup 99m}Tc-sestamibi SPET reveals a high prevalence (18 out of 28 patients in this study, i.e. 64%) of myocardial perfusion abnormalities in asymptomatic lupus patients, probably due to the primary immunological damage of this autoimmune disease. In conclusion, rest/dipyridamole {sup 99m}Tc-sestamibi SPET can be a useful non-invasive method to identify subclinical myocardial involvement in systemic lupus erythematosus, and patients potentially at risk of later cardiac events. (orig.) With 2 figs., 2 tabs., 21 refs.

  12. Regional perfusion and oxygenation of tumors upon methylxanthine derivative administration

    International Nuclear Information System (INIS)

    Kelleher, Debra K.; Thews, Oliver; Vaupel, Peter

    1998-01-01

    Purpose: The use of methylxanthine derivatives has been postulated as a means of increasing tumor perfusion and thus ameliorating tumor hypoxia. The aim of this study was to quantify and compare the effects of three methylxanthine derivatives: pentoxifylline (PX), torbafylline (TB), and HWA 138 (HW) on tumor perfusion and oxygenation. Methods and Materials: Anesthetized Sprague Dawley rats with DS-sarcomas implanted subcutaneously onto the hind foot dorsum were used in this study. Mean arterial blood pressure (MABP) was measured throughout experiments. Regional red blood cell (RBC) flux was monitored using a multichannel laser Doppler device and tumor oxygenation on a more global level was assessed polarographically using an O 2 -sensitive catheter electrode. The methylxanthine derivatives were administered as a single dose intraperitoneally (for PX 50 mg/kg; for TB and HW 75 mg/kg). Results: Following drug administration, initial decreases in MABP down to 75% of baseline values were observed for all three substances. PX, HW, and TB caused initial transient reductions in mean RBC flux followed by gradual increases to values of 137 ± 27 %, 139 ± 14 %, and 122 ± 14 % respectively at t = 60 min. Following a small initial decrease upon drug administration, O 2 partial pressure (pO 2 ) rose to 160 ± 31 %, 153 ± 34 %, and 121 ± 11 % for PX, HW, and TB, respectively at t = 60 min. At the end of the observation period (t = 90 min), increases in RBC flux and pO 2 were still evident. When individual tumors were considered, a variety of patterns (including opposing effects) for changes in RBC flux were seen, not necessarily reflected in the mean values. Thus, while the methylxanthine derivatives caused an increased average tumor perfusion, there is evidence suggesting that a redistribution of tumor blood flow occurs which may amplify preexisting heterogeneity. Conclusions: Substantial improvements in tumor oxygenation and perfusion were observed after administration of

  13. Fatty acid metabolic and perfusion abnormalities in hypertrophied myocardium assessed by dual tracer tomography using thallium-201 and iodine-123-beta-methylpentadecanoic acid

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Hiroshi; Nakata, Tomoaki; Han, Shizui (Sapporo Medical Coll. (Japan)) (and others)

    Fatty acid and perfusion abnormalities associated with cardiac hypertrophy were investigated using dual tracer tomography with thallium and a cardiac metabolic tracer, 15-(p-iodophenyl)-3-R, S-methylpentadecanoic acid (BMIPP), in eight patients with hypertrophic cardiomyopathy (HCM) and in three with hypertension (HT). Thallium and BMIPP uptakes were scored and analyzed in 143 segments (13/heart) by comparison with the left ventricular wall thickness measured by two dimensional echocardiography. Complete agreement of both scores in HT patients was significantly higher than that in HCM patients (64% vs 24%, p<0.001), while a lower BMIPP uptake compared to that of thallium (mismatching) was observed more frequently in HCM than in HT patients (65% vs 31%, p<0.001). The wall thickness significantly (p<0.005) correlated with BMIPP uptake score. HCM patients showed a low BMIPP uptake in 22 hypertrophic segments (59%) and 15 non-hypertrophic segments (41%), and reduced BMIPP uptake in 29% hypertrophic segments, while HT patients showed just five segments with decreased BMIPP uptake of which 4 were non-hypertrophic and only one hypertrophic. The left ventricular ejection fraction assessed by radionuclide ventriculography was normal and no regional wall motion abnormality was detected in any patient by echocardiographic and scintigraphic studies. Metabolic abnormalities detected by the iodine-123-beta-methyl fatty acid analog in hypertrophic cardiomyopathy may be independent of thallium myocardial perfusion, regional wall motion, or the magnitude of cardiac hypertrophy, suggesting that fatty acid imaging may be useful in investigating the pathogenesis and subclinical abnormality of hypertrophic cardiomyopathy, and differentiation from secondary, induced cardiac hypertrophy. (author).

  14. Computer analysis of regional cerebral perfusion: a critical clinical analysis

    International Nuclear Information System (INIS)

    Ronai, P.M.; O'Reilly, R.J.; Collins, P.J.

    1975-01-01

    An advanced computer program has been developed for the analysis of regional cerebral perfusion data obtained by the scintillation camera during sup(99m)Tc-pertechnetate cerebral radioangiography. The program evaluates and corrects detector non-uniformity; selects (using statistical criteria) three regions of interest (ROIs) corresponding to the distribution of the left and right middle cerebral arteries and both anterior cerebral arteries; measures the areas of the ROIs and plots total corrected counts per unit ROI area per unit time against time for each ROI. The significance of differences in perfusion between ROIs is assessed and related to a normal population distribution. A critical clinical evaluation of this program was undertaken on 686 patients who had cerebral radioangiograms during 1970 and 1971. Final diagnoses were determined from case records after a follow-up period of two years or more. Original digital data were reprocessed and original analogue dynamic scintiphotos were re-reported without knowledge of the clinical data or digital results. Analogue reports were compared with the results of digital analysis using two different statistical methods to analyse the digital results. Neither method of digital analysis gave any increase in the yield of true positive findings while one method of analysis substantially increased the yield of false-positive findings. Comparison of these findings with those of a similar study carried out in 1971 shows a dramatic improvement in the accuracy of analogue results in the present study compared with the earlier one, but no change in the accuracy of digital results. Observer ''education'' by continued exposure to digital data at routine reporting sessions in the intervening three years between the two studies is suggested as the main cause of the improvement in analogue results. Attention is also drawn to the importance of good detector uniformity characteristics for accurate analogue reporting and to the fact that

  15. Study of regional lung ventilation and perfusion by xenon 133

    International Nuclear Information System (INIS)

    Lombard, Yves.

    1976-01-01

    The present work consists of a regional lung exploration after injection of xenon 133, dissolved in physiological serum, followed a few minutes later by that of 99m Tc-labelled serumalbumin microspheres. The aim is three fold: first of all to study perfusion and ventilation by xenon 133, next to compare the results obtained after xenon 133 and 99 m Tc-labelled microsphere injection, lastly to establish the value of the technique and its routine application. This examination has not solved all problems of lung exploration by xenon 133. For example we deliberately kept to intraveinous injection of the gas dissolved in physiological serum, leaving aside the breathing test. Xenon 133 scintigraphy in our opinion will not tend to replace 99m Tc-labelled microsphere scintigraphy, which has irreplaceable morphological qualities, but will serve as an excellent complement. The basic advantage of xenon 133 is the regional ventilation estimate it provides allowing any anomaly of the lung parenchyma to be located immediately or conversely the functional value of the healthy lung to be established with a view to a surgical removal of a diseased zone [fr

  16. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    International Nuclear Information System (INIS)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young

    2003-01-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value

  17. Is the cerebellum the optimal reference region for intensity normalization of perfusion MR studies in early Alzheimer's disease?

    Directory of Open Access Journals (Sweden)

    María Lacalle-Aurioles

    Full Text Available The cerebellum is the region most commonly used as a reference when normalizing the intensity of perfusion images acquired using magnetic resonance imaging (MRI in Alzheimer's disease (AD studies. In addition, the cerebellum provides unbiased estimations with nuclear medicine techniques. However, no reports confirm the cerebellum as an optimal reference region in MRI studies or evaluate the consequences of using different normalization regions. In this study, we address the effect of using the cerebellum, whole-brain white matter, and whole-brain cortical gray matter in the normalization of cerebral blood flow (CBF parametric maps by comparing patients with stable mild cognitive impairment (MCI, patients with AD and healthy controls. According to our results, normalization by whole-brain cortical gray matter enables more sensitive detection of perfusion abnormalities in AD patients and reveals a larger number of affected regions than data normalized by the cerebellum or whole-brain white matter. Therefore, the cerebellum is not the most valid reference region in MRI studies for early stages of AD. After normalization by whole-brain cortical gray matter, we found a significant decrease in CBF in both parietal lobes and an increase in CBF in the right medial temporal lobe. We found no differences in perfusion between patients with stable MCI and healthy controls either before or after normalization.

  18. Whole body perfusion for hybrid aortic arch repair: evolution of selective regional perfusion with a modified extracorporeal circuit.

    Science.gov (United States)

    Fernandes, Philip; Walsh, Graham; Walsh, Stephanie; O'Neil, Michael; Gelinas, Jill; Chu, Michael W A

    2017-04-01

    Patients undergoing hybrid aortic arch reconstruction require careful protection of vital organs. We believe that whole body perfusion with tailored dual circuitry may help to achieve optimal patient outcomes. Our circuit has evolved from a secondary circuit utilizing a cardioplegia delivery device for lower body perfusion to a dual-oxygenator circuit. This allows individually controlled regional perfusion with ease of switching from secondary to primary circuit for total body flow. The re-design allows for separate flow and temperature regulation with two oxygenators in parallel. All patients underwent a single-stage operation for simultaneous treatment of arch and descending aortic pathology via a sternotomy, using a hybrid frozen elephant trunk technique. We report six consecutive patients undergoing hybrid arch and frozen elephant trunk reconstruction using a dual-oxygenator circuit. Five patients underwent elective surgery and one was emergent. One patient had an acute dissection while three underwent concomitant procedures, including a Ross procedure and two valve-sparing root reconstructions. Three cases were redo sternotomies. The mean pump time was 358 ± 131 min, the aortic cross clamp time 243 ± 135 min, the cardioplegia volume of 33,208 ml ± 16,173, cerebral ischemia 0 min, lower body ischemia 76 ± 34 min and the average lower body perfusion time was 142 min. Two patients did not require any donor blood products. The median intensive care unit (ICU) and hospital lengths of stay (LOS) were two days and 10 days, respectively. The average peak serum lactate on CPB was 7.47 mmol/L and, at admission to the ICU, it was 3.37 mmol/L. Renal and respiratory failure developed in the salvage acute type A dissection patient. No other complications occurred in this series. Whole body perfusion as delivered through individually controlled dual-oxygenator circuitry allows maximum flexibility for hybrid aortic arch reconstruction. A modified circuit perfusion

  19. Imaging of ventilation/perfusion ratio by gated regional spirometry

    International Nuclear Information System (INIS)

    Touya, J.J.; Jones, J.P.; Price, R.R.; Patton, J.A.; Erickson, J.J.; Rollo, F.D.

    1981-01-01

    Gated 133 Xe images of patients rebreathing into a closed system can provide images of the distribution of lung volumes, ventilation and specific ventilation. These have been shown to be accurate, precise, and do not require unusually sophisticated equipment or skills. A mathematical transformation is used to correct the images for lung movement, which does not alter the total number of counts in the image. Perfusion images are gated to remove motion blurring but not transformed. Ventilation/perfusion images showing the distribution of V/Q ratio are then generated from the individual ventilation and perfusion images. (author)

  20. Demonstration of cerebral abnormalities in cocaine abusers with SPECT perfusion brain scans

    International Nuclear Information System (INIS)

    Nagel, J.S.; Tumeh, S.S.; English, R.J.; Moore, M.; Lee, V.W.; Holman, L.B.

    1989-01-01

    This paper reports I-123 isopropyl iodoamphetamine (IMP) single-photon emission CT (SPECT) brain scans performed on cocaine users to investigate the effects of cocaine on the cerebral perfusion in a manner similar to previous CT, angiographic and positron-emission tomographic (PET) studies. Ten asymptomatic or mildly symptomatic cocaine users, two users with major neurovascular complications, and five normal subjects were studied with IMP SPECT. Rotating-brain images of the cerebral IMP uptake were displayed by using a distance-weighted surface-projection technique and were visually analyzed for focal cortical perfusion deficits. Eleven cocaine users had multiple scattered cortical IMP defects. Frontal lobe defects were most prominent. One user had confluent defects resembling swiss cheese. Concurrent CT scans available in nine patients were negative in seven and showed infarcts in two. No similar focal findings were visible in normals

  1. Abnormalities of Microcirculation and Intracranial and Cerebral Perfusion Pressures in Severe Brain Injury

    Directory of Open Access Journals (Sweden)

    Yu. A. Churlyaev

    2008-01-01

    Full Text Available Objective: to evaluate the states of microcirculation, cerebral perfusion intracranial pressures in patients with isolated severe brain injury (SBI and to determine their possible relationships. Subjects and methods. 148 studies were performed in 16 victims with SBI. According to the outcome of brain traumatic disease, the patients were divided into two groups: 1 those who had a good outcome (n=8 and 2 those who had a fatal outcome (n=8. Microcirculation was examined by skin laser Doppler flowmetry using a LAKK-01 capillary blood flow laser analyzer (LAZMA Research-and-Production Association, Russian Federation. All the victims underwent surgical interventions to remove epi-, subdural, and intracerebral hematomas. A Codman subdural/intraparenchymatous intracranial pressure (ICD sensor (Johnson & Johnson, United Kingdom was intraoperatively inserted in the victims. Cerebral perfusion pressure (CPP was calculated using the generally accepted formula: CPP = MBP (mean blood pressure — ICD. ICD, CPP, and microcirculation were studied on postoperative days 1, 3, 5, and 7. Their values were recorded simultaneously. Ninety and 58 studies were conducted in the group of patients with good and fatal outcomes, respectively. Results. No correlation between the changes in MBP, ICD, and microcirculatory parameters suggested that the value of ICD was determined by the nature of brain damage and it was the leading and determining indicator in the diagnosis and treatment of secondary cerebral lesions. The amplitude of low-frequency fluctuations directly correlated with ICD, which indicated that they might be used to evaluate cerebral perfusion and impaired cerebral circulation indirectly in victims with severe brain injury. Conclusion. The laser Doppler flowmetric technique makes it possible not only to qualitatively, but also quantitatively determine changes in the tissue blood flow system in severe brain injury. With this technique, both the local and central

  2. Relation between exercise-induced ventricular arrhythmias and myocardial perfusion abnormalities in patients with intermediate pretest probability of coronary artery disease

    International Nuclear Information System (INIS)

    Elhendy, A.; Sozzi, F.B.; Van Domburg, R.T.; Bax, J.J.; Roelandt, J.R.T.C.

    2000-01-01

    We studied 302 patients (mean age 54±9 years, 152 men and 150 women) with intermediate pretest probability of CAD (range=0.25- 0.80, mean=0.43±0.20) by upright bicycle exercise stress test in conjunction with technetium-99m single-photon emission tomography (SPET) imaging. Exercise-induced VAs (frequent or complex premature ventricular contractions or ventricular tachycardia) occurred in 65 patients (22%). No significant difference was found between patients with and patient without VAs regarding the pretest probability of CAD (0.45±0.21 vs 0.43±0.20). Patients with exercise-induced VAs had a higher prevalence of perfusion abnormalities (52% vs 26%, P=0.002) and ischaemic electrocardiographic changes (31% vs 16%, P<0.05) compared to patients without VAs. A higher prevalence of perfusion abnormalities in patients with VAs was observed in both men (67% vs 35%, P<0.01) and women (38% vs 16%, P<0.05). However, the positive predictive value of exercise-induced VAs for the presence of myocardial perfusion abnormalities was higher in men than in women (67% vs 38%, P<0.05). The presence of abnormal myocardial perfusion was the only independent predictor of exercise-induced VAs (OR 2.2; 95% CI, 1.2-4.2) by multivariate analysis of clinical and stress test variables. It is concluded that in patients with intermediate pretest probability of CAD, exercise-induced VAs are predictive of a higher prevalence of myocardial perfusion abnormalities in both men and women. However, the positive predictive value of exercise-induced VAs for perfusion abnormalities is higher in men. Because of the underestimation of ischaemia by electrocardiographic changes, exercise-induced VAs should be interpreted as a marker of a higher probability of CAD. (orig./MG) (orig.)

  3. Decreased perfusion in myocardial region of normal donor artery secondary to collateral development

    International Nuclear Information System (INIS)

    Koga, Y.; Takahashi, M.; Kojima, A.; Takaki, Y.; Tomiguchi, S.; Hirota, Y.; Kugiyama, K.; Yasue, H.; Hayasaki, K.; Kumamoto Saiseikai Hospital

    1992-01-01

    Thirty-one patients suffering from single vessel exertional angina with collaterals (Group A) were evaluated by stress 201 Tl myocardial emission CT (Tl-SPECT) with 16 controls of severely stenotic single vessel exertional angina without collaterals (Group B). Group A included 21 patients (68%) who showed an extensive perfusion defect in double artery myocardial regions, including the normal donor artery myocardial region (DMR). However, there were no such cases in Group B, giving a significant difference between these 2 groups (p < 0.001). Four patients in Group A, having a perfusion defect both in DMR and in the collateral dependent myocardial region (CMR) underwent a successful percutaneous transluminal coronary angioplasty (PTCA) with disappearance of collaterals. Tl-SPECT findings after PTCA showed no perfusion defect either in CMR or in DMR. This has been explained on the basis that the coronary collaterals stole blood and produced perfusion defect in DMR. (orig.)

  4. Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion.

    Science.gov (United States)

    Kajimoto, Masaki; Ledee, Dolena R; Olson, Aaron K; Isern, Nancy G; Robillard-Frayne, Isabelle; Des Rosiers, Christine; Portman, Michael A

    2016-11-01

    Deep hypothermic circulatory arrest is often required for the repair of complex congenital cardiac defects in infants. However, deep hypothermic circulatory arrest induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. We tested the hypothesis that selective cerebral perfusion modulates glucose utilization, and ameliorates abnormalities in glutamate flux, which occur in association with neuroapoptosis during deep hypothermic circulatory arrest. Eighteen infant male Yorkshire piglets were assigned randomly to two groups of seven (deep hypothermic circulatory arrest or deep hypothermic circulatory arrest with selective cerebral perfusion for 60 minutes at 18℃) and four control pigs without cardiopulmonary bypass support. Carbon-13-labeled glucose as a metabolic tracer was infused, and gas chromatography-mass spectrometry and nuclear magnetic resonance were used for metabolic analysis in the frontal cortex. Following 2.5 h of cerebral reperfusion, we observed similar cerebral adenosine triphosphate levels, absolute levels of lactate and citric acid cycle intermediates, and carbon-13 enrichment among three groups. However, deep hypothermic circulatory arrest induced significant abnormalities in glutamate cycling resulting in reduced glutamate/glutamine and elevated γ-aminobutyric acid/glutamate along with neuroapoptosis, which were all prevented by selective cerebral perfusion. The data suggest that selective cerebral perfusion prevents these modifications in glutamate/glutamine/γ-aminobutyric acid cycling and protects the cerebral cortex from apoptosis. © The Author(s) 2016.

  5. Non-invasive detection of ischemic left ventricular dysfunction using rest gated SPECT. Expectation of simultaneous evaluation of both myocardial perfusion and wall motion abnormality

    International Nuclear Information System (INIS)

    Maeba, Hirofumi; Takehana, Kazuya; Nakamura, Seishi; Yoshida, Susumu; Ueyama, Takanao; Hatada, Kengo; Iwasaka, Toshiji

    2008-01-01

    Although the accurate detection of ischemic etiology is important in the management of patients with severe left ventricular (LV) dysfunction, it is difficult to determine using a non-invasive strategy. The present study investigates whether perfusion and regional functional abnormalities identified by quantitative electrocardiographic gated single-photon emission computed tomography (QGS) at rest can detect ischemic LV dysfunction in patients with severe LV dysfunction. Rest QGS with 99m Tc-tetrofosmin was performed on 54 consecutive patients with LV ejection fraction of ≤40%. Ischemic LV dysfunction (n=32) was defined according to the established standard. Regional perfusion and wall motion were calculated using a 14-segment model (six mid-ventricular and eight apical segments) and compared with a normal control group. The numbers of reduced [mean -1 standard deviation (SD) of normal individuals] and severely reduced (mean -2 SD) wall motion segments were similar between patients with ischemic and non-ischemic LV dysfunction (13.5±1.1 vs. 13.6±0.9 and 10.6±2.0 vs. 9.9±3.0 segments, respectively). The number of hypoperfused (mean -1 SD) segments was significantly greater in patients with ischemic LV dysfunction than in those with non-ischemic LV dysfunction (9.3±3.8 vs. 2.0±2.8 segments, P<0.0001). The analysis of the receiver operating characteristics showed that a cut-off value of 4 hypoperfused segments among 14 segments provided the best separation between ischemic and non-ischemic LV dysfunction (sensitivity=88% and specificity=91%). Furthermore, patients with non-ischemic LV dysfunction had no severely hypoperfused (mean -2 SD) segments in any of the segments, whereas patients with ischemic LV dysfunction had 4.4±0.2 segments. The QGS strategy at rest can accurately differentiate patients with ischemic LV dysfunction from those with severe LV dysfunction by simultaneous regional evaluation of wall motion and myocardial perfusion. (author)

  6. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Cermik, Tevfik F. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Trakya Universitesi Hastanesi, Nukleer Tip Anabilim Dali, Gullapoglu Yerleskesi, Edirne (Turkey); Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N. [Hospital of the University of Trakya, Department of Nuclear Medicine, Edirne (Turkey); Ugur-Altun, Betuel [Hospital of the University of Trakya, Department of Internal Medicine, Division of Endocrinology, Edirne (Turkey)

    2007-04-15

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 {+-} 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 {+-} 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms. (orig.)

  7. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Cermik, Tevfik F.; Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N.; Ugur-Altun, Betuel

    2007-01-01

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 ± 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 ± 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior temporal cortex. Our results indicate that alterations in rCBF in patients with PHP can be demonstrated with brain SPECT. The correlation between serum calcium, PTH levels and the sum of hypoperfused regions indicates that there may be a strong relationship between rCBF abnormalities and increased levels of serum calcium and PTH. In addition, the degree of rCBF abnormalities could be determined by brain SPECT in PHP patients with or without psychiatric symptoms. (orig.)

  8. VERTICAL GRADIENTS IN REGIONAL LUNG DENSITY AND PERFUSION IN THE SUPINE HUMAN LUNG: THE SLINKY® EFFECT

    Science.gov (United States)

    Hopkins, Susan R.; Henderson, A. Cortney; Levin, David L.; Yamada, Kei; Arai, Tatsuya; Buxton, Richard B.; Prisk., G. Kim

    2008-01-01

    In-vivo radioactive tracer and microsphere studies have differing conclusions as to the magnitude of the gravitational effect on the distribution of pulmonary blood flow. We hypothesized that some of the apparent vertical perfusion gradient in-vivo is due to compression of dependent lung increasing local lung density and therefore perfusion/volume. To test this, 6 normal subjects underwent functional MRI with arterial spin labeling during a breath-hold at functional residual capacity, and perfusion quantified in non-overlapping 15mm sagittal slices covering most of the right lung. Lung proton density was measured in the same slices using a short echo 2D-FLASH sequence. Mean perfusion was 1.7 ± 0.6 ml/min/cm3 and was related to vertical height above the dependent lung (slope = −3%/cm, p Slinky®, a deformable spring distorting under its own weight. The greater density of lung tissue in the dependent regions of the lung is analogous to a greater number of coils in the dependent portion of the vertically oriented spring. This implies that measurements of perfusion in-vivo will be influenced by density distributions and will differ from excised lungs where density gradients are reduced by processing. PMID:17395757

  9. Vertical gradients in regional lung density and perfusion in the supine human lung: the Slinky effect.

    Science.gov (United States)

    Hopkins, Susan R; Henderson, A Cortney; Levin, David L; Yamada, Kei; Arai, Tatsuya; Buxton, Richard B; Prisk, G Kim

    2007-07-01

    In vivo radioactive tracer and microsphere studies have differing conclusions as to the magnitude of the gravitational effect on the distribution of pulmonary blood flow. We hypothesized that some of the apparent vertical perfusion gradient in vivo is due to compression of dependent lung increasing local lung density and therefore perfusion/volume. To test this, six normal subjects underwent functional magnetic resonance imaging with arterial spin labeling during breath holding at functional residual capacity, and perfusion quantified in nonoverlapping 15 mm sagittal slices covering most of the right lung. Lung proton density was measured in the same slices using a short echo 2D-Fast Low-Angle SHot (FLASH) sequence. Mean perfusion was 1.7 +/- 0.6 ml x min(-1) x cm(-3) and was related to vertical height above the dependent lung (slope = -3%/cm, P Slinky (Slinky is a registered trademark of Poof-Slinky Incorporated), a deformable spring distorting under its own weight. The greater density of lung tissue in the dependent regions of the lung is analogous to a greater number of coils in the dependent portion of the vertically oriented spring. This implies that measurements of perfusion in vivo will be influenced by density distributions and will differ from excised lungs where density gradients are reduced by processing.

  10. Wiener filtering improves quantification of regional myocardial perfusion with thallium-201 SPECT

    International Nuclear Information System (INIS)

    Links, J.M.; Jeremy, R.W.; Dyer, S.M.; Frank, T.L.; Becker, L.C.

    1990-01-01

    Quantitation of myocardial perfusion with thallium-201 (201Tl) SPECT is limited by finite resolution and image noise. This study examined whether Wiener filtering could improve quantitation of the severity of myocardial perfusion deficits. In 19 anesthetized dogs, adjustable stenoses were placed on the left anterior descending (LAD, n = 12) or circumflex (LCx, n = 7) arteries. Thallium-201 SPECT images were acquired during maximal coronary vasodilation with dipyridamole, and simultaneous measurements of myocardial blood flow were made with microspheres. The relationship between SPECT and microsphere flow deficits in the LAD region was significantly better (p less than 0.05) with Wiener filtering (Y = 0.90X + 0.03, r = 0.78) than with conventional Hanning filtering (Y = 0.66X + 0.34, r = 0.61). Similarly, in the LCx region the relationship between SPECT and microsphere perfusion deficits was better (p less than 0.01) with the Wiener filter (Y = 0.91X + 0.07, r = 0.66) than with the Hanning filter (Y = 0.36X + 0.50, r = 0.40). Wiener filtering improves quantitation of the severity of regional myocardial perfusion deficits, allowing better assessment of the functional significance of coronary artery stenoses

  11. Quantitative pulmonary perfusion imaging with 3-dimensional, contrast-enhanced MR: regional difference in the perfusion parameters of healthy volunteers

    International Nuclear Information System (INIS)

    Kim, Song Soo; Seo, Joon Beom; Kim, Nam Kuk; Do, Kyung Hyun; Lee, Young Kyung; Song, Jae Woo; Lee, Jin Seong; Kim, Jin Hwan

    2007-01-01

    We wanted to evaluate the regional differences in such perfusion parameters as pulmonary blood flow (PBF), mean transit time (MTT) and pulmonary blood volume (PBV) in the entire lung of healthy volunteers with using three-dimensional, contrast-enhanced MR imaging (3D CEMRI). Six healthy volunteers underwent dynamic 3D CEMRI (TR/TE 2.7/0.6 msec; flip angle 40 .deg. ; matrix 128 x 96; reconstructed matrix 256 x 192; rectangular field of view 450 x 315 mm; coronal 100-150mm-thick x 10 slabs; temporal resolution 1.0 sec; 35 dynamic phases) For all subjects, 2 mL of Gd-DTPA mixed with 3 ml of physiologic saline was administered as a bolus at a rate of 5 mL/sec, and this was followed by 20 mL of physiologic saline flush. From the signal intensity-time curves, the PBF, MTT and PBV maps were generated using indicator dilution theories and the central volume principle on a pixel-by-pixel basis. A total of 54 round, 1-cm sized ROIs were placed in the lung in each subject (6 ROIs per slab x 9 slices except for the most posterior slab). The regional differences of the measured parameters were statistically evaluated in the gravitational direction and in the upper-mid-lower direction by one-way ANOVA tests. The calculated PBF, MTT and PBV in the entire lung were 141.8 ± 53.4 mL/100 mL/min (mean ± SD), 5.35 ± 1.38 sec, and 13.4 ± 6.48 mL/100mL, respectively. In the gravitational direction, there was a significant increase in the PBF and PBV as it goes to the posterior direction (ρ < 0.05). No statistical difference was found in PBF or PBV between the upper, mid and lower lung zone areas. Regional difference in the various perfusion parameters of the lung in healthy volunteers can be quantitatively assessed with performing 3D CEMRI

  12. Assessment of myocardial perfusion abnormality and hibernating myocardium by gated blood pool and exercise-stress thallium tomographies after successful coronary angioplasty

    International Nuclear Information System (INIS)

    Hashimoto, Akiyoshi; Nakata, Tomoaki; Tsuchihashi, Kazufumi

    1993-01-01

    Cardiac function and myocardial perfusion were assessed by exercise-stress thallium SPECT and resting gated blood pool SPECT techniques before and after 47 successful coronary angioplasties. Thallium perfusion was analyzed visually and quantitatively in stress and resting studies. Left ventricular ejection fraction (LVEF) and peak filling rate (PFR) were calculated and regional wall motion was scored by amplitude and phase images in radionuclide planar and tomographic imagings. The thallium redistribution in delayed or resting SPECTs was more sensitive (87%) for detecting myocardial ischemia compared to symptoms (36%) and ECG changes (60%). An exercise capacity, LVEF, PFR, and the scores of perfusion and regional wall motion were improved significantly after coronary angioplasty. Stress thallium and gated blood pool SPECTs showed the improvements of myocardial perfusion in 159 (79%) of 201 segments and regional wall motion in 47 (51%) of 92 segments, respectively. These results suggest that the combined use of stress thallium SPECT, gated blood pool planar and SPECT techniques can contribute not only to the assessment of the efficacy of coronary angioplasty but also to detecting the mismatching of myocardial perfusion and contraction ('myocardial hibernation') in infarct-related myocardial lesions. (author)

  13. Flow territory mapping of the cerebral arteries with regional perfusion MRI.

    Science.gov (United States)

    Hendrikse, Jeroen; van der Grond, Jeroen; Lu, Hanzhang; van Zijl, Peter C M; Golay, Xavier

    2004-04-01

    Conventional contrast-enhanced angiography is the gold standard for visualization of the vascular tree supplied by the major cerebral arteries and assessment of collateral flow. Thus far, however, no methods are available to assess the actual flow territories of the individual cerebral arteries. In the present study, we evaluate a noninvasive arterial spin labeling MRI method for selective mapping of the flow territories of the left and right internal carotid arteries and posterior circulation (basilar artery and vertebral arteries). A spatially selective labeling approach, regional perfusion imaging, was developed on the basis of selective slab inversion of the arterial water with a pulsed arterial spin labeling sequence. The selectivity of this method was demonstrated. Regional perfusion imaging enables assessment of the perfusion territories of the major cerebral arteries. With selective labeling of an internal carotid artery, signal is present in both the ipsilateral anterior cerebral artery and ipsilateral middle cerebral artery flow territory. With labeling of the basilar artery, perfusion-weighted signal is symmetrically present in both posterior cerebral artery flow territories. Cerebral blood flow values measured with regional perfusion imaging in the complete hemisphere (40.1 mL x min(-1) x 100 g(-1) tissue), white matter (22.1 mL x min(-1) x 100 g(-1) tissue), and gray matter (65.8 mL x min(-1) x 100 g(-1) tissue) are in agreement with data in the literature. We present the first imaging method capable of evaluating both quantitatively and qualitatively the flow territories of the individual brain-feeding arteries in vivo.

  14. Regional cerebral blood perfusion SPECT imaging in brain ischemic injury due to cerebral hemorrhage

    International Nuclear Information System (INIS)

    Zhang Chunyin; Chen Yue; Li Zuoxiao; Tan Hua; Li Xiaohong

    2006-01-01

    Objective: To explore the clinical value of SPECT perfusion imaging in brain ischemic injury due to cerebral hemorrhage before and after treatment. Methods: Sixty cases of cerebral hemorrhage were randomly divided into nimodipine treated group and routine treated group. The volume of primary ischemic focus, changes of regional cerebral blood perfusion around hematoma and other cerebral areas were observed by SPECT imaging. Results: Volume of the primary focus was reduced apparently in both groups, but much more in nimodipine treated group (P<0.01). Also the regional cerebral blood flow in ischemic focus and remote areas increased much more in nimodipine treated group than routine treated group (P< 0.01). Conclusions: Brain SPECT imaging can sensitively reflect the regional cerebral blood flow before and after treatment. Thereby, it is useful for therapeutic monitoring. (authors)

  15. Development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids

    International Nuclear Information System (INIS)

    Wang Peng; Ji Xunming

    2007-01-01

    The neuroprotection of induced hypothermia has been investigated intensively and confirmed in animal models and it has been used clinically in many fields since the finding of sub-hypothermia can also reduce cerebral injury. However the use of hypothermia in clinics is limited by the simultaneously induced systemic complications. Recently the sub-hypothermia induced by hypothermic regional arterial perfusion is proved to be the most effective method to reach the goal, including hypothermic normal saline with no influences on whole body temperature, cardiac rhythm and blood coagulation. According to the well development, fruitful achievement in the present status of this field, the authors are surely to have the inspiration for the further investigation and development of regional cerebral sub-hypothermia with perfusion of hypothermic liquids. (authors)

  16. Regional lung perfusion and ventilation with radioisotopes in cervical cord-injured patients

    International Nuclear Information System (INIS)

    Hiraizumi, Y.; Fujimaki, E.; Hishida, T.; Maruyama, T.; Takeuchi, M.

    1986-01-01

    In general, cervical cord-injured patients present with restrictive pulmonary dysfunction resulting from paralysis of the intercostal muscles. Vital capacity frequently decreases below 50% of that in normal subjects, and their respiratory pattern frequently includes paradoxical movement in which the intercostal spaces sink and the abdomen distends at inspiration. Ventilation scintigraphy using Xe-133 and pulmonary perfusion scintigraphy using Tc-99m macroaggregated albumin (MAA) were performed on nine cervical cord-injured patients and four normal subjects to investigate regional lung functions in the cervical cord-injured patients. Pulmonary perfusion scintigraphy, in which measurement was made in the supine position, revealed no differences between the patients and the normal subjects. The inhomogeneous ventilation/perfusion distribution was presumed to have resulted from change in regional intrapleural pressure due to paradoxical movement of the thoracic cage. Washing and washout times were prolonged by paralysis of the intercostal muscles. These phenomena were particularly apparent in the upper and middle lung regions where compensating action by movement of the diaphragm is small

  17. Automated scoring of regional lung perfusion in children from contrast enhanced 3D MRI

    Science.gov (United States)

    Heimann, Tobias; Eichinger, Monika; Bauman, Grzegorz; Bischoff, Arved; Puderbach, Michael; Meinzer, Hans-Peter

    2012-03-01

    MRI perfusion images give information about regional lung function and can be used to detect pulmonary pathologies in cystic fibrosis (CF) children. However, manual assessment of the percentage of pathologic tissue in defined lung subvolumes features large inter- and intra-observer variation, making it difficult to determine disease progression consistently. We present an automated method to calculate a regional score for this purpose. First, lungs are located based on thresholding and morphological operations. Second, statistical shape models of left and right children's lungs are initialized at the determined locations and used to precisely segment morphological images. Segmentation results are transferred to perfusion maps and employed as masks to calculate perfusion statistics. An automated threshold to determine pathologic tissue is calculated and used to determine accurate regional scores. We evaluated the method on 10 MRI images and achieved an average surface distance of less than 1.5 mm compared to manual reference segmentations. Pathologic tissue was detected correctly in 9 cases. The approach seems suitable for detecting early signs of CF and monitoring response to therapy.

  18. Radiation-Induced Reductions in Regional Lung Perfusion: 0.1-12 Year Data From a Prospective Clinical Study

    International Nuclear Information System (INIS)

    Zhang Junan; Ma Jinli; Zhou Sumin; Hubbs, Jessica L.; Wong, Terence Z.; Folz, Rodney J.; Evans, Elizabeth S.; Jaszczak, Ronald J.; Clough, Robert; Marks, Lawrence B.

    2010-01-01

    Purpose: To assess the time and regional dependence of radiation therapy (RT)-induced reductions in regional lung perfusion 0.1-12 years post-RT, as measured by single photon emission computed tomography (SPECT) lung perfusion. Materials/Methods: Between 1991 and 2005, 123 evaluable patients receiving RT for tumors in/around the thorax underwent SPECT lung perfusion scans before and serially post-RT (0.1-12 years). Registration of pre- and post-RT SPECT images with the treatment planning computed tomography, and hence the three-dimensional RT dose distribution, allowed changes in regional SPECT-defined perfusion to be related to regional RT dose. Post-RT follow-up scans were evaluated at multiple time points to determine the time course of RT-induced regional perfusion changes. Population dose response curves (DRC) for all patients at different time points, different regions, and subvolumes (e.g., whole lungs, cranial/caudal, ipsilateral/contralateral) were generated by combining data from multiple patients at similar follow-up times. Each DRC was fit to a linear model, and differences statistically analyzed. Results: In the overall groups, dose-dependent reductions in perfusion were seen at each time post-RT. The slope of the DRC increased over time up to 18 months post-RT, and plateaued thereafter. Regional differences in DRCs were only observed between the ipsilateral and contralateral lungs, and appeared due to tumor-associated changes in regional perfusion. Conclusions: Thoracic RT causes dose-dependent reductions in regional lung perfusion that progress up to ∼18 months post-RT and persists thereafter. Tumor shrinkage appears to confound the observed dose-response relations. There appears to be similar dose response for healthy parts of the lungs at different locations.

  19. Dynamic (4D) CT perfusion offers simultaneous functional and anatomical insights into pulmonary embolism resolution

    Energy Technology Data Exchange (ETDEWEB)

    Mirsadraee, Saeed, E-mail: saeed.mirsadraee@ed.ac.uk [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); Reid, John H.; Connell, Martin [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); MacNee, William; Hirani, Nikhil [The Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom); Murchison, John T. [Department of Radiology, Royal Infirmary of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA (United Kingdom); Beek, Edwin J. van [Clinical Research Imaging Centre, Queen' s Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh EH16 4TJ (United Kingdom)

    2016-10-15

    Objective: Resolution and long-term functional effects of pulmonary emboli are unpredictable. This study was carried out to assess persisting vascular bed perfusion abnormalities and resolution of arterial thrombus in patients with recent pulmonary embolism (PE). Methods and materials: 26 Patients were prospectively evaluated by dynamic (4D) contrast enhanced CT perfusion dynamic pulmonary CT perfusion. Intermittent volume imaging was performed every 1.5–1.7 s during breath-hold and perfusion values were calculated by maximum-slope technique. Thrombus load (modified Miller score; MMS) and ventricular diameter were determined. Perfusion maps were visually scored and correlated with residual endoluminal filling defects. Results: The mean initial thrombus load was 13.1 ± 4.6 MMS (3–16), and 1.2 ± 2.1 MMS (0–8) at follow up. From the 24 CTPs with diagnostic quality perfusion studies, normal perfusion was observed in 7 (29%), and mildly-severely abnormal in 17 (71%). In 15 patients with no residual thrombus on follow up CTPA, normal perfusion was observed in 6, and abnormal perfusion in 9. Perfusion was abnormal in all patients with residual thrombus on follow up CTPA. Pulmonary perfusion changes were classified as reduced (n = 4), delayed (systemic circulation pattern; n = 5), and absent (no-flow; n = 5). The right ventricle was dilated in 12/25 (48%) at presentation, and normal in all 26 follow up scans. Weak correlation was found between initial ventricular dilatation and perfusion abnormality at follow up (r = 0.15). Conclusions: Most patients had substantial perfusion abnormality at 3–6 months post PE. Abnormal perfusion patterns were frequently observed in patients and in regions with no corresponding evidence of residual thrombus on CTPA. Some defects exhibit delayed, presumed systemic, enhancement (which we have termed ‘stunned’ lung). CT perfusion provides combined anatomical and functional information about PE resolution.

  20. Relationship between regional cerebral perfusion and cognitive disorders in type 2 diabetes mellitus

    International Nuclear Information System (INIS)

    Zhao Jinhua; Zhao Peiqin; Zhao Yan; Liu Fuyuan; Meng Juanjuan; Chen Huidong

    2001-01-01

    Objective: To investigate the characteristic rCBF abnormalities and the relationship between rCBF and cognitive disorders in type 2 diabetes mellitus patients. Methods: The study subjects were 11 middle aged, glycemic controlled type 2 diabetes mellitus patients. Age range of type 2 diabetes mellitus patients was 46 - 59 years. Eleven age-, sex-, education- and occupation- matched normal controls (age range 41 - 58 years) were studied under identical conditions. Cognitive functions were evaluated by Wechsler Memory Scale (WMS), Trail Marking Test A and Wisconsin Card Sorting Test (WCST), respectively. 99 Tc m -ECD (ethyl-cysteine ate dimer) SPECT imaging was performed on all patients and normal controls. Results: 1) Cognitive test scores of type 2 diabetes mellitus patients were lower than that of normal controls. Diabetic patients were scored lower in memory test than controls (accumulation adding, visual recognition, learning and total memory quotient of WMS, P < 0.05). Type 2 diabetes mellitus patients needed much more time to complete the trail marking test (74.2 s vs. 48.7 s). WCST scores were significantly different between two groups. 2) The rCBF values of frontal, temporal and parietal lobe were decreased significantly in type 2 diabetes mellitus patients. 3) For type 2 diabetes mellitus patients, there was a correlation between rCBF values of right frontal lobe and adding, understanding scores of WMS (positively correlated), preservative errors(%) of WCST (negatively correlated). The rCBF values of right temporal lobe were positively correlated with inverted counting. Conclusions: 1) Impairments of central nervous system are existed in glycemic controlled (lack of repeated hypoglycemia) type 2 diabetes mellitus patients. Abnormalities in CNS can express as cognitive dysfunction, such as decrement of memory, attention, thinking and conceptual reasoning abilities. 2) Hypo-perfusions of frontal, temporal and parietal cortex can be identified in patients of

  1. Quantification of left ventricular regional functions using ECG-gated myocardial perfusion SPECT. Validation of left ventricular systolic functions

    International Nuclear Information System (INIS)

    Yamamoto, Akira; Takahashi, Naoto; Iwahara, Shin-ichiro; Munakata, Kazuo; Hosoya, Tetsuo

    2006-01-01

    We have developed a program to quantify regional left ventricular (LV) function and wall motion synchrony using electrocardiogram (ECG)-gated myocardial perfusion SPECT (MPS). This preliminary study was undertaken to validate the use of this program for estimating regional LV systolic function. Patients were subjected to MPS by 99m Tc-sestamibi at rest. The study included 20 patients who were confirmed to have a low probability of coronary artery disease (LPG; low probability group), 19 heart disease patients who were examined by MPS and equilibrium radionuclide angiography (ERNA) (ERG; ERNA group), and 24 patients who were examined by MPS and 2-dimensional echocardiography (2DE) (2DEG; 2DE group). The values of the ejection fraction (EF) and peak ejection rate (PER) were estimated. The global functions evaluated by this program were compared with those obtained by ERNA in the ERG. For regional assessment, the reference values of the functional indices were obtained for 17 LV segments in LPG. The Z score, (reference average value of the segment-patient's value of the segment)/reference standard deviation of the segment, was used for the evaluation of regional functions; a score equal to or greater than 2 was defined as abnormal. Semiquantitative visual interpretation of 2DE was used as the standard to assess wall motion. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of these criteria and the relationship between 2DE grading and Z scoring were validated in 2DEG. The values of the global EF and PER evaluated by this program correlated with those determined by ERNA (r=0.76 and 0.58, respectively; p -10 ). The potential of this program to quantify the regional systolic function was validated. (author)

  2. Role of 99mTc-ECD brain SPECT in the detection of cerebral perfusion abnormality in cases of Attention Deficit Hyperactivity Disorder

    International Nuclear Information System (INIS)

    Kumar, A.; Phom, H.; Thomas, E.J.; Tripathi, M.; Chandrashekar, N.; Bal, C.S.; Zamir, H.; Gulati, S.; Kalra, V.

    2002-01-01

    Aim: A randomized placebo controlled drug trial with Mentat, a herbal pharmacological agent, was initiated in January 2000 in the department of pediatrics at AIIMS, New Delhi, to compare the efficacy of Mentat with a placebo in school children with Attention Deficit Hyperactivity Disorder (ADHD). Materials and Methods: Contact was established with 12 Public schools in Delhi, to identify poor performers in classes I-V (age 6-12 yrs.). About 195 children with poor school performance were recruited in the study. They were screened for causes of poor performance, which included attention problems, hyperactivity, behavior problems, emotional problems, mental sub-normality and learning disability. ADHD suspected children were identified using the Malin's WISC, Connor's rating scale, Problem Behavior checklist, Bender Gestalt test and some sub tests of the Kaufman's Assessment Battery for Children (K-ABC). Sixty children diagnosed as ADHD (using DSM-IV criteria), with an IQ between 90-110, were enrolled into the study. Of the 60 children randomized in the study, 30 received Mentat and 30 received an identical looking placebo. The drug/Placebo was given for a six-month period. 99mTC-ECD brain SPECT was performed in a subset of 34 children with ADHD. Results: Abnormal cerebral perfusion was seen in 23/34; thalamic hypoperfusion in 11, basal ganglia hypoperfusion in 9, thalamus and basal ganglia hypoperfusion in 2 and basifrontal hypoperfusion in 1. So far, in ten children with abnormal pretreatment scans, post treatment scans have also been done. In mentat group, 2/5 children showed normalization of perfusion abnormality after treatment whereas in placebo group, 1/5. Conclusion: This study suggests that there is selective focal cerebral hypoperfusion in cases of ADHD and 99mTc-ECD brain SPECT can be used for evaluation and further monitoring of therapeutic outcome in such cases

  3. Hypertension impairs myocardial blood perfusion reserve in subjects without regional myocardial ischemia

    International Nuclear Information System (INIS)

    Nakajima, Hiroshi; Onishi, Katsuya; Kurita, Tairo

    2010-01-01

    Quantitative analysis of myocardial perfusion MRI can provide noninvasive assessments of myocardial perfusion reserve (MPR), which is associated with endothelial function. Endothelial function is influenced by various factors, including hypertension, diabetes, dyslipidemia, renal dysfunction and anemia. The purpose of this study was to evaluate which risk factor is the strongest effector of MPR in subjects without regional myocardial ischemia. We studied 110 patients (66 years ±10, male 68%, hypertension 76%, diabetes mellitus (DM) 40% and dyslipidemia 65%) without regional myocardial ischemia. Adenosine triphosphate (ATP) stress and rest first-pass perfusion magnetic resonance (MR) images were acquired with a 1.5-T MR system, and MPR was calculated as the ratio of stress to rest myocardial blood flow (MBF). Average rest MBF in 110 patients was 1.07±0.62 ml min -1 g -1 , whereas stress MBF was 3.15±1.93 ml min -1 g -1 and the MPR was 3.33±1.82. Rest MBF correlated significantly with hematocrit, whereas stress MBF showed a strong correlation with estimated glomerular filtration rate (e-GFR). MPR was associated with hypertension, age, e-GFR, hematocrit and left ventricular mass index (LVMI). In multiple regression analysis, hypertension (P=0.003, β=-0.274) showed the strongest correlation with MPR among other risk factors, such as diabetes (P=ns), dyslipidemia (P=ns), e-GFR (P=ns), LVMI (P=0.007, β=-0.248) and hematocrit (P=ns) after adjusting age and gender. Hypertension is the most important effector of MPR in subjects without myocardial ischemia. (author)

  4. A RARE CASE OF CONGENITAL ABNORMALITIES OF THE MAXILLOFACIAL REGION

    Directory of Open Access Journals (Sweden)

    Юлия Владимировна Степанова

    2014-09-01

    Full Text Available This article describes a rare case of congenital abnormality: a median facial cleft in combination with congenital complete bilateral cleft lip and palate. An integrated approach to the treatment of children with severe pathology of the maxillofacial area provides a good aesthetic and functional result. Surgical treatment in combination with orthodontic treatment, massage, myogymnastics, dynamic observation of the child contributes to the normal development of the maxillofacial area in a child with a rare congenital facial cleft.

  5. A robust real-time abnormal region detection framework from capsule endoscopy images

    Science.gov (United States)

    Cheng, Yanfen; Liu, Xu; Li, Huiping

    2009-02-01

    In this paper we present a novel method to detect abnormal regions from capsule endoscopy images. Wireless Capsule Endoscopy (WCE) is a recent technology where a capsule with an embedded camera is swallowed by the patient to visualize the gastrointestinal tract. One challenge is one procedure of diagnosis will send out over 50,000 images, making physicians' reviewing process expensive. Physicians' reviewing process involves in identifying images containing abnormal regions (tumor, bleeding, etc) from this large number of image sequence. In this paper we construct a novel framework for robust and real-time abnormal region detection from large amount of capsule endoscopy images. The detected potential abnormal regions can be labeled out automatically to let physicians review further, therefore, reduce the overall reviewing process. In this paper we construct an abnormal region detection framework with the following advantages: 1) Trainable. Users can define and label any type of abnormal region they want to find; The abnormal regions, such as tumor, bleeding, etc., can be pre-defined and labeled using the graphical user interface tool we provided. 2) Efficient. Due to the large number of image data, the detection speed is very important. Our system can detect very efficiently at different scales due to the integral image features we used; 3) Robust. After feature selection we use a cascade of classifiers to further enforce the detection accuracy.

  6. Noninvasive measurements of regional cerebral perfusion in preterm and term neonates by magnetic resonance arterial spin labeling

    DEFF Research Database (Denmark)

    Miranda Gimenez-Ricco, Maria Jo; Olofsson, K; Sidaros, Karam

    2006-01-01

    Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term-born neon......Magnetic resonance arterial spin labeling (ASL) at 3 Tesla has been investigated as a quantitative technique for measuring regional cerebral perfusion (RCP) in newborn infants. RCP values were measured in 49 healthy neonates: 32 preterm infants born before 34 wk of gestation and 17 term...

  7. Selective cerebral perfusion prevents abnormalities in glutamate cycling and neuronal apoptosis in a model of infant deep hypothermic circulatory arrest and reperfusion

    Energy Technology Data Exchange (ETDEWEB)

    Kajimoto, Masaki; Ledee, Dolena R.; Olson, Aaron K.; Isern, Nancy G.; Robillard-Frayne, Isabelle; Des Rosiers, Christine; Portman, Michael A.

    2016-10-01

    Rationale: Deep hypothermic circulatory arrest (DHCA) is often required for the repair of complex congenital cardiac defects in infants. However, DHCA induces neuroapoptosis associated with later development of neurocognitive abnormalities. Selective cerebral perfusion (SCP) theoretically provides superior neural protection possibly through modifications in cerebral substrate oxidation and closely integrated glutamate cycling. Objectives: We tested the hypothesis that SCP modulates glucose entry into the citric acid cycle, and ameliorates abnormalities in glutamate flux which occur in association neuroapoptosis during DHCA. Methods and Results: Eighteen male Yorkshire piglets (age 34-44 days) were assigned randomly to 2 groups of 7 (DHCA or DHCA with SCP for 60 minutes at 18 °C) and 4 control pigs without cardiopulmonary bypass support. After the completion of rewarming from DHCA, 13-Carbon-labeled (13C) glucose as a metabolic tracer was infused. We used gas chromatography-mass spectrometry (GCMS) and nuclear magnetic resonance for metabolic analysis in the frontal cortex. Following 2.5 hours of cerebral reperfusion, we observed similar cerebral ATP levels, absolute levels of lactate and citric acid cycle intermediates, and 13C-enrichment. However, DHCA induced significant abnormalities in glutamate cycling resulting in reduced glutamate/glutamine and elevated γ-aminobutyric acid (GABA)/glutamate along with neuroapoptosis (TUNEL), which were all prevented by SCP. Conclusions: DHCA alone induces abnormalities in cycling of the major neurotransmitters in association with neuroapoptosis, but does not alter cerebral glucose utilization during reperfusion. The data suggest that SCP prevents these modifications in glutamate/glutamine/GABA cycling and protects the cerebral cortex from neuroapoptosis.

  8. Perfusion MRI abnormalities in the absence of diffusion changes in a case of moyamoya-like syndrome in neurofibromatosis type 1

    International Nuclear Information System (INIS)

    El-Koussy, Marwan; Kiefer, Claus; Schroth, Gerhard; Loevblad, Karl-Olof; Steinlin, Maja

    2002-01-01

    We report on a 12-year-old boy with neurofibromatosis type 1 who suffered a transient ischemic attack. Angiography revealed occlusion of intracranial arteries, moyamoya vessels and leptomeningeal collaterals. The conventional T2-weighted and the diffusion-weighted MRI images demonstrated no pathology. Dynamic first-pass postgadolinium T2* perfusion-weighted MRI depicted altered hemodynamics in the vascular territory of the left middle cerebral artery, which defined this region as ischemic tissue at risk. The patient suffered a repeat transient ischemic attack5 days later. (orig.)

  9. Prevalence of abnormal birth weight and related factors in Northern region, Ghana

    OpenAIRE

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-01-01

    Background: Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. Methods: The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on t...

  10. Is the Cerebellum the Optimal Reference Region for Intensity Normalization of Perfusion MR Studies in Early Alzheimer’s Disease?

    OpenAIRE

    Lacalle-Aurioles, María; Alemán-Gómez, Yasser; Guzmán-De-Villoria, Juan Adán; Cruz-Orduña, Isabel; Olazarán, Javier; Mateos-Pérez, José María; Martino, María Elena; Desco, Manuel

    2013-01-01

    The cerebellum is the region most commonly used as a reference when normalizing the intensity of perfusion images acquired using magnetic resonance imaging (MRI) in Alzheimer's disease (AD) studies. In addition, the cerebellum provides unbiased estimations with nuclear medicine techniques. However, no reports confirm the cerebellum as an optimal reference region in MRI studies or evaluate the consequences of using different normalization regions. In this study, we address the effect of using ...

  11. Effect of steroid on brain tumors and surround edemas : observation with regional cerebral blood volume (rCBV) maps of perfusion MRI

    International Nuclear Information System (INIS)

    Choi, Ju Youl; Sun, Joo Sung; Kim, Sun Yong; Kim, Ji Hyung; Suh, Jung Ho; Cho, Kyung Gi; Kim, Jang Sung

    2000-01-01

    To observe the hemodynamic change in brain tumors and peritumoral edemas after steroid treatment, and then investigate the clinical usefulness of perfusion MRI. We acquired conventional and perfusion MR images in 15 patients with various intracranial tumors (4 glioblastoma multiformes, 4 meningiomas, 3 metastatic tumors, 1 anaplastic ependymoma, 1 anaplastic astrocytoma, 1 hemangioblastoma, and 1 pilocytic astrocytoma). For perfusion MR imaging, a 1.5T unit employing the gradient-echo EPI technique was used, and further perfusion MR images were obtained 2-10 days after intravenous steroid therapy. After processing of the raw data, regional cerebral blood volume (rCBV) maps were reconstructed. The maps were visually evaluated by comparing relative perfusion in brain tumors and peritumoral edemas with that in contralateral white matter. Objective evaluations were performed by comparing the perfusion ratios of brain tumors and peritumoral edemas. Visual evaluations of rCBV maps, showed that in most brain tumors (67%, 10/15), perfusion was high before steroid treatment and showed in (80%, 12/15) decreased afterwards. Objective evaluation, showed that in all brain tumors, perfusion decreased. Visual evaluation of perfusion change in peritumoral edemas revealed change in only one case, but objective evaluation indicated that perfusion decreased significantly in all seven cases. rCBV maps acquired by perfusion MR imaging can provide hemodynamic information about brain tumors and peritumoral edemas. Such maps could prove helpful in the preoperative planning of brain tumor surgery and the monitoring of steroid effects during conservative treatment. (author)

  12. Regional ventilation/perfusion mismatch pattern in patient with Swyer James (MacLeod′s syndrome

    Directory of Open Access Journals (Sweden)

    Sait Sager

    2014-01-01

    Full Text Available Swyer James (McLeod′s syndrome (SJMS is an uncommon disease, which occurs as a result of childhood bronchiolitis obliterans. Patients may not be diagnosed until later in their life. A 46-year-old man underwent ventilation/perfusion scintigraphy for acute onset of dyspnea. The scan showed markedly diminished ventilation and perfusion unilaterally on the right middle and inferior lobes. However, mismatched ventilation-perfusion pattern was shown on the upper right lobe, which was consistent with pulmonary embolism. Unilaterally matched ventilation/perfusion defect can see in SJMS in lung scintigraphy; however, when pulmoner embolism may accompany, scintigraphy should be carefully examined.

  13. Microheterogeneity of regional myocardial blood flows in low-perfused rat hearts evaluated by double-tracer digital radiography

    International Nuclear Information System (INIS)

    Matsumoto, Takeshi; Asano, Takahisa; Takemoto, Mami; Tachibana, Hiroyuki; Ogasawara, Yasuo; Kajiya, Fumihiko

    2007-01-01

    Using 3 H- and 125 I-labeled desmethylimipramine (DMI) for regional flow tracers, we established a two-time measurement method for the spatial pattern of myocardial perfusion in cross-circulated rat hearts. Myocardial extractions and retentions of these tracers were confirmed to be satisfactory; however, the latter were less than 90% after 3 min at a perfusion rate of 2.9 ml/min/g, limiting the present application to a short-time perfusion measurement. Distributions of myocardial depositions were separated by subtraction digital radiography with 400-μm pixel resolution. Its feasibility was examined by regression analysis between local deposition densities of 3 H- and 125 I-DMI injected simultaneously. The slope, y-intercept, and correlation coefficient (r) of the regression line were 0.98±0.04, 0.02±0.04, and 0.95±0.03, respectively, indicating the validity of the present image subtraction technique. The spatial pattern of myocardial perfusion in response to flow reduction was evaluated by the injections of 3 H- and 125 I-DMI, respectively, before and after a nearly 70% flow reduction. A significant correlation between normalized density distributions of these tracers was found in both subepicardium (r=0.77±0.12) and subendocardium (r=0.73±0.20), indicating the stable pattern of myocardial perfusion. However, the coefficient of variation of tracer densities showed a decrease of subendocardial flow heterogeneity from 35±15% to 31±16%. Thus, flow differences between originally high- and low-flow regions in subendocardium were reduced on a relative basis during low perfusion

  14. Computer program for regional assessment of lung perfusion defect. Part II - verification of the algorithm

    International Nuclear Information System (INIS)

    Stefaniak, B.

    2002-01-01

    As described earlier, a dedicated computer program was developed for quantitative evaluation of regional lung perfusion defects, visualized by pulmonary scintigraphy. The correctness of the basic assumptions accepted to construct the algorithms and of the all program functions needed to be checked, before application of the program into the clinical routine. The aim of this study was to verified the program using various software instruments and physical models. Evaluation of the proposed method was performed using software procedures, physical lung phantom, and selected lung image.The reproducibility of lung regions, defined by the program was found excellent. No significant distortion of registered data was observed after ROI transformation into the circle and retransformation into the original shape. The obtained results comprised parametric presentation of activity defects as well as a set of numerical indices which defined extent and intensity of decreased counts density. Among these indices PD2 and DM* were proved the most suitable for the above purposes. The obtained results indicate that the algorithms used for the program construction were correct and suitable for the aim of the study. The above algorithms enable function under study to be presented graphically with true imaging of activity distribution, as well as numerical indices, defining extent and intensity of activity defects to calculated. (author)

  15. Quantitative plaque features from coronary computed tomography angiography to identify regional ischemia by myocardial perfusion imaging.

    Science.gov (United States)

    Diaz-Zamudio, Mariana; Fuchs, Tobias A; Slomka, Piotr; Otaki, Yuka; Arsanjani, Reza; Gransar, Heidi; Germano, Guido; Berman, Daniel S; Kaufmann, Philipp A; Dey, Damini

    2017-05-01

    We aimed to investigate whether quantitative plaque features measured from coronary CT angiography (CCTA) predict ischemia by myocardial perfusion SPECT imaging (MPI). Hundred and eighty-four consecutive patients (63% males) with suspected-coronary artery disease, undergoing hybrid CCTA, and attenuation corrected solid state 99mTc stress/rest MPI and single vessel ischemia were considered. Quantitative analysis of CCTA derived non-calcified plaque (NCP), low-density NCP [difference (CD, maximum difference in HU/lumen area within lesion). Normal thresholds for plaque features were defined as 95th percentile thresholds, from 40% of vessels with non-ischemic MPI regions. These vessels were excluded from further analysis. Regional ischemia (≥ 2%) was quantified from MPI. All plaque features were higher in arteries corresponding to ischemia (P Quantitative plaque features obtained from CCTA, LDNCP, and CD, are associated with ischemia by MPI independent of stenosis. LDNCP burden and CD are associated with ischemia in stenosis 30-69% and ≥ 70%, respectively. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions, please email: journals.permissions@oup.com.

  16. A pilot study of regional perfusion and oxygenation in calf muscles of individuals with diabetes with a noninvasive measure.

    Science.gov (United States)

    Zheng, Jie; Hasting, Mary K; Zhang, Xiaodong; Coggan, Andrew; An, Hongyu; Snozek, Darrah; Curci, John; Mueller, Michael J

    2014-02-01

    To assess alterations in the regional perfusion and oxygenation of the calf muscles in individuals with diabetes. Age-matched individuals with (n = 5) and without diabetes (n = 6) were investigated. Skeletal muscle perfusion, oxygen extraction fraction, and oxygen consumption rate were measured by newly developed noncontrast magnetic resonance imaging (MRI) techniques. The subjects lay supine on the MRI table with their foot firmly strapped to a custom-built isometric exercise device. The measurements were performed at rest and during an isometric plantar flexion muscle contraction. Individuals without diabetes had up to a 10-fold increase in muscle perfusion, 25% elevation in muscle oxygen extraction fraction, and a 12-fold increase in oxygen consumption rate in the calf during the plantar flexion isometric contraction. In patients with diabetes, the increases in these parameters were only up to sixfold, 2%, and sixfold, respectively. Exercise oxygen consumption rate was inversely associated with blood HbA1c levels (r(2) = .91). This is the first study to quantify regional skeletal muscle oxygenation in patients with diabetes using noncontrast MRI and warrants additional study. Attenuation of perfusion and oxygenation during exercise may have implications for understanding diabetic complications in the lower extremities. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  17. Regional myocardial perfusion and mechanics: a model-based method of analysis.

    Science.gov (United States)

    Mazhari, R; Omens, J H; Waldman, L K; McCulloch, A D

    1998-01-01

    A new parametric model-based method has been developed that allows epicardial strain distributions to be computed on the left ventricular free wall in normal and ischemic myocardium and integrated with the regional distributions of anatomic and physiological measurements so that underlying relationships can be explored. An array of radiopaque markers was sewn on the anterior wall of the left ventricle (LV) in three anesthetized open-chest canines, and their positions were recorded using biplane video fluoroscopy before and 2 min after occlusion of the left anterior descending coronary artery. The three-dimensional (3D) anatomy of the LV and epicardial fiber angles were measured post-mortem using a 3D probe. A prolate spheroidal finite element model was fitted to the epicardial surface points (with <0.2 mm accuracy) and fiber angles (<5 degrees error). Regional myocardial blood flows (MBFs) were measured using fluorescent microspheres and fitted into the model (<0.3 ml min(-1) g(-1) error). Epicardial fiber and cross-fiber strain distributions were computed by allowing the model to deform from end-diastole to end-systole according to the recorded motion of the surface markers. Systolic fiber strain varied from -0.05 to 0.01 within the region of the markers during baseline, and regional MBF varied from 1.5 to 2.0 ml min(-1) g(-1). During 2 min ischemia, regional MBF was less than 0.3 ml min(-1) g(-1) in the ischemic region and 1.0 ml min(-1) g(-1) in the nonischemic region, and fiber strain ranged from 0.05 in the central ischemic zone to -0.025 in the remote nonischemic tissue. This analysis revealed a zone of impaired fiber shortening extending into the normally perfused myocardium that was significantly wider at the base than the apex. A validation analysis showed that a regularizing function can be optimized to minimize both fitting errors and numerical oscillations in the computed strain fields.

  18. The Abnormal Quiet Days in SQ(H) in Mid and Low Latitudes Regions

    African Journals Online (AJOL)

    From the analysis and study of abnormal quiet days (AQDs) at mid and low latitudes locations, it was found that there is difference between the characteristics of phase variability Sq (H) of the low latitude locations. This suggests that the origin and cause of AQDs are of different sources in the two latitude regions. The AQDs ...

  19. Cerebral perfusion computerized tomography: influence of reference vessels, regions of interest and interobserver variability

    International Nuclear Information System (INIS)

    Soustiel, Jean F.; Mor, Nadav; Zaaroor, Menashe; Goldsher, Dorith

    2006-01-01

    There are still no standardized guidelines for perfusion computerized tomography (PCT) analysis. A total of 61 PCT studies were analyzed using either the anterior cerebral artery (ACA) or the middle cerebral artery (MCA) as the arterial reference, and the superior sagittal sinus (SSS) or the vein of Galen (VG) as the venous reference. The sizes of regions of interest (ROI) were investigated comparing PCT results obtained using a hemispheric ROI combined with vascular pixel elimination with those obtained using five smaller ROIs located over the cortex and basal ganglia. In addition, interobserver variations were explored using a standardized protocol. MCA-based measurements of cerebral blood flow (CBF) and blood volume (CBV) were in accordance with those obtained with the ACA except in 16 patients with ischemic stroke, in whom CBF was overestimated by the ipsilateral MCA. Venous maximal intensity was significantly lower with the VG when compared with the SSS, resulting in overestimation of CBF and CBV. However, in 13.3% of patients the VG ROI yielded higher maximal intensities than the SSS ROI. There was no difference in PCT results between hemispheric ROI and averaged separate ROI when vascular pixel elimination was used. Finally, interobserver variations were as high as 11% for CBF and 12% for CBV. The present results suggest that pathological rather than anatomical considerations should dictate the choice of the arterial ROI. For venous ROI, although SSS seems to be adequate in most instances, deep cerebral veins may occasionally generate higher maximal intensities and should therefore be selected. Importantly, significant user-dependency should be taken into account. (orig.)

  20. High-permeability region size on perfusion CT predicts hemorrhagic transformation after intravenous thrombolysis in stroke.

    Directory of Open Access Journals (Sweden)

    Josep Puig

    Full Text Available Blood-brain barrier (BBB permeability has been proposed as a predictor of hemorrhagic transformation (HT after tissue plasminogen activator (tPA administration; however, the reliability of perfusion computed tomography (PCT permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT in predicting HT after intravenous tPA administration in patients with acute stroke.We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4.5 hours of symptom onset. HT was graded at 24 hours using the European-Australasian Acute Stroke Study II criteria. ROC curves selected optimal volume threshold, and multivariate logistic regression analysis identified predictors of HT.The study included 156 patients (50% male, median age 75.5 years. Thirty-seven (23,7% developed HT [12 (7,7%, parenchymal hematoma type 2 (PH-2]. At admission, patients with HT had lower platelet values, higher NIHSS scores, increased ischemic lesion volumes, larger HPrs-PCT, and poorer collateral status. The negative predictive value of HPrs-PCT at a threshold of 7mL/100g/min was 0.84 for HT and 0.93 for PH-2. The multiple regression analysis selected HPrs-PCT at 7mL/100g/min combined with platelets and baseline NIHSS score as the best model for predicting HT (AUC 0.77. HPrs-PCT at 7mL/100g/min was the only independent predictor of PH-2 (OR 1, AUC 0.68, p = 0.045.HPrs-PCT can help predict HT after tPA, and is particularly useful in identifying patients at low risk of developing HT.

  1. Evaluation of regional metabolic abnormality and treatment effect in patients with narcolepsy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Yoon, In Young; Shin, Youn Kyung; Eo, Jae Sean; Won, Oh So; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    The aim of the present study was to evaluated regional metabolic abnormalities in untreated narcoleptic patients and the changes in regional cerebral metabolism after treatment with modafinil. Eight drug free narcoleptic patients (mean age of 17{+-}1 yr) participated in this study. Two [{sup 18}F]fluorodeoxyglucose positron emission tomography (FDG-PET) scans before and after a 2-week titrated modafinil treatment (target dose = 100{approx}400 mg/day). The PET data were analyzed by using statistical parametric mapping methods to identify the regional cerebral abnormalities compared with those of healthy young controls. In addition, treatment effect was evaluated by comparison between before and after treatment scan. In narcolepsy patients, a significant reduction of regional metabolism was demonstrated in the brain stem, bilateral hypothalamus, posterior thalamus, hippocampus, parahippocampal gyrus, and adjacent perihinal area on pretreatment scans compared with those of healthy subjects. The decrease glucose metabolism was also found in the occipital cortex and cerebellum. The patients could control daytime sleepiness after treatment. Posttreatment scan showed a significant increase in regional metabolism in the left hippocampus. This study demonstrated the metabolic abnormalities and the effect of modafinil treatment in narcoleptic patients in the sleep associated regions. This results could be helpful to understand the pathophysiology of the narcolepsy and treatment mechanism.

  2. Abnormalities by pulmonary regions studied with computer tomography following local or local-regional radiotherapy for breast cancer

    International Nuclear Information System (INIS)

    Lind, Pehr; Svane, Gunilla; Gagliardi, Giovanna; Svensson, Christer

    1999-01-01

    Purpose: To study pulmonary radiological abnormalities with computer tomography (CT) following different radiotherapy (RT) techniques for breast cancer with respect to regions and density, and their correlation to pulmonary complications and reduction in vital capacity (VC). Methods and Materials: CT scans of the lungs were performed prior to and 4 months following RT in 105 breast cancer patients treated with local or local-regional RT. The radiological abnormalities were analyzed with a CT-adapted modification of a classification system originally proposed by Arriagada, and scored according to increasing density (0-3) and affected lung regions (apical-lateral, central-parahilar, basal-lateral). The highest density grade in each region were added together to form scores ranging from 0-9. The patients were monitored for RT-induced pulmonary complications. VC was measured prior to and 5 months following RT. Results: Increasing CT scores were correlated with both local-regional RT and pulmonary complications (p < 0.001). The mean reduction of VC for patients scoring 4-9 (-202 ml) was larger than for patients scoring 0-3 (-2 ml) (p = 0.035). The effect of confounding factors on the radiological scoring was tested in the local-regional RT group. Scores of 4-9 were less frequently seen in the patients who had received adjuvant chemotherapy prior to RT. The importance of the respective lung regions on the outcome of pulmonary complications was tested. Only radiological abnormalities in the central-parahilar and apical-lateral regions were significantly correlated to pulmonary complications. Discussion: Radiological abnormalities detected on CT images and scored with a modification of Arriagada's classification system can be used as an objective endpoint for pulmonary side effects in breast cancer. The described model should, however, be expanded with information about the volume of lung affected in each region before definite conclusions can be drawn concerning each

  3. Regional gray matter abnormalities in patients with schizophrenia determined with optimized voxel-based morphometry

    Science.gov (United States)

    Guo, XiaoJuan; Yao, Li; Jin, Zhen; Chen, Kewei

    2006-03-01

    This study examined regional gray matter abnormalities across the whole brain in 19 patients with schizophrenia (12 males and 7 females), comparing with 11 normal volunteers (7 males and 4 females). The customized brain templates were created in order to improve spatial normalization and segmentation. Then automated preprocessing of magnetic resonance imaging (MRI) data was conducted using optimized voxel-based morphometry (VBM). The statistical voxel based analysis was implemented in terms of two-sample t-test model. Compared with normal controls, regional gray matter concentration in patients with schizophrenia was significantly reduced in the bilateral superior temporal gyrus, bilateral middle frontal and inferior frontal gyrus, right insula, precentral and parahippocampal areas, left thalamus and hypothalamus as well as, however, significant increases in gray matter concentration were not observed across the whole brain in the patients. This study confirms and extends some earlier findings on gray matter abnormalities in schizophrenic patients. Previous behavior and fMRI researches on schizophrenia have suggested that cognitive capacity decreased and self-conscious weakened in schizophrenic patients. These regional gray matter abnormalities determined through structural MRI with optimized VBM may be potential anatomic underpinnings of schizophrenia.

  4. Prospective assessment of regional myocardial perfusion before and after coronary revascularization surgery by quantitative thallium-201 scintigraphy

    International Nuclear Information System (INIS)

    Gibson, R.S.; Watson, D.D.; Taylor, G.J.; Crosby, I.K.; Wellons, H.L.; Holt, N.D.; Beller, G.A.

    1983-01-01

    Because thallium-201 uptake relates directly to the amount of viable myocardium and nutrient blood flow, the potential for exercise scintigraphy to predict response to coronary revascularization surgery was investigated in 47 consecutive patients. All patients underwent thallium-201 scintigraphy and coronary angiography at a mean (+/- standard deviation) of 4.3 +/- 3.1 weeks before and 7.5 +/- 1.6 weeks after surgery. Thallium uptake and washout were computer-quantified and each of six segments was defined as normal, showing total or partial redistribution or a persistent defect. Persistent defects were further classified according to the percent reduction in regional thallium activity; PD25-50 denoted a 25 to 50% constant reduction in relative thallium activity and PD greater than 50 denoted a greater than 50% reduction. Of 82 segments with total redistribution before surgery, 76 (93%) showed normal thallium uptake and washout postoperatively, versus only 16 (73%) of 22 with partial redistribution (probability [p] . 0.01). Preoperative ventriculography revealed that 95% of the segments with total redistribution had preserved wall motion, versus only 74% of those with partial redistribution (p . 0.01). Of 42 persistent defects thought to represent myocardial scar before surgery, 19 (45%) demonstrated normal perfusion postoperatively. Of the persistent defects that showed improved thallium perfusion postoperatively, 75% had normal or hypokinetic wall motion before surgery, versus only 14% of those without improvement (p less than 0.001). Whereas 57% of the persistent defects that showed a 25 to 50% decrease in myocardial activity demonstrated normal thallium uptake and washout postoperatively, only 21% of the persistent defects with a decrease in myocardial activity greater than 50% demonstrated improved perfusion after surgery (p . 0.02)

  5. [The distribution of abnormal hemoglobins in the silk road region of China].

    Science.gov (United States)

    Li, H; Zhao, X; Li, L

    1995-05-01

    215,785 individuals living in the Silk Road region of China were surveyed for abnormal hemoglobins (Hbs). Among them, 695 carriers were detected. The average incidence of abnormal Hbs was 3/22 and the frequencies of abnormal Hbs among 12 nationalities reached 0.15/1000-12.17/1000. The primary structural analyses were made in 271 persons, and 24 variants [13 alpha-chain variants and 11 beta-chain variants] were identified. HbJ Tashikuergan and Hb Tianshui were discovered the first time in the world. HbS, Hb Bunbury, Hb Setif and HbI Philadelphia were not found previously in the Chinese population. Three variants, i.e. HbD Punjab, HbG Taipei and HbG Coushatta occurred at the highest frequencies and showed a gradient distribution along the Silk Road, suggesting that they may originate from Caucasians in Central Asia, Han in the Yellow River valley, and the ancient nomadic minorities of China in Mongolia Plateau respectively. The frequencies of other variants were quite low. Some were probably imported from other countries and areas, and some arose from independent mutations. The data from many variants support the movements of various populations in this area, as reported in numerous historical documents. It is indicated that the Silk Road promoted the national fusion among the Chinese nationalities, Mongolian and Caucasian races.

  6. A comprehensive texture segmentation framework for segmentation of capillary non-perfusion regions in fundus fluorescein angiograms.

    Science.gov (United States)

    Zheng, Yalin; Kwong, Man Ting; Maccormick, Ian J C; Beare, Nicholas A V; Harding, Simon P

    2014-01-01

    Capillary non-perfusion (CNP) in the retina is a characteristic feature used in the management of a wide range of retinal diseases. There is no well-established computation tool for assessing the extent of CNP. We propose a novel texture segmentation framework to address this problem. This framework comprises three major steps: pre-processing, unsupervised total variation texture segmentation, and supervised segmentation. It employs a state-of-the-art multiphase total variation texture segmentation model which is enhanced by new kernel based region terms. The model can be applied to texture and intensity-based multiphase problems. A supervised segmentation step allows the framework to take expert knowledge into account, an AdaBoost classifier with weighted cost coefficient is chosen to tackle imbalanced data classification problems. To demonstrate its effectiveness, we applied this framework to 48 images from malarial retinopathy and 10 images from ischemic diabetic maculopathy. The performance of segmentation is satisfactory when compared to a reference standard of manual delineations: accuracy, sensitivity and specificity are 89.0%, 73.0%, and 90.8% respectively for the malarial retinopathy dataset and 80.8%, 70.6%, and 82.1% respectively for the diabetic maculopathy dataset. In terms of region-wise analysis, this method achieved an accuracy of 76.3% (45 out of 59 regions) for the malarial retinopathy dataset and 73.9% (17 out of 26 regions) for the diabetic maculopathy dataset. This comprehensive segmentation framework can quantify capillary non-perfusion in retinopathy from two distinct etiologies, and has the potential to be adopted for wider applications.

  7. MR-based assessment of pulmonary ventilation-perfusion in animal models

    International Nuclear Information System (INIS)

    Yang Jian; Wan Mingxi; Guo Youmin

    2003-01-01

    Objective: To show the feasibility and value in the diagnosis of airway obstruction and pulmonary embolism with MR oxygen-enhanced ventilation combined with pulmonary perfusion imaging. Methods: Eight canines were implemented for peripheral pulmonary embolism by intravenous injection of gelfoam granules at pulmonary segmental arterial level, and five of them were formed airway obstruction models by inserting self-made balloon catheter at second-bronchia. The oxygen-enhanced MR ventilation imaging was introduced by subtracting the images of pre- and post- inhaled pure oxygen. The MR pulmonary perfusion imaging was achieved by the first-pass contrast agent method. Moreover, the manifestation of MR ventilation and perfusion imaging was observed and contradistinguished with that of general pathologic anatomy, ventilation-perfusion scintigraphy, and pulmonary angiography. Results: The manifestations of airway obstruction regions in MR ventilation and perfusion imaging were matched, but those of pulmonary embolism regions were dismatched. The defect range of airway obstruction in MR ventilation image was smaller than that in ventilation scintigraphy. The abnormal perfusion regions of pulmonary embolism were divided into defect regions and reduce regions based on the time courses of signal intensity changes. The sensitivity and specificity of diagnosis on pulmonary embolism by MR ventilation combined with perfusion technique were 75.0% and 98.1%. The diagnostic results were in good coherence with ventilation-perfusion scintigraphy and pulmonary angiography (K=0.743, 0.899). Conclusion: The MR oxygen-enhanced ventilation combined with pulmonary perfusion imaging can be used to diagnose the airway and vascular abnormity in lung. This technique resembles the ventilation-perfusion scintigraphy. It can provide quantitative functional information and better spatial and temporal resolution, and possesses the value of clinical application

  8. Measuring myocardial perfusion

    DEFF Research Database (Denmark)

    Qayyum, A A; Kastrup, J

    2015-01-01

    Recently, focus has changed from anatomical assessment of coronary arteries towards functional testing to evaluate the effect of stenosis on the myocardium before intervention. Besides positron-emission tomography (PET), cardiac MRI (CMR), and cardiac CT are able to measure myocardial perfusion......-known and is used in routine clinical practice. However, PET uses radioactive tracers and has a lower spatial resolution compared to CMR and CT. CMR and CT are emerging techniques in the field of myocardial perfusion imaging. CMR uses magnetic resonance to obtain images, whereas CT uses x-rays during first....... Myocardial perfusion abnormalities are the first sign of the ischaemic cascade in the development of coronary artery disease (CAD). PET is considered the non-invasive clinical reference standard for absolute quantification of myocardial perfusion. The diagnostic and prognostic value of PET is well...

  9. Quantitative Study of Thermal Disturbances Due to Nonuniformly Perfused Tumors in Peripheral Regions of Women’s Breast

    Directory of Open Access Journals (Sweden)

    Akshara Makrariya

    2017-04-01

    Full Text Available Background: Mathematical modeling of biothermal processes is widely used to enhance the quantitative understanding of thermoregulation system of human body organs. This quantitative knowledge of thermal information of various human body organs can be used for developing clinical applications. In the past, investigators have studied thermal distribution in hemisphere-shaped human breast in the presence of sphere-shaped tumor. The shape and size of the breast as well as tumor may also affect thermal distribution which can have serious implications in thermography. In this article, a model of thermal disturbances in peripheral regions of ellipsoid-shaped human breast involving ellipse-shaped nonuniformly perfused tumor has been developed for a 2-dimensional steady-state case. The modeling study will provide biomedical scientists vital insights of thermal changes occurring due to the shape and size of breast and tumor which can influence the development of protocols of thermography for diagnosis of tumors in women’s breast. Method: We have incorporated the significant parameters such as blood flow, metabolic activity, and thermal conductivity in the thermal model for normal and malignant tissues. The controlled metabolic activity has been incorporated for normal tissues, and uncontrolled metabolic activity has been incorporated for tumor regions. The peripheral regions of breast are divided into 3 major layers, namely, epidermis, dermis, and subdermal tissues. An ellipse-shaped nonuniformly perfused tumor is assumed to be present in dermal layers. The nonuniformly perfused tumor is divided into 2 natural components, namely, the necrotic core and tumor periphery. The outer surface of the breast is assumed to be exposed to the environment, and the heat loss takes place by conduction, convection, radiation, and evaporation. The finite element approach is used to obtain the solution. The numerical results have been used to study the effect of shape

  10. Prevalence of abnormal birth weight and related factors in Northern region, Ghana.

    Science.gov (United States)

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-12-15

    Birth weight is a crucial determinant of the development potential of the newborn. Abnormal newborn weights are associated with negative effects on the health and survival of the baby and the mother. Therefore, this study was designed to determine the prevalence of abnormal birth weight and related factors in Northern region, Ghana. The study was a facility-based cross-sectional survey in five hospitals in Northern region, Ghana. These hospitals were selected based on the different socio-economic backgrounds of their clients. The data on birth weight and other factors were derived from hospital records. It was observed that low birth weight is still highly prevalent (29.6%), while macrosomia (10.5%) is also increasingly becoming important. There were marginal differences in low birth weight observed across public hospitals but marked difference in low birth weight was observed in Cienfuegos Suglo Specialist Hospital (Private hospital) as compared to the public hospitals. The private hospital also had the highest prevalence of macrosomia (20.1%). Parity (0-1) (p malnutrition phenomenon, which is currently being experienced by developing and transition counties. Both low birth weight and macrosomia are risk factors, which could contribute considerably to the current and future burden of diseases. This may overstretch the already fragile health system in Ghana. Therefore, it is prudent to recommend that policies aiming at reducing diet related diseases should focus on addressing malnutrition during pregnancy and early life.

  11. Identification of hemodynamically compromised regions by means of cerebral blood volume mapping utilizing computed tomography perfusion imaging.

    Science.gov (United States)

    Takahashi, Satoshi; Tanizaki, Yoshio; Akaji, Kazunori; Kimura, Hiroaki; Katano, Takehiro; Suzuki, Kentaro; Mochizuki, Yoichi; Shidoh, Satoka; Nakazawa, Masaki; Yoshida, Kazunari; Mihara, Ban

    2017-04-01

    The aim of the study was to evaluate the potential role of computed tomography perfusion (CTP) imaging in identifying hemodynamically compromised regions in patients with occlusive cerebrovascular disease. Twelve patients diagnosed with either occlusion or severe stenosis of the internal carotid artery or the M1 portion of the middle cerebral artery underwent CTP imaging. The data was analyzed by an automated ROI-determining software. Patients were classified into two subgroups: an asymptomatic group consisting of three patients in whom perfusion pressure distal to the site of occlusion/stenosis (PP dis ) could be maintained in spite of the arterial occlusion/stenosis, and a symptomatic group consisting of nine patients in whom PP dis could not be maintained enough to avoid watershed infarction. Four CTP-related parameters were independently compared between the two groups. Significant differences were determined using a two-sample t-test. When statistically significant differences were identified, cut-off points were calculated using ROC curves. Analysis revealed statistically significant differences between the asymptomatic and symptomatic subgroups only in the measure of relCBV (p=0.028). Higher relCBV values were observed in the symptomatic subgroup. ROC curve analysis revealed 1.059 to be the optimal relCBV cut-off value for distinguishing between the asymptomatic and symptomatic subgroups. The data revealed that, in patients whose PP dis is maintained, relCBV remains around 1.00. Conversely, in patients whose PP dis decreased, relCBV increased. From these findings, we conclude that elevation of relCBV as observed using CTP imaging accurately reflects the extent of compensatory vasodilatation involvement and can identify hemodynamically compromised regions. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Noninvasive quantification of regional myocardial perfusion with rubidium-82 and positron emission tomography. Exploration of a mathematical model

    International Nuclear Information System (INIS)

    Herrero, P.; Markham, J.; Shelton, M.E.; Weinheimer, C.J.; Bergmann, S.R.

    1990-01-01

    Positron emission tomography (PET) centers without cyclotrons use generator-produced rubidium-82 (82Rb) for assessment of myocardial perfusion. The aim of the present study was to determine whether myocardial blood flow could be assessed quantitatively with 82Rb and PET. Because the myocardial extraction fraction of 82Rb varies inversely and nonlinearly with flow and cannot be measured conveniently with PET, we used an experimentally derived mathematical function defining the relation between single-pass extraction fraction of 82Rb and flow to obviate the necessity of measuring the extraction fraction directly. Myocardial blood flow in absolute terms (ml/g/min) was estimated from dynamic PET scans after intravenous administration of 82Rb in intact dogs and compared with flows measured with radiolabeled microspheres. In 36 comparisons in 13 dogs studied at rest, or after coronary occlusion, reperfusion, or after coronary hyperemia induced with intravenous dipyridamole, over the flow range from 0.2 to 2.0 ml/g/min, estimates of perfusion with rubidium correlated well with flows measured concomitantly with microspheres, although there was a slight underestimation of flow with rubidium (flow by 82Rb = 0.92 x flow by microspheres-0.021, r = 0.83). In general, estimates of flow in ischemic regions were less reliable than estimates for regions with normal flow. Thus, although the relation between myocardial extraction and retention of 82Rb and flow can vary under a variety of physiological and pathophysiological conditions, this study demonstrates the ability to obtain quantitative estimates of myocardial blood flow with 82Rb and PET under carefully defined conditions without measuring the extraction fraction directly

  13. Regional Abnormality of Grey Matter in Schizophrenia: Effect from the Illness or Treatment?

    Directory of Open Access Journals (Sweden)

    Ying Yue

    Full Text Available Both schizophrenia and antipsychotic treatment are known to modulate brain morphology. However, it is difficult to establish whether observed structural brain abnormalities are due to disease or the effects of treatment. The aim of this study was to investigate the effects of illness and antipsychotic treatment on brain structures in antipsychotic-naïve first-episode schizophrenia based on a longitudinal short-term design. Twenty antipsychotic-naïve subjects with first-episode schizophrenia and twenty-four age- and sex-matched healthy controls underwent 3T MRI scans. Voxel-based morphometry (VBM was used to examine the brain structural abnormality in patients compared to healthy controls. Nine patients were included in the follow-up examination after 8 weeks of treatment. Tensor-based morphometry (TBM was used to identify longitudinal brain structural changes. We observed significantly reduced grey matter volume in the right superior temporal gyrus in antipsychotic-naïve patients with schizophrenia compared with healthy controls. After 8 weeks of treatment, patients showed significantly increased grey matter volume primarily in the bilateral prefrontal cortex, insula, right thalamus, left superior occipital cortex and the bilateral cerebellum. In addition, a greater enlargement of the prefrontal cortex is associated with the improvement in negative symptoms, and a more enlarged thalamus is associated with greater improvement in positive symptoms. Our results suggest the following: (1 the abnormality in the right superior temporal gyrus is present in the early stages of schizophrenia, possibly representing the core region related to schizophrenia; and (2 atypical antipsychotics could modulate brain morphology involving the thalamus, cortical grey matter and cerebellum. In addition, examination of the prefrontal cortex and thalamus might facilitate an efficient response to atypical antipsychotics in terms of symptom improvement.

  14. Regional grey matter volume abnormalities in bulimia nervosa and binge-eating disorder.

    Science.gov (United States)

    Schäfer, Axel; Vaitl, Dieter; Schienle, Anne

    2010-04-01

    This study investigated whether bulimia nervosa (BN) and binge-eating disorder (BED) are associated with structural brain abnormalities. Both disorders share the main symptom binge-eating, but are considered differential diagnoses. We attempted to identify alterations in grey matter volume (GMV) that are present in both psychopathologies as well as disorder-specific GMV characteristics. Such information can help to improve neurobiological models of eating disorders and their classification. A total of 50 participants (patients suffering from BN (purge type), BED, and normal-weight controls) underwent structural MRI scanning. GMV for specific brain regions involved in food/reinforcement processing was analyzed by means of voxel-based morphometry. Both patient groups were characterized by greater volumes of the medial orbitofrontal cortex (OFC) compared to healthy controls. In BN patients, who had increased ventral striatum volumes, body mass index and purging severity were correlated with striatal grey matter volume. Altogether, our data implicate a crucial role of the medial OFC in the studied eating disorders. The structural abnormality might be associated with dysfunctions in food reward processing and/or self-regulation. The bulimia-specific volume enlargement of the ventral striatum is discussed in the framework of negative reinforcement through purging and associated weight regulation. Copyright 2009 Elsevier Inc. All rights reserved.

  15. Prenatal diagnosis of foetuses with congenital abnormalities and duplication of the MECP2 region.

    Science.gov (United States)

    Fu, Fang; Liu, Huan-ling; Li, Ru; Han, Jin; Yang, Xin; Min, Pan; Zhen, Li; Zhang, Yong-ling; Xie, Gui-e; Lei, Ting-ying; Li, Yan; Li, Jian; Li, Dong-zhi; Liao, Can

    2014-08-10

    MECP2 duplication results in a well-recognised syndrome in 100% of affected male children; this syndrome is characterised by severe neurodevelopmental disabilities and recurrent infections. However, no sonographic findings have been reported for affected foetuses, and prenatal molecular diagnosis has not been possible for this disease due to lack of prenatal clinical presentation. In this study, we identified a small duplication comprising the MECP2 and L1CAM genes in the Xq28 region in a patient from a family with severe X-linked mental retardation and in a prenatal foetus with brain structural abnormalities. Using high-resolution chromosome microarray analysis (CMA) to screen 108 foetuses with congenital structural abnormalities, we identified additional three foetuses with the MECP2 duplication. Our study indicates that ventriculomegaly, hydrocephalus, agenesis of the corpus callosum, choroid plexus cysts, foetal growth restriction and hydronephrosis might be common ultrasound findings in prenatal foetuses with the MECP2 duplication and provides the first set of prenatal cases with MECP2 duplication, the ultrasonographic phenotype described in these patients will help to recognise the foetuses with possible MECP2 duplication and prompt the appropriate molecular testing. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Automatic assessment of regional and global wall motion abnormalities in echocardiography images by nonlinear dimensionality reduction.

    Science.gov (United States)

    Shalbaf, Ahmad; Behnam, Hamid; Alizade-Sani, Zahra; Shojaifard, Maryam

    2013-05-01

    Identification and assessment of left ventricular (LV) global and regional wall motion (RWM) abnormalities are essential for clinical evaluation of various cardiovascular diseases. Currently, this evaluation is performed visually which is highly dependent on the training and experience of echocardiographers and thus is prone to considerable interobserver and intraobserver variability. This paper presents a new automatic method, based on nonlinear dimensionality reduction (NLDR) for global wall motion evaluation and also detection and classification of RWM abnormalities of LV wall in a three-point scale as follows: (1) normokinesia, (2) hypokinesia, and (3) akinesia. Isometric feature mapping (Isomap) is one of the most popular NLDR algorithms. In this paper, a modified version of Isomap algorithm, where image to image distance metric is computed using nonrigid registration, is applied on two-dimensional (2D) echocardiography images of one cycle of heart. By this approach, nonlinear information in these images is embedded in a 2D manifold and each image is characterized by a point on the constructed manifold. This new representation visualizes the relationship between these images based on LV volume changes. Then, a new global and regional quantitative index from the resultant manifold is proposed for global wall motion estimation and also classification of RWM of LV wall in a three-point scale. Obtained results by our method are quantitatively evaluated to those obtained visually by two experienced echocardiographers as the reference (gold standard) on 10 healthy volunteers and 14 patients. Linear regression analysis between the proposed global quantitative index and the global wall motion score index and also with LV ejection fraction obtained by reference experienced echocardiographers resulted in the correlation coefficients of 0.85 and 0.90, respectively. Comparison between the proposed automatic RWM scoring and the reference visual scoring resulted in an

  17. Pharmacokinetics, pharmacodynamics and local tolerance at injection site of marbofloxacin administered by regional intravenous limb perfusion in standing horses.

    Science.gov (United States)

    Lallemand, Elodie; Trencart, Pierre; Tahier, Carine; Dron, Frederic; Paulin, Angelique; Tessier, Caroline

    2013-08-01

    To evaluate pharmacokinetic-pharmacodynamic variables and local tolerance at injection-site of marbofloxacin administered via regional intravenous limb perfusion (RIVLP) in standing horses. Adult horses (n = 6). RIVLP were performed with rubber tourniquets applied to the forelimbs of standing sedated horses. Marbofloxacin (0.67 mg/kg) was randomly injected in 1 forelimb, with the contralateral limb serving as a control (0.9% NaCl solution). Samples of jugular blood and synovial fluid from the radiocarpal joint of the marbofloxacin-perfused limb were collected before and at intervals after RIVLP for determination of drug concentrations. All injection sites were evaluated before, 24 and 48 hours after RIVLP by means of ultrasonographic examination, circumferential measurements and subjective visible inflammation scores by veterinarians unaware of treatment received. No adverse effects associated with the technique or antibiotic were observed. High marbofloxacin concentrations were obtained in the synovial fluid, AUCINF was significantly higher in synovial fluid than in plasma (78.64 ± 49.41 and 2.85 ± 0.60 µg h/mL respectively, P = .028). The efficacy indices, AUC0-24 /MIC90 and Cmaxobs/MIC90 , predicted a favorable outcome in the treatment of synovial fluid infections caused by enterobacteriaceae and Staphylococcus aureus. After RIVLP, there was no statistically significant difference between marbofloxacin-injected and control limbs for lameness, visual inflammation score, limb circumference, and ultrasonographic appearance of the veins. Marbofloxacin injected limbs had a significantly greater subcutaneous thickness, compared with control limbs. These data suggest that RIVLP of marbofloxacin (0.67 mg/kg) could be a safe and effective method for treatment of infections of the distal portion of the limb for susceptible organisms. © Copyright 2013 by The American College of Veterinary Surgeons.

  18. Regional brain structural abnormality in ischemic stroke patients: a voxel-based morphometry study

    Directory of Open Access Journals (Sweden)

    Ping Wu

    2016-01-01

    Full Text Available Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clinical rating scales of the Fugl-Meyer Motor Assessment (r = -0.609, P = 0.047 and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale (r = -0.737, P = 0.010. Our findings can objectively identify the functional abnormality in some brain regions of ischemic stroke patients.

  19. Regional brain structural abnormality in ischemic stroke patients: a voxel-based morphometry study.

    Science.gov (United States)

    Wu, Ping; Zhou, Yu-Mei; Zeng, Fang; Li, Zheng-Jie; Luo, Lu; Li, Yong-Xin; Fan, Wei; Qiu, Li-Hua; Qin, Wei; Chen, Lin; Bai, Lin; Nie, Juan; Zhang, San; Xiong, Yan; Bai, Yu; Yin, Can-Xin; Liang, Fan-Rong

    2016-09-01

    Our previous study used regional homogeneity analysis and found that activity in some brain areas of patients with ischemic stroke changed significantly. In the current study, we examined structural changes in these brain regions by taking structural magnetic resonance imaging scans of 11 ischemic stroke patients and 15 healthy participants, and analyzing the data using voxel-based morphometry. Compared with healthy participants, patients exhibited higher gray matter density in the left inferior occipital gyrus and right anterior white matter tract. In contrast, gray matter density in the right cerebellum, left precentral gyrus, right middle frontal gyrus, and left middle temporal gyrus was less in ischemic stroke patients. The changes of gray matter density in the middle frontal gyrus were negatively associated with the clinical rating scales of the Fugl-Meyer Motor Assessment ( r = -0.609, P = 0.047) and the left middle temporal gyrus was negatively correlated with the clinical rating scales of the nervous functional deficiency scale ( r = -0.737, P = 0.010). Our findings can objectively identify the functional abnormality in some brain regions of ischemic stroke patients.

  20. Biphasic thallium 201 SPECT-imaging for the noninvasive diagnosis of myocardial perfusion abnormalities in a child with Kawasaki disease--a case report

    International Nuclear Information System (INIS)

    Hausdorf, G.; Nienaber, C.A.; Spielman, R.P.

    1988-01-01

    The mucocutaneous lymph node syndrome (Kawasaki disease) is of increasing importance for the pediatric cardiologist, for coronary aneurysms with the potential of thrombosis and subsequent stenosis can develop in the course of the disease. The authors report a 2 1/2-year-old female child in whom, fourteen months after the acute phase of Kawasaki disease, myocardial infarction occurred. Biphasic thallium 201 SPECT-imaging using dipyridamole depicted anterior wall ischemia and inferolateral infarction. This case demonstrates that noninvasive vasodilation-redistribution thallium 201 SPECT-imaging has the potential to predict reversible myocardial perfusion defects and myocardial necrosis, even in small infants with Kawasaki disease

  1. An Arterial Spin Labeling MRI Perfusion Study of Migraine without Aura Attacks

    Directory of Open Access Journals (Sweden)

    Raquel Gil-Gouveia

    2017-06-01

    Full Text Available BackgroundStudies of brain perfusion during migraine without aura attacks have inconsistent results.MethodsArterial spin labeling MRI, a non-invasive quantitative perfusion technique, was used to prospectively study a spontaneous untreated migraine without aura attack and a headache-free period. Image analysis used FSL and MATLAB software; Group analysis used permutation methods for perfusion differences between sessions.ResultsThirteen women (age 35.7 were scanned during an attack of an average intensity of 6.8 (on 0–10 Visual Analog Scale and 16 h duration. No global or regional perfusion differences were identified when comparing migraine and migraine-free sessions.DiscussionOur findings suggest that the painful phase of migraine without aura attacks is not associated with brain perfusion abnormalities.

  2. Regional cerebral blood flow abnormalities in late-life depression. Relation to refractoriness and chronification

    International Nuclear Information System (INIS)

    Awata, Shuichi; Konno, Michiko; Sato, Mitsumoto; Ito, Hiroshi; Ono, Shuichi; Kawashima, Ryuta; Fukuda, Hiroshi

    1998-01-01

    We examined patterns of regional cerebral blood flow (rCBF) abnormalities in 18 patients with major depressive disorder in late life using single photon emission computed tomography (SPECT) and 99m Tc-hexamethyl-propylenamine oxime ( 99m Tc-HMPAO). Compared with 13 age-matched controls, relative rCBF was significantly decreased bilaterally in the anterior cingulate gyrus, the prefrontal cortex, the temporal cortex, the parietal cortex, the hippocampus and the caudate nucleus. However, it was not correlated with the severity of depression or global cognitive dysfunction. In 10 patients with a prolonged depressive episode or prolonged residual symptoms (the refractory subgroup), robust and extensive decreases in rCBF were found compared with controls and the rCBF decreased significantly in the anterior cingulate gyrus and the prefrontal cortex compared with that in the non-refractory subgroup. In the non-reflactory subgroup, rCBF decreased significantly in the caudate nucleus and tended to decrease in the anterior cingulate gyrus compared with controls. These findings indicate that dysfunction of the limbic system, the cerebral association cortex and the caudate nucleus may be implicated in late-life depression and that robust and extensive hypoperfusion, especially in the anterior cingulate and the prefrontal regions, may relate to refractoriness or chronification of depression. (author). 60 refs

  3. Cardiopulmonary fitness correlates with regional cerebral grey matter perfusion and density in men with coronary artery disease.

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

    Full Text Available Physical activity is associated with positive effects on the brain but there is a paucity of clinical neuroimaging data in patients with coronary artery disease (CAD, a cardiovascular condition associated with grey matter loss. The purpose of this study was to determine which brain regions are impacted by cardiopulmonary fitness and with the change in fitness after 6 months of exercise-based cardiac rehabilitation.CAD patients underwent magnetic resonance imaging at baseline, and peak volume of oxygen uptake during exercise testing (VO2Peak was measured at baseline and after 6 months of training. T1-weighted structural images were used to perform grey matter (GM voxel-based morphometry (VBM. Pseudo-continuous arterial spin labeling (pcASL was used to produce cerebral blood flow (CBF images. VBM and CBF data were tested voxel-wise using VO2Peak and age as explanatory variables.In 30 men with CAD (mean age 65±7 years, VBM and CBF identified 7 and 5 respective regions positively associated with baseline VO2Peak. These included the pre- and post-central, paracingulate, caudate, hippocampal regions and converging findings in the putamen. VO2Peak increased by 20% at follow-up in 29 patients (t = 9.6, df = 28, p<0.0001. Baseline CBF in the left post-central gyrus and baseline GM density in the right putamen predicted greater change in VO2Peak.Perfusion and GM density were associated with fitness at baseline and with greater fitness gains with exercise. This study identifies new neurobiological correlates of fitness and demonstrates the utility of multi-modal MRI to evaluate the effects of exercise in CAD patients.

  4. Improving the Outcomes of Organs Obtained From Controlled Donation After Circulatory Death Donors Using Abdominal Normothermic Regional Perfusion.

    Science.gov (United States)

    Miñambres, E; Suberviola, B; Dominguez-Gil, B; Rodrigo, E; Ruiz-San Millan, J C; Rodríguez-San Juan, J C; Ballesteros, M A

    2017-08-01

    The use of donation after circulatory death (DCD) has increased significantly during the past decade. However, warm ischemia results in a greater risk for transplantation. Indeed, controlled DCD (cDCD) was associated with inferior outcomes compared with donation after brain death. The use of abdominal normothermic regional perfusion (nRP) to restore blood flow before organ recovery in cDCD has been proposed as better than rapid recovery to reverse the effect of ischemia and improve recipients' outcome. Here, the first Spanish series using abdominal nRP as an in situ conditioning method is reported. A specific methodology to avoid restoring circulation to the brain after death determination is described. Twenty-seven cDCD donors underwent abdominal nRP during at least 60 min. Thirty-seven kidneys, 11 livers, six bilateral lungs, and one pancreas were transplanted. The 1-year death-censored kidney survival was 91%, and delayed graft function rate was 27%. The 1-year liver survival rate was 90.1% with no cases of ischemic cholangiopathy. Transplanted lungs and pancreas exhibited primary function. The use of nRP may represent an advance to increase the number and quality of grafts in cDCD. Poor results in cDCD livers could be reversed with nRP. Concerns about restoring brain circulation after death are easily solved. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. MRS algorithm: a new method for searching myocardial region in SPECT myocardial perfusion images.

    Science.gov (United States)

    He, Yuan-Lie; Tian, Lian-Fang; Chen, Ping; Li, Bin; Mao, Zhong-Yuan

    2005-10-01

    First, the necessity of automatically segmenting myocardium from myocardial SPECT image is discussed in Section 1. To eliminate the influence of the background, the optimal threshold segmentation method modified for the MRS algorithm is explained in Section 2. Then, the image erosion structure is applied to identify the myocardium region and the liver region. The contour tracing method is introduced to extract the myocardial contour. To locate the centriod of the myocardium, the myocardial centriod searching method is developed. The protocol of the MRS algorithm is summarized in Section 6. The performance of the MRS algorithm is investigated and the conclusion is drawn in Section 7. Finally, the importance of the MRS algorithm and the improvement of the MRS algorithm are discussed.

  6. Abnormal regional homogeneity in Parkinson's disease: a resting state fMRI study

    International Nuclear Information System (INIS)

    Li, Y.; Liang, P.; Jia, X.; Li, K.

    2016-01-01

    Aim: To examine the functional brain alterations in Parkinson's disease (PD) by measuring blood oxygenation level dependent (BOLD) functional MRI (fMRI) signals at rest while controlling for the structural atrophy. Materials and methods: Twenty-three PD patients and 20 age, gender, and education level matched normal controls (NC) were included in this study. Resting state fMRI and structural MRI data were acquired. The resting state brain activity was measured by the regional homogeneity (ReHo) method and the grey matter (GM) volume was attained by the voxel-based morphology (VBM) analysis. Two-sample t-test was then performed to detect the group differences with structural atrophy as a covariate. Results: VBM analysis showed GM volume reductions in the left superior frontal gyrus, left paracentral lobule, and left middle frontal gyrus in PD patients as compared to NC. There were widespread ReHo differences between NC and PD patients. Compared to NC, PD patients showed significant alterations in the motor network, including decreased ReHo in the right primary sensory cortex (S1), while increased ReHo in the left premotor area (PMA) and left dorsolateral prefrontal cortex (DLPFC). In addition, a cluster in the left superior occipital gyrus (SOG) also showed increased ReHo in PD patients. Conclusion: The current findings indicate that significant changes of ReHo in the motor and non-motor cortices have been detected in PD patients, independent of age, gender, education level, and structural atrophy. The present study thus suggests ReHo abnormalities as a potential biomarker for the diagnosis of PD and further provides insights into the biological mechanism of the disease. - Highlights: • Functional changes were found in PD patients independent of structural atrophy. • Both increased and decreased ReHo were observed in motor network regions in PD. • Increased ReHo was detected in visual association cortex for PD patients.

  7. Thallium-201 is comparable to technetium-99m-sestamibi for estimating cardiac function in patients with abnormal myocardial perfusion imaging

    Directory of Open Access Journals (Sweden)

    Ming-Che Wu

    2015-11-01

    Full Text Available We analyzed the left-ventricular functional data obtained by cardiac-gated single-photon emission computed tomography myocardial perfusion imaging (MPI with thallium-201 (Tl-201 and technetium-99m-sestamibi (MIBI protocols in different groups of patients, and compared the data between Tl-201 and MIBI. Two hundred and seventy-two patients undergoing dipyridamole stress/redistribution Tl-201 MPI and 563 patients undergoing 1-day rest/dipyridamole stress MIBI MPI were included. Higher mean stress ejection fraction (EF, rest EF, and change in EF (ΔEF were noticed in the normal MPI groups by both Tl-201 and MIBI protocols. Higher mean EF was observed in the females with normal MPI results despite their higher mean age. Comparisons between the Tl-201 and MIBI groups suggested a significant difference in all functional parameters, except for the rest end diastolic volume/end systolic volume and ΔEF between groups with negative MPI results. For the positive MPI groups, there was no significant difference in all parameters, except for the change in end diastolic volume and change in end systolic volume after stress between both protocols. The Tl-201 provides comparable left-ventricular functional data to MIBI cardiac-gated single-photon emission computed tomography in patients with positive MPI results, and may therefore be undertaken routinely for incremental functional information that is especially valuable to this patient group.

  8. Relationships between left ventricular sympathetic innervation and diastolic dysfunction: the role of myocardial innervation/perfusion mismatch.

    Science.gov (United States)

    Gimelli, Alessia; Liga, Riccardo; Avogliero, Francesco; Coceani, Michele; Marzullo, Paolo

    2016-12-27

    A possible relationship between cardiac sympathetic denervation and left ventricular (LV) diastolic dysfunction has been suggested. However, an evaluation of the interactions between myocardial adrenergic tone and LV perfusion and diastolic function is lacking. Seventy-two patients underwent 99m Tc-tetrofosmin/ 123 I-metaiodobenzylguanidine ( 123 I-MIBG) cardiac Cadmium-Zinc-Telluride (CZT) imaging. The summed rest score (SRS) and summed 123 I-MIBG score (SS-MIBG) were computed as measures of regional perfusion and innervation heterogeneities. LV segments showing an impaired innervation, despite a relatively preserved perfusion ( 99m Tc-tetrofosmin- 123 I-MIBG tracers' uptake ≥25%), were individuated (innervation/perfusion mismatch). The peak filling rate (PFR) was computed as a measure of LV diastolic function. Nineteen of the 72 (26%) patients presented a normal LV diastolic function, while 29 (40%) and 24 (34%) had a mild and overt diastolic dysfunction. Subjects with diastolic dysfunction showed more abnormal SRS and SS-MIBG values (P mismatch. A modest correlation between the extent of cardiac innervation/perfusion mismatch and PFR values was evident (R = -0.27, P = 0.029). On multivariate analysis, the extent of regional innervation/perfusion mismatch remained an independent predictor of overt LV diastolic abnormalities (P = 0.017). The burden of LV regions showing an innervation/perfusion mismatch associates with the occurrence of overt diastolic dysfunction.

  9. Contralateral thalamic hypoperfusion on brain perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Seok Mo; Bae, Sang Kyun; Yoo, Kyung Moo; Yum, Ha Yong

    2000-01-01

    Brain perfusion single photon emission computed tomography (SPECT) is useful for the localization of cerebrovascular lesion and sometimes reveals more definite lesion than radiologic imaging modality such as CT or MRI does. The purpose of this study was to evaluate the diagnostic usefulness of brain perfusion SPECT in patients with hemisensory impairment. Thirteen consecutive patients (M:F= 8:5, mean age = 48) who has hemisensory impairment were included. Brain perfusion SPECT was performed after intravenous injection of 1110 MBq of Tc-99m ECD. The images were obtained using a dual-head gamma camera with ultra-high resolution collimator. Semiquantitative analysis was performed after placing multiple ROIs on cerebral cortex, basal ganglia, thalamus and cerebellum. There were 10 patients with left hemisensory impairment and 3 patients with right-sided symptom. Only 2 patients revealed abnormal signal change in the thalamus on MRI. But brain perfusion SPECT showed decreased perfusion in the thalamus in 9 patients. Six patients among 10 patients with left hemisensory impairment revealed decreased perfusion in the contralateral thalamus on brain SPECT. The other 4 patients revealed no abnormality. Two patients among 3 patients with right hemisensory impairment also showed decreased perfusion in the contralateral thalamus on brain SPECT. One patients with right hemisensory impairment showed ipsilateral perfusion decrease. Two patients who had follow-up brain perfusion SEPCT after treatment revealed normalization of perfusion in the thalamus. Brain perfusion SPECT might be a useful tool in diagnosing patients with hemisensory impairment

  10. Statistical voxel-wise analysis of ictal SPECT reveals pattern of abnormal perfusion in patients with temporal lobe epilepsy Análise estatística baseada em voxel do SPECT ictal revela um padrão de alteração perfusional em pacientes com epilepsia de lobo temporal

    Directory of Open Access Journals (Sweden)

    Bárbara Juarez Amorim

    2005-12-01

    Full Text Available OBJECTIVE: To investigate the pattern of perfusion abnormalities in ictal and interictal brain perfusion SPECT images (BSI from patients with temporal lobe epilepsy (TLE. METHOD: It was acquired interictal and ictal BSI from 24 patients with refractory TLE. BSIs were analyzed by visual inspection and statistical parametric mapping (SPM2. Statistical analysis compared the patients group to a control group of 50 volunteers. The images from patients with left-TLE were left-right flipped. RESULTS: It was not observed significant perfusional differences in interictal scans with SPM. Ictal BSI in SPM analysis revealed hyperperfusion within ipsilateral temporal lobe (epileptogenic focus and also contralateral parieto-occipital region, ipsilateral posterior cingulate gyrus, occipital lobes and ipsilateral basal ganglia. Ictal BSI also showed areas of hypoperfusion. CONCLUSION: In a group analysis of ictal BSI of patients with TLE, voxel-wise analysis detects a network of distant regions of perfusional alteration which may play active role in seizure genesis and propagation.OBJETIVO: Investigar o padrão de anormalidades perfusionais no SPECT de perfusão cerebral (SPC ictal e interictal na epilepsia de lobo temporal (ELT. MÉTODO: Foram realizados SPCs ictal e interictal de 24 pacientes com ELT que foram analisados visualmente e com o statistical parametric mapping (SPM2. A análise estatística comparou o grupo de pacientes versus um grupo controle de 50 voluntários. RESULTADOS: Na análise do SPM não foram observadas diferenças significativas no grupo de SPC interictal. No grupo de SPC ictal o SPM revelou hiperperfusão no lobo temporal ipsilateral (foco epileptogênico e também na região parieto-occipital contralateral, porção posterior do cíngulo ipsilateral, lobos occipitais e núcleos da base ipsilateral. O SPC ictal também mostrou áreas de hipoperfusão. CONCLUSÃO: Em uma análise de grupo do SPC ictal de pacientes com ELT, a an

  11. Prenatal diagnosis of chromosome 15 abnormalities in the Prader-Willi/Angelman syndrome region by traditional and molecular cytogenetics

    Energy Technology Data Exchange (ETDEWEB)

    Toth-Fejel, S.; Magenis, R.E.; Leff, S. [Oregon Health Sciences Univ., Portland, OR (United States)] [and others

    1995-02-13

    With improvements in culturing and banding techniques, amniotic fluid studies now achieve a level of resolution at which the Prader-Willi syndrome (PWS) and Angelman syndrome (AS) region may be questioned. Chromosome 15 heteromorphisms, detected with Q- and R-banding and used in conjunction with PWS/AS region-specific probes, can confirm a chromosome deletion and establish origin to predict the clinical outcome. We report four de novo cases of an abnormal-appearing chromosome 15 in amniotic fluid samples referred for advanced maternal age or a history of a previous chromosomally abnormal child. The chromosomes were characterized using G-, Q-, and R-banding, as well as isotopic and fluorescent in situ hybridization of DNA probes specific for the proximal chromosome 15 long arm. In two cases, one chromosome 15 homolog showed a consistent deletion of the ONCOR PWS/AS region A and B. In the other two cases, one of which involved an inversion with one breakpoint in the PWS/AS region, all of the proximal chromosome 15 long arm DNA probes used in the in situ hybridization were present on both homologs. Clinical follow-up was not available on these samples, as in all cases the parents chose to terminate the pregnancies. These cases demonstrate the ability to prenatally diagnose chromosome 15 abnormalities associated with PWS/AS. In addition, they highlight the need for a better understanding of this region for accurate prenatal diagnosis. 41 refs., 5 figs.

  12. II. Characterization and development of the regional- and cellular-specific abnormalities in the epididymis of mice with beta-hexosaminidase A deficiency.

    Science.gov (United States)

    Adamali, H I; Somani, I H; Huang, J Q; Gravel, R A; Trasler, J M; Hermo, L

    1999-01-01

    Beta-hexosaminidase (Hex) is a lysosomal enzyme that exists as two isoenzymes: Hex A (subunit structure alphabeta) and Hex B (betabeta). Its presence in the testis and epididymis suggests important roles for Hex and its substrates in male fertility and reproductive functions. Disruption of the Hexa gene encoding the alpha-subunit of Hex has led to the generation of a mildly affected mouse model of human Tay-Sachs disease, allowing us the opportunity to analyze the effects of isolated Hex A deficiency on epithelial cellular morphology of the male reproductive tract. At 5 weeks and at 3, 5, and 12 months, the testes, efferent ducts and epididymides of Hex A-deficient (Hexa -/-) and wild-type (Hexa +/+) mice were perfuse fixed and analyzed by routine light and electron microscopy as well as with immunocytochemistry employing antibodies to lysosomal enzymes. In the testis, the seminiferous epithelium of Hexa -/- mice appeared comparable to that of wild-type mice in appearance and topographical arrangement of its cell types at all ages examined. Also, no differences were noted for the efferent ducts. In contrast, there were striking abnormalities in the epididymides of the mutant mice; however, the abnormalities were mainly restricted to the initial segment and intermediate zone. Principal cells of these regions at 5 weeks showed a dramatic increase in the number of lysosomes as compared with those from wild-type animals, and this progressed with increasing age. Furthermore, unlike the few small lysosomes present in wild-type mice, those of Hexa -/- mice were at times enlarged and often filled the supranuclear and basal regions of these cells. In the light microscope, large, dense cellular aggregates were noted at the base of the epithelium in the proximal initial segment that corresponded in the electron microscope to two different cell types, both of which increased in size with age. One aggregate was considered to belong to narrow cells on the basis of the presence

  13. Contribution of quantitative perfusion pulmonary scintiscanning with particles to the study of the regional pulmonary blood flow distribution

    International Nuclear Information System (INIS)

    Barreto, S.S.M.

    1988-01-01

    The quantitative perfusion pulmonary scintiscanning with macro aggregates was studied by digital images of perfusion, obtained in scintiscanning chamber coupled to the data processing system. The study was developed in four phases, in the Nuclear Medicine Service of Porto Alegre Clinical Hospital. In each phase, it was studied groups with different ages and different clinical aspects (normal and cardiopathic persons), and they were submitted to several diagnostic techniques. The macro aggregates used was the human albumin and was labelled with technetium 99. A comparative evaluation of this method with others diagnostic techniques was also presented. (C.G.C)

  14. : Myocardial Perfusion

    OpenAIRE

    Dacher, Jean-Nicolas; Lefebvre, V.; Dubourg, Bernard; Deux, Jean-François; Caudron, Jérôme

    2013-01-01

    International audience; The analysis of myocardial perfusion is a key step in the cardiac MRI examination. In routine work, this exploration carried out at rest is based on the qualitative first pass study of gadolinium with an ECG-triggered saturation recovery bFFE sequence. In view of recent knowledge, the analysis of the myocardial perfusion under vasodilator stress may be carried out by scintigraphy or MRI, the latter benefiting from the absence of exposure to ionizing rays and a lower co...

  15. Preoperative localization of epileptic foci with SPECT brain perfusion imaging, electrocorticography, surgery and pathology

    International Nuclear Information System (INIS)

    Jia Shaowei; Xu Wengui; Chen Hongyan; Weng Yongmei; Yang Pinghua

    2002-01-01

    Objective: The value of preoperative localization of epileptic foci with SPECT brain perfusion imaging was investigated. Methods: The study population consisted of 23 patients with intractable partial seizures which was difficult to control with anticonvulsant for long period. In order to preoperatively locate the epileptic foci, double SPECT brain perfusion imaging was performed during interictal and ictal stage. The foci were confirmed with electrocorticography (EcoG), surgery and pathology. Results: The author checked with EcoG the foci shown by SPECT, 23 patients had all typical spike discharge. The regions of radioactivity increase in ictal matched with the abnormal electrical activity areas that EcoG showed. The spike wave originated in the corresponding cerebrum cortex instead of hyperplastic and adherent arachnoid or tumor itself. Conclusions: SPECT brain perfusion imaging contributes to distinguishing location, size, perfusion and functioning of epileptogenic foci, and has some directive function on to making out a treatment programme at preoperation

  16. Evaluation of regional wall motion abnormalities of the heart. Comparison with Doppler tissue echocardiography, MR-tagging and levocardiography

    International Nuclear Information System (INIS)

    Kivelitz, D.E.; Enzweiler, C.N.H.; Hamm, B.; Borges, A.C.; Walde, T.; Rutsch, W.; Baumann, G.

    2004-01-01

    Purpose: To compare the visual analysis of magnetic resonance imaging (MRI) with the tagging technique and Doppler tissue echocardiography with invasive ventriculography in detecting and quantifying regional left ventricular wall motion abnormalities. Materials and Methods: Sixteen patients with coronary artery disease and a history of prior myocardial infarction underwent invasive ventriculography. Doppler tissue echocardiography and MR-tagging within one week. Regional wall motion abnormalities (WMA) were detected in all patients. WMA were graded as normal=1; hypokinetic=2; akinetic=3; or dyskinetic=4. For agreement between MRI, echocardiography, and ventriculography the kappa coefficient (κ) according to Cohen was calculated. Results: The kappa coefficient (κ) was 0.962 for agreement between MRI and echocardiography and 0.602 for agreement between MRI and ventriculography as well as between echocardiography and ventriculography. Conclusion: Reliable analysis of regional left ventricular wall motion abnormalities is feasible using visual analysis of MR-tagging. MRI and Doppler tissue echocardiography detect more WMA than invasive ventriculography and grade them as more severe. (orig.)

  17. Phase II study of regional chemotherapy using the hypoxic abdominal perfusion technique in advanced abdominal carcinoma. 5-FU pharmacokinetics, complications and outcome.

    Science.gov (United States)

    Pohlen, U; Rieger, H; Kunick-Pohlen, S; Berger, G; Buhr, H J

    2007-01-01

    The aim of this study was to verify the rationale of a hypoxic abdominal perfusion (HAP) technique for the perfusion of 5-FU, mitomycin C and cisplatin in patients with inoperable, recurrent abdominal cancer. In a phase II study, 59 patients with various non-resectable abdominal tumours were treated with 102 perfusions by the HAP-technique. The HAP-technique was performed by using double-balloon arterial-venous catheters that selectively isolated the abdominal vascular section and perfusion was provided by an extracorporal pump for 20 min. Thirty-four patients with unresectable colorectal cancer, 11 with unresectable gastric cancer, eight with unresectable pancreatic cancer and six with cancer of the gall bladder were included. They were treated with a combination of 5-fluorouracil (5-FU 1 g/m(2)), mitomycin C (MMC, 10 mg/m(2)) plus cisplatin (50 mg/m(2)) infused into the isolated abdominal compartment. The cytostatic concentration of 5-FU was determined intrainterventionally within the systemic and regional compartment. Toxicity- and procedure-related complications were documented. Tumour responses were assessed by computer tomography. 5-FU concentration was 16.3-fold higher within the regional compared to the systemic compartment at its maximum, and the area under the curve (AUC) was 7.9 times larger. During the procedure two major complications were experienced (1x perforation of the A. iliaca, lx deep vein thrombosis), no deaths occurred during surgery or in the postoperative period. Minimal systemic and local toxicities were observed (WHO grade III-IV 1%, grade I-II 33%). No complete response but 22 partial responses were observed. Median survival was 15.5 months for colorectal cancer, 12. 5 months for gastric cancer, 12.7 months for pancreatic cancer and 7.8 months for gall bladder cancer. The hypoxic abdominal perfusion is a safe and effective palliative treatment for patients with unresectable advanced colorectal, gastric and pancreatic carcinoma. The HAP

  18. Change in regional pulmonary perfusion as a result of posture and lung volume assessed using technetium-99m macroaggregated albumin single-photon emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kosuda, Shigeru; Kusano, Shoichi [Department of Radiology, National Defense Medical College, Tokorozawa (Japan); Kobayashi, Hideo [Department of Internal Medicine, National Defense Medical College, Tokorozawa (Japan)

    2000-05-01

    The purpose of this study was to evaluate the effects of gravity and lung volume on regional pulmonary perfusion using technetium-99m macroaggregated albumin ({sup 99m}Tc MAA) single-photon emission tomography (SPET). Twenty-five subjects were classified into three groups according to their position during the injection of the tracer [11 subjects sitting, six supine and eight both supine and prone (S+P) positions]. All of these subjects were injected with the tracer during normal tidal breathing. In the S+P group, half of the tracer was injected while the subject was in each position. The remaining 11 subjects were classified into two groups according to their lung volume during the injection. Supine patients were instructed to hold their breath at residual volume (RV) (five subjects) or total lung capacity (TLC) (six subjects) while receiving the tracer injection. A region of interest with a ventrodorsal axis was defined in the centre of each lung. Profile curves were produced by plotting and normalizing the perfusion values as a percentage of the maximum value. The perfusion distributions for the sitting and S+P positions and at RV were relatively uniform. However, the distributions for the supine position and at TLC showed a gravitational influence [sitting vs TLC: 87.8%{+-}10.4% vs 67.3%{+-}8.7% for % maximum perfusion at +5 pixels from the midpoint of the upper lobe (P<0.00002)]. The gravity-related perfusion inhomogeneity was more prominent in the lower lobe than in the upper lobe. It is concluded that the physiological vertical gravitational gradient should be taken into consideration during the interpretation of lung SPET images. Preferably, patients should be injected with the tracer twice, once in the supine position and once in the prone position, while breathing normally. Alternatively, they may be injected with the tracer once while in the supine position and holding their breath at RV. Either of these protocols should ensure a uniform distribution of

  19. Assessment of collateralized myocardium with Cardiac Magnetic Resonance (CMR): transmural extent of infarction but not angiographic collateral vessel filling determines regional function and perfusion in collateral-dependent myocardium.

    Science.gov (United States)

    Muehling, Olaf; Jerosch-Herold, Michael; Cyran, Clemens; Huber, Armin; Schoenberg, Stefan; Reiser, Maximilian; Steinbeck, Gerhard; Nabauer, Michael

    2007-08-09

    Angiographic collateral vessel filling is limited to evaluate collateral-dependent myocardium. We hypothesize, that quantitative assessment of regional myocardial function, perfusion and viability with Cardiac Magnetic Resonance (CMR) adds complementary information to angiography of collateralized myocardium. CMR was performed in 30 patients with one chronic occluded coronary artery and no further flow limiting stenosis to assess transmural extend of infarction (TEI), resting perfusion and perfusion during adenosine-induced hyperemia and regional wall thickening (RWT) in collateral-dependent and antegradely-perfused myocardium. Collateral vessels were evaluated by angiography and the Rentrop grade (0-3). In 15 patients with or = 50% TEI in collateral-dependent myocardium resting perfusion and hyperemia as well as RWT were significantly lower (rest 0.84+/-0.19, p<0.001 and hyperemia 1.34+/-0.43 ml/min/g, p<0.001; RWT 1.0+/-1.0 mm, p<0.0001) compared to antegradely-perfused myocardium. There was an inverse correlation between TEI and resting or hyperemic perfusion or RWT. In contrary, resting perfusion and hyperemia as well as RWT in collateral-dependent myocardium were not different between patients with good (2-3) compared to patients with poor Rentrop grade (0-1). There was no correlation between TEI and Rentrop grade. Function and perfusion in collateral-dependent myocardium are preserved, if transmural extent of infarction is limited (< 50%). This is independent of their angiographic collateral vessel filling. Thus, CMR adds complementary information to angiographic standard assessment of collateral vessels.

  20. Arterial spin-labeling perfusion imaging of childhood meningitis: a case series.

    Science.gov (United States)

    Wong, Alex Mun-Ching; Yeh, Chih-Hua; Liu, Ho-Ling; Lin, Kuang-Lin; Wang, Huei-Shyong; Toh, Cheng-Hong

    2016-03-01

    Conventional magnetic resonance imaging (MRI), which is mainly used to detect complications, is ineffective in determining the neurological status of patients with meningitis. Hemodynamic change in the brain may be more indicative of the neurological status but few imaging studies have verified this. Arterial spin-labeling (ASL) perfusion, a noninvasive MR method requiring no contrast agent injection, can be used to measure cerebral blood flow (CBF). We describe three pediatric patients with meningitis, who all showed regions of increased CBF on perfusion imaging. One patient, presenting with headache and conscious disturbance, had CBF changes in the frontal, temporal, and occipital regions. The other two patients, presenting with hallucinations, memory deficits, and seizures, had CBF changes in the frontal and temporal regions. ASL perfusion imaging may be helpful in assessing patients with meningitis, demonstrating CBF changes more strongly correlating with the neurological status, and detecting active brain abnormalities.

  1. Abnormal cervical cytology risk factors in the Western Black Sea Region and the importance of health insurance.

    Science.gov (United States)

    Sımavli, Serap; Kaygusuz, Ikbal; Cukur, Selma; Aksel, Ferda

    2014-01-01

    To evaluate the prevalence of abnormal cervical cytological findings in the Western Black Sea Region and investigate an association between socio-demographic risk factors and the presence of cytological abnormalities. The reports of 11,539 cervical smears diagnosed according to Bethesda System 2001 version in the Pathology Department between January 2011 and December 2012 were reviewed retrospectively from the hospital records and cytopathology reports. Repeated smear results, unsatisfactory smear results, patients with known gynecologic malignancy history, smear results of patients with hysterectomy and smear results of patients whose socio-demographic information could not be obtained were excluded from the evaluation. The results of 7,740 patients who met the criteria for the study were evaluated. The prevalence of cervical cytological abnormalities was 1.8 % in general. The prevalence rates for atypical squamous cells with undetermined significance (ASC-US), atypical squamous cells, cannot exclude a high-grade squamous intraepithelial lesion (ASC-H), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and atypical glandular cells (AGC) were 1.16%, 0.11%, 0.29%, 0.15%, and 0.03% respectively. The prevalence of cytologically diagnosed cervical invasive neoplasia was 0.025%. Advanced age, low education level (primary school or less) and not having health insurance were found as to be risk factors for preinvasive and invasive lesions. Women who had a high school education and previously had a smear test had decreased risk for developing preinvasive and invasive lesions. This study shows prevalence of abnormal cervical cytology findings and associated risk factors in the Western Black Sea Region of Turkey. The most important risk factor was identified as not having health insurance.

  2. Combined evaluation of regional coronary artery calcium and myocardial perfusion by82Rb PET/CT in the identification of obstructive coronary artery disease.

    Science.gov (United States)

    Zampella, Emilia; Acampa, Wanda; Assante, Roberta; Nappi, Carmela; Gaudieri, Valeria; Mainolfi, Ciro Gabriele; Green, Roberta; Cantoni, Valeria; Panico, Mariarosaria; Klain, Michele; Petretta, Mario; Slomka, Piotr J; Cuocolo, Alberto

    2018-01-25

    Cardiac imaging with PET/CT allows measurement of coronary artery calcium (CAC), myocardial perfusion and coronary vascular function. We investigated whether the combined assessment of regional CAC score, ischemic total perfusion deficit (ITPD) and quantitative coronary vascular function would further improve the diagnostic accuracy of PET/CT in predicting obstructive coronary artery disease (CAD). We analyzed 113 patients with suspected CAD referred to 82 Rb PET/CT myocardial perfusion imaging with available coronary angiographic data. Obstructive CAD was defined as ≥75% stenosis. The receiver operating characteristic area under curve (AUC) was applied to evaluate the ability of CAC score, ITPD, hyperemic myocardial blood flow (MBF) and coronary flow reserve (CFR) to identify CAD. Vessels with obstructive CAD (71 vessels) had higher ITPD (4.6 ± 6.2 vs. 0.6 ± 1.3) and lower hyperemic MBF (1.01 ± 0.5 vs. 1.75 ± 0.6 ml/min/g) and CFR (1.56 ± 0.6 vs. 2.38 ± 0.7; all p < 0.001) than those without. In prediction of per-vessel CAD, the AUCs for the models including CAC/ITPD/hyperemic MBF (0.869) and CAC/ITPD/CFR (0.875) were higher (both p < 0.01) than for the model including CAC/ITPD (0.790). Compared with CAC/ITPD, continuous net reclassification improvement was 0.69 (95% bootstrap confidence interval, CI, 0.365-1.088) for the CAC/ITPD/hyperemic MBF model and 0.99 (95% bootstrap CI 0.64-1.26) for the CAC/ITPD/CFR model. Hyperemic MBF and CFR provide incremental information about the presence of CAD over CAC score and perfusion imaging parameters. The combined use of CAC, myocardial perfusion imaging and quantitative coronary vascular function in may help predict more accurately the presence of obstructive CAD.

  3. Brain tissue- and region-specific abnormalities on volumetric MRI scans in 21 patients with Bardet-Biedl syndrome (BBS

    Directory of Open Access Journals (Sweden)

    Johnston Jennifer

    2011-07-01

    Full Text Available Abstract Background Bardet-Biedl syndrome (BBS is a heterogeneous human disorder inherited in an autosomal recessive pattern, and characterized by the primary findings of obesity, polydactyly, hypogonadism, and learning and behavioural problems. BBS mouse models have a neuroanatomical phenotype consisting of third and lateral ventriculomegaly, thinning of the cerebral cortex, and reduction in the size of the corpus striatum and hippocampus. These abnormalities raise the question of whether humans with BBS have a characteristic morphologic brain phenotype. Further, although behavioral, developmental, neurological and motor defects have been noted in patients with BBS, to date, there are limited reports of brain findings in BBS. The present study represents the largest systematic evaluation for the presence of structural brain malformations and/or progressive changes, which may contribute to these functional problems. Methods A case-control study of 21 patients, most aged 13-35 years, except for 2 patients aged 4 and 8 years, who were diagnosed with BBS by clinical criteria and genetic analysis of known BBS genes, and were evaluated by qualitative and volumetric brain MRI scans. Healthy controls were matched 3:1 by age, sex and race. Statistical analysis was performed using SAS language with SAS STAT procedures. Results All 21 patients with BBS were found to have statistically significant region- and tissue-specific patterns of brain abnormalities. There was 1 normal intracranial volume; 2 reduced white matter in all regions of the brain, but most in the occipital region; 3 preserved gray matter volume, with increased cerebral cortex volume in only the occipital lobe; 4 reduced gray matter in the subcortical regions of the brain, including the caudate, putamen and thalamus, but not in the cerebellum; and 5 increased cerebrospinal fluid volume. Conclusions There are distinct and characteristic abnormalities in tissue- and region- specific volumes

  4. Diffusion- and perfusion-weighted MRI in a patient with a prolonged reversible ischaemic neurological deficit

    International Nuclear Information System (INIS)

    Neumann-Haefelin, T.; Wittsack, H.J.; Wenserski, F.; Li, T.Q.; Moseley, M.E.; Siebler, M.; Freund, H.J.

    2000-01-01

    We report acute and follow-up diffusion- and perfusion-weighted MRI (DWI, PWI) findings in a patient with a prolonged reversible ischaemic neurological deficit. PWI 12 h after the patient was last seen to be without symptoms revealed a large perfusion deficit in the left posterior MCA territory with a relatively inconspicuous and much smaller abnormality on DWI. Follow-up showed resolution of abnormalities on both DWI and PWI, and conventional MRI was normal, apart from a very slight abnormality, visible only on FLAIR images, at the centre of the initially DWI-positive region. These findings demonstrate the utility of PWI when be used in combination with DWI to investigate the pathophysiology of transient ischemic syndromes. (orig.)

  5. Electroencephalography reveals lower regional blood perfusion and atrophy of the temporoparietal network associated with memory deficits and hippocampal volume reduction in mild cognitive impairment due to Alzheimer’s disease

    Directory of Open Access Journals (Sweden)

    Moretti DV

    2015-02-01

    Full Text Available Davide Vito MorettiNational Institute for the research and cure of Alzheimer’s disease, S. John of God, Fatebenefratelli, Brescia, Italy Background: An increased electroencephalographic (EEG upper/lower alpha power ratio has been associated with less regional blood perfusion, atrophy of the temporoparietal region of the brain, and reduction of hippocampal volume in subjects affected by mild cognitive impairment due to Alzheimer’s disease as compared with subjects who do not develop the disease. Moreover, EEG theta frequency activity is quite different in these groups. This study investigated the correlation between biomarkers and memory performance.Methods: EEG α3/α2 power ratio and cortical thickness were computed in 74 adult subjects with prodromal Alzheimer’s disease. Twenty of these subjects also underwent assessment of blood perfusion by single-photon emission computed tomography (SPECT. Pearson’s r was used to assess the correlation between cortical thinning, brain perfusion, and memory impairment.Results: In the higher α3/α2 frequency power ratio group, greater cortical atrophy and lower regional perfusion in the temporoparietal cortex was correlated with an increase in EEG theta frequency. Memory impairment was more pronounced in the magnetic resonance imaging group and SPECT groups.Conclusion: A high EEG upper/low alpha power ratio was associated with cortical thinning and less perfusion in the temporoparietal area. Moreover, atrophy and less regional perfusion were significantly correlated with memory impairment in subjects with prodromal Alzheimer’s disease. The EEG upper/lower alpha frequency power ratio could be useful for identifying individuals at risk for progression to Alzheimer’s dementia and may be of value in the clinical context.Keywords: electroencephalography, perfusion, atrophy, temporoparietal network, memory deficits, hippocampal volume, mild cognitive impairment, Alzheimer’s disease

  6. SPM analysis of brain perfusion SPECT and F-18 FDG PET in the Korean autosomal dominant nocturnal frontal lobe epilepsy family

    International Nuclear Information System (INIS)

    Won, Kyoung Sook; Zeon, Seok Kil

    2004-01-01

    This study attempted to investigate the specific pattern of brain perfusion and glucose metabolism in the Korean autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) family. Using Tc-99m ECD brain perfusion SPECT. we assessed brain perfusion in 6 patients at interictal period and 5 patients at ictal period. Interictal F-18 FDG PET was performed on 6 affected family members. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The data of the affected family members were compared to those of the control subjects. Interictal F-18 FDG PET SPM group analysis showed decreased glucose metabolism over the left middle and superior frontal gyri and the left central regions including the anterior parietal lobe. There was a less pronounced decrease in glucose uptake in the right anterior superior frontal gyrus. Interictal brain perfusion SPECT SPM group analysis showed similar pattern of decreased perfusion compared to those of interictal F-18 FDG PET. Ictal brain perfusion SPECT SPM group analysis revealed increased perfusion over the left pre-and postcentral gyri and less pronounced increased perfusion in the right postcentral gyrus. lnterictal F -18 PET and brain perfusion SPECT SPM group analysis suggest that major abnormalities of ADNFLE family are in the left frontal lobe. These findings may be helpful to elucidate the pathophysiological mechanism of this rare disease entity

  7. Ventilation and ventilation/perfusion ratios

    International Nuclear Information System (INIS)

    Valind, S.O.

    1989-01-01

    The thesis is based on five different papers. The labelling of specific tracer compounds with positron emitting radionuclides enables a range of structural, physiological and biochemical parameters in the lung to be measured non-invasively, using positron emission tomography. This concept affords a unique opportunity for in vivo studies of different expressions of pulmonary pathophysiology at the regional level. The present thesis describes the application of positron emission tomography to the measurements of ventilation and ventilation/perfusion ratios using inert gas tracers, neon-19 and nitrogen-13 respectively. The validity of the methods applied was investigated with respect to the transport of inert gas tracers in the human lung. Both ventilation and the ventilation/perfusion ratio may be obtained with errors less than 10 % in the normal lung. In disease, however, errors may increase in those instances where the regional ventilation is very low or the intra-regional gas flow distribution is markedly nonuniform. A 2-3 fold increase in ventilation was demonstrated in normal nonsmoking subjects going from ventral to dorsal regions in the supine posture. These large regional differences could be well explained by the intrinsic elastic properties of lung tissue, considering the gravitational gradient in transpulmonary pressure. In asymptomatic smokers substantial regional ventilatroy abnormalities were found whilst the regional gas volume was similar in smokers and nonsmokers. The uncoupling between ventilation and gas volume probably reflects inflammatory changes in the airways. The regional differences in dV/dt/dQ/dt were relatively small and blood flow was largely matched to ventilation in the supine posture. However, small regions of lung with very low ventilation, unmatched by blood flow commonly exists in the most dependent parts of the lung in both smokers and nonsmokers. (29 illustrations, 7 tables, 113 references)

  8. Apathy is associated with white matter abnormalities in anterior, medial brain regions in persons with HIV infection

    Science.gov (United States)

    Kamat, Rujvi; Brown, Gregory G.; Bolden, Khalima; Fennema-Notestine, Christine; Archibald, Sarah; Marcotte, Thomas D.; Letendre, Scott L.; Ellis, Ronald J.; Woods, Steven Paul; Grant, Igor; Heaton, Robert K.

    2015-01-01

    Apathy is a relatively common psychiatric syndrome in HIV infection, but little is known about its neural correlates. In the present study, we examined the associations between apathy and diffusion tensor imaging (DTI) indices in key frontal white matter regions in the thalamocorticostriatal circuit that has been implicated in the expression of apathy. Nineteen participants with HIV infection and 19 demographically comparable seronegative comparison subjects completed the Apathy subscale of the Frontal Systems Behavioral Scale as a part of a comprehensive neuropsychiatric research evaluation. When compared to the seronegative participants, the HIV+ group had significantly more frontal white matter abnormalities. Within HIV+ persons, and as predicted, higher ratings of apathy were associated with greater white matter alterations in the anterior corona radiata, genu, and orbital medial prefrontal cortex. The associations between white matter alterations and apathy were independent of depression and were stronger among participants with lower current CD4 counts. All told, these findings indicate that apathy is independently associated with white matter abnormalities in anterior, medial brain regions in persons infected with HIV, particularly in the setting of lower current immune functioning, which may have implications for antiretroviral therapy. PMID:25275424

  9. Adaptive optics imaging of healthy and abnormal regions of retinal nerve fiber bundles of patients with glaucoma.

    Science.gov (United States)

    Chen, Monica F; Chui, Toco Y P; Alhadeff, Paula; Rosen, Richard B; Ritch, Robert; Dubra, Alfredo; Hood, Donald C

    2015-01-08

    To better understand the nature of glaucomatous damage of the macula, especially the structural changes seen between relatively healthy and clearly abnormal (AB) retinal regions, using an adaptive optics scanning light ophthalmoscope (AO-SLO). Adaptive optics SLO images and optical coherence tomography (OCT) vertical line scans were obtained on one eye of seven glaucoma patients, with relatively deep local arcuate defects on the 10-2 visual field test in one (six eyes) or both hemifields (one eye). Based on the OCT images, the retinal nerve fiber (RNF) layer was divided into two regions: (1) within normal limits (WNL), relative RNF layer thickness within mean control values ±2 SD; and (2) AB, relative thickness less than -2 SD value. As seen on AO-SLO, the pattern of AB RNF bundles near the border of the WNL and AB regions differed across eyes. There were normal-appearing bundles in the WNL region of all eyes and AB-appearing bundles near the border with the AB region. This region with AB bundles ranged in extent from a few bundles to the entire AB region in the case of one eye. All other eyes had a large AB region without bundles. However, in two of these eyes, a few bundles were seen within this region of otherwise missing bundles. The AO-SLO images revealed details of glaucomatous damage that are difficult, if not impossible, to see with current OCT technology. Adaptive optics SLO may prove useful in following progression in clinical trials, or in disease management, if AO-SLO becomes widely available and easy to use. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  10. Perinatal factors and regional brain volume abnormalities at term in a cohort of extremely low birth weight infants.

    Directory of Open Access Journals (Sweden)

    Nehal A Parikh

    Full Text Available Our objective was to investigate diverse clinical antecedents of total and regional brain volume abnormalities and white matter hyperintensity volume on term MRI in extremely low birth weight (birth weight ≤1000 g survivors. A consecutive cohort of extremely low birth weight infants who survived to 38 weeks postmenstrual age (n = 122 and a control group of 16 healthy term newborns underwent brain MRI at term-equivalent age. Brain volumes were measured using semi-automated and manual segmentation methods. Using multivariable linear regression, clinical antecedents were correlated with volumes of total brain tissue, white matter hyperintensities, and regional tissues/structures, adjusted for age at MRI, total cranial volume, and total tissue volume. Regional brain volumes were markedly reduced in extremely low birth weight infants as compared to term newborns (relative difference range: -11.0%, -35.9%. Significant adverse clinical associations for total brain tissue volume included: small for gestational age, seizures, caffeine therapy/apnea of prematurity, duration of parenteral nutrition, pulmonary hemorrhage, and white matter injury (p<0.01 for each; relative difference range: -1.4% to -15.0%. Surgery for retinopathy of prematurity and surgery for necrotizing enterocolitis or spontaneous intestinal perforation were significantly associated with increasing volume of white matter hyperintensities. Regional brain volumes are sensitive to multiple perinatal factors and neonatal morbidities or interventions. Brain growth measurements in extremely low birth weight infants can advance our understanding of perinatal brain injury and development.

  11. Dynamic contrast enhanced MRI for perfusion quantification

    DEFF Research Database (Denmark)

    Andersen, Irene Klærke

    2002-01-01

    Magnetic resonance imaging, during bolus passage of a paramagnetic contrast agent, is used world-wide to obtain parameters that reflect the pathological state of tissue. Abnormal perfusion occurs in diseases such as stoke and tumour. Consequently, perfusion quantication could have signi cant...... the contrastagent concentration, [Ca], and the changes in R2 or R 2 has been questioned. In this thesis, an MRI scanner sequence for detection of the longitudinal relaxation rate, R1 during bolus passage was modied for brain perfusion measurements, since the linearity between the changes in R1 and [Ca] is expected...... to be more robust. Successful brain perfusion quantication based on R1 weighted signals has not previously been reported, due to the poor signal to noise ratio of the images. Initial experiments reported in this thesis show that improved sequence may provide more accurate perfusion estimates in the brain...

  12. Global adiposity rather than abnormal regional fat distribution characterizes women with polycystic ovary syndrome.

    Science.gov (United States)

    Barber, Thomas M; Golding, Stephen J; Alvey, Christopher; Wass, John A H; Karpe, Fredrik; Franks, Stephen; McCarthy, Mark I

    2008-03-01

    Obesity-related predisposition to polycystic ovary syndrome (PCOS) could reflect overall adiposity and/or regional accumulation of abdominal visceral fat. The objective of the study was to compare distributions of visceral, abdominal sc, and gluteofemoral sc adipose tissue in PCOS cases vs. control women. This was a cross-sectional study. Fat depot measurements from axial magnetic resonance imaging scans taken at anatomically predefined sites were compared between 22 body mass index (BMI)/fat mass-matched pairs of PCOS cases and controls; whole-group comparisons included 50 PCOS cases vs. 28 female controls. All subjects were of UK British/Irish origin. We measured cross-sectional areas of adipose tissue within visceral (mid-L4), abdominal (mid-L4) sc, and gluteofemoral (greater trochanteric and midfemoral) sc fat depots. Other measurements included fat mass, BMI, testosterone, SHBG, and homeostasis model assessment of insulin resistance (a measure of insulin sensitivity). Whole-group analyses were adjusted for fat mass and age. There were no significant differences in fat-depot measurements between BMI/fat mass-matched pairs of PCOS cases and controls: mid-L4 visceral (P=0.40), abdominal sc (P=0.22), gluteal sc (P=0.67), and midfemoral sc (P=0.37) depots. Whole-group comparisons gave similar results after adjustments for fat mass and age. Fasting serum insulin concentrations (P=0.03) and homeostasis model assessment of insulin resistance (P=0.03) were significantly higher in the PCOS group than BMI/fat mass-matched controls. PCOS cases and BMI/fat mass-matched control women are indistinguishable with respect to distribution of fat within visceral, abdominal sc, and gluteofemoral sc depots, despite significant differences in insulin resistance between these two groups.

  13. Brain perfusion and markers of neurodegeneration in rapid eye movement sleep behavior disorder.

    Science.gov (United States)

    Vendette, Mélanie; Gagnon, Jean-François; Soucy, Jean-Paul; Gosselin, Nadia; Postuma, Ronald B; Tuineag, Maria; Godin, Isabelle; Montplaisir, Jacques

    2011-08-01

    Potential early markers of neurodegeneration such as subtle motor signs, reduced color discrimination, olfactory impairment, and brain perfusion abnormalities have been reported in idiopathic rapid eye movement sleep behavior disorder, a risk factor for Parkinson's disease and Lewy body dementia. The aim of this study was to reproduce observations of regional cerebral blood flow abnormalities in a larger independent sample of patients and to explore correlations between regional cerebral blood flow and markers of neurodegeneration. Twenty patients with idiopathic rapid eye movement sleep behavior disorder and 20 healthy controls were studied by single-photon emission computerized tomography. Motor examination, color discrimination, and olfactory identification were examined. Patients with rapid eye movement sleep behavior disorder showed decreased regional cerebral blood flow in the frontal cortex and in medial parietal areas and increased regional cerebral blood flow in subcortical regions including the bilateral pons, putamen, and hippocampus. In rapid eye movement sleep behavior disorder, brain perfusion in the frontal cortex and occipital areas was associated with poorer performance in the color discrimination test. Moreover, a relationship between loss of olfactory discrimination and regional cerebral blood flow reduction in the bilateral anterior parahippocampal gyrus, a region known to be involved in olfactory functions, was found. This study provides further evidence of regional cerebral blood flow abnormalities in rapid eye movement sleep behavior disorder that are similar to those seen in Parkinson's disease and Lewy body dementia. Moreover, regional cerebral blood flow anomalies were associated with markers of neurodegeneration. Copyright © 2011 Movement Disorder Society.

  14. C-Arm Conebeam CT Perfusion Imaging in the Angiographic Suite: A Comparison with Multidetector CT Perfusion Imaging.

    Science.gov (United States)

    Niu, K; Yang, P; Wu, Y; Struffert, T; Doerfler, A; Schafer, S; Royalty, K; Strother, C; Chen, G-H

    2016-07-01

    Perfusion imaging in the angiography suite may provide a way to reduce time from stroke onset to endovascular revascularization of patients with large-vessel occlusion. Our purpose was to compare conebeam CT perfusion with multidetector CT perfusion. Data from 7 subjects with both multidetector CT perfusion and conebeam CT perfusion were retrospectively processed and analyzed. Two algorithms were used to enhance temporal resolution and temporal sampling density and reduce the noise of conebeam CT data before generating perfusion maps. Two readers performed qualitative image-quality evaluation on maps by using a 5-point scale. ROIs indicating CBF/CBV abnormalities were drawn. Quantitative analyses were performed by using the Sørensen-Dice coefficients to quantify the similarity of abnormalities. A noninferiority hypothesis was tested to compare conebeam CT perfusion against multidetector CT perfusion. Average image-quality scores for multidetector CT perfusion and conebeam CT perfusion images were 2.4 and 2.3, respectively. The average confidence score in diagnosis was 1.4 for both multidetector CT and conebeam CT; the average confidence scores for the presence of a CBV/CBF mismatch were 1.7 (κ = 0.50) and 1.5 (κ = 0.64). For multidetector CT perfusion and conebeam CT perfusion maps, the average scores of confidence in making treatment decisions were 1.4 (κ = 0.79) and 1.3 (κ = 0.90). The area under the visual grading characteristic for the above 4 qualitative quality scores showed an average area under visual grading characteristic of 0.50, with 95% confidence level cover centered at the mean for both readers. The Sørensen-Dice coefficient for CBF maps was 0.81, and for CBV maps, 0.55. After postprocessing methods were applied to enhance image quality for conebeam CT perfusion maps, the conebeam CT perfusion maps were not inferior to those generated from multidetector CT perfusion. © 2016 by American Journal of Neuroradiology.

  15. Value of multidetector computed tomography evaluation of myocardial perfusion in the assessment of ischemic heart disease: comparison with nuclear perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kachenoura, Nadjia; Lodato, Joseph A.; Bardo, Dianna M.E.; Newby, Barbara; Lang, Roberto M.; Mor-Avi, Victor [University of Chicago Medical Center, Chicago, IL (United States); Gaspar, Tamar; Gips, Sarah; Peled, Nathan [Lady Davis Carmel Medical Center, Haifa (Israel)

    2009-08-15

    MDCT-derived myocardial perfusion has not yet been validated against accepted standards. We developed a technique for quantification of myocardial perfusion from MDCT images and studied its diagnostic value against SPECT myocardial perfusion imaging (MPI). Ninety-eight patients were studied. Abnormal perfusion was detected by comparing normalized segmental x-ray attenuation against values obtained in 20 control subjects. Disagreement with resting MPI was investigated in relationship to MDCT image quality, severity of MPI abnormalities, and stress MPI findings. Resting MPI detected mild or worse abnormalities in 20/78 patients. MDCT detected abnormalities in 15/20 patients (sensitivity of 0.75). Most abnormalities missed by MDCT analysis were graded as mild on MPI. Additional abnormalities found in 16/78 patients were not confirmed on resting MPI (specificity of 0.72). However, 8 of these 16 apparently false positive MDCT perfusion tests had abnormal stress MPI; of these 8 patients, 7 had optimal MDCT image quality, while in 6/8 remaining patients, image quality was suboptimal. When compared with resting MPI, MDCT detected perfusion abnormalities with high accuracy. Moreover, half of MDCT perfusion abnormalities not confirmed by resting MPI were associated with abnormal stress MPI. Importantly, this information can be obtained without additional radiation dose or contrast agent. (orig.)

  16. Alterations of the Blood-Brain Barrier and Regional Perfusion in Tumor Development: MRI Insights from a Rat C6 Glioma Model.

    Directory of Open Access Journals (Sweden)

    Monika Huhndorf

    Full Text Available Angiogenesis and anti-angiogenetic medications play an important role in progression and therapy of glioblastoma. In this context, in vivo characterization of the blood-brain-barrier and tumor vascularization may be important for individual prognosis and therapy optimization.We analyzed perfusion and capillary permeability of C6-gliomas in rats at different stages of tumor-growth by contrast enhanced MRI and dynamic susceptibility contrast (DSC MRI at 7 Tesla. The analyses included maps of relative cerebral blood volume (CBV and signal recovery derived from DSC data over a time period of up to 35 days after tumor cell injections.In all rats tumor progression was accompanied by temporal and spatial changes in CBV and capillary permeability. A leakage of the blood-brain barrier (slow contrast enhancement was observed as soon as the tumor became detectable on T2-weighted images. Interestingly, areas of strong capillary permeability (fast signal enhancement were predominantly localized in the center of the tumor. In contrast, the tumor rim was dominated by an increased CBV and showed the highest vessel density compared to the tumor center and the contralateral hemisphere as confirmed by histology.Substantial regional differences in the tumor highlight the importance of parameter maps in contrast or in addition to region-of-interest analyses. The data vividly illustrate how MRI including contrast-enhanced and DSC-MRI may contribute to a better understanding of tumor development.

  17. The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy patients with or without left ventricular outflow tract obstruction: Assessment with first-pass perfusion imaging using 3.0-T cardiac magnetic resonance

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Hua-yan [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Yang, Zhi-gang, E-mail: yangzg666@163.com [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Sun, Jia-yu; Wen, Ling-yi; Zhang, Ge; Zhang, Shuai [Department of Radiology, National Key Laboratory of Biotherapy, West China Hospital, Sichuan University, 37# Guo Xue Xiang, Chengdu, Sichuan 610041 (China); Guo, Ying-kun [Department of Radiology, West China Second University Hospital, Sichuan University (China)

    2014-04-15

    Purpose: To assess regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction using 3.0-T cardiac magnetic resonance (CMR) first-pass perfusion imaging. Materials and methods: Forty-two HCM patients, including 25 HCM patients with left ventricular outflow tract obstruction (HOCM), 17 HCM patients without left ventricular outflow tract obstruction (NOHCM), and 14 healthy subjects underwent CMR. The left ventricular (LV) function, left ventricular end-diastolic wall thickness (EDTH), and diameter of left ventricular outflow tract (LVOT) were measured and calculated. Based on the signal–time curve of the first-pass myocardium perfusion imaging, perfusion parameters including upslope, time to peak, and peak intensity, were assessed and compared by using one-way analysis of variance and independent t tests. Results: On the first-pass perfusion imaging, lower upslope and peak intensity and longer time to peak were found in HCM patients compared with normal subjects (all p < 0.05). In contrast to the NOHCM group, the average time to peak of the HOCM group was increased (13.30 ± 4.82 s vs 16.28 ± 4.90 s, p < 0.05), but first-pass perfusion upslope was reduced (4.96 ± 2.55 vs 2.58 ± 0.77, p < 0.05). According to the bull's-eye model, the HOCM group's average thickness of basal segments was thicker than the NOHCM group, especially the anteroseptal, inferolateral, and anterior wall values, with a corresponding lower first-pass perfusion upslope than the NOHCM group (all p < 0.05). A significant correlation was observed between first-pass perfusion upslope and LV EDTH (r = −0.551, p < 0.001) and LVOT diameter (r = 0.472, p < 0.001). Conclusions: The regional myocardial microvascular dysfunction differences in hypertrophic cardiomyopathy (HCM) patients with or without left ventricular outflow tract obstruction can be detected with first-pass perfusion CMR

  18. PET scan perfusion imaging in the Prader-Willi syndrome: new insights into the psychiatric and social disturbances

    International Nuclear Information System (INIS)

    Mantoulan, C.; Payoux, P.; Mantoulan, C.; Diene, G.; Glattard, M.; Molinas, C.; Tauber, M.; Payoux, P.; Sevely, A.; Glattard, M.; Roge, B.; Molinas, C.; Tauber, M.; Zilbovicius, M.; Celsis, P.; Celsis, P.

    2011-01-01

    The Prader-Willi syndrome (PWS), a rare multisystem genetic disease, leads to severe disabilities, such as morbid obesity, endocrine dysfunctions, psychiatric disorders, and social disturbances. We explored the whole brain of patients with PWS to detect abnormalities that might explain the behavioral and social disturbances, as well as the psychiatric disorders of these patients. Nine patients with PWS (six males, three females; mean age 16.4 years) underwent a positron emission tomography (PET) scan with H(2)(15)O as a tracer to measure regional cerebral blood flow (rCBF). The images were compared with those acquired from nine controls (six males, three females; mean age 21.2 years). A morphologic magnetic resonance imaging (MRI) was also performed in PWS patients, and their cognitive and behavioral skills were assessed with Wechsler Intelligence Scale for Children III and the Child Behavior Check List (CBCL). The MRI images showed no evident anatomic abnormalities, whereas PET scans revealed hypo-perfused brain regions in PWS patients compared with controls, particularly in the anterior cingulum and superior temporal regions. We observed a significant relationship (P≤0.05) between rCBF in the hypo-perfused regions and CBCL scores. The functional consequences of these perfusion abnormalities in specific brain regions might explain the behavioral and social problems observed in these individuals. (authors)

  19. Changes in Global Function and Regional Ventilation and Perfusion on SPECT During the Course of Radiotherapy in Patients With Non-Small-Cell Lung Cancer

    International Nuclear Information System (INIS)

    Yuan Shuanghu; Frey, Kirk A.; Gross, Milton D.; Hayman, James A.; Arenberg, Doug; Cai Xuwei; Ramnath, Nithya; Hassan, Khaled; Moran, Jean; Eisbruch, Avraham; Ten Haken, Randall K.; Kong Fengming

    2012-01-01

    Purpose: This study aimed to (1) examine changes in dyspnea, global pulmonary function test (PFT) results, and functional activity on ventilation (V)/perfusion (Q) single-photon emission computerized tomography (SPECT) scans during the course of radiation (RT), and (2) factors associated with the changes in patients with non-small-cell lung cancer (NSCLC). Methods and Materials: Fifty-six stage I to III NSCLC patients treated with definitive RT with or without chemotherapy were enrolled prospectively. Dyspnea was graded according to Common Terminology Criteria for Adverse Events version 3.0 prior to and weekly during RT. V/Q SPECT-computed tomography (CT) and PFTs were performed prior to and during RT at approximately 45 Gy. Functions of V and Q activities were assessed using a semiquantitative scoring of SPECT images. Results: Breathing improved significantly at the third week (mean dyspnea grade, 0.8 vs. 0.6; paired t-test p = 0.011) and worsened during the later course of RT (p > 0.05). Global PFT results did not change significantly, while regional lung function on V/Q SPECT improved significantly after ∼45 Gy. The V defect score (DS) was 4.9 pre-RT versus 4.3 during RT (p = 0.01); Q DS was 4.3 pre-RT versus 4.0 during RT (p < 0.01). Improvements in V and Q functions were seen primarily in the ipsilateral lung (V DS, 1.9 pre-RT versus 1.4 during RT, p < 0.01; Q DS, 1.7 pre-RT versus 1.5 during RT, p < 0.01). Baseline primary tumor volume was significantly correlated with pre-RT V/Q DS (p < 0.01). Patients with central lung tumors had greater interval changes in V and Q than those with more peripheral tumors (p <0.05 for both V and Q DS). Conclusions: Regional ventilation and perfusion improved during RT at 45 Gy. This suggests that adaptive planning based on V/Q SPECT during RT may allow sparing of functionally recoverable lung tissue.

  20. Auxílio à detecção de anormalidade perfusional miocárdica utilizando atlas de SPECT e registro de imagens: resultados preliminares Aid in the detection of myocardial perfusion abnormality utilizing SPECT atlas and images registration: preliminary results

    Directory of Open Access Journals (Sweden)

    Rodrigo Donizete Santana de Pádua

    2008-12-01

    standard deviation for each gender and physiological condition. RESULTS: Myocardial perfusion scintigraphy images of one male and one female patient were aligned with the corresponding atlas template image, and voxels with myocardial uptake rates two standard deviations below the mean voxel value of the respective region in the atlas template image were highlighted on the tomographic sections and confirmed as perfusion defects by both observers. CONCLUSION: The present study demonstrated the creation of an atlas of myocardial perfusion scintigraphy with promising results of this tool as an aid in the detection of myocardial perfusion defects. However, further prospective validation with a more representative sample is recommended.

  1. Ventilation/perfusion scintigraphy in children with post-infectious bronchiolitis obliterans: a pilot study.

    Directory of Open Access Journals (Sweden)

    Bo-Qia Xie

    Full Text Available PURPOSE: Childhood post-infectious bronchiolitis obliterans (BO is an infrequent lung disease leading to narrowing and/or complete obliteration of small airways. Ventilation and perfusion (V/Q scan can provide both regional and global pulmonary information. However, only few retrospective researches investigating post-infectious BO involved V/Q scan, the clinical value of this method is unknown. This preliminary prospective study was aimed to evaluate the correlation of V/Q scan with disease severity, pulmonary function test results, and prognosis in children with post-infectious BO. METHODS: Twenty-five post-infectious BO children (18 boys and 7 girls; mean age, 41 months underwent V/Q scan and pulmonary function tests. Patients were followed after their inclusion. Ventilation index and perfusion index obtained from V/Q scan were used to measure pulmonary abnormalities. Spearman's rank correlation test of ventilation index and perfusion index on disease severity, lung function tests indices, and follow-up results were performed. RESULTS: The median follow-up period was 4.6 years (range, 2.2 to 5.0 years. Ventilation index and perfusion index were both correlated with disease severity (r = 0.72, p<0.01 and r = 0.73, p<0.01, but only ventilation index was related to pulmonary function tests results (all p<0.05. In addition, Spearman test yielded significant correlations between perfusion index and prognosis (r = 0.77, p<0.01, and ventilation index and prognosis (r = 0.63, p = 0.01. CONCLUSIONS: For children with post-infectious BO, the present study preliminarily indicated that the degree of ventilation and perfusion abnormalities evaluated by V/Q scan may be used to assess disease severity, and may be predictive of patient's outcome.

  2. Value of cardiac 320-multidetector computed tomography and cardiac magnetic resonance imaging for assessment of myocardial perfusion defects in patients with known chronic ischemic heart disease

    DEFF Research Database (Denmark)

    Qayyum, Abbas Ali; Kühl, Jørgen T; Mathiasen, Anders B

    2013-01-01

    The challenge for therapies targeting perfusion abnormalities is to identify and evaluate the region of interest. The aim of this study was to compare rest and stress myocardial perfusion measured by cardiac multi-detector computed tomography (MDCT) and cardiac magnetic resonance (CMR) imaging...... in patients with invasive coronary angiography demonstrated occluded vessels. Twenty-four patients with refractory angina due to occluded coronary arteries underwent perfusion imaging obtained by 320-MDCT scanner and 1.5 T MR scanner. Rest and adenosine stress images were obtained and interpreted using...... the modified 17-segment American Heart Association model. For the qualitative analysis, each segment was graded according to the following scoring system: 0 = no defect, 1 = hypoperfusion transmural extent 1/2, and 4 = infarct stigmata. In the semiquantitative analysis the perfusion was either scored 0 (normal...

  3. Cerebral perfusion changes in schizophrenia patients evaluated with Tc-99 HMPAO

    International Nuclear Information System (INIS)

    Sehweil, A.; El-Hilu, S.; Jahan, S.; Higazi, E.; Salhat, M.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

    1989-01-01

    Tc-99m HMPAO has been used to image cerebral perfusion changes in 20 chronic schizophrenia patients (19 men and 1 woman), with an average age of 29 years (range, 22-48 years). All were receiving neuroleptic drugs. Twelve had received electroconvulsive therapy. All patients had abnormal studies (except one, which was normal) and poor response to treatment. Ventricular dilation and cerebral atrophy were seen in 11 patients. Seventy-seven focal lesions were detected. Forty-two lesions showed increased HMPAO retention: 26 in the basal ganglia in 14 patients (12, bilateral, two unilateral), 10 along the sylvian fissure in the parietotemporal region, three in the frontal region, and one in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions showed decreased perfusion: 10 parietal, eight frontal, seven temporal, six cerebellar, and four occipital. This study demonstrates the potential value of Tc-99m HMPAO in the study of schizophrenia and other psychiatric disorders

  4. Long-term cigarette smoking is associated with increased myocardial perfusion heterogeneity assessed by positron emission tomography

    International Nuclear Information System (INIS)

    Meeder, J.G.; Blanksma, P.K.; Wall, E.E. van der; Anthonio, R.L.; Willemsen, A.T.M.; Pruim, J.; Vaalburg, W.; Lie, K.I.

    1996-01-01

    The pathophysiology of smoking-related coronary events in patients with normal coronary arteries is incompletely understood. This study was conducted to explore, in subjects without symptoms of cardiovascular disease, the long-term effects of smoking on regional coronary artery vasoactivity, especially during sympathetic stimulation. In ten smoking and ten non-smoking sex- and age-matched healthy volunteers, segmental myocardial perfusion was studied using dynamic parametric nitrogen-13 ammonia positron emission tomography at rest and during sympathetic stimulation evoked by the cold pressor stimulation. Smokers demonstrated a higher myocardial perfusion at rest (116±17 ml/min/100 g vs 96±20 ml/min/100 g, P <0.01) and an impaired myocardial perfusion increase during cold pressor stimulation (1.02±0.15 vs 1.18±0.17, P <0.05). The heterogeneity of perfusion, expressed as coefficient of variation, was significantly different between the smoking and the non-smoking group. The coefficient of variation of segmental myocardial perfusion was higher in smokers at rest (17.5%±4.2% vs 13.5%±1.9%, P <0.05) and during cold pressor stimulation (17.0%±3.2% vs 13.9%±1.8%, P <0.05). We conclude that the long-term effects of smoking in healthy volunteers are associated with (1) increased myocardial perfusion at rest, (2) impaired myocardial perfusion response to cold pressor stimulation, and (3) increased myocardial perfusion heterogeneity both at rest and during cold pressor stimulation. These results may suggest that in healthy subjects the long-term effect of smoking is related to abnormal coronary artery vasoactivity, presumably induced by an interplay of regional endothelial dysfunction and autonomic dysregulation. (orig.). With 1 fig., 1 tab

  5. CT Perfusion of the Head

    Science.gov (United States)

    ... Site Index A-Z CT Perfusion of the Head Computed tomography (CT) perfusion of the head uses ... the Head? What is CT Perfusion of the Head? Computed tomography (CT) perfusion imaging shows which areas ...

  6. Clinical values for abnormal {sup 18}F-FDG uptake in the head and neck region of patients with head and neck squamous cell carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hwan Seo [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Jae Seung [Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Roh, Jong-Lyel, E-mail: rohjl@amc.seoul.kr [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Choi, Seung-Ho; Nam, Soon Yuhl [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Kim, Sang Yoon [Department of Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of); Biomedical Research Institute, Korea Institute of Science and Technology, Seoul (Korea, Republic of)

    2014-08-15

    Highlights: • Abnormal {sup 18}F-FDG uptakes in the head and neck (HN) region can be carefully interpreted as being index primary, second primary cancer (SP) or benign. • {sup 18}F-FDG PET/CT identified 91.9% primary HN squamous cell carcinomas (HNSCC). • The specificity and negative predictive value of {sup 18}F-FDG PET/CT for identification of SP were as high as 98.7% and 99.3%, respectively. • Proper detection of primary tumors and SP in the HN region may promote appropriate therapeutic planning of HNSCC patients. - Abstract: Purpose: Fluorine 18-fluorodeoxyglucose ({sup 18}F-FDG) positron emission tomography (PET)/computed tomography (CT) is used to identify index or second primary cancer (SP) of the head and neck (HN) through changes in {sup 18}F-FDG uptake. However, both physiologic and abnormal lesions increase {sup 18}F-FDG uptake. Therefore, we evaluated {sup 18}F-FDG uptake in the HN region to determine clinical values of abnormal tracer uptake. Methods: A prospective study approved by the institutional review board was conducted in 314 patients with newly diagnosed HN squamous cell carcinoma (HNSCC) and informed consent was obtained from all enrolled patients. The patients received initial staging workups including {sup 18}F-FDG PET/CT and biopsies. All lesions with abnormal HN {sup 18}F-FDG uptake were recorded and most of those were confirmed by biopsies. Diagnostic values for abnormal {sup 18}F-FDG uptake were calculated. Results: Abnormal {sup 18}F-FDG uptake was identified in primary tumors from 285 (91.9%) patients. False-negative results were obtained for 22.3% (23/103) T1 tumors and 2.2% (2/93) T2 tumors (P < 0.001). Thirty-eight regions of abnormal {sup 18}F-FDG uptake were identified in 36 (11.5%) patients: the thyroid (n = 13), maxillary sinus (n = 7), palatine tonsil (n = 6), nasopharynx (n = 5), parotid gland (n = 2) and others (n = 5). Synchronous SP of the HN was identified in eight (2.5%) patients: the thyroid (n = 5), palatine

  7. Improved visualization of delayed perfusion in lung MRI

    International Nuclear Information System (INIS)

    Risse, Frank; Eichinger, Monika; Kauczor, Hans-Ulrich; Semmler, Wolfhard; Puderbach, Michael

    2011-01-01

    Introduction: The investigation of pulmonary perfusion by three-dimensional (3D) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was proposed recently. Subtraction images are generated for clinical evaluation, but temporal information is lost and perfusion defects might therefore be masked in this process. The aim of this study is to demonstrate a simple analysis strategy and classification for 3D-DCE-MRI perfusion datasets in the lung without omitting the temporal information. Materials and methods: Pulmonary perfusion measurements were performed in patients with different lung diseases using a 1.5 T MR-scanner with a time-resolved 3D-GRE pulse sequence. 25 3D-volumes were acquired after iv-injection of 0.1 mmol/kg KG Gadolinium-DTPA. Three parameters were determined for each pixel: (1) peak enhancement S n,max normalized to the arterial input function to detect regions of reduced perfusion; (2) time between arterial peak enhancement in the large pulmonary artery and tissue peak enhancement τ to visualize regions with delayed bolus onset; and (3) ratio R = S n,max /τ was calculated to visualize impaired perfusion, irrespectively of whether related to reduced or delayed perfusion. Results: A manual selection of peak perfusion images is not required. Five different types of perfusion can be found: (1) normal perfusion; (2) delayed non-reduced perfusion; (3) reduced non-delayed perfusion; (4) reduced and delayed perfusion; and (5) no perfusion. Types II and IV could not be seen in subtraction images since the temporal information is necessary for this purpose. Conclusions: The analysis strategy in this study allows for a simple and observer-independent visualization and classification of impaired perfusion in dynamic contrast-enhanced pulmonary perfusion MRI by using the temporal information of the datasets.

  8. Left ventricular systolic wall motion after exercise stress and myocardial perfusion in patients with ischemic heart disease. Investigation by ECG gated myocardial tomography

    Energy Technology Data Exchange (ETDEWEB)

    Narita, Michihiro; Kurihara, Tadashi; Sindoh, Takashi; Sawada, Yoshihiro; Honda, Minoru [Sumitomo Hospital, Osaka (Japan)

    2001-01-01

    To investigate regional left ventricular (LV) wall motion (WM) after recovery from myocardial ischemia, we performed ECG-gated myocardial perfusion tomography with {sup 99m}Tc-MIBI (G-SPECT) in patients with ischemic heart disease (IHD). In addition, we compared the left ventricular (LV) systolic function obtained by G-SPECT at rest with that obtained by contrast left ventriculography (LVG). We performed G-SPECT at 30 minutes after exercise stress (Ex-30) and 3 hours after exercise (rest). LVWM and LV ejection fractions (EF) were analyzed by the QGS (quantitative gated SPECT) program. The LV was divided into 9 segments and regional WM (RWM) was analyzed quantitatively. In addition, myocardial perfusion was assessed quantitatively. In 64 patients with several different types of heart disease, EF obtained by G-SPECT correlated well with LVG-EF (r=0.907, p<0.001), and RWM of G-SPECT coincided well with that of LVG ({kappa} value 0.67, p<0.01). Eighty patients with suspected IHD were divided according to Ex-Rest myocardial perfusion. In 83% of patients with Ex-induced perfusion abnormalities disappeared completely at rest, and in 58% of patients with Ex-induced abnormalities disappeared incompletely, RWM abnormalities which were observed at Ex-30 improved at rest and as did EF. In 79% of patients with a fixed defect (FD), RWM abnormalities and EF at Ex-30 did not differ with those at rest, but in 12% of the patients, the RWM abnormality of Ex-30 improved at rest. In most myocardial segments that had recovered from transient ischemia, RWM abnormalities persisted at least 30 minutes after Ex (stunning). In a small portion of the myocardial segments regarded as having myocardial necrosis because of a fixed perfusion abnormality, RWM abnormalities at Ex-30 improved at rest. These segments were supposed to contain viable myocardium. In conclusion, G-SPECT is a powerful method for clarifying the relation between the regional systolic function and myocardial perfusion

  9. Myocardial metabolism, perfusion, wall motion and electrical activity in Duchenne muscular dystrophy

    International Nuclear Information System (INIS)

    Perloff, J.K.; Henze, E.; Schelbert, H.R.

    1982-01-01

    The cardiomyopathy of Duchenne's muscular dystrophy originates in the posterobasal left ventricle and extends chiefly to the contiguous lateral wall. Ultrastructural abnormalities in these regions precede connective tissue replacement. We postulated that a metabolic fault coincided with or antedated the subcellular abnormality. Accordingly, regional left ventricular metabolism, perfusion and wall motion were studied using positron computed tomography and metabolic isotopes supplemented by thallium perfusion scans, equilibrium radionuclide angiography and M-mode and two-dimensional echocardiography. To complete the assessment, electrocardiograms, vectorcardiograms, 24 hour taped electrocardiograms and chest x-rays were analyzed. Positron computed tomography utilizing F-18 2-fluoro 2-deoxyglucose (FDG) provided the first conclusive evidence supporting the hypothesis of a premorphologic regional metabolic fault. Thus, cardiac involvement in duchenne dystrophy emerges as a unique form of heart disease, genetically targeting specific regions of ventricular myocardium for initial metabolic and subcellular changes. Reported ultrastructural abnormalities of the impulse and conduction systems provide, at least in part, a basis for the clinically observed sinus node, intraatrial, internodal, AV nodal and infranodal disorders

  10. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

    Radionuclide cerebral perfusion studies are assuming a far greater importance in the detection and differential diagnosis of cerebral lesions. Perfusion studies not only contribute to the differential diagnosis of lesions but in certain cases are the preferred methods by which more accurate clinical interpretations can be made. The characteristic blood flow of arterio-venous malformations readily differentiates this lesion from neoplasms. The decreased perfusion or absent perfusion observed in cerebral infarctions is diagnostic without concurrent evidence from static images. Changes in rates and direction of blood flow contribute fundamental information to the status of stenosis and vascular occlusion and, in addition, offer valuable information on the competency and routes of collateral circulation. The degree of cerebral perfusion after cerebral vascular accidents appears to be directly related to patient recovery, particularly muscular function. Cerebral perfusion adds a new parameter in the diagnosis of subdural haematomas and concussion and in the differentiation of obscuring radioactivity from superficial trauma. Although pictorial displays of perfusion blood flow will offer information in most cerebral vascular problems, the addition of computer analysis better defines temporal relationships of regional blood flow, quantitative changes in flow and the detection of the more subtle increases or decreases in cerebral blood flow. The status of radionuclide cerebral perfusion studies has taken on an importance making it the primary modality for the diagnosis of cerebral lesions. (author)

  11. Congenital Abnormalities

    Science.gov (United States)

    ... Stages Ages and Stages Prenatal Baby (0-12 mos.) Toddler 1-3yrs. Preschool 3-5yrs Grade School ... Categories of Congenital Abnormalities Chromosome Abnormalities Chromosomes are structures that carry genetic material inherited from one generation ...

  12. The Effect of Intravenous Regional Perfusion of the Distal Limb With Amikacin Sulfate on Wounds Healing by Second Intention in Horses.

    Science.gov (United States)

    Edwards-Milewski, Margaux L; Morello, Samantha L; Zhao, Qianqian; Mattan-Bell, Cynthia

    2016-01-01

    To compare the gross and histological effects of intravenous regional limb perfusion (IVRLP) using amikacin sulfate on second intention healing of distal limb wounds in adult horses with healing in untreated wounds. In vivo experimental study. Adult horses (n = 7). Two full thickness wounds (2.5 × 2.5 cm) were created aseptically on the dorsal aspect of each metacarpus and maintained under sterile bandages. One forelimb was randomly selected from each horse for IVRLP on days 2, 3, and 4 post-wounding. Sequential biopsies were taken from 1 wound on each limb to evaluate the histological effects of IVRLP. Photographs were obtained of nonbiopsied wounds from days 2 to 62 for gross assessment and wound measurement. Wound size and contraction, healing rate during and immediately after IVRLP treatment, total healing rate, and histological scores for edema, hemorrhage, inflammatory infiltrate, and fibrovascular proliferation were compared. No differences were observed between groups for wound size, wound contraction, healing rates during or after IVRLP treatment periods, or total healing rate. Wound size over time was larger in the IVRLP group compared with the control group; however, this difference did not reach statistical significance. Mononuclear cell infiltration was greater in the IVRLP group compared with controls. No differences were observed for other histological variables. All wounds healed without the formation of exuberant granulation tissue. Treatment for 3 consecutive days with IVRLP using amikacin sulfate did not negatively affect surgical wounds healing by second intention in the distal limb of horses. © Copyright 2015 by The American College of Veterinary Surgeons.

  13. Reversible Stress Cardiomyopathy Presenting as Acute Coronary Syndrome with Elevated Troponin in the Absence of Regional Wall Motion Abnormalities: A Forme Fruste of Stress Cardiomyopathy?

    Directory of Open Access Journals (Sweden)

    Mahesh Anantha Narayanan

    2014-01-01

    Full Text Available We present a case of reversible stress cardiomyopathy in a surgical patient, described here as a forme fruste due to its atypical features. It is important to recognize such unusual presentation of stress cardiomyopathy that mimics acute coronary syndrome. Stress cardiomyopathy commonly presents as acute coronary syndrome and is characterized by typical or atypical variants of regional wall motion abnormalities. We report a 60-year-old Caucasian male with reversible stress cardiomyopathy following a sternal fracture fixation. Although the patient had several typical features of stress cardiomyopathy including physical stress, ST-segment elevation, elevated cardiac biomarkers and normal epicardial coronaries, there were few features that were atypical, including unusual age, gender, absence of regional wall motion abnormalities, high lateral ST elevation, and high troponin-ejection fraction product. In conclusion, this could represent a forme fruste of stress cardiomyopathy.

  14. Ventilation and perfusion display in a single image

    International Nuclear Information System (INIS)

    Lima, J.J.P. de; Botelho, M.F.R.; Pereira, A.M.S.; Rafael, J.A.S.; Pinto, A.J.; Marques, M.A.T.; Pereira, M.C.; Baganha, M.F.; Godinho, F.

    1991-01-01

    A new method of ventilation and perfusion display onto a single image is presented. From the data on regions of interest of the lungs, three-dimensional histograms are created, containing as parameters X and Y for the position of the pixels, Z for the perfusion and colour for local ventilation. The perfusion value is supplied by sets of curves having Z proportional to the local perfusion count rate. Ventilation modulates colour. Four perspective views of the histogram are simultaneously displayed to allow visualization of the entire organ. Information about the normal ranges for both ventilation and perfusion is also provided in the histograms. (orig.)

  15. Stretched alignment due to pairing correlation between the normal and abnormal parity orbits for the γ-soft nuclei in the light rare-earth region

    International Nuclear Information System (INIS)

    Ding, H.; Wu, L.

    1996-01-01

    For the γ-soft rotational motion, a two-parameter model is constructed considering the pair correlation between the normal and abnormal parity states based on the fermion dynamical symmetry model. The numerical calculation of this model shows that the data of ground bands of ten typical γ-soft rotational nuclei in the light rare-earth region are fitted in a very high quality. copyright 1996 The American Physical Society

  16. Reduced Perfusion in Broca’s Area in Developmental Stuttering

    Science.gov (United States)

    Desai, Jay; Huo, Yuankai; Wang, Zhishun; Bansal, Ravi; Williams, Steven C. R.; Lythgoe, David; Zelaya, Fernando O.; Peterson, Bradley S.

    2016-01-01

    Objective To study resting cerebral blood flow in children and adults with developmental stuttering. Methods We acquired pulsed arterial spin labeling magnetic resonance imaging data in 26 participants with stuttering and 36 healthy, fluent controls. While covarying for age, sex, and IQ, we compared perfusion values voxel-wise across diagnostic groups and assessed correlations of perfusion with stuttering severity within the stuttering group and with measures of motor speed in both groups. Results We detected lower regional Cerebral Blood Flow (rCBF) at rest in the stuttering group compared to healthy controls in Broca’s area bilaterally and the superior frontal gyrus. rCBF values in Broca’s area bilaterally correlated inversely with the severity of stuttering and extended posteriorly into other portions of the language loop. We also found increased rCBF in cerebellar nuclei and parietal cortex in the stuttering group compared to healthy controls. Findings were unchanged in child-only analyses and when excluding participants with comorbid illnesses or those taking medication. Conclusions rCBF is reduced in Broca’s region in persons who stutter. More severe stuttering is associated with even greater reductions in rCBF to Broca’s region, additive to the underlying putative trait reduction in rCBF relative to control values. Moreover, a greater abnormality in rCBF in the posterior language loop is associated with more severe symptoms, suggesting that a common pathophysiology throughout the language loop likely contributes to stuttering severity. PMID:28035724

  17. Functional lung MRI in chronic obstructive pulmonary disease: comparison of T1 mapping, oxygen-enhanced T1 mapping and dynamic contrast enhanced perfusion.

    Directory of Open Access Journals (Sweden)

    Bertram J Jobst

    Full Text Available Monitoring of regional lung function in interventional COPD trials requires alternative endpoints beyond global parameters such as FEV1. T1 relaxation times of the lung might allow to draw conclusions on tissue composition, blood volume and oxygen fraction. The aim of this study was to evaluate the potential value of lung Magnetic resonance imaging (MRI with native and oxygen-enhanced T1 mapping for the assessment of COPD patients in comparison with contrast enhanced perfusion MRI.20 COPD patients (GOLD I-IV underwent a coronal 2-dimensional inversion recovery snapshot flash sequence (8 slices/lung at room air and during inhalation of pure oxygen, as well as dynamic contrast-enhanced first-pass perfusion imaging. Regional distribution of T1 at room air (T1, oxygen-induced T1 shortening (ΔT1 and peak enhancement were rated by 2 chest radiologists in consensus using a semi-quantitative 3-point scale in a zone-based approach.Abnormal T1 and ΔT1 were highly prevalent in the patient cohort. T1 and ΔT1 correlated positively with perfusion abnormalities (r = 0.81 and r = 0.80; p&0.001, and with each other (r = 0.80; p<0.001. In GOLD stages I and II ΔT1 was normal in 16/29 lung zones with mildly abnormal perfusion (15/16 with abnormal T1. The extent of T1 (r = 0.45; p<0.05, ΔT1 (r = 0.52; p<0.05 and perfusion abnormalities (r = 0.52; p<0.05 showed a moderate correlation with GOLD stage.Native and oxygen-enhanced T1 mapping correlated with lung perfusion deficits and severity of COPD. Under the assumption that T1 at room air correlates with the regional pulmonary blood pool and that oxygen-enhanced T1 reflects lung ventilation, both techniques in combination are principally suitable to characterize ventilation-perfusion imbalance. This appears valuable for the assessment of regional lung characteristics in COPD trials without administration of i.v. contrast.

  18. Non-contrast MRI perfusion angiosome in diabetic feet

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Jie [Cardiovascular Imaging Lab, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Hastings, Mary K.; Mueller, Michael J. [Washington University School of Medicine, The Program in Physical Therapy, St. Louis, MO (United States); Muccigross, David; Hildebolt, Charles F. [Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Fan, Zhaoyang [Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA (United States); Gao, Fabao [West China Hospital, Sichuan University, Department of Radiology, Chengdu (China); Curci, John [Washington University School of Medicine, The Department of Surgery, St. Louis, MO (United States)

    2015-01-15

    The purpose of this study is to develop a non-contrast magnetic resonance imaging (MRI) approach to evaluate skeletal muscle perfusion in the diabetic foot based on the concept of angiosomes of the foot. Five healthy volunteers and five participants with diabetes (HbA1c = 7.2 ± 1.8 %) without a history of peripheral artery disease were examined. The non-contrast perfusion measurements were performed during a toe flexion challenge. Absolute perfusion maps were created and two regions (medial and lateral) on the maps were segmented based on angiosomes. Regional difference in the perfusion of foot muscle was readily visualized in the MRI perfusion angiosomes during the challenge. In the participants with diabetes, the perfusion during toe flexion challenge was significantly lower than in healthy volunteers (P < 0.01). The average perfusion for the medial plantar region of the right foot was lower in subjects with diabetes (38 ± 9 ml/min/100 g) than in healthy subjects (93 ± 33 ml/min/100 g). Non-contrast MRI perfusion angiosome maps demonstrate the feasibility of determining regional perfusion in foot muscles during toe challenge and may facilitate evaluation of muscle perfusion in diabetic feet. (orig.)

  19. Value of dynamic susceptibility contrast perfusion MRI in the acute phase of transient global amnesia.

    Directory of Open Access Journals (Sweden)

    Alex Förster

    Full Text Available Transient global amnesia (TGA is a transitory, short-lasting neurological disorder characterized by a sudden onset of antero- and retrograde amnesia. Perfusion abnormalities in TGA have been evaluated mainly by use of positron emission tomography (PET or single-photon emission computed tomography (SPECT. In the present study we explore the value of dynamic susceptibility contrast perfusion-weighted MRI (PWI in TGA in the acute phase.From a MRI report database we identified TGA patients who underwent MRI including PWI in the acute phase and compared these to control subjects. Quantitative perfusion maps (cerebral blood flow (CBF and volume (CBV were generated and analyzed by use of Signal Processing In NMR-Software (SPIN. CBF and CBV values in subcortical brain regions were assessed by use of VOI created in FIRST, a model-based segmentation tool in the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB Software Library (FSL.Five TGA patients were included (2 men, 3 women. On PWI, no relevant perfusion alterations were found by visual inspection in TGA patients. Group comparisons for possible differences between TGA patients and control subjects showed significant lower rCBF values bilaterally in the hippocampus, in the left thalamus and globus pallidus as well as bilaterally in the putamen and the left caudate nucleus. Correspondingly, significant lower rCBV values were observed bilaterally in the hippocampus and the putamen as well as in the left caudate nucleus. Group comparisons for possible side differences in rCBF and rCBV values in TGA patients revealed a significant lower rCBV value in the left caudate nucleus.Mere visual inspection of PWI is not sufficient for the assessment of perfusion changes in TGA in the acute phase. Group comparisons with healthy control subjects might be useful to detect subtle perfusion changes on PWI in TGA patients. However, this should be confirmed in larger data sets and serial PWI

  20. Voxel-by-voxel analysis of brain SPECT perfusion in Fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France)]. E-mail: eric.guedj@ap-hm.fr; Taieb, David [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Cammilleri, Serge [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Lussato, David [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Laforte, Catherine de [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France); Niboyet, Jean [Unite d' Etude et de Traitement de la Douleur, Clinique La Phoceanne, Marseille (France); Mundler, Olivier [Service Central de Biophysique et de Medecine Nucleaire, AP-HM Timone, Marseille (France)

    2007-02-01

    We evaluated brain perfusion SPECT at rest, without noxious stiumuli, in a homogeneous group of hyperalgesic FM patients. We performed a voxel-based analysis in comparison to a control group, matched for age and gender. Under such conditions, we made the assumption that significant cerebral perfusion abnormalities could be demonstrated, evidencing altered cerebral processing associated with spontaneous pain in FM patients. The secondary objective was to study the reversibility and the prognostic value of such possible perfusion abnormalities under specific treatment. Eighteen hyperalgesic FM women (mean age 48 yr; range 25-63 yr; ACR criteria) and 10 healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). All brain SPECT were performed before any change was made in therapy in the pain care unit. A second SPECT was performed a month later after specific treatment by Ketamine. Compared to control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. We also found that a medial frontal and anterior cingulate hypoperfusions were highly predictive (PPV=83%; NPV=91%) of non-response on Ketamine, and that only responders showed significant modification of brain perfusion, after treatment. In the present study performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective dimension. As current pharmacological and non-pharmacological therapies act differently on both components of pain, we hypothesize that SPECT could be a valuable and readily available tool to guide individual therapeutic

  1. Voxel-by-voxel analysis of brain SPECT perfusion in Fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Niboyet, Jean; Mundler, Olivier

    2007-01-01

    We evaluated brain perfusion SPECT at rest, without noxious stiumuli, in a homogeneous group of hyperalgesic FM patients. We performed a voxel-based analysis in comparison to a control group, matched for age and gender. Under such conditions, we made the assumption that significant cerebral perfusion abnormalities could be demonstrated, evidencing altered cerebral processing associated with spontaneous pain in FM patients. The secondary objective was to study the reversibility and the prognostic value of such possible perfusion abnormalities under specific treatment. Eighteen hyperalgesic FM women (mean age 48 yr; range 25-63 yr; ACR criteria) and 10 healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). All brain SPECT were performed before any change was made in therapy in the pain care unit. A second SPECT was performed a month later after specific treatment by Ketamine. Compared to control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. We also found that a medial frontal and anterior cingulate hypoperfusions were highly predictive (PPV=83%; NPV=91%) of non-response on Ketamine, and that only responders showed significant modification of brain perfusion, after treatment. In the present study performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective dimension. As current pharmacological and non-pharmacological therapies act differently on both components of pain, we hypothesize that SPECT could be a valuable and readily available tool to guide individual therapeutic

  2. Region of interest-based versus whole-lung segmentation-based approach for MR lung perfusion quantification in 2-year-old children after congenital diaphragmatic hernia repair

    Energy Technology Data Exchange (ETDEWEB)

    Weis, M.; Sommer, V.; Hagelstein, C.; Schoenberg, S.O.; Neff, K.W. [Heidelberg University, Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Zoellner, F.G. [Heidelberg University, Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Mannheim (Germany); Zahn, K. [University of Heidelberg, Department of Paediatric Surgery, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany); Schaible, T. [Heidelberg University, Department of Paediatrics, University Medical Center Mannheim, Medical Faculty Mannheim, Mannheim (Germany)

    2016-12-15

    With a region of interest (ROI)-based approach 2-year-old children after congenital diaphragmatic hernia (CDH) show reduced MR lung perfusion values on the ipsilateral side compared to the contralateral. This study evaluates whether results can be reproduced by segmentation of whole-lung and whether there are differences between the ROI-based and whole-lung measurements. Using dynamic contrast-enhanced (DCE) MRI, pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) were quantified in 30 children after CDH repair. Quantification results of an ROI-based (six cylindrical ROIs generated of five adjacent slices per lung-side) and a whole-lung segmentation approach were compared. In both approaches PBF and PBV were significantly reduced on the ipsilateral side (p always <0.0001). In ipsilateral lungs, PBF of the ROI-based and the whole-lung segmentation-based approach was equal (p=0.50). In contralateral lungs, the ROI-based approach significantly overestimated PBF in comparison to the whole-lung segmentation approach by approximately 9.5 % (p=0.0013). MR lung perfusion in 2-year-old children after CDH is significantly reduced ipsilaterally. In the contralateral lung, the ROI-based approach significantly overestimates perfusion, which can be explained by exclusion of the most ventral parts of the lung. Therefore whole-lung segmentation should be preferred. (orig.)

  3. Molecular analysis of abnormal hemoglobins in beta chain in Aegean region of Turkey and first reports of hemoglobin Andrew-Minneapolis and Hb Hinsdale from Turkey.

    Science.gov (United States)

    Aykut, Ayça; Onay, Hüseyin; Durmaz, Asude; Karaca, Emin; Vergin, Canan; Aydınok, Yeşim; Özkınay, Ferda

    2015-07-01

    The Agean is one of the regions in Turkey where thalassemias and abnormal hemoglobins (Hbs) are prevalent. Combined heterozygosity of thalassemia mutations with a variety of structural Hb variants lead to an extremely wide spectrum of clinical and hematological phenotypes which is of importance for prenatal diagnosis. One hundred and seventeen patients and carriers diagnosed by hemoglobin electrophoresis (HPLC), at risk for abnormal hemoglobinopathies were screened for mutational analysis of the beta-globin gene. The full coding the 5' UTR, and the 3' UTR sequences of beta-globin gene (GenBank accession no. U01317) were amplified and sequenced. In this study, a total of 118 (12.24%) structural Hb variant alleles were identified in 1341 mutated beta-chain alleles in Medical Genetics Department of Ege University between January 2006 and November 2013. Here, we report the mutation spectrum of abnormal Hbs associated with the beta-globin gene in Aegean region of Turkey. In the present study, the Hb Hinsdale and Hb Andrew-Minneapolis variants are demonstrated for the first time in the Turkish population.

  4. Perfusion deficits and functional connectivity alterations in patients with post-traumatic stress disorder

    Science.gov (United States)

    Liu, Yang; Li, Baojuan; Zhang, Xi; Zhang, Linchuan; Li, Liang; Lu, Hongbing

    2016-03-01

    To explore the alteration in cerebral blood flow (CBF) and functional connectivity between survivors with recent onset post-traumatic stress disorder (PTSD) and without PTSD, survived from the same coal mine flood disaster. In this study, a processing pipeline using arterial spin labeling (ASL) sequence was proposed. Considering low spatial resolution of ASL sequence, a linear regression method was firstly used to correct the partial volume (PV) effect for better CBF estimation. Then the alterations of CBF between two groups were analyzed using both uncorrected and PV-corrected CBF maps. Based on altered CBF regions detected from the CBF analysis as seed regions, the functional connectivity abnormities in PTSD patients was investigated. The CBF analysis using PV-corrected maps indicates CBF deficits in the bilateral frontal lobe, right superior frontal gyrus and right corpus callosum of PTSD patients, while only right corpus callosum was identified in uncorrected CBF analysis. Furthermore, the regional CBF of the right superior frontal gyrus exhibits significantly negative correlation with the symptom severity in PTSD patients. The resting-state functional connectivity indicates increased connectivity between left frontal lobe and right parietal lobe. These results indicate that PV-corrected CBF exhibits more subtle perfusion changes and may benefit further perfusion and connectivity analysis. The symptom-specific perfusion deficits and aberrant connectivity in above memory-related regions may be putative biomarkers for recent onset PTSD induced by a single prolonged trauma exposure and help predict the severity of PTSD.

  5. CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Fainardi, Enrico; Borrelli, Massimo; Saletti, Andrea; Ceruti, Stefano; Tamarozzi, Riccardo; Schivalocchi, Roberta; Cavallo, Michele; Azzini, Cristiano; Chieregato, Arturo

    2008-01-01

    We sought to quantify perfusion changes associated to acute spontaneous intracerebral hemorrhage (SICH) by means of computed tomography perfusion (CTP) imaging. We studied 89 patients with supratentorial SICH at admission CT by using CTP scanning obtained within 24 h after symptom onset. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV) and mean transit time (rMTT) levels were measured in four different regions of interest manually outlined on CT scan: (1) hemorrhagic core; (2) perihematomal low-density area; (3) 1 cm rim of normal-appearing brain tissue surrounding the perilesional area; and (4) a mirrored area, including the clot and the perihematomal region, located in the non-lesioned contralateral hemisphere. rCBF, rCBV, and rMTT mean levels showed a centrifugal distribution with a gradual increase from the core to the periphery (p 20 ml) hematomas (p<0.01 and p <0.02, respectively). Multi-parametric CTP mapping of acute SICH indicates that perfusion values show a progressive improvement from the core to the periphery. In the first 24 h, perihemorrhagic region was hypoperfused with CTP values which were not suggestive of ischemic penumbra destined to survive but more likely indicative of edema formation. These findings also argue for a potential influence of early amounts of bleeding on perihematomal hemodynamic abnormalities. (orig.)

  6. Cerebral perfusion imaging in HIV positive patients

    International Nuclear Information System (INIS)

    Kundley, Kshama; Chowdhury, D.; Lele, V.R.; Lele, R.D.

    1998-01-01

    Full text: Twelve human immunodeficiency virus (HIV) positive patients were studied by SPECT cerebral perfusion imaging 1 hour post injection of 15 mCi of 99m Tc-ECD under ideal conditions with a triple head gamma camera (Prism 3000 X P LEUHR), fanbeam collimators followed by Folstein Mini Mental Status Examination (FMMSE) and AIDS dementia complex (ADC) staging on the same day. All 12 patients were male, in the age range of 23-45 y (mean 31 y). The infected status was diagnosed by ELISA (10 patients) or Western blot (5 patients). The interval between diagnosis and imaging ranged from 1 month - 35 months (mean 15.3 months). Two patients were alcoholic and 2 were smokers. None of them had CNS disorder clinically. ADC staging and FMMSE could be performed in 4 patients. Two patients were normal (stage 0) and 2 were subclinical (stage 0.5) on ADC staging. FMMSE revealed normal or near normal status (mean score 35; maximum score 36). Cerebral perfusion images were interpreted simultaneously by 3 observers blind towards history and examination using semi-quantitative and quantitative methods by consensus. It revealed multiple areas of hypoperfusion, viz. temporal (11 patients (91 %), parietal 10 patients (83%), frontal 9 patients (75%, pre and post central gyrus 7 patients (58%), occipital 6 patients (50%) cingulate gyrus and cerebellum 5 patients (41%) and thalamic in 2 patients (16%). Hyper perfusion in caudate nuclei was noted in 10 patients (83%). The study reveals presence of multiple perfusion abnormalities on cerebral perfusion imaging in HIV positive patients who have normal/near normal mental status suggesting precedence of perfusion abnormality over clinically apparent mental deficit

  7. Preliminary studies of pulmonary perfusion scanning in patients with pulmonary hypertension

    International Nuclear Information System (INIS)

    Shi Rongfang; Liu Xiujie; Wang Yanqun

    1986-01-01

    A comparative analysis of pulmonary perfusion scanning through cardiac catheterization of 57 patients including 32 patients with congenital heart disease, 8 patients with chronic pulmonary thromboembolism and 7 patients with primary pulmonary hypertension is reported. The lung scintigram obtained with In-113m or Tc-99m-MAA represents the distribution of pulmonary blood. It has been found that the lung scintigram was abnormal in patients of congenital heart disease with pulmonary hypertension (i. e. pulmonary artery pressure between 41-80 mmHg) and the extent of radoiactive regional defects is proportional to the level of pulmonary hypertension. The results of the analysis indicated that pulmonary perfusion scanning being a noninvasive technique would be a useful method in evaluating the level of pulmonary hypertension in patients with left to right shunt before and after surgical operation

  8. Specification LV regional wall motion abnormalities (RWMA) in CAD and non-CAD patients by phase analysis of radionuclide ventriculograms (RNV)

    International Nuclear Information System (INIS)

    Henze, E.; Muller, D.; De Lagardelle, C.; Bitter, F.; Stauch, M.; Adam, W.E.

    1984-01-01

    RWMA are thought to be highly specific for CAD although they have been described in aortic regurgitation (AR) and in pts on daunorubicin (DAU) as well. In an attempt to further specify non-CAD RWMA, consecutive exercise RNV of 17 pts with proven severe CAD were compared with resting RNV of 24 pts with transmural myocardial infarction (MI), 28 pts on a critical dose of DAU and 25 AR pts. RWMA were defined objectively from parametric images by a decreased sectorial amplitude of more than 2 standard deviations of normal. In 15/17 CAD pts (88%) and in 19/24 MI pts (79%) a significantly decreased regional amplitude was found. Importantly, in all abnormal CAD and MI amplitude scans (100%) a significantly abnormal phase shift in the same region could be noted. In 6/28 pts on DAU (21%) an apical hypokinesis could be verified. In contrast to CAD, however, the phase distribution was normal in all these DAU pts. The pts with AR demonstrated a very inhomogeneous pattern. A normal image was seen in 5 pts, 6 pts had an infarct-like pattern with regionally decreased amplitudes and phase shifting, 7 pts showed a normal amplitude image with yet regional phasic delay, and the remainder 7 pts had an apical hypokinesis with normal phase distribution. The authors conclude that standardized phase analysis of RNV data provides a powerful tool for specifying RWMA. It allows a highly specific separation of RWMA between CAD and DAU pts. The inhomogeneous pattern in AR pts can in part be explained by increased wall stress and/or incomplete left bundle conduction abnormalities and awaits further evaluation

  9. Role of myocardial perfusion single photon emission computed tomography in pediatric cardiology practice

    Directory of Open Access Journals (Sweden)

    Sundaram P

    2009-01-01

    Full Text Available Diagnostic and prognostic power of myocardial perfusion imaging in patients with coronary artery disease has been demonstrated with planar imaging which was further improvised with addition of gated SPECT and newer Technetium labeled myocardial perfusion tracers like SestaMIBI, Tetrofosmin. Myocardial perfusion abnormalities at rest and after stress are considered to be the best predictors of cardiac event-free survival in adults with ischemic heart disease. This article highlights various myocardial perfusion imaging (MPIradiopharmaceuticals, exercise procedures, pharmacological stress protocols, indications for MPI and myocardial perfusion patterns in children with some of the common congenital and acquired heart diseases.

  10. Meiotic abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1993-12-31

    Chapter 19, describes meiotic abnormalities. These include nondisjunction of autosomes and sex chromosomes, genetic and environmental causes of nondisjunction, misdivision of the centromere, chromosomally abnormal human sperm, male infertility, parental age, and origin of diploid gametes. 57 refs., 2 figs., 1 tab.

  11. Autologous mesenchymal stem cells produce concordant improvements in regional function, tissue perfusion, and fibrotic burden when administered to patients undergoing coronary artery bypass grafting: The Prospective Randomized Study of Mesenchymal Stem Cell Therapy in Patients Undergoing Cardiac Surgery (PROMETHEUS) trial.

    Science.gov (United States)

    Karantalis, Vasileios; DiFede, Darcy L; Gerstenblith, Gary; Pham, Si; Symes, James; Zambrano, Juan Pablo; Fishman, Joel; Pattany, Pradip; McNiece, Ian; Conte, John; Schulman, Steven; Wu, Katherine; Shah, Ashish; Breton, Elayne; Davis-Sproul, Janice; Schwarz, Richard; Feigenbaum, Gary; Mushtaq, Muzammil; Suncion, Viky Y; Lardo, Albert C; Borrello, Ivan; Mendizabal, Adam; Karas, Tomer Z; Byrnes, John; Lowery, Maureen; Heldman, Alan W; Hare, Joshua M

    2014-04-11

    Although accumulating data support the efficacy of intramyocardial cell-based therapy to improve left ventricular (LV) function in patients with chronic ischemic cardiomyopathy undergoing CABG, the underlying mechanism and impact of cell injection site remain controversial. Mesenchymal stem cells (MSCs) improve LV structure and function through several effects including reducing fibrosis, neoangiogenesis, and neomyogenesis. To test the hypothesis that the impact on cardiac structure and function after intramyocardial injections of autologous MSCs results from a concordance of prorecovery phenotypic effects. Six patients were injected with autologous MSCs into akinetic/hypokinetic myocardial territories not receiving bypass graft for clinical reasons. MRI was used to measure scar, perfusion, wall thickness, and contractility at baseline, at 3, 6, and 18 months and to compare structural and functional recovery in regions that received MSC injections alone, revascularization alone, or neither. A composite score of MRI variables was used to assess concordance of antifibrotic effects, perfusion, and contraction at different regions. After 18 months, subjects receiving MSCs exhibited increased LV ejection fraction (+9.4 ± 1.7%, P=0.0002) and decreased scar mass (-47.5 ± 8.1%; P<0.0001) compared with baseline. MSC-injected segments had concordant reduction in scar size, perfusion, and contractile improvement (concordant score: 2.93 ± 0.07), whereas revascularized (0.5 ± 0.21) and nontreated segments (-0.07 ± 0.34) demonstrated nonconcordant changes (P<0.0001 versus injected segments). Intramyocardial injection of autologous MSCs into akinetic yet nonrevascularized segments produces comprehensive regional functional restitution, which in turn drives improvement in global LV function. These findings, although inconclusive because of lack of placebo group, have important therapeutic and mechanistic hypothesis-generating implications. http

  12. Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

    International Nuclear Information System (INIS)

    Suga, K.; Yasuhiko, K.; Iwanaga, H.; Tokuda, O.; Matsunaga, N.

    2009-01-01

    Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

  13. Functional Mechanism of Lung Mosaic CT Attenuation: Assessment with Deep-Inspiration Breath-Hold Perfusion SPECT-CT Fusion Imaging and Non-Breath-Hold Technegas SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Suga, K.; Yasuhiko, K. (Dept. of Radiology, St. Hill Hospital, Ube, Yamaguchi (Japan)); Iwanaga, H.; Tokuda, O.; Matsunaga, N. (Dept. of Radiology, Yamaguchi Univ. School of Medicine, Ube, Yamaguchi (Japan))

    2009-01-15

    Background: The functional mechanism of lung mosaic computed tomography attenuation (MCA) in pulmonary vascular disease (PVD) and obstructive airway disease (OAD) has not yet been fully clarified. Purpose: To clarify the mechanism of MCA in these diseases by assessing the relationship between regional lung function and CT attenuation change at MCA sites with the use of automated deep-inspiratory breath-hold (DIBrH) perfusion single-photon emission computed tomography (SPECT)-CT fusion images and non-breath-hold Technegas SPECT. Material and Methods: Subjects were 42 PVD patients (31 pulmonary thromboembolism, four primary/two secondary pulmonary hypertension, and five Takayasu arteritis), 12 OAD patients (five acute asthma, four obliterative bronchiolitis, and three bronchiectasis), and 12 normal controls, all of whom had MCA on DIBrH CT. The relationship between regional lung function and CT attenuation change at the lung slices with MCA was assessed using DIBrH perfusion SPECT-CT fusion images and non-breath-hold Technegas SPECT. The severity of perfusion defects with or without MCA was quantified by regions-of-interest analysis. Results: On DIBrH CT and perfusion SPECT, in contrast to no noticeable CT attenuation abnormality and fairly uniform perfusion in controls, 60 MCA and 274 perfusion defects in PVD patients, and 18 MCA and 61 defects in OAD patients were identified, with a total of 77 ventilation defects on Technegas SPECT in all patients. SPECT-CT correlation showed that, throughout the 78 MCA sites of all patients, lung perfusion was persistently decreased at low CT attenuation and preserved at intervening high CT attenuation, while lung ventilation was poorly correlated with CT attenuation change. The radioactivity ratios of reduced perfusion and the intervening preserved perfusion at the 78 perfusion defects with MCA were significantly lower than those at the remaining 257 defects without MCA (P<0.0001). Conclusion: Although further validation is

  14. Regional brain metabolite abnormalities in inherited prion disease and asymptomatic gene carriers demonstrated in vivo by quantitative proton magnetic resonance spectroscopy

    International Nuclear Information System (INIS)

    Waldman, A.D.; Cordery, R.J.; Godbolt, A.; Rossor, M.N.; MacManus, D.G.; Collinge, J.

    2006-01-01

    Inherited prion diseases are caused by mutations in the gene which codes for prion protein (PrP), leading to proliferation of abnormal PrP isomers in the brain and neurodegeneration; they include Gerstmann-Straeussler-Scheinker disease (GSS), fatal familial insomnia (FFI) and familial Creutzfeldt-Jakob disease (fCJD). We studied two patients with symptomatic inherited prion disease (P102L) and two pre-symptomatic P102L gene carriers using quantitative magnetic resonance spectroscopy (MRS). Short echo time spectra were acquired from the thalamus, caudate region and frontal white matter, metabolite levels and ratios were measured and z-scores calculated for individual patients relative to age-matched normal controls. MRS data were compared with structural magnetic resonance imaging. One fCJD case had generalised atrophy and showed increased levels of myo-inositol (MI) in the thalamus (z=3.7). The other had decreased levels of N-acetylaspartate (z=4) and diffuse signal abnormality in the frontal white matter. Both asymptomatic gene carriers had normal imaging, but increased frontal white matter MI (z=4.3, 4.1), and one also had increased MI in the caudate (z=5.3). Isolated MI abnormalities in asymptomatic gene carriers are a novel finding and may reflect early glial proliferation, prior to significant neuronal damage. MRS provides potential non-invasive surrogate markers of early disease and progression in inherited prion disease. (orig.)

  15. Regional brain metabolite abnormalities in inherited prion disease and asymptomatic gene carriers demonstrated in vivo by quantitative proton magnetic resonance spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Waldman, A.D.; Cordery, R.J.; Godbolt, A.; Rossor, M.N. [University College London, Dementia Research Group, Department of Neurodegenerative Disease, Institute of Neurology, London (United Kingdom); Imperial College of Science, Technology and Medicine, Division of Neuroscience and Psychological Medicine, Faculty of Medicine, London (United Kingdom); MacManus, D.G. [University College London, NMR Research Unit, Department of Clinical Neurology, Institute of Neurology, London (United Kingdom); Collinge, J. [University College London, MRC Prion Unit, Department of Neurodegenerative Disease, Institute of Neurology, London (United Kingdom)

    2006-06-15

    Inherited prion diseases are caused by mutations in the gene which codes for prion protein (PrP), leading to proliferation of abnormal PrP isomers in the brain and neurodegeneration; they include Gerstmann-Straeussler-Scheinker disease (GSS), fatal familial insomnia (FFI) and familial Creutzfeldt-Jakob disease (fCJD). We studied two patients with symptomatic inherited prion disease (P102L) and two pre-symptomatic P102L gene carriers using quantitative magnetic resonance spectroscopy (MRS). Short echo time spectra were acquired from the thalamus, caudate region and frontal white matter, metabolite levels and ratios were measured and z-scores calculated for individual patients relative to age-matched normal controls. MRS data were compared with structural magnetic resonance imaging. One fCJD case had generalised atrophy and showed increased levels of myo-inositol (MI) in the thalamus (z=3.7). The other had decreased levels of N-acetylaspartate (z=4) and diffuse signal abnormality in the frontal white matter. Both asymptomatic gene carriers had normal imaging, but increased frontal white matter MI (z=4.3, 4.1), and one also had increased MI in the caudate (z=5.3). Isolated MI abnormalities in asymptomatic gene carriers are a novel finding and may reflect early glial proliferation, prior to significant neuronal damage. MRS provides potential non-invasive surrogate markers of early disease and progression in inherited prion disease. (orig.)

  16. Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Fu, Jun; Chen, Wei-jian; Wang, Mei-hao; Li, Jian-ce; Zhang, Qian; Xia, Neng-zhi; Yang, Yun-jun; Wu, Gui-yun; Cheng, Jing-liang; Zhang, Yong; Zhuge, Qichuan

    2015-01-01

    The purpose of this study was to evaluate the value of 320-detector row CT used to detect crossed cerebellar diaschisis (CCD) in patients with unilateral supratentorial spontaneous intracerebral hemorrhage (SICH). We investigated 62 of 156 patients with unilateral supratentorial SICH using 320-detector row CT scanning. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time to peak (rTTP) levels were measured in different regions of interest (ROIs) that were manually outlined on computed tomography perfusion (CTP) for the cerebrum, including normal-appearing brain tissue that surrounded the perilesional low-density area (NA) and the perihematomal low-density area (PA) in all patients and the cerebellum (ipsilateral and contralateral) in CCD-positive patients. Of 62 cases, a total of 14 met the criteria for CCD due to cerebellar perfusion asymmetry on CTP maps. In the quantitative analysis, significant differences were found in the perfusion parameters between the contralateral and ipsilateral cerebellum in CCD-positive cases. No significant differences were found between the CCD-positive group and the CCD-negative group according to the hematoma volume, NIHSS scores, and cerebral perfusion abnormality (each P > 0.05). The correlation analysis of the degree of NA, PA perfusion abnormality, and the degree of CCD severity showed negative and significant linear correlations (R, -0.66∝-0.56; P < 0.05). 320-detector row CT is a robust and practicable method for the comprehensive primary imaging work-up of CCD in unilateral supratentorial SICH patients. (orig.)

  17. Whole-brain 320-detector row dynamic volume CT perfusion detected crossed cerebellar diaschisis after spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fu, Jun; Chen, Wei-jian; Wang, Mei-hao; Li, Jian-ce; Zhang, Qian; Xia, Neng-zhi; Yang, Yun-jun [Wenzhou Medical University, Department of Radiology, First Affiliated Hospital, Wenzhou (China); Wu, Gui-yun [Cleveland Clinics Foundation, Department of Nuclear Medicine, Imaging Institute, Cleveland, OH (United States); Cheng, Jing-liang; Zhang, Yong [Zhengzhou University, Department of Radiology, First Affiliated Hospital, Zhengzhou (China); Zhuge, Qichuan [Wenzhou Medical University, Department of Neurosurgery, First Affiliated Hospital, Wenzhou (China)

    2014-11-09

    The purpose of this study was to evaluate the value of 320-detector row CT used to detect crossed cerebellar diaschisis (CCD) in patients with unilateral supratentorial spontaneous intracerebral hemorrhage (SICH). We investigated 62 of 156 patients with unilateral supratentorial SICH using 320-detector row CT scanning. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV), mean transit time (rMTT), and time to peak (rTTP) levels were measured in different regions of interest (ROIs) that were manually outlined on computed tomography perfusion (CTP) for the cerebrum, including normal-appearing brain tissue that surrounded the perilesional low-density area (NA) and the perihematomal low-density area (PA) in all patients and the cerebellum (ipsilateral and contralateral) in CCD-positive patients. Of 62 cases, a total of 14 met the criteria for CCD due to cerebellar perfusion asymmetry on CTP maps. In the quantitative analysis, significant differences were found in the perfusion parameters between the contralateral and ipsilateral cerebellum in CCD-positive cases. No significant differences were found between the CCD-positive group and the CCD-negative group according to the hematoma volume, NIHSS scores, and cerebral perfusion abnormality (each P > 0.05). The correlation analysis of the degree of NA, PA perfusion abnormality, and the degree of CCD severity showed negative and significant linear correlations (R, -0.66∝-0.56; P < 0.05). 320-detector row CT is a robust and practicable method for the comprehensive primary imaging work-up of CCD in unilateral supratentorial SICH patients. (orig.)

  18. Brain SPECT perfusion in children and adolescents poly drug abusers

    International Nuclear Information System (INIS)

    Ramos, R.R.N.; Etchebehere, E.C.S.C.; Santos, A.O.; Lima, M.C.L.; Ramos, C.D.; Camargo, E.E.; Silva, C.A.M.; Serrat, S.M.

    2002-01-01

    Polydrug abuse in children and adolescents is a major social problem. Aim: The aim of this study was to evaluate brain perfusion in polydrug abuser adolescents with brain SPECT imaging (BSI) using 99m Tc-HMPAO. Materials and Methods: Sixteen male polydrug abuser patients (11 to 18 years) were submitted to BSI. Forty-eight normal individuals (26 males, 22 females; 18 to 31 years) were used as a control group. Images were performed after an intravenous injection of 99m Tc-HMPAO in a dark, quiet room. Images were acquired in a camera-computer system equipped with a fan beam collimator. The images were reconstructed in the transaxial, coronal and sagittal views and submitted to semi-quantitative analysis using the thalami as reference, by placing regions of interest (ROIs) in the cerebral and cerebellar cortices. Patients were also submitted to neuropsychology tests and neurologic examination. Results: Significant hypoperfusion was found in the inferior portion of the frontal lobes (left and right: p<0.0001), temporal lobes (left lateral: p=0.0392; right lateral: p=0.0044; left and right mesial: p<0.0005), right parietal lobe (p=0.025), visual cortex (p=0.0013), pons (p = 0.0002), cerebellar hemispheres (left: p=0.0216; right: p=0.0005) and vermis (p=0.0015). An inverse relationship was observed between the degree of perfusion and the duration of drug abuse in the inferior left frontal lobe (? = -0.55; p=0.0255), superior right frontal lobe (? = -0.51; p=0.043), lateral right temporal lobe (? = -0.58; p=0.0172), mesial left temporal lobe (? -0.52; p=0.0384), left parietal lobe (? = -0.51; p=0.0416), basal ganglia (left: ? = -0.70; p=0.0022; right: ? = -0.65; p=0.0056) and cingulate gyrus (? = -0.66; p=0.0054). A significant correlation was observed between the perfusion of the temporal lobes with the Bender-Koppits test (left and right lateral: p=0.0559). Significant correlation was also noted between the perfusion of the lateral left temporal lobe (p=0.0559), parietal

  19. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...... of Gd-DTPA (lambda), the vascular blood volume (Vb), and the time delay through the coronary arteries (delta T). The model was evaluated by computer simulation and used on experimental results from seven healthy subjects. The results in the healthy volunteers for a region of interest placed...... in the anterior myocardial wall were (mean +/- SD) Ki = 54 +/- 10 ml/100 g/min, lambda = 30 +/- 3 ml/100 g, Vb = 9 +/- 2 ml/100 g, delta T = 3.2 +/- 1.1 s. These results are in good agreement with similar results obtained by other methods....

  20. Laser doppler perfusion imaging

    International Nuclear Information System (INIS)

    Waardell, K.

    1992-01-01

    Recording of tissue perfusion is important in assessing the influence of peripheral vascular diseases on the microcirculation. This thesis reports on a laser doppler perfusion imager based on dynamic light scattering in tissue. When a low power He-Ne laser beam sequentally scans the tissue, moving blood cells generate doppler components in the back-scattered light. A fraction of this light is detected by a photodetector and converted into an electrical signal. In the processor, a signal proportional to the tissue perfusion at each measurement site is calculated and stored. When the scanning procedure is completed, a color-coded perfusion image is presented on a monitor. To convert important aspects of the perfusion image into more quantitative parameters, data analysis functions are implemented in the software. A theory describing the dependence of the distance between individual measurement points and detector on the system amplification factor is proposed and correction algorithms are presented. The performance of the laser doppler perfusion imager was evaluated using a flow simulator. A linear relationship between processor output signal and flow through the simulator was demonstrated for blood cell concentrations below 0.2%. The median sampling depth of the laser beam was simulated by a Monte Carlo technique and estimated to 235 μm. The perfusion imager has been used in the clinic to study perfusion changes in port wine stains treated with argon laser and to investigate the intensity and extension of the cutaneous axon reflex response after electrical nerve stimulation. The fact that perfusion can be visualized without touching the tissue implies elimination of sterilization problems, thus simplifying clinical investigations of perfusion in association with diagnosis and treatment of peripheral vascular diseases. 22 refs

  1. Walking abnormalities

    Science.gov (United States)

    ... include: Arthritis of the leg or foot joints Conversion disorder (a mental disorder) Foot problems (such as a ... injuries. For an abnormal gait that occurs with conversion disorder, counseling and support from family members are strongly ...

  2. Relationships between cardiac innervation/perfusion imbalance and ventricular arrhythmias: impact on invasive electrophysiological parameters and ablation procedures

    Energy Technology Data Exchange (ETDEWEB)

    Gimelli, Alessia [Fondazione Toscana Gabriele Monasterio, Pisa (Italy); Menichetti, Francesca; Soldati, Ezio; Liga, Riccardo; Vannozzi, Andrea; Bongiorni, Maria Grazia [University Hospital of Pisa, Cardio-Thoracic and Vascular Department, Pisa (Italy); Marzullo, Paolo [Fondazione Toscana Gabriele Monasterio, Pisa (Italy); CNR, Institute of Clinical Physiology, Pisa (Italy)

    2016-12-15

    To assess the relationship between regional myocardial perfusion and sympathetic innervation parameters at myocardial scintigraphy and intra-cavitary electrophysiological data in patients with ventricular arrhythmias (VA) submitted to invasive electrophysiological study and ablation procedure. Sixteen subjects underwent invasive electrophysiological study with electroanatomical mapping (EAM) followed by trans-catheter ablations of VA. Before ablation all patients were studied with a combined evaluation of regional myocardial perfusion and sympathetic innervation by means of tomographic {sup 99m}Tc-tetrofosmin and {sup 123}I- metaiodobenzylguanidine cadmium-zinc-telluride (CZT) scintigraphies, respectively. Off-line spatial co-registration of CZT perfusion and innervation data with the three-dimensional EAM reconstruction was performed in every patient. CZT revealed the presence of myocardial scar in 55 (20 %) segments. Of the viable myocardial segments, 131 (60 %) presented a preserved adrenergic innervation, while 86 (40 %) showed a significantly depressed innervation (i.e. innervation/perfusion mismatch). On EAM, the invasively measured intra-cavitary voltage was significantly lower in scarred segments than in viable ones (1.7 ± 1.5 mV vs. 4.0 ± 2.2 mV, P < 0.001). Interestingly, among the viable segments, those showing an innervation/perfusion mismatch presented a significantly lower intra-cavitary voltage than those with preserved innervation (1.9 ± 2.5 mV vs. 4.7 ± 2.3 mV, P < 0.001). Intra-cardiac ablation was performed in 63 (23 %) segments. On multivariate analysis, after correction for scar burden, the segments showing an innervation/perfusion mismatch remained the most frequent ablation targets (OR 5.6, 95 % CI 1.5-20.8; P = 0.009). In patients with VA, intra-cavitary electrical abnormalities frequently originate at the level of viable myocardial segments with depressed sympathetic innervation that frequently represents the ultimate ablation target

  3. Gonadal abnormalities in frogs (Lithobates spp.) collected from managed wetlands in an agricultural region of Nebraska, USA

    International Nuclear Information System (INIS)

    Papoulias, Diana M.; Schwarz, Matt S.; Mena, Lourdes

    2013-01-01

    Nebraska's Rainwater Basin (RWB) provides important wetland habitat for North American migratory birds. Concern exists that pesticide and nutrient runoff from surrounding row-crops enters wetlands degrading water quality and adversely affecting birds and wildlife. Frogs may be especially vulnerable. Plains leopard (Lithobates blairi) metamorphs from RWB wetlands with varying concentrations of pesticides were evaluated for a suite of biomarkers of exposure to endocrine active chemicals. Froglets had ovarian dysgenesis, high rates of testicular oocytes, and female-biased sex ratios however, there was no clear statistical association between pesticide concentrations and biomarkers. Data interpretation was hindered because timing and duration of exposures were unknown and due to an incomplete understanding of L. blairi sexual development. Emphasis is on describing the complex developmental biology of closely-related leopard frogs, how this understanding can explain RWB L. blairi anomalies, and the need for sampling at the appropriate life stage. - Highlights: ► We collected froglets from wetlands in agricultural and non-agricultural areas. ► We compared metamorph gonad morphology and parasite abundance. ► Pesticides, parasites were lower in wetlands buffered against agricultural run-off. ► Abnormalities were enlarged ovarian cavities, testicular oocytes, biased sex ratios. ► Results show importance of understanding normal reproductive biology of the species. - Frogs from wetlands in agricultural areas had reproductive anomalies however no statistical relationship existed between biomarkers and measured concentrations of pesticides.

  4. Brain perfusion imaging in amyotrophic lateral sclerosis with dementia

    International Nuclear Information System (INIS)

    Ishikawa, Takehisa; Morita, Mitsuya; Nakano, Imaharu

    2007-01-01

    Single photon emission computed tomography (SPECT) studies have been applied for evaluation of regional cerebral blood flow (rCBF) in various neurodegenerative disorders including amyotrophic lateral sclerosis (ALS) and ALS with dementia (ALS-D). Brain perfusion SPECT using statistical image analysis is useful for accurate and objective diagnosis to evaluate slight decreases in rCBF, even in cases difficult to assess by visual inspection. We have used statistical parametric mapping (SPM), three-dimensional stereotactic surface projection (3D-SSP), easy Z-score imaging system (eZIS) as statistical image analyses. ALS-D cases, even if a case manifests minimal mentality change, showed obvious rCBF reduction in the bilateral prefrontal area with some irregularity and laterality of its decrease. This abnormality was clear in ALS-D compared with classic ALS. Our study has demonstrated that brain perfusion SPECT imaging using statistical image analyses is quite useful as an adjunct to presume the existence of dementia in ALS, even if ALS patients have trouble in verbal or manual communication of the language because of progressive bulbar symptoms and muscle weakness. Thus, for ALS patients with any subtle signs and symptoms suggesting dementia, we recommend a SPECT study with use of statistical image analyses. (author)

  5. Dynamic perfusion patterns in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Dupont, Patrick; Paesschen, Wim van [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); Zaknun, John J. [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Maes, Alex [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); AZ Groeninge, Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn; Locharernkul, Chaichon [Chulalongkorn University, Nuclear Medicine and Neurology, Bangkok (Thailand); Vasquez, Silvia; Carpintiero, Silvina [Fleni Instituto de Investigaciones Neurologicas, Nuclear Medicine, Buenos Aires (Argentina); Bal, C.S. [All India Institute of Medical Sciences, Nuclear Medicine, New Delhi (India); Dondi, Maurizio [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); Ospedale Maggiore, Nuclear Medicine, Bologna (Italy)

    2009-05-15

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  6. CT perfusion mapping of hemodynamic disturbances associated to acute spontaneous intracerebral hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Fainardi, Enrico; Borrelli, Massimo; Saletti, Andrea; Ceruti, Stefano; Tamarozzi, Riccardo [Azienda Ospedaliera Universitaria, Neuroradiology Unit, Department of Neuroscience, Ferrara (Italy); Schivalocchi, Roberta; Cavallo, Michele [Azienda Ospedaliera Universitaria, Neurosurgery Unit, Department of Neuroscience, Ferrara (Italy); Azzini, Cristiano [Azienda Ospedaliera Universitaria, Neurology Unit, Department of Neuroscience, Ferrara (Italy); Chieregato, Arturo [Ospedale M. Bufalini, Neurocritical Care Unit, Cesena (Italy)

    2008-08-15

    We sought to quantify perfusion changes associated to acute spontaneous intracerebral hemorrhage (SICH) by means of computed tomography perfusion (CTP) imaging. We studied 89 patients with supratentorial SICH at admission CT by using CTP scanning obtained within 24 h after symptom onset. Regional cerebral blood flow (rCBF), cerebral blood volume (rCBV) and mean transit time (rMTT) levels were measured in four different regions of interest manually outlined on CT scan: (1) hemorrhagic core; (2) perihematomal low-density area; (3) 1 cm rim of normal-appearing brain tissue surrounding the perilesional area; and (4) a mirrored area, including the clot and the perihematomal region, located in the non-lesioned contralateral hemisphere. rCBF, rCBV, and rMTT mean levels showed a centrifugal distribution with a gradual increase from the core to the periphery (p < 0.0001). Perfusion absolute values were indicative of ischemia in hemorrhagic core, oligemia in perihematomal area, and hyperemia in normal-appearing and contralateral areas. Perihematomal rCBF and rCBV mean levels were higher in small ({<=}20 ml) than in large (>20 ml) hematomas (p<0.01 and p <0.02, respectively). Multi-parametric CTP mapping of acute SICH indicates that perfusion values show a progressive improvement from the core to the periphery. In the first 24 h, perihemorrhagic region was hypoperfused with CTP values which were not suggestive of ischemic penumbra destined to survive but more likely indicative of edema formation. These findings also argue for a potential influence of early amounts of bleeding on perihematomal hemodynamic abnormalities. (orig.)

  7. Ventilation-perfused studies using SPECT

    International Nuclear Information System (INIS)

    Zwijnenburg, A.

    1989-01-01

    A method for the quantitative analysis of ventilation-perfusion SPECT studies is decribed and an effort is made to evaluate its usefullness. The technical details of the emthod are described. In the the transaxial reconstructions of the tomographic studies the contour of the lungs is detected and regional values of lung volume, ventilation, perfusion and ventilation-perfusion ratios are calculated. The method is operator independent. The lung volume calculations from the SPECT studies are validated by comparing them with lung volume measurements using the helium dilution technique. A good correlation (r=0.91) was found between the two volumes. SPECT volume was greater than the volume measured with helium dilution, which was attributed to non-gas-containing structures in the. lungs. The use of ventilation-perfusion ratio SPECT is described to evaluate the effect of ionizing radiation on the lungs in patients treated with mantle field irradiation for Hodgkin's disease. Perfusion changes appear as early as 2 months after the start of irradiation. Ventilation changes appear later and relatively minor. No changes are seen outside the radiation portals. The ventilation-perfusion inequality in pulmonary sarcoidosis is treated. It is suggested that the decrease D LCO in these patients may be partly due to an even distribution of ventilation perfusion ratios. An effort is made to establish the properties of a new tracer used for the assessment of the metabolic function of the pulmonary endothelium. The lung uptake of I-123 IMP mimics the distribution of a perfusion tracer and it is suggested that this tracer may be useful for the early detection of pulmonary vascular damage, even when blood flow is still intact. Some aspects of the use of Kr-81m as a ventilation tracer are discussed as well as the effect of noise on Kr-81m SPECT reconstructions. (author). 146 refs.; 39 figs.; 8 tabs

  8. Myocardial perfusion in type 2 diabetes with left ventricular hypertrophy

    DEFF Research Database (Denmark)

    Hesse, Birger; Meyer, Christian; Nielsen, Flemming S

    2004-01-01

    The purpose of this study was to assess whether acute angiotensin-converting enzyme (ACE) inhibition would improve myocardial perfusion and perfusion reserve in a subpopulation of normotensive patients with diabetes and left ventricular hypertrophy (LVH), both independent risk factors of coronary...... disease. Using positron emission tomography (PET), we investigated the response of regional myocardial perfusion to acute ACE inhibition with i.v. infusion of perindoprilat (vs saline infusion as control, minimum interval 3 days) in 12 diabetic patients with LVH. Myocardial perfusion was quantified...... with controls, maximal perfusion was reduced in patients (1.8+/-0.6 vs 2.5+/-1.0 ml min(-1) g(-1); P2.7+/-1.0 vs 3.6+/-1.3; P=0.059). During perindoprilat infusion, myocardial perfusion reserve in patients increased to 3.9+/-0.9 ( P

  9. Brain perfusion: computed tomography and magnetic resonance techniques.

    Science.gov (United States)

    Copen, William A; Lev, Michael H; Rapalino, Otto

    2016-01-01

    Cerebral perfusion imaging provides assessment of regional microvascular hemodynamics in the living brain, enabling in vivo measurement of a variety of different hemodynamic parameters. Perfusion imaging techniques that are used in the clinical setting usually rely upon X-ray computed tomography (CT) or magnetic resonance imaging (MRI). This chapter reviews CT- and MRI-based perfusion imaging techniques, with attention to image acquisition, clinically relevant aspects of image postprocessing, and fundamental differences between CT- and MRI-based techniques. Correlations with cerebrovascular physiology and potential clinical applications of perfusion imaging are reviewed, focusing upon the two major classes of neurologic disease in which perfusion imaging is most often performed: primary perfusion disorders (including ischemic stroke, transient ischemic attack, and reperfusion syndrome), and brain tumors. © 2016 Elsevier B.V. All rights reserved.

  10. Prior CT May Improve Diagnostic Confidence in Myocardial Perfusion Imaging.

    Science.gov (United States)

    Mehta, Pareen; Wassef, Heidi; Colletti, Patrick M

    2015-10-01

    Many patients with matching myocardial perfusion imaging defects may have prior CT examinations that include the myocardial region of interest, such as a CT chest or CT abdomen. We correlate these perfusion defects with available prior CT examinations to determine if this will improve diagnostic confidence. Myocardial perfusion scans were reviewed to identify cases with myocardial perfusion defects and prior CT imaging that included the myocardium. The CT was reviewed for evidence of myocardial injury that correlated with the perfusion defect. A retrospective review of 732 myocardial perfusion scans was performed, of which 69 cases with perfusion defects were identified that also had prior CT imaging available for review. Of this subset of patients, 19 patients had findings on the CT scan compatible with ischemia or infarction in the expected region of the perfusion defect, which allowed for a more confident diagnosis. Reviewing a prior CT scan, if available, during the interpretation of a myocardial perfusion scan, can help improve diagnostic confidence in over 25% of cases. This can lead to decreased indeterminate results and can be used to potentially avoid unhelpful further testing.

  11. Abnormal regional spontaneous neural activity in visual pathway in retinal detachment patients: a resting-state functional MRI study

    Directory of Open Access Journals (Sweden)

    Huang X

    2017-11-01

    Full Text Available Xin Huang,1,2,* Dan Li,3,* Hai-Jun Li,3 Yu-Lin Zhong,1 Shelby Freeberg,4 Jing Bao,1 Xian-Jun Zeng,3 Yi Shao1 1Department of Ophthalmology, The First Affiliated Hospital of Nanchang University, Jiangxi Province Clinical Ophthalmology Institute, Nanchang, Jiangxi, People’s Republic of China; 2Department of Ophthalmology, Eye Center, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, People’s Republic of China; 3Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China; 4Department of Ophthalmology, University of Florida, Gainesville, FL, USA *These authors contributed equally to this work Objective: The aim of the study was to investigate changes of brain neural homogeneity in retinal detachment (RD patients using the regional homogeneity (ReHo method to understand their relationships with clinical features. Materials and methods: A total of 30 patients with RD (16 men and 14 women, and 30 healthy controls (HCs (16 men and 14 women closely matched in age and sex were recruited. Resting-state functional magnetic resonance imaging scans were performed for all subjects. The ReHo method was used to investigate the brain regional neural homogeneity. Patients with RD were distinguished from HCs by receiver operating characteristic curve. The relationships between the mean ReHo signal values in many brain regions and clinical features in RD patients were calculated by Pearson correlation analysis. Results: Compared with HCs, RD patients had significantly decreased ReHo values in the right occipital lobe, right superior temporal gyrus, bilateral cuneus and left middle frontal gyrus. Moreover, we found that the mean ReHo signal of the bilateral cuneus showed positive relationships with the duration of the RD (r=0.392, P=0.032. Conclusion: The RD patients showed brain neural homogeneity dysfunction in the visual pathway, which may underline the pathological mechanism

  12. Theoretical considerations in measurement of time discrepancies between input and myocardial time-signal intensity curves in estimates of regional myocardial perfusion with first-pass contrast-enhanced MRI.

    Science.gov (United States)

    Natsume, Takahiro; Ishida, Masaki; Kitagawa, Kakuya; Nagata, Motonori; Sakuma, Hajime; Ichihara, Takashi

    2015-11-01

    The purpose of this study was to develop a method to determine time discrepancies between input and myocardial time-signal intensity (TSI) curves for accurate estimation of myocardial perfusion with first-pass contrast-enhanced MRI. Estimation of myocardial perfusion with contrast-enhanced MRI using kinetic models requires faithful recording of contrast content in the blood and myocardium. Typically, the arterial input function (AIF) is obtained by setting a region of interest in the left ventricular cavity. However, there is a small delay between the AIF and the myocardial curves, and such time discrepancies can lead to errors in flow estimation using Patlak plot analysis. In this study, the time discrepancies between the arterial TSI curve and the myocardial tissue TSI curve were estimated based on the compartment model. In the early phase after the arrival of the contrast agent in the myocardium, the relationship between rate constant K1 and the concentrations of Gd-DTPA contrast agent in the myocardium and arterial blood (LV blood) can be described by the equation K1={dCmyo(tpeak)/dt}/Ca(tpeak), where Cmyo(t) and Ca(t) are the relative concentrations of Gd-DTPA contrast agent in the myocardium and in the LV blood, respectively, and tpeak is the time corresponding to the peak of Ca(t). In the ideal case, the time corresponding to the maximum upslope of Cmyo(t), tmax, is equal to tpeak. In practice, however, there is a small difference in the arrival times of the contrast agent into the LV and into the myocardium. This difference was estimated to correspond to the difference between tpeak and tmax. The magnitudes of such time discrepancies and the effectiveness of the correction for these time discrepancies were measured in 18 subjects who underwent myocardial perfusion MRI under rest and stress conditions. The effects of the time discrepancies could be corrected effectively in the myocardial perfusion estimates. Copyright © 2015 Elsevier Inc. All rights

  13. MRI of myocardial perfusion.

    Science.gov (United States)

    Jerosch-Herold, Michael; Muehling, Olaf; Wilke, Norbert

    2006-02-01

    An overwhelming number of myocardial perfusion studies are done by nuclear isotope imaging. Magnetic resonance imaging during the first pass of an injected, contrast bolus has some significant advantages for detection of blood flow deficits, namely higher spatial resolution, absence of ionizing radiation, and speed of the test. Previous clinical studies have demonstrated that excellent sensitivity and specificity can be achieved with MR myocardial perfusion imaging for detecting coronary artery disease, and assessment of patients with acute chest pain. Furthermore, an absolute quantification of myocardial blood flow is feasible, as was demonstrated by comparison of MR perfusion imaging, to measurements with isotope labeled microspheres in experimental models. An integrated assessment of perfusion, function, and viability, is thus feasible by MRI to answer important clinical challenges such as the identification of stunned or hibernating, but viable myocardium.

  14. Association of formal thought disorder in schizophrenia with structural brain abnormalities in language-related cortical regions.

    Science.gov (United States)

    Sans-Sansa, B; McKenna, P J; Canales-Rodríguez, E J; Ortiz-Gil, J; López-Araquistain, L; Sarró, S; Dueñas, R M; Blanch, J; Salvador, R; Pomarol-Clotet, E

    2013-05-01

    Formal thought disorder (FTD) in schizophrenia has been found to be associated with volume reductions in the left superior temporal cortex. However, there have been negative findings and some studies have also found associations in other cortical regions. Fifty-one schizophrenic patients were evaluated for presence of FTD with the Thought, Language and Communication (TLC) scale and underwent whole-brain structural MRI using optimized voxel-based morphometry (VBM). Fifty-nine matched healthy controls were also scanned. Compared to 31 patients without FTD (global TLC rating 0 or 1), 20 patients with FTD (global TLC rating 2-5) showed clusters of volume reduction in the medial frontal and orbitofrontal cortex bilaterally, and in two left-sided areas approximating to Broca's and Wernicke's areas. The pattern of FTD-associated volume reductions was largely different from that found in a comparison between the healthy controls and the patients without FTD. Analysis of correlations within regions-of-interest based on the above clusters indicated that the 'fluent disorganization' component of FTD was correlated with volume reductions in both Broca's and Wernicke's areas, whereas poverty of content of speech was correlated with reductions in the medial frontal/orbitofrontal cortex. The findings point to a relationship between FTD in schizophrenia and structural brain pathology in brain areas involved in language and executive function. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. A voxel-based morphometry (VBM) analysis of regional grey and white matter volume abnormalities within the speech production network of children who stutter

    Science.gov (United States)

    Beal, Deryk S.; Gracco, Vincent L.; Brettschneider, Jane; Kroll, Robert M.; De Nil, Luc F.

    2012-01-01

    It is well documented that neuroanatomical differences exist between adults who stutter and their fluently speaking peers. Specifically, adults who stutter have been found to have more grey matter volume (GMV) in speech relevant regions including inferior frontal gyrus, insula and superior temporal gyrus (Beal et al., 2007; Song et al., 2007). Despite stuttering having its onset in childhood only one study has investigated the neuroanatomical differences between children who do and do not stutter. Chang et al. (2008) reported children who stutter had less GMV in the bilateral inferior frontal gyri and middle temporal gyrus relative to fluently speaking children. Thus it appears that children who stutter present with unique neuroanatomical abnormalities as compared to those of adults who stutter. In order to better understand the neuroanatomical correlates of stuttering earlier in its development, near the time of onset, we used voxel-based morphometry to examine volumetric differences between 11 children who stutter and 11 fluent children. Children who stutter had less GMV in the bilateral inferior frontal gyri and left putamen but more GMV in right Rolandic operculum and superior temporal gyrus relative to fluent children. Children who stutter also had less white matter volume bilaterally in the forceps minor of the corpus callosum. We discuss our findings of widespread anatomic abnormalities throughout the cortical network for speech motor control within the context of the speech motor skill limitations identified in people who stutter (Namasivayam and van Lieshout, 2008; Smits-Bandstra et al., 2006). PMID:23140891

  16. Dynamic Chest Image Analysis: Evaluation of Model-Based Pulmonary Perfusion Analysis With Pyramid Images

    National Research Council Canada - National Science Library

    Liang, Jianming

    2001-01-01

    Dynamic Chest Image Analysis aims to develop model-based computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence...

  17. Nitroglycerin reverts clinical manifestations of poor peripheral perfusion in patients with circulatory shock

    NARCIS (Netherlands)

    A.A.P. Lima (Alexandre ); M.E. van Genderen (Michel); J. van Bommel (Jasper); E. Klijn (Elko); T. Jansem (Tim); J. Bakker (Jan)

    2014-01-01

    textabstractIntroduction: Recent clinical studies have shown a relationship between abnormalities in peripheral perfusion and unfavorable outcome in patients with circulatory shock. Nitroglycerin is effective in restoring alterations in microcirculatory blood flow. The aim of this study was to

  18. Detection of regional derangements in myocardial metabolism by positron computed tomography in Duchenne's muscular dystrophy

    International Nuclear Information System (INIS)

    Henze, E.; Schelbert, H.R.; Perloff, J.K.; Schwaiger, M.; Phelps, M.E.

    1982-01-01

    Duchenne's Muscular Dystrophy is unique in genetically targeting for disease a specific region of myocardium: the postero-basal left ventricular wall. Postmortem examinations revealed focal fibrous degenerations in the postero-basal segment, while the coronary arteries were usually not affected. A predystrophic metabolic fault has been postulated for this region. This hypothesis was tested with positron computed tomography as a new means for the noninvasive study of regional myocadial perfusion and metabolism and to determine the incidence of regional and global left ventricular dysfunction and perfusion abnormalities using Thallium-201 and gated blood pool imaging. Myocardial perfusion was evaluated with N-13 ammonia while regional myocardial glucose uptake was studied with the glucose analog F-18 DG. The sensitivity of each diagnostic test for detecting cardiac involvement in Duchenne's Muscular Dystrophy was evaluated. It was highest for ammonia and glucose imaging and it was low for Thallium and radionuclide blood pool imaging

  19. GAMMAGRAFÍA DE PERFUSIÓN MIOCÁRDICA EN MUJERES POSMENOPÁUSICAS CON ANGINA Y CORONARIAS EPICÁRDICAS ANGIOGRÁFICAMENTE NORMALES / Myocardial perfusion scintigraphy in postmenopausal women with angina and angiographically normal epicardial coronary

    Directory of Open Access Journals (Sweden)

    Sherien Sixto Fernández

    2011-03-01

    Full Text Available Introduction and Objectives: Microvascular angina is common in postmenopausal women. Myocardial ischemia was induced by stress testing, and reports have been published about the relationship between endothelial dysfunction and myocardial perfusion. The objective of this research was to determine whether myocardial ischemia can be evidenced by abnormalities in perfusion and function, as detected by myocardial scintigraphy in women with typical angina, normal coronary angiography and endothelial dysfunction. Methods: 59 women underwent lipid and endothelial function measurements by brachial artery ultrasound, in addition, a 24-hour ECG study (Holter. During the scintigraphy a stress-rest protocol was applied. Patients were divided into two groups according to presence (group I or absence (group II of myocardial perfusion defects. Results: 21 patients showed perfusion defects. 57 % of group I exhibited greater endothelial dysfunction. Only twelve patients showed reversible perfusion defects, and 75 % of the cases was associated with a reduction of post-stress left ventricular ejection fraction, greater than 5 %, and regional abnormalities of wall motion. Three patients in group I showed evidence of ischemia compared with four in Group II. Conclusions: The stress-induced ischemia was associated with a reduced post-stress ejection fraction and endothelial dysfunction in the studied women, and no ischemic changes in the Holter were found.

  20. Quantitative renal perfusion measurements in a rat model of acute kidney injury at 3T: testing inter- and intramethodical significance of ASL and DCE-MRI.

    Directory of Open Access Journals (Sweden)

    Fabian Zimmer

    Full Text Available OBJECTIVES: To establish arterial spin labelling (ASL for quantitative renal perfusion measurements in a rat model at 3 Tesla and to test the diagnostic significance of ASL and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI in a model of acute kidney injury (AKI. MATERIAL AND METHODS: ASL and DCE-MRI were consecutively employed on six Lewis rats, five of which had a unilateral ischaemic AKI. All measurements in this study were performed on a 3 Tesla MR scanner using a FAIR True-FISP approach and a TWIST sequence for ASL and DCE-MRI, respectively. Perfusion maps were calculated for both methods and the cortical perfusion of healthy and diseased kidneys was inter- and intramethodically compared using a region-of-interest based analysis. RESULTS/SIGNIFICANCE: Both methods produce significantly different values for the healthy and the diseased kidneys (P<0.01. The mean difference was 147±47 ml/100 g/min and 141±46 ml/100 g/min for ASL and DCE-MRI, respectively. ASL measurements yielded a mean cortical perfusion of 416±124 ml/100 g/min for the healthy and 316±102 ml/100 g/min for the diseased kidneys. The DCE-MRI values were systematically higher and the mean cortical renal blood flow (RBF was found to be 542±85 ml/100 g/min (healthy and 407±119 ml/100 g/min (AKI. CONCLUSION: Both methods are equally able to detect abnormal perfusion in diseased (AKI kidneys. This shows that ASL is a capable alternative to DCE-MRI regarding the detection of abnormal renal blood flow. Regarding absolute perfusion values, nontrivial differences and variations remain when comparing the two methods.

  1. Unusual ventilation perfusion scintigram in a case of immunologic pulmonary edema clinically simulating pulmonary embolism

    International Nuclear Information System (INIS)

    Campeau, R.J.; Faust, J.M.; Ahmad, S.

    1987-01-01

    A case of immunologic pulmonary edema secondary to hydrochlorothiazide allergy developed in a 55-year-old woman that clinically simulated pulmonary embolism. The patient had abnormal washin images with normal washout images on an Xe-133 ventilation study. On the perfusion study, large bilateral central and posterior perfusion defects were present that showed an unusual mirror image pattern on the lateral and posterior oblique views. Resolution of radiographic and scintigraphic abnormalities occurred over a 3-day period in conjunction with corticosteroid therapy

  2. Unusual ventilation perfusion scintigram in a case of immunologic pulmonary edema clinically simulating pulmonary embolism

    Energy Technology Data Exchange (ETDEWEB)

    Campeau, R.J.; Faust, J.M.; Ahmad, S.

    1987-11-01

    A case of immunologic pulmonary edema secondary to hydrochlorothiazide allergy developed in a 55-year-old woman that clinically simulated pulmonary embolism. The patient had abnormal washin images with normal washout images on an Xe-133 ventilation study. On the perfusion study, large bilateral central and posterior perfusion defects were present that showed an unusual mirror image pattern on the lateral and posterior oblique views. Resolution of radiographic and scintigraphic abnormalities occurred over a 3-day period in conjunction with corticosteroid therapy.

  3. [MSCT perfusion imaging and its correlation with perfusion parameters, survivin expression, MVD, and pathologic grade in hepatocellular carcinomas].

    Science.gov (United States)

    Long, Xueying; Cao, Jue; Shi, Linbo; Li, Wenzheng; Liu, Hui

    2009-11-01

    (1)To obtain the perfusion parameters of hepatocellular carcinomas(HCCs), peritumour livers and normal livers by multi-slice CT(MSCT)and to investigate their characteristics and clinical significances;(2)To investigate the correlation among perfusion parameters, survivin expression, microvessel density(MVD)and pathologic grade of HCCs. A total of 31 patients with HCC (5 well-differentiated HCCs, 17 moderately differentiated HCCs, and 9 poorly differentiated HCCs) and 10 normal liver were studied. All underwent CT plain scan, perfusion scan, and conventional enhancement scan of the whole liver using 16-slice spiral CT (Philips Brilliance 16). Perfusion parameters were obtained by time-density curves (TDC) of region of interest (ROI) through the perfusion scans. Tissue sections of HCCs and their corresponding peritumour liver tissues of the 31 patients were detected by immunohistochemistry (SABC methods) for protein expression of survivin and MVD, and 10 normal liver tissue sections were as used as negative controls. The correlation among the perfusion parameters, survivin expression, MVD and pathology grade were analysed. (1)The mean values of HAP, HPP, TLP, and HAI of HCCs were 27.50 mL/(min.100 mL), 19.37 mL/(min.100 mL), 46.87 mL/(min.100 mL), and 60.38%, respectively. The mean values of those of the peritumour livers were 14.93 mL/(min.100 mL), 55.70 mL/(min.100 mL), 69.63 mL/(min.100 mL), and 21.51%, respectively. The mean value of those of the normal livers were 12.22 mL/(min.100mL), 74.56 mL/(min.100 mL), 86.78 mL/(min.100 mL), and 14.00%, respectively. The values of HAP and HAI of HCCs were significantly higher than those of the peritumor livers and the normal livers(PHAP and decrease of HPP of peritumor livers were both significant compared with that of the normal livers(PHAP, HPP, and HAI of HCCs were significantly different from those of peritumor livers (Pcancerous adjacent liver tissues and normal liver tissues (PHAP values were significantly and

  4. Reduced perfusion in Broca's area in developmental stuttering.

    Science.gov (United States)

    Desai, Jay; Huo, Yuankai; Wang, Zhishun; Bansal, Ravi; Williams, Steven C R; Lythgoe, David; Zelaya, Fernando O; Peterson, Bradley S

    2017-04-01

    To study resting cerebral blood flow in children and adults with developmental stuttering. We acquired pulsed arterial spin labeling magnetic resonance imaging data in 26 participants with stuttering and 36 healthy, fluent controls. While covarying for age, sex, and IQ, we compared perfusion values voxel-wise across diagnostic groups and assessed correlations of perfusion with stuttering severity within the stuttering group and with measures of motor speed in both groups. We detected lower regional Cerebral Blood Flow (rCBF) at rest in the stuttering group compared with healthy controls in Broca's area bilaterally and the superior frontal gyrus. rCBF values in Broca's area bilaterally correlated inversely with the severity of stuttering and extended posteriorly into other portions of the language loop. We also found increased rCBF in cerebellar nuclei and parietal cortex in the stuttering group compared with healthy controls. Findings were unchanged in child-only analyses and when excluding participants with comorbid illnesses or those taking medication. rCBF is reduced in Broca's region in persons who stutter. More severe stuttering is associated with even greater reductions in rCBF to Broca's region, additive to the underlying putative trait reduction in rCBF relative to control values. Moreover, a greater abnormality in rCBF in the posterior language loop is associated with more severe symptoms, suggesting that a common pathophysiology throughout the language loop likely contributes to stuttering severity. Hum Brain Mapp 38:1865-1874, 2017. © 2017 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. The influence of regional urbanization and abnormal weather conditions on the processes of human climatic adaptation on mountain resorts

    Science.gov (United States)

    Artamonova, M.; Golitsyn, G.; Senik, I.; Safronov, A.; Babyakin, A.; Efimenko, N.; Povolotskaya, N.; Topuriya, D.; Chalaya, E.

    2012-04-01

    in patients with coronary heart disease, hypertension stage I-II syndrome disadaptative using the transcranial mezo diencephalic modulation / L.I.Zherlitsina, N.V. Efimenko, N.P. Povolotskaya, I.I. Velikanov. the Patent for the invention No.2422128, RU (11) 2 422 128 (13) C1 from 6/27/2011; Bull.13). We have observed that such anthropogenic characteristics as accumulation of aerosol with the size of particles 500-5000 nanometers in the lower atmosphere in the quantity more than 60 particles/sm3 (getting to alveoli); decrease in quantity of negative ions (N-) lower than 200 ions/sm3, high coefficient of ions unipolarity (N+/N-) - more than 4-6; mass concentration of aerosol more than 150 mkg/m3 and other modules of the environment can act as limited markers for the forecast of dangerous NAR, SAD and taking of urgent radical preventive measures. These techniques of medical weather forecast and meteo prevention can be used in other mountain regions of the world. The studies were performed by support of the Program "Basic Sciences for Medicine" and RFBR project No.10-05-01014_a.

  6. Quantitative assessment of pulmonary perfusion using dynamic contrast-enhanced CT in patients with chronic obstructive pulmonary disease: correlations with pulmonary function test and CT volumetric parameters.

    Science.gov (United States)

    Guan, Yu; Xia, Yi; Fan, Li; Liu, Shi-yuan; Yu, Hong; Li, Bin; Zhao, Li-ming; Li, Bing

    2015-05-01

    Pulmonary function test (PFT) is commonly used to help diagnose chronic obstructive pulmonary disease (COPD) and other lung diseases. However, it cannot be used to evaluate regional function and morphological abnormalities. To quantitatively evaluate pulmonary perfusion imaging using dynamic contrast-enhanced (DCE) computed tomography (CT) and observe its correlations with PFT and CT volumetric parameters in COPD patients. PFT and CT pulmonary perfusion examination were performed in 63 COPD patients. Perfusion defects were quantitated by calculating the CT value ratio (RHU) between perfusion defects (HUdefect) and normal lung (HUnormal). Volumetric CT data were used to calculate emphysema index (EI), total lung volume (TLV), and total emphysema volume (TEV). Emphysematous parenchyma was defined as the threshold of lung area lower than -950 HU. Correlations between RHU and TLV, TEV, EI, and PFT were assessed using Spearman correlation analysis. The positive rate of perfusion defects on CT perfusion images was higher than that of emphysema on CT mask images (χ(2) = 17.027, P < 0.001). The Spearman correlation test showed that RHU was positively correlated with FEV1 (R = 0.59, P < 0.001), FEV1% Predicted (R = 0.61, P < 0.001), FVC (R = 0.47, P = 0.002), and FEV1/FVC (R = 0.65, P < 0.001), and negatively correlated with EI (R = -0.67, P < 0.001). CT perfusion imaging is more sensitive in detecting emphysema that is inconspicuous on CT images. RHU is correlated with PFT and CT volumetric parameters, suggesting that it is more sensitive in detecting early COPD changes and may prove to be a potential predictor of focal lung function. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  7. Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [School of Medicine, Dong-A University, Busan (Korea, Republic of)

    2004-07-01

    Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5{+-}5.6 years, educational period: 4.5{+-}4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1{+-}4.5 years, educational period: 6.5{+-}4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP.

  8. Intra-Arterial MR Perfusion Imaging of Meningiomas: Comparison to Digital Subtraction Angiography and Intravenous MR Perfusion Imaging.

    Directory of Open Access Journals (Sweden)

    Mark A Lum

    Full Text Available To evaluate the ability of IA MR perfusion to characterize meningioma blood supply.Studies were performed in a suite comprised of an x-ray angiography unit and 1.5T MR scanner that permitted intraprocedural patient movement between the imaging modalities. Patients underwent intra-arterial (IA and intravenous (IV T2* dynamic susceptibility MR perfusion immediately prior to meningioma embolization. Regional tumor arterial supply was characterized by digital subtraction angiography and classified as external carotid artery (ECA dural, internal carotid artery (ICA dural, or pial. MR perfusion data regions of interest (ROIs were analyzed in regions with different vascular supply to extract peak height, full-width at half-maximum (FWHM, relative cerebral blood flow (rCBF, relative cerebral blood volume (rCBV, and mean transit time (MTT. Linear mixed modeling was used to identify perfusion curve parameter differences for each ROI for IA and IV MR imaging techniques. IA vs. IV perfusion parameters were also directly compared for each ROI using linear mixed modeling.18 ROIs were analyzed in 12 patients. Arterial supply was identified as ECA dural (n = 11, ICA dural (n = 4, or pial (n = 3. FWHM, rCBV, and rCBF showed statistically significant differences between ROIs for IA MR perfusion. Peak Height and FWHM showed statistically significant differences between ROIs for IV MR perfusion. RCBV and MTT were significantly lower for IA perfusion in the Dural ECA compared to IV perfusion. Relative CBF in IA MR was found to be significantly higher in the Dural ICA region and MTT significantly lower compared to IV perfusion.

  9. Disturbances in the cerebral perfusion of human immune deficiency virus-1 seropositive asymptomatic subjects: A quantitative tomography study of 18 cases

    International Nuclear Information System (INIS)

    Tran Dinh, Y.R.; Mamo, H.; Cervoni, J.; Caulin, C.; Saimot, A.C.

    1990-01-01

    Quantitative measurements of cerebral blood flow (CBF) by xenon-133 ( 133 Xe) tomography, together with magnetic resonance imaging (MRI), electroencephalography (EEG), psychometric tests, and laboratory analyses were performed on 18 human immunodeficiency virus 1 (HIV-1) seropositive asymptomatic subjects. Abnormalities of cerebral perfusion were observed in 16 cases (88%). These abnormalities were particularly frequent in the frontal regions (77% of cases). MRI demonstrated leucoencephalopathy in only two cases. EEG showed only induced diffuse abnormalities in two cases. Psychometric tests showed restricted moderate disturbances in 55% of patients. These disturbances mostly concerned those sectors involved in cognitive functions and memorization. These results indicate that quantitative measurements of CBF by 133 Xe-SPECT is capable of detecting abnormalities of cerebral perfusion at a very early stage (Phase II) of HIV-1 infection. These abnormalities are indications of disturbances resulting from unidentified metabolic or vascular lesions. This technique appears to be superior to MRI at this stage of the disease's development. It could provide objective information leading to earlier treatment, and prove useful in evaluating potential antiviral chemotherapy

  10. The utility of first-pass perfusion CT in hyperacute ischemic stroke: early experience

    International Nuclear Information System (INIS)

    Lee, Tae Jin; Lee, Myeong Sub; Kim, Myung Soon; Hong, In Soo; Lee, Young Han; Lee, Ji Yong; Whang, Kum

    2003-01-01

    To evaluate the findings of first-pass perfusion CT in hyperacute stroke patients and to determine the relationship between a perfusion map and final infarct outcome. Thirty-five patients admitted with ischemic stroke within six hours of the onset of symptoms underwent conventional cerebral CT immediately followed by first-pass perfusion CT. Nineteen underwent follow-up CT or MRI, and three types of dynamic perfusion map-cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) - were evaluated by two radiologists. In these 19 patients, initial perfusion maps correlated with final infarct size, determined during follow-up studies. In all 35 patients, major large vessel perfusion abnormalities [middle cerebral artery - MCA MCA and anterior cerebral artery - ACA (n=2); posterior cerebral artery - PCA (n=8)] were detected. On first-pass perfusion maps depicting CBF and MTT, all lesions were detected, and CBF and delayed MTT values were recorded. CBV maps showed variable findings. In all 19 patients who were followed up, the final infarct size of perfusion abnormalities was less than that depicted on CBF and MTT maps, and similar to or much greater than that seen on CBV maps. First-pass perfusion CT scanning is a practical, rapid and advanced imaging technique. In hyperacute stroke patients, it provides important and reliable hemodynamic information as to which brain tissue is salvageable by thrombolytic therapy, and predicts outcome of such treatment

  11. Dynamic Chest Image Analysis: Model-Based Perfusion Analysis in Dynamic Pulmonary Imaging

    Directory of Open Access Journals (Sweden)

    Kiuru Aaro

    2003-01-01

    Full Text Available The "Dynamic Chest Image Analysis" project aims to develop model-based computer analysis and visualization methods for showing focal and general abnormalities of lung ventilation and perfusion based on a sequence of digital chest fluoroscopy frames collected with the dynamic pulmonary imaging technique. We have proposed and evaluated a multiresolutional method with an explicit ventilation model for ventilation analysis. This paper presents a new model-based method for pulmonary perfusion analysis. According to perfusion properties, we first devise a novel mathematical function to form a perfusion model. A simple yet accurate approach is further introduced to extract cardiac systolic and diastolic phases from the heart, so that this cardiac information may be utilized to accelerate the perfusion analysis and improve its sensitivity in detecting pulmonary perfusion abnormalities. This makes perfusion analysis not only fast but also robust in computation; consequently, perfusion analysis becomes computationally feasible without using contrast media. Our clinical case studies with 52 patients show that this technique is effective for pulmonary embolism even without using contrast media, demonstrating consistent correlations with computed tomography (CT and nuclear medicine (NM studies. This fluoroscopical examination takes only about 2 seconds for perfusion study with only low radiation dose to patient, involving no preparation, no radioactive isotopes, and no contrast media.

  12. Is there any advantage to the acquisition of 24-hour thallium images, in the presence of persistent perfusion defects at 4 h after reinjection?

    Energy Technology Data Exchange (ETDEWEB)

    Bobba, K.; Botvinick, E.H.; Sciammarella, M.G.; Starsken, N.F.; Zhu, Y.Y.; Lapidus, A.; Dae, M.W. [Nuclear Medicine Section, Department of Radiology, Cardiovascular Division, Department of Medicine, and the Cardiovascular Research Institute, University of California, San Francisco (United States)

    1998-05-01

    We determined the incidence of delayed 24-h reversibility post thallium-201 reinjection and imaging at 4 h, as well as the prognostic and significance of such delayed reversibility. We studied 46 consecutive patients with persistent thallium-201 perfusion or incompletely reversible SPET perfusion defects acquired within 10 min after reinjection performed 4 h after stress. In 38 of 46 patients 24-h images showed no further reversibility beyond the post-reinjection 4-h study (group A). Eight of 46 patients demonstrated reversibility on 24-h imaging (group B). Of these eight, three patients showed no improvement compared with the post-stress images, with a mean perfusion score of the abnormal segments of 1.25{+-}0.50 on the 4-h images, and of 3.00 on the 24-h images. Four patients presented with nine mixed regions. Four of these regions showed an improvement in the mean perfusion score of 2.50{+-}0.58 on 4- and 24-h images. Two of them, with moderate/severe defects, demonstrated complete reversibility at 4-h post-reinjection imaging. In addition, five other regions presented no improvement at 4-h imaging, but showed an improvement in the mean perfusion score from 0.80{+-}0.84 at 4-h to 3.30{+-}0.89 at 24-h imaging. Two of these regions in one patient showed a severe perfusion score of 0 at 4 h, and complete reversibility at 24 hours. Another patient had three severe perfusion defects; two of them redistributed partially at 4 h and completely at 24 h. The remaining segment with a perfusion score of 0 at 4 h, presented complete reversibility at 24 h. Two patients revealed significant reversibility at 24 h in a region that was severely underperfused after post-reinjection imaging at 4 h. Among group B patients, 75% had recent acute ischemic syndrome, compared with only 13% in group A. Among 11 patients with unstable angina, six had evidence of delayed 24-h reversibility, compared with 2 of 35 patients without clinically acute ischemia. On follow-up, there were seven

  13. Magnetic resonance diffusion-perfusion mismatch in acute ischemic stroke: An update

    Science.gov (United States)

    Chen, Feng; Ni, Yi-Cheng

    2012-01-01

    The concept of magnetic resonance perfusion-diffusion mismatch (PDM) provides a practical and approximate measure of the tissue at risk and has been increasingly applied for the evaluation of hyperacute and acute stroke in animals and patients. Recent studies demonstrated that PDM does not optimally define the ischemic penumbra; because early abnormality on diffusion-weighted imaging overestimates the infarct core by including part of the penumbra, and the abnormality on perfusion weighted imaging overestimates the penumbra by including regions of benign oligemia. To overcome these limitations, many efforts have been made to optimize conventional PDM. Various alternatives beyond the PDM concept are under investigation in order to better define the penumbra. The PDM theory has been applied in ischemic stroke for at least three purposes: to be used as a practical selection tool for stroke treatment; to test the hypothesis that patients with PDM pattern will benefit from treatment, while those without mismatch pattern will not; to be a surrogate measure for stroke outcome. The main patterns of PDM and its relation with clinical outcomes were also briefly reviewed. The conclusion was that patients with PDM documented more reperfusion, reduced infarct growth and better clinical outcomes compared to patients without PDM, but it was not yet clear that thrombolytic therapy is beneficial when patients were selected on PDM. Studies based on a larger cohort are currently under investigation to further validate the PDM hypothesis. PMID:22468186

  14. Brain perfusion abnormality in patients with chronic pain.

    Science.gov (United States)

    Honda, Tetsumi; Maruta, Toshihiko; Takahashi, Kumiko

    2007-06-01

    We performed single photon emission computed tomography (SPECT) of the brain in 15 patients with chronic pain (males, 7; females, 8; average age 49.1 +/- 17.9 years) and identified the locus of cerebral blood flow reduction by a new analytical method (easy Z-score Imaging System: eZIS) to clarify the functional neuroanatomical basis of chronic pain. Of the 15 patients, 6 had backache, 2 neck pain, 2 gonalgia, and 5 pain at other sites, with an average Visual analog scale of pain (VAS) value of 6.1 +/- 1.9. In comparison with a information on a data base on physically unimpaired persons, the dorsolateral prefrontal area (both sides, right dominant), medial prefrontal area (both sides), dorsal aspect of the anterior cingulate gyrus nociceptive cortex (both sides) and the lateral part of the orbitofrontal cortex (right side) were found to have blood flow reduction in the group of patients with chronic pain. As for chronic pain and its correlation with clinical features such as a depressive state, anticipation anxiety, PTSD, and conversion hysteria, the mechanism in the brain that was suggested by this study should be followed-up by functional neuroimaging studies.

  15. Brain perfusion abnormality in patients with chronic pain

    International Nuclear Information System (INIS)

    Honda, Tetsumi; Maruta, Toshihiko; Takahashi, Kumiko

    2007-01-01

    We performed single photon emission computed tomography (SPECT) of the brain in 15 patients with chronic pain (males, 7; females, 8; average age 49.1±17.9 years) and identified the locus of cerebral blood flow reduction by a new analytical method (easy Z-score Imaging System: eZIS) to clarify the functional neuroanatomical basis of chronic pain. Of the 15 patients, 6 had backache, 2 neck pain, 2 gonalgia, and 5 pain at other sites, with an average Visual analog scale of pain (VAS) value of 6.1±1.9. In comparison with a information on a data base on physically unimpaired persons, the dorsolateral prefrontal area (both sides, right dominant), medial prefrontal area (both sides), dorsal aspect of the anterior cingulate gyrus nociceptive cortex (both sides) and the lateral part of the orbitofrontal cortex (right side) were found to have blood flow reduction in the group of patients with chronic pain. As for chronic pain and its correlation with clinical features such as a depressive state, anticipation anxiety, post-traumatic stress disorder (PTSD), and conversion hysteria, the mechanism in the brain that was suggested by this study should be followed-up by functional neuroimaging studies. (author)

  16. Extremity perfusion for sarcoma

    NARCIS (Netherlands)

    Hoekstra, Harald Joan

    2008-01-01

    For more than 50 years, the technique of extremity perfusion has been explored in the limb salvage treatment of local, recurrent, and multifocal sarcomas. The "discovery" of tumor necrosis factor-or. in combination with melphalan was a real breakthrough in the treatment of primarily irresectable

  17. Isolated limb perfusion.

    Science.gov (United States)

    Gillespie, Rosalyn; Chantier, Nariane

    1994-12-08

    Growing concern over the rising incidence of malignant melanoma has brought about a need for information on this disorder and the treatment available. Isolated limb perfusion is a relatively new technique used in only a few hospitals. An increased knowledge base will lead to a better understanding of the nursing care required and to a more in-depth care plan.

  18. Spatio-temporal analysis of blood perfusion by imaging photoplethysmography

    Science.gov (United States)

    Zaunseder, Sebastian; Trumpp, Alexander; Ernst, Hannes; Förster, Michael; Malberg, Hagen

    2018-02-01

    Imaging photoplethysmography (iPPG) has attracted much attention over the last years. The vast majority of works focuses on methods to reliably extract the heart rate from videos. Only a few works addressed iPPGs ability to exploit spatio-temporal perfusion pattern to derive further diagnostic statements. This work directs at the spatio-temporal analysis of blood perfusion from videos. We present a novel algorithm that bases on the two-dimensional representation of the blood pulsation (perfusion map). The basic idea behind the proposed algorithm consists of a pairwise estimation of time delays between photoplethysmographic signals of spatially separated regions. The probabilistic approach yields a parameter denoted as perfusion speed. We compare the perfusion speed versus two parameters, which assess the strength of blood pulsation (perfusion strength and signal to noise ratio). Preliminary results using video data with different physiological stimuli (cold pressure test, cold face test) show that all measures are influenced by those stimuli (some of them with statistical certainty). The perfusion speed turned out to be more sensitive than the other measures in some cases. However, our results also show that the intraindividual stability and interindividual comparability of all used measures remain critical points. This work proves the general feasibility of employing the perfusion speed as novel iPPG quantity. Future studies will address open points like the handling of ballistocardiographic effects and will try to deepen the understanding of the predominant physiological mechanisms and their relation to the algorithmic performance.

  19. Detection of resting myocardial perfusion defects by SonoVue myocardial contrast echocardiography.

    Science.gov (United States)

    Nahar, Tamanna; Li, Peng; Kuersten, Bettina; Batra, Sanjay; Vannan, Mani A

    2003-08-01

    SonoVue is a new microbubble contrast agent containing sulfur hexafluoride. We assessed the efficacy of SonoVue myocardial contrast echocardiography (MCE) to detect resting perfusion abnormalities. Nineteen adult patients with a wall motion abnormality in a screening echocardiogram were studied. Each patient received up to four bolus injections of 2.0 mL SonoVue (Bracco Diagnostics, Inc.) during echocardiographic examination using either B-mode(n = 12)or power Doppler(n = 7)imaging. Each patient also had SPECT nuclear perfusion imaging performed. Segmental assessment of myocardial perfusion from SonoVue MCE images were compared with corresponding SPECT nuclear images. Using B-mode imaging, the mean number of views obtained with a single SonoVue injection ranged from 1.4 to 1.9, with 2 or 3 injections required for a complete examination. Ninety-four percent of segments were scored as diagnostic. Agreement between B-mode and SPECT images was 72% for segments with a perfusion defect, 86% for normal perfusion, and 80% for segments with either perfusion defect or normal perfusion (all views combined). Using power Doppler imaging, the mean number of views obtained with a single SonoVue injection ranged from 1.0 to 1.3, with 2 to 4 injections required for a complete examination. Sixty-eight percent of segments were scored as diagnostic. Agreement between power Doppler and SPECT images was 67% for perfusion defects, 53% for segments with normal perfusion, and 59% for segments with either perfusion defect or normal perfusion (all views combined). SonoVue MCE has the potential to assess myocardial perfusion at rest. B-mode imaging was more accurate than power Doppler imaging when compared with SPECT nuclear imaging.

  20. Influence of excessive iodine intake on the thyroid function and spectrum of thyroid abnormalities in population of Turinsk, Sverdlovsk Region, of Russia

    Directory of Open Access Journals (Sweden)

    Aleksey Vasil'evich Kiyaev

    2015-05-01

    Full Text Available Background.Previous surveys showed chronic iodine excess - median urinary iodine concentration (UIC over 500 mcg/l — supposedly due to water contamination in population of Turinsk, a town in Sverdlovsk Region of Russia.Aim.Conduct an assessment of the effects of chronic iodine excess on thyroid function and spectrum of thyroid abnormalities in schoolchildren and adults.Materials and methods.Assessment was conducted in 100 schoolchildren and 100 adults residing in Turinsk and 97 schoolchildren and 100 adults in the control site (city of Pervouralsk with optimal UIC. Assessment included thyroid ultrasonogrpahy, urinary iodine and dry spot TSH in schoolchildren and TSH and TPO-ab in adults. Iodine was also measured in random water samples from 10 households in Turinsk.Results.Median UIC in schoolchildren in Turinsk (719 mcg/l was significantly higher (129 mcg/l than in Pervouralsk resulting in higher prevalence of thyroid enlargement and TSH level. In adults TSH level as well as prevalence of sub-clinical hypothyroidism and autoimmune thyroiditis were higher in residents of Turinsk compared to control group from Pervouralsk.Conclusions.Iodine excess alters thyroid function in schoolchildren and adults increasing prevalence of thyroid enlargement in children and autoimmune thyroidis in adults.

  1. White matter abnormalities at a regional and voxel level in focal and generalized epilepsy : A systematic review and meta-analysis

    NARCIS (Netherlands)

    Slinger, Geertruida; Sinke, Michel R T|info:eu-repo/dai/nl/413981355; Braun, Kees P J|info:eu-repo/dai/nl/207237239; Otte, Willem M.|info:eu-repo/dai/nl/168455706

    2016-01-01

    Objective Since the introduction of diffusion tensor imaging, white matter abnormalities in epilepsy have been studied extensively. However, the affected areas reported, the extent of abnormalities and the association with relevant clinical parameters are highly variable. We aimed to obtain a more

  2. Left ventricular regional contraction abnormalities by echocardiographic speckle tracking in combined right bundle branch with left anterior fascicular block compared to left bundle branch block

    DEFF Research Database (Denmark)

    Leeters, Irene P M; Davis, Ashlee; Zusterzeel, Robbert

    2016-01-01

    BACKGROUND: In contrast to LBBB patients less is known about patients with RBBB+LAFB regarding LV contractile abnormalities and the potential role of CRT. This study investigated whether patients with RBBB+LAFB morphology have echocardiographic mechanical strain abnormalities between the inferior...

  3. Prediction of Liver Function by Using Magnetic Resonance-based Portal Venous Perfusion Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Cao Yue, E-mail: yuecao@umich.edu [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Wang Hesheng [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Johnson, Timothy D. [Department of Biostatistics, University of Michigan, Ann Arbor, Michigan (United States); Pan, Charlie [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Hussain, Hero [Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Normolle, Daniel; Ben-Josef, Edgar; Ten Haken, Randall K.; Lawrence, Theodore S.; Feng, Mary [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2013-01-01

    Purpose: To evaluate whether liver function can be assessed globally and spatially by using volumetric dynamic contrast-enhanced magnetic resonance imaging MRI (DCE-MRI) to potentially aid in adaptive treatment planning. Methods and Materials: Seventeen patients with intrahepatic cancer undergoing focal radiation therapy (RT) were enrolled in institution review board-approved prospective studies to obtain DCE-MRI (to measure regional perfusion) and indocyanine green (ICG) clearance rates (to measure overall liver function) prior to, during, and at 1 and 2 months after treatment. The volumetric distribution of portal venous perfusion in the whole liver was estimated for each scan. We assessed the correlation between mean portal venous perfusion in the nontumor volume of the liver and overall liver function measured by ICG before, during, and after RT. The dose response for regional portal venous perfusion to RT was determined using a linear mixed effects model. Results: There was a significant correlation between the ICG clearance rate and mean portal venous perfusion in the functioning liver parenchyma, suggesting that portal venous perfusion could be used as a surrogate for function. Reduction in regional venous perfusion 1 month after RT was predicted by the locally accumulated biologically corrected dose at the end of RT (P<.0007). Regional portal venous perfusion measured during RT was a significant predictor for regional venous perfusion assessed 1 month after RT (P<.00001). Global hypovenous perfusion pre-RT was observed in 4 patients (3 patients with hepatocellular carcinoma and cirrhosis), 3 of whom had recovered from hypoperfusion, except in the highest dose regions, post-RT. In addition, 3 patients who had normal perfusion pre-RT had marked hypervenous perfusion or reperfusion in low-dose regions post-RT. Conclusions: This study suggests that MR-based volumetric hepatic perfusion imaging may be a biomarker for spatial distribution of liver function, which

  4. Role of myocardial perfusion SPECT in asymptomatic diabetic patients

    International Nuclear Information System (INIS)

    Cho, I.; Chun, K.; Won, K.; Lee, H.; Park, J.; Shin, D.; Kim, Y.; Shim, B.; Lee, J.

    2002-01-01

    Purpose: It is important that early diagnosis and treatment of coronary artery disease in diabetic patients, but there are few reports on the prevalence of stress-induced myocardial perfusion abnormalities and the rates of cardiac event in patients with type 2 diabetes. We evaluated the scan findings on gated myocardial perfusion SPECT in asymptomatic diabetic patients. Methods: We performed pharmacological stress test and gated perfusion SPECT in 69 diabetic patients without cardiovascular symptom (mean age: 65 year, male 31 and female 38). Patients underwent two-day imaging protocol and stress study was performed injection of Tc-99m MIBI during adenosine infusion. We followed up these patients by reviewing medical records. Results: Fifty-two of 69 patients (74.5%) showed normal scan findings and 17 patients (24.6%) showed reversible or fixed perfusion defects. Three of 52 patients with normal scan findings showed decreased LV ejection fraction and decreased wall motion. Twenty-three patients with normal scan findings were possible to follow up for more than 1yr (mean time: 18.3±3.3 mo.) and they all had no cardiac event. Three patients with reversible perfusion defects were performed coronary angioplasty. Conclusion: Myocardial perfusion SPECT is a noninvasive method and maybe useful in early diagnosis and predicting prognosis in diabetic patients

  5. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

    NARCIS (Netherlands)

    A. Mendrik (Adrienne); E.J.P.A. Vonken; B.T.J. van Ginneken (Berbke); J.R. Riordan (John ); H.W.A.M. de Jong (Hugo); T. van Seeters (Tom); E.J. Smit (Ewoud); M.A. Viergever (Max); M. Prokop (Mathias)

    2011-01-01

    textabstractCerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of

  6. TIPS bilateral noise reduction in 4D CT perfusion scans produces high-quality cerebral blood flow maps

    NARCIS (Netherlands)

    Mendrik, A.M.; Vonken, E.J.; Ginneken, B. van; Jong, H.W. de; Riordan, A.; Seeters, T. van; Smit, E.J.; Viergever, M.A.; Prokop, M.

    2011-01-01

    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray

  7. Hepatic perfusion changes in an experimental model of acute pancreatitis: Evaluation by perfusion CT

    Energy Technology Data Exchange (ETDEWEB)

    Tutcu, Semra [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Serter, Selim, E-mail: serterselim@gmail.co [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Kaya, Yavuz; Kara, Eray [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey); Nese, Nalan [Department of Pathology, Celal Bayar University, School of Medicine, Manisa (Turkey); Pekindil, Goekhan [Department of Radiology, Celal Bayar University, School of Medicine, Manisa (Turkey); Coskun, Teoman [Department of Surgery, Celal Bayar University, School of Medicine, Manisa (Turkey)

    2010-08-15

    Purpose: It is known that acute pancreatitis may cause secondary changes in several organs. Liver is one of these involved organs. In different experimental studies hepatic damages were shown histopathologically in acute pancreatitis but there are a few studies about perfusion disorders that accompany these histopathologic changes. Perfusion CT (pCT) provides the ability to detect regional and global alterations in organ blood flow. The purpose of the study was to describe hepatic perfusion changes in experimental acute pancreatitis model with pCT. Materials and methods: Forty Sprague-Dawley rats of both genders with average weights of 250 g were used. Rats were randomized into two groups. Twenty rats were in control group and 20 in acute pancreatitis group. pCT was performed. Perfusion maps were formed by processing the obtained images with perfusion CT software. Blood flow (BF) and blood volume (BV) values were obtained from these maps. All pancreatic and liver tissues were taken off with laparotomy and histopathologic investigation was performed. Student's t test was used for statistical analyses. Results: In pCT we found statistically significant increase in blood volume in both lobes of liver and in blood flow in right lobe of the liver (p < 0.01). Although blood flow in left lobe of the liver increased, it did not reach statistical significance. Conclusion: The quantitative analysis of liver parenchyma with pCT showed that acute pancreatitis causes a significant perfusion changes in the hepatic tissue. Systemic mediators seem to be effective as well as local inflammatory changes in perfusion changes.

  8. Assessment of myocardial perfusion and function in victims of scorpion envenomation using gated-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Figueiredo, Alexandre Baldini de; Cupo, Palmira; Pintya, Antonio O.; Caligaris, Fabio; Marin-Neto, Jose A; Hering, Sylvia E.; Simoes, Marcus Vinicius, E-mail: simoesmv@yahoo.co [Universidade de Sao Paulo (USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2010-04-15

    Background: cardiogenic shock and acute pulmonary edema are the major causes of death of patients with scorpion envenomation, whose pathophysiological mechanism remains controversial. Objective: to investigate the correlation between myocardial perfusion abnormalities and left ventricular contractile function in victims of scorpion envenomation. Methods: fifteen patients underwent ECG-gated myocardial perfusion scintigraphy (gated SPECT) within 72 hours of, and 15 days after scorpion envenomation. Images were analyzed by means of a semi-quantitative visual perfusion score (0 = normal, 4 = absent) and motion score (0 = normal, 4 akinesia), using the 17-segment model. Summed perfusion (SPS) and summed motion (SMS) scores were calculated for each patient. Ejection fraction (LVEF) was calculated by a commercially available software. Results: at baseline, 12 out of the 15 patients presented abnormal myocardial perfusion and contractility. Mean values of SPS, SMS and LVEF were 12.5 +- 7.3, 17.0 +- 12.8, and 44.6 +- 16.0%, respectively. A positive correlation between SPS and SMS (r = 0.68; p = 0.005) and negative correlation between SPS and LVEF (r -0.75; p = 0.0021) were found. The follow-up studies showed recovery of global contractility (LVEF of 68.9 +- 9.5, p = 0.0002), segmental contractility (SMS of 2.6 +- 3.1, p = 0.0009) and perfusion (SPS of 3.7 +- 3.3, p = 0.0003). Improvement of LVEF correlated positively with improvement of SPS (r = 0.72; p = 0.0035). Conclusions: myocardial perfusion abnormalities are common in scorpion envenomation and correlate topographically with the contractile dysfunction. Recovery of contractility correlates with reversibility of perfusion defects. These findings suggest the participation of myocardial perfusion abnormalities in the pathophysiology of this form of acute ventricular failure. (author)

  9. Myocardial perfusion tomography with 7-pinhole collimator

    Energy Technology Data Exchange (ETDEWEB)

    Yonekura, Y.; Mukai, T.; Yamamoto, K. (Kyoto Univ. (Japan). Faculty of Medicine)

    1980-12-01

    The clinical efficacy of tomographic presentation of myocardial perfusion imaging with 7-pinhole collimator was evaluated. 35 cases including 5 normals, 4 patients with diffuse left ventricular hypertrophy, 21 with coronary artery disease (CAD) and 5 with hypertrophic cardiomyopathy (HCM) documented by coronary angiography and left ventriculography were selected for this study. Following the conventional /sup 201/Tl myocardial perfusion imaging (MPI), myocardial perfusion tomography (MPT) with 7-pinhole collimator was performed in both LAO and RAO projection. In addition, to examine wall motion abnormalities tomographically, /sup 201/Tl MPI as well as sup(99m)Tc-RBC blood pool imaging were gated to reconstruct multigated MPT (MGMPT) and multigated cardiac pool tomography (MGCPT). The detectability of the defect of the 7-pinhole tomography was compared with that of the conventional image using a cardiac phantom. The same degree of detectability was shown with both these two images. The MPT in LAO projection revealed superior sensitivity to the conventional MPI in the case of inferior wall infarction, and the MPT in RAO projection revealed superior sensitivity in the case of anterior wall infarction. A combination of the MGMPT and MGCPT succeeded in visualizing a subendocardial infarction as a focal gap between these two images. In the case of the small infarction undetectable in the conventional MPI, it can be seen as subtle wall motion abnormalities in the tomographic presentation in movie format. An asymmetrical hypertrophy in HCM can readily be localized in tomographic visualization. Tomographic reconstruction with 7-pinhole collimator from the optimal tomographic plane should be attempted, when the conventional display is equivocal.

  10. Regional wall thickening in gated myocardial perfusion SPECT in a Japanese population: effect of sex, radiotracer, rotation angles and frame rates

    International Nuclear Information System (INIS)

    Akhter, Nasima; Nakajima, Kenichi; Okuda, Koichi; Matsuo, Shinro; Yoneyama, Tatsuya; Taki, Junichi; Kinuya, Seigo

    2008-01-01

    Gated single-photon emission computed tomography (SPECT) imaging of myocardium by 99m Tc and 201 Tl is used extensively to measure quantitative cardiac functional parameters. However, factors affecting normal values for myocardial functional parameters and population-specific standards have not yet been established. The aim of the study was to determine the effect of sex, radiotracer, rotation angles and frame rates on resting myocardial wall thickening (WT) and to develop a Japanese standard of normal values for WT. Data from a total of 202 patients with low possibility of having cardiac problems were collected from nine hospitals throughout Japan. Patients were divided into five groups according to study protocol, and WT was evaluated according to the 17-segment and four-region (basal, mid and apical regions and the apex) polar map distribution. WT was generally higher in women than in men irrespective of the use of radiotracers, rotation angles or frame rates, and the difference was highly significant in the mid and apical regions. In any protocol used, resting myocardial thickening in the apex was higher than in the mid and apical regions, and thickening was lowest in the basal region, suggesting heterogeneous regional myocardial thickening (%) in normal subjects. Different rotation angles showed no significant change on WT, but different frame rates and tracers showed significant WT change in both sexes. Percent thickening of the myocardium was significantly higher in imaging by 99m Tc-labelled tracers than in 201 Tl. Sex, radiotracers and frame rates had a significant effect on myocardial thickening, and the importance of population-specific standards should be emphasized. A normal database can serve as a standard for gated SPECT evaluation of myocardial thickening in a Japanese population and might be applicable to Asian populations having a similar physique. (orig.)

  11. Raise up 99mTc-HMPAO brain SPECT for detecting the change in cerebral perfusion pressure

    International Nuclear Information System (INIS)

    Hayashida, Kohei; Nishimura, Tsunehiko; Uehara, Toshiisa; Kaminaga, Tatsurou; Hirose, Yoshiaki

    1992-01-01

    99m Tc-hexamethylpropyleneamine oxime ( 99 mTc-HMPAO) crossed the blood brain barrier instantly in proportional to cerebral blood flow. Raise up stress and supine resting 99m Tc-HMPAO with brain SPECT was devised for detecting abnormal response in the changes of cerebral perfusion pressure. Asymmetric ratio in the middle cerebral artery area in patients with internal carotid artery occlusion (n=5) was changed significantly from 0.82±0.06 to 0.90±0.06 and that of normal (n=5) was not changed from 0.94±0.03 to 0.95±0.01. Raise up 99m Tc-HMPAO brain SPECT enhanced the detectability in abnormality of regional cerebral blood flow and visualized the dys-autoregulated area during blood pressure falls. (author)

  12. Hepatic vascular isolation and perfusion for patients with progressive unresectable liver metastases from colorectal carcinoma refractory to previous systemic and regional chemotherapy

    Czech Academy of Sciences Publication Activity Database

    Alexander, HR.; Libutti, S. K.; Barlett, D. L.; Pingpank, J. F.; Kranda, Karel; Helsabeck, C.; Beresnev, T.

    2002-01-01

    Roč. 95, č. 4 (2002), s. 730-736 ISSN 0008-543X R&D Projects: GA AV ČR KSK4055109 Keywords : colorectal carcinoma * liver metastases * regional chemotherapy Subject RIV: FD - Oncology ; Hematology Impact factor: 1.000, year: 2002

  13. Quantitative aspects of myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Vogel, R.A.

    1980-01-01

    Myocardial perfusion measurements have traditionally been performed in a quantitative fashion using application of the Sapirstein, Fick, Kety-Schmidt, or compartmental analysis principles. Although global myocardial blood flow measurements have not proven clinically useful, regional determinations have substantially advanced our understanding of and ability to detect myocardial ischemia. With the introduction of thallium-201, such studies have become widely available, although these have generally undergone qualitative evaluation. Using computer-digitized data, several methods for the quantification of myocardial perfusion images have been introduced. These include orthogonal and polar coordinate systems and anatomically oriented region of interest segmentation. Statistical ranges of normal and time-activity analyses have been applied to these data, resulting in objective and reproducible means of data evaluation

  14. Perfusion based cell culture chips

    DEFF Research Database (Denmark)

    Heiskanen, Arto; Emnéus, Jenny; Dufva, Martin

    2010-01-01

    Performing cell culture in miniaturized perfusion chambers gives possibilities to experiment with cells under near in vivo like conditions. In contrast to traditional batch cultures, miniaturized perfusion systems provide precise control of medium composition, long term unattended cultures...... and tissue like structuring of the cultures. However, as this chapter illustrates, many issues remain to be identified regarding perfusion cell culture such as design, material choice and how to use these systems before they will be widespread amongst biomedical researchers....

  15. Reverse ventilation--perfusion mismatch

    Energy Technology Data Exchange (ETDEWEB)

    Palmaz, J.C.; Barnett, C.A.; Reich, S.B.; Krumpe, P.E.; Farrer, P.A.

    1984-01-01

    Patients having lobar airway obstruction or consolidation usually have decreases of both ventilation and perfusion on lung scans. We report three patients in whom hypoxic vasoconstriction was apparently incomplete, resulting in a ''reversed'' ventilation-perfusion mismatch. Perfusion of the hypoxic lobe on the radionuclide scan was associated with metabolic alkalosis, pulmonary venous and pulmonary arterial hypertension in these patients.

  16. Non-invasive MR perfusion study in patients with depression

    International Nuclear Information System (INIS)

    Lv Su; Huang Xiaoqi; Zou Ling; Li Dongming; Tang Hehan; Yang Hong; Zhang Tijiang; Li Xiuli; Gong Qiyong; Sun Xueli; Zou Ke

    2009-01-01

    Objective: To investigate the brain perfusion changes in patients with refractory depressive disorder (RDD) and non-refractory depressive disorder (NDD) using arterial spin labeling (ASL). Methods: Present study included 12 patients with RDD, 37 patients with NDD and 42 controls, and their age, sex and handedness were matched among the three groups. FAIR sequences were performed using a 3 T MR imaging system with an 8 channel phase array head coil. The labelled and controled images were subtracted and then averaged to obtain perfusion-weighted images. The first 2 images were excluded to avoid T 1 equilibrium effects and then voxel based analysis was performed using SPM2. One way ANOVA analysis using age as covariance (thresholded at P<0.01 uncorrected) was performed. Results: Patients with NDD showed regional alteration of the brain perfusion, mainly involved in two frontal- subcortical circuits, i.e. significantly decreased perfusion in the left frontal and thalamus (the limbic- thalamo-cortical circuit) whereas significantly increased perfusion in bilateral hippocampi, right lentiform and left anterior cingulated gyms (the limbic-striatal-pallidal-thalamic circuit). In contrast, patients with RDD presented significantly decreased perfusion involving bilateral frontal areas (the limbic-thalamo-cortical circuit) whereby no significantly increased perfusion areas were observed. Conclusion: In addition to the reported experimental evidences, our results suggest that the RDD is associated with inactivity of bilateral frontal areas, while the NDD is associated with inactivity of left frontal areas and overaetivity of bilateral limbic system. (authors)

  17. Ventilation-perfusion distribution in normal subjects.

    Science.gov (United States)

    Beck, Kenneth C; Johnson, Bruce D; Olson, Thomas P; Wilson, Theodore A

    2012-09-01

    Functional values of LogSD of the ventilation distribution (σ(V)) have been reported previously, but functional values of LogSD of the perfusion distribution (σ(q)) and the coefficient of correlation between ventilation and perfusion (ρ) have not been measured in humans. Here, we report values for σ(V), σ(q), and ρ obtained from wash-in data for three gases, helium and two soluble gases, acetylene and dimethyl ether. Normal subjects inspired gas containing the test gases, and the concentrations of the gases at end-expiration during the first 10 breaths were measured with the subjects at rest and at increasing levels of exercise. The regional distribution of ventilation and perfusion was described by a bivariate log-normal distribution with parameters σ(V), σ(q), and ρ, and these parameters were evaluated by matching the values of expired gas concentrations calculated for this distribution to the measured values. Values of cardiac output and LogSD ventilation/perfusion (Va/Q) were obtained. At rest, σ(q) is high (1.08 ± 0.12). With the onset of ventilation, σ(q) decreases to 0.85 ± 0.09 but remains higher than σ(V) (0.43 ± 0.09) at all exercise levels. Rho increases to 0.87 ± 0.07, and the value of LogSD Va/Q for light and moderate exercise is primarily the result of the difference between the magnitudes of σ(q) and σ(V). With known values for the parameters, the bivariate distribution describes the comprehensive distribution of ventilation and perfusion that underlies the distribution of the Va/Q ratio.

  18. Evaluation of myocardial involvement in Duchenne's progressive muscular dystrophy with thallium-201 myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Kawai, Naoki; Sotobata, Iwao; Okada, Mitsuhiro

    1985-01-01

    Myocardial involvement in progressive muscular dystrophy of the Duchenne type was evaluated in 19 patients using thallium-201 myocardial perfusion imaging. A qualitative analysis was performed from five projection images by three experienced physicians. Distinct perfusion defects were shown in 13 patients, especially in the LV posterolateral or posterior wall (11 patients). There was no significant relationship between the presence of perfusion defects and the skeletal muscle involvements or thoracic deformities assessed by transmission computed tomography. Extensive perfusion defects were shown in 2 patients who died of congestive heart failure 1 to 2 years after the scintigraphic study. Progression of the myocardial scintigraphic abnormalities were considered to be minimal in 7 of 9 patients who underwent two serial scintigraphic studies over 2 to 3 years. It was concluded that thallium myocardial perfusion imaging is a useful clinical technique to assess myocardial involvement in Duchenne's progressive muscular dystrophy. (author)

  19. Volume/perfusion ratio from lung SPECT/CT.

    Science.gov (United States)

    Schaefer, Wolfgang Michael; Knollmann, Daniela; Avondo, Jerome; Meyer, Andreas

    2018-02-01

    In pulmonary emphysema lung volume reduction procedures (LVRP) can optimize respiratory pump function. Identification of the most affected lobe can be reached using relative lobar volume (relVol) from CT, but this approach disregards the corresponding lobar perfusion. The aim of the study was therefore to establish a new parameter combining relVol from CT and relative perfusion (relPerf) from perfusion SPECT as a single parameter (volume/perfusion ratio (VPR)) to optimize the identification procedure. As a proof of principle VPR was calculated from hybrid V-/P-SPECT/CT scans from 20 patients with severe pulmonary emphysema (SPE) before LVRP. Lung V-/P-SPECT/CT (Siemens SymbiaT) was done with Technegas and 99mTc-MAA. Quantification of lobar perfusion from scintigraphy and volume from CT was performed using "HERMES Hybrid 3D - Lung Lobe Quantification". Using normal ranges - from 12 patients with suspected pulmonary embolism and normal lung structure and perfusion - all lobes were classified as normal or abnormal to identify targets for LVRP. Normal values for VPR: right upper lobe 1.09 ± 0.10, middle lobe 1.31 ± 0.31, right lower lobe 0.87 ± 0.08; left upper lobe 1.09 ± 0.11, left lower lobe 0.87 ± 0.12. In the 20 SPE patients there were only 7 lobes with pathological values for rel- Vol, 14 lobes with pathological values for rel- Perf but 31 lobes with pathological VPR. Estimation of VPR from lung SPECT/CT enables a combined view of lobar volume and perfusion with one parameter. In SPE patients VPR allows identifying possible target structures with much higher sensitivity than when using relPerf or relVol alone. The specificity and the prognostic value of this new parameter have to be tested in a clinical trial. Schattauer GmbH.

  20. Clinical evaluation of non-invasive perfusion-weighted MRI

    International Nuclear Information System (INIS)

    Takasu, Miyuki

    2000-01-01

    A spin labeling method to measure cerebral blood flow without a contrast medium was developed and applied clinically to obtain a non-invasive perfusion-weighted image. The purpose of this study is to compare the non-invasive perfusion-weighted image using FAIR with the well-established PWI using a bolus injection of Gd-DTPA. Of 41 lesions which revealed decreased perfusion, 13 were shown to be low signal intensity areas on FAIR. Therefore, detection rate of FAIR for hypoperfusion was 32%. Of 8 lesions which revealed increased perfusion, 7 demonstrated high intensity on FAIR. Therefore, detection rate of FAIR for hyperperfusion was 88%. Seven lesions were found to have a mean pixel value of zero on PWI. Of these lesions, 5 lesions could be detected as high signal intensity area on FAIR. The rCBV- and rCBF index ratios of hypoperfused lesions detected on FAIR were significantly lower than those of lesions which were not detected on FAIR (p=0.007, p=0.01). As concerns the lesions detected of FAIR, there were positive correlation between rCBV- or rCBF index ratio and FAIR signal ratio (rCBV ratio: ρ=0.873, p=0.0002, rCBF index ratio: ρ=0.858, p=0.0003). FAIR is valuable clinical tool to detect perfusion abnormality semi-quantitatively without contrast medium, although it showed relatively low detection rate for hypoperfused lesions. (author)

  1. Magnetic resonance imaging of luxury perfusion of the optic nerve head in anterior ischemic optic neuropathy.

    Science.gov (United States)

    Yovel, Oren S; Katz, Miriam; Leiba, Hana

    2012-09-01

    A 49-year-old woman with painless reduction in visual acuity in her left eye was found to have nonarteritic anterior ischemic optic neuropathy (NAION). Fluorescein angiography revealed optic disc capillary leakage consistent with "luxury perfusion." Contrast-enhanced FLAIR magnetic resonance imaging (MRI) showed marked enhancement of the left optic disc. Resolution of the optic disc edema and the MRI abnormalities followed a similar time course. This report appears unique in documenting the MRI findings of luxury perfusion in NAION.

  2. Perfusion Bioreactor Module

    Science.gov (United States)

    Morrison, Dennis R.

    1990-01-01

    Perfusion bioreactor module, self-contained, closed-loop cell-culture system that operates in microgravity or on Earth. Equipment supports growth or long-term maintenance of cultures of human or other fragile cells for experiments in basic cell biology or process technology. Designed to support proliferation (initially at exponential rates of growth) of cells in complex growth medium and to maintain confluent cells in defined medium under conditions optimized to permit or encourage selected functions of cells, including secretion of products of cells into medium.

  3. Assessment of cerebral perfusion with single-photon emission tomography in normal subjects and in patients with Alzheimer's disease: effects of region of interest selection

    International Nuclear Information System (INIS)

    Claus, J.J.; Harskamp, F. van; Breteler, M.M.B.; Krenning, E.P.; Cammen, T.J.M. van der; Hofman, A.; Hasan, D.

    1994-01-01

    We compared three different ROIs in a SPET study with 60 controls and in 48 patients with probable Alzheimer's disease diagnosed according to the NINCDS-ADRDA criteria. Regional cerebral blood flow (rCBF) was assessed with SPET using technetium-99m d,l-hexamethylpropylene amine oxime ( 99m Tc-HMPAO), normalized to the mean activity in a cerebellar reference slice. The three different ROIs were: a multi-slice and a single-slice ROI with reference to the normal brain anatomy (using an anatomical atlas), and a rectangular (2x4 pixels) ROI in the frontal, temporal, temporoparietal and occipital cortices. No differences were observed for the means of rCBF values between the single-slice and multi-slice ROI's with reference to the normal anatomy, but some variability was present for individual comparisons. In contrast, significantly higher mean rCBF values were obtained with the single-slice rectangular ROIs in all four regions for both patients and controls and considerable variability was shown for individual subjects. After analysis with multivariate logistic regression and receiver operator characteristic curves, the ability of SPET to discriminate between controls and Alzheimer patients was similar in the three methods for mild and moderate Alzheimer patients (Global Deterioration Scale = GDS of 3 and 4). However, with increasing dementia severity (GDS>4) the rectangular ROIs showed lower ability to discriminate between groups compared to the single-slice and multi-slice anatomically defined ROIs. This study suggests that results of rCBF assessment with SPET using 99m Tc-HMPAO in patients with severe Alzheimer's disease are influenced by the shape and size of the ROI. (orig.)

  4. Consideration of QRS complex in addition to ST-segment abnormalities in the estimated "risk region" during acute anterior myocardial infarction

    DEFF Research Database (Denmark)

    van Hellemond, Irene E. G.; Bouwmeester, Sjoerd; Olson, Charles W.

    2011-01-01

    a falsely low estimated total MaR if determined by using ST segment-based methods. The purpose of this study was to investigate if consideration of the abnormalities in the QRS complex, in addition to those in the ST segment, provides a more accurate estimated total MaR during anterior AMI than...

  5. An evaluation of the feasibility of assessment of volume perfusion for the whole lung by 128-slice spiral CT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Haitao [Imaging Center of Taian Central Hospital, Taian, Shandong (China); Gao, Fei; Li, Ning; Liu, Cheng [Shandong Univ., Shandong Medical Imaging Research Inst., CT Room, Shandong (China)], e-mail: liucheng491025@sina.com

    2013-10-15

    Background: Lung perfusion based on dynamic scanning cannot provide a quantitative assessment of the whole lung because of the limited coverage of the current computed tomography (CT) detector designs. Purpose: To evaluate the feasibility of dynamic volume perfusion CT (VPCT) of the whole lung using a 128-slice CT for the quantitative assessment and visualization of pulmonary perfusion. Material and Methods: Imaging was performed in a control group of 17 subjects who had no signs of disturbance of pulmonary function or diffuse lung disease, and 15 patients (five patients with acute pulmonary embolism and 10 with emphysema) who constituted the abnormal lung group. Dynamic VPCT was performed in all subjects, and pulmonary blood flow (PBF), pulmonary blood volume (PBV), and mean transit time (MTT) were calculated from dynamic contrast images with a coverage of 20.7 cm. Regional and volumetric PBF, PBV, and MTT were statistically evaluated and comparisons were made between the normal and abnormal lung groups. Results: Regional PBF (94.2{+-}36.5, 161.8 {+-}29.6, 185.7 {+-}38.1 and 125.5 {+-}46.1, 161.9 {+-}31.4, 169.3 {+-}51.7), PBV (6.7 {+-}2.8, 10.9 {+-}3.0, 12.9 {+-}4.5 and 9.9 {+-}4.6, 10.3 {+-}2.9, 11.9 {+-}4.5), and MTT (5.8 {+-}2.4, 4.5 {+-}1.3, 4.7 {+-}2.1 and 5.6 {+-}2.3, 4.3 {+-}1.5, 4.9 {+-}1.5) demonstrated significant differences in the gravitational and isogravitational directions in the normal lung group (P < 0.05). The PBF (154.2 {+-}30.6 vs. 94.9 {+-}15.9) and PBV (11.1 {+-}4.0 vs. 6.6 {+-}1.7) by dynamic VPCT showed significant differences between normal and abnormal lungs (P < 0.05), notwithstanding the four large lungs that had coverage > 20.7 cm. Conclusion: Dynamic VPCT of the whole lung is feasible for the quantitative assessment of pulmonary perfusion by 128-slice CT, and may in future permit the evaluation of both morphological and functional features of the whole lung in a single examination.

  6. Myocardial perfusion modeling using MRI

    DEFF Research Database (Denmark)

    Larsson, H B; Fritz-Hansen, T; Rostrup, Egill

    1996-01-01

    In the present study, it is shown that it is possible to quantify myocardial perfusion using magnetic resonance imaging in combination with gadolinium diethylenetriaminopentaacetic acid (Gd-DTPA). Previously, a simple model and method for measuring myocardial perfusion using an inversion recovery...

  7. Measurement of temporal regional cerebral perfusion with single-photon emission tomography predicts rate of decline in language function and survival in early Alzheimer's disease

    International Nuclear Information System (INIS)

    Claus, J.J.; Walstra, G.J.M.; Hijdra, A.; Gool, W.A. van; Royen, E.A. van; Verbeeten, B. Jr.

    1999-01-01

    We determined the relationship between regional cerebral blood flow (rCBF) measured with single-photon emission tomography (SPET) and decline in cognitive function and survival in Alzheimer's disease. In a prospective follow-up study, 69 consecutively referred patients with early probable Alzheimer's disease (NINCDS/ADRDA criteria) underwent SPET performed at the time of initial diagnosis using technetium-99m-labelled hexamethylpropylene amine oxime. Neuropsychological function was assessed at baseline and after 6 months and survival data were available on all patients, extending to 5.5 years of follow-up. Lower left temporal (P<0.01) and lower left parietal (P<0.01) rCBF were statistically significantly related to decline in language function after 6 months. The association between left temporal rCBF and survival was also statistically significant (P<0.05) using Cox proportional hazards regression analysis. Performing analysis with quartiles of the distribution, we found a threshold effect for low left temporal rCBF (rCBF<73.7%, P<0.01) and high risk of mortality. In this lowest quartile, median survival time was 2.7 years (follow-up to 5.2 years), compared with 4.4 years in the other quartiles (follow-up to 5.5 years). Kaplan-Meier survival curves showed statistically significant (P<0.05, log rank test) survival curves for the lowest versus other quartiles of left temporal rCBF. All results were unaffected by adjustment for age, sex, dementia severity, duration of symptoms, education and ratings of local cortical atrophy. We conclude that left temporal rCBF predicts decline in language function and survival in patients with early probable Alzheimer's disease, with a threshold effect of low rCBF and high risk of mortality. (orig.)

  8. Abnormal Head Position

    Science.gov (United States)

    ... Frequently Asked Questions Español Condiciones Chinese Conditions Abnormal Head Position En Español Read in Chinese What is an abnormal head posture? An abnormal or compensatory head posture occurs ...

  9. Cerebral perfusion and automated individual analysis using SPECT among an obsessive-compulsive population

    Directory of Open Access Journals (Sweden)

    Euclides Timóteo da Rocha

    2011-01-01

    Full Text Available OBJECTIVE: To make individual assessments using automated quantification methodology in order to screen for perfusion abnormalities in cerebral SPECT examinations among a sample of subjects with OCD. METHODS: Statistical parametric mapping (SPM was used to compare 26 brain SPECT images from patients with OCD individually with an image bank of 32 normal subjects, using the statistical threshold of p < 0.05 (corrected for multiple comparisons at the level of individual voxels or clusters. The maps were analyzed, and regions presenting voxels that remained above this threshold were sought. RESULTS: Six patients from a sample of 26 OCD images showed abnormalities at cluster or voxel level, considering the criteria described above, which represented 23.07%. However, seven images from the normal group of 32 were also indicated as cases of perfusional abnormality, representing 21.8% of the sample. CONCLUSION: The automated quantification method was not considered to be a useful tool for clinical practice, for analyses complementary to visual inspection.

  10. Physiological basis for angina and ST-segment change PET-verified thresholds of quantitative stress myocardial perfusion and coronary flow reserve.

    Science.gov (United States)

    Johnson, Nils P; Gould, K Lance

    2011-09-01

    This study aimed to determine the quantitative low-flow threshold for stress-induced perfusion defects with severe angina and/or significant ST-segment depression during dipyridamole hyperemia. Vasodilator stress reveals differences in regional perfusion without ischemia in most patients. However, in patients with a perfusion defect, angina, and/or significant ST-segment depression during dipyridamole stress, quantitative absolute myocardial perfusion and coronary flow reserve (CFR) at the exact moment of definite ischemia have not been established. Defining these low-flow thresholds of angina or ST-segment changes may offer insight into physiological disease severity in patients with atherosclerosis. Patients underwent rest-dipyridamole stress positron emission tomography (PET) with absolute flow quantification in ml/min/g. Definite ischemia was defined as a new or worse perfusion defect during dipyridamole stress with significant ST-segment depression and/or severe angina requiring pharmacological treatment. Indeterminate clinical features required only 1 of these 3 abnormalities. The comparison group included patients without prior myocardial infarction, or angina or electrocardiographic changes after dipyridamole. In 1,674 sequential PET studies, we identified 194 (12%) with definite ischemia, 840 (50%) studies with no ischemia, and 301 (18%) that were clinically indeterminate. A vasodilator stress perfusion cutoff of 0.91 ml/min/g optimally separated definite from no ischemia with an area under the receiver-operator characteristic curve (AUC) of 0.98 and a CFR cutoff of 1.74 with an AUC = 0.91, reflecting excellent discrimination at the exact moment of definite ischemia. Thresholds of low myocardial vasodilator stress perfusion in ml/min/g and CFR sharply separate patients with angina or ST-segment change from those without these manifestations of ischemia during dipyridamole stress with excellent discrimination. Stress flow below 0.91 ml/min/g in dipyridamole

  11. A Simplified Whole-Organ CT Perfusion Technique with Biphasic Acquisition: Preliminary Investigation of Accuracy and Protocol Feasibility in Kidneys.

    Science.gov (United States)

    Yuan, XiaoDong; Zhang, Jing; Quan, ChangBin; Tian, Yuan; Li, Hong; Ao, GuoKun

    2016-04-01

    To determine the feasibility and accuracy of a protocol for calculating whole-organ renal perfusion (renal blood flow [RBF]) and regional perfusion on the basis of biphasic computed tomography (CT), with concurrent dynamic contrast material-enhanced (DCE) CT perfusion serving as the reference standard. This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Biphasic CT of the kidneys, including precontrast and arterial phase imaging, was integrated with a first-pass dynamic volume CT protocol and performed and analyzed in 23 patients suspected of having renal artery stenosis. The perfusion value derived from biphasic CT was calculated as CT number enhancement divided by the area under the arterial input function and compared with the DCE CT perfusion data by using the paired t test, correlation analysis, and Bland-Altman plots. Correlation analysis was made between the RBF and the extent of renal artery stenosis. All postprocessing was independently performed by two observers and then averaged as the final result. Mean ± standard deviation biphasic and DCE CT perfusion data for RBF were 425.62 mL/min ± 124.74 and 419.81 mL/min ± 121.13, respectively (P = .53), and for regional perfusion they were 271.15 mL/min per 100 mL ± 82.21 and 266.33 mL/min per 100 mL ± 74.40, respectively (P = .31). Good correlation and agreement were shown between biphasic and DCE CT perfusion for RBF (r = 0.93; ±10% variation from mean perfusion data [P perfusion (r = 0.90; ±13% variation from mean perfusion data [P CT perfusion (r = -0.81, P = .012). Biphasic CT perfusion is clinically feasible and provides perfusion data comparable to DCE CT perfusion data at both global and regional levels in the kidney. Online supplemental material is available for this article.

  12. Contrast-enhanced 3D MRI of lung perfusion in children with cystic fibrosis - initial results

    International Nuclear Information System (INIS)

    Eichinger, Monika; Puderbach, Michael; Zuna, Ivan; Kauczor, Hans-Ulrich; Fink, Christian; Gahr, Julie; Mueller, Frank-Michael; Ley, Sebastian; Plathow, Christian; Tuengerthal, Siegfried

    2006-01-01

    This paper is a feasibility study of magnetic resonance imaging (MRI) of lung perfusion in children with cystic fibrosis (CF) using contrast-enhanced 3D MRI. Correlation assessment of perfusion changes with structural abnormalities. Eleven CF patients (9 f, 2 m; median age 16 years) were examined at 1.5 T. Morphology: HASTE coronal, transversal (TR/TE/α/ST: 600 ms/28 ms/180 /6 mm), breath-hold 18 s. Perfusion: Time-resolved 3D GRE pulse sequence (FLASH, TE/TR/α: 0.8/1.9 ms/40 ), parallel imaging (GRAPPA, PAT 2). Twenty-five data sets were acquired after intravenous injection of 0.1 mmol/kg body weight of gadodiamide, 3-5 ml/s. A total of 198 lung segments were analyzed by two radiologists in consensus and scored for morphological and perfusion changes. Statistical analysis was performed by Mantel-Haenszel chi-square test. Results showed that perfusion defects were observed in all patients and present in 80% of upper, and 39% of lower lobes. Normal lung parenchyma showed homogeneous perfusion (86%, P<0.0001). Severe morphological changes led to perfusion defects (97%, P<0.0001). Segments with moderate morphological changes showed normal (53%) or impaired perfusion (47%). In conclusion, pulmonary perfusion is easy to judge in segments with normal parenchyma or severe changes. In moderately damaged segments, MRI of lung perfusion may help to better assess actual functional impairment. Contrast-enhanced 3D MRI of lung perfusion has the potential for early vascular functional assessment and therapy control in CF patients. (orig.)

  13. Brain perfusion image using N-isopropyl-p-[123I] iodoamphetamine

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Seki, Hiroyasu; Ishida, Hiroko

    1984-01-01

    In brain perfusion images using N-Isopropyl-p-[ 123 I] Iodoamphetamine and rotating gamma camera emission computed tomography, brain maps showing laterality indices (LI) were made for the purpose of detecting ineterhemispheric differences. Left (L) and right (R) leteral images were made by adding sagittal section images in each hemisphere, respectively. LI was calculated as follows. LI=100(1+(R-L)/(R+L)). The normal ranges (mean+-2 s.d.) of the indices determined by those obtained in five normal right-handed subjects were 103+-4 and 103+-10 for brain mean and each pixel, respectively. Out of 25 measurements in 22 righthanded patients with cerebrovascular accidents, brain mean LI beyond the normal limits and areas showing abnormal regional LI were observed in 5 (20%) and 21 (84%) measurements, respectively. On the other hand, X-ray CT showed low density areas in only 12 (48%). These brain maps were clinically useful for detecting and quantifying interhemispheric differences in brain perfusion images with N-Isopropyl-p-[ 123 I] Iodoamphetamine. (author)

  14. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France); University Bordeaux Segalen, Bordeaux Cedex (France); Bullier, Eric; Riviere, Annalisa [Hopital Haut-Leveque, CHU Bordeaux, Department of Nuclear Medicine, Pessac (France); Dromer, Claire [Hopital Haut-Leveque, CHU Bordeaux, Department of Respiratory Diseases, Pessac (France); Picard, Francois [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiology, Pessac (France); Billes, Marc-Alain [Hopital Haut-Leveque, CHU Bordeaux, Department of Cardiac Surgery, Pessac (France); Corneloup, Olivier [Hopital Haut-Leveque, CHU Bordeaux, Department of Medical Imaging, Pessac (France)

    2014-01-15

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  15. Dual-energy CT perfusion and angiography in chronic thromboembolic pulmonary hypertension: diagnostic accuracy and concordance with radionuclide scintigraphy

    International Nuclear Information System (INIS)

    Dournes, Gael; Verdier, Damien; Montaudon, Michel; Laurent, Francois; Lederlin, Mathieu; Bullier, Eric; Riviere, Annalisa; Dromer, Claire; Picard, Francois; Billes, Marc-Alain; Corneloup, Olivier

    2014-01-01

    To evaluate the diagnostic accuracy of dual-energy computed tomography (DECT) perfusion and angiography versus ventilation/perfusion (V/Q) scintigraphy in chronic thromboembolic pulmonary hypertension (CTEPH), and to assess the per-segment concordance rate of DECT and scintigraphy. Forty consecutive patients with proven pulmonary hypertension underwent V/Q scintigraphy and DECT perfusion and angiography. Each imaging technique was assessed for the location of segmental defects. Diagnosis of CTEPH was established when at least one segmental perfusion defect was detected by scintigraphy. Diagnostic accuracy of DECT perfusion and angiography was assessed and compared with scintigraphy. In CTEPH patients, the per-segment concordance between scintigraphy and DECT perfusion/angiography was calculated. Fourteen patients were diagnosed with CTEPH and 26 with other aetiologies. DECT perfusion and angiography correctly identified all CTEPH patients with sensitivity/specificity values of 1/0.92 and 1/0.93, respectively. At a segmental level, DECT perfusion showed moderate agreement (κ = 0.44) with scintigraphy. Agreement between CT angiography and scintigraphy ranged from fair (κ = 0.31) to slight (κ = 0.09) depending on whether completely or partially occlusive patterns were considered, respectively. Both DECT perfusion and angiography show satisfactory performance for the diagnosis of CTEPH. DECT perfusion is more accurate than angiography at identifying the segmental location of abnormalities. (orig.)

  16. Changes in kidney perfusion and renal cortex metabolism in septic shock: an experimental study.

    Science.gov (United States)

    Post, Emiel Hendrik; Su, Fuhong; Hosokawa, Koji; Taccone, Fabio Silvio; Herpain, Antoine; Creteur, Jacques; Vincent, Jean-Louis; De Backer, Daniel

    2017-01-01

    The etiology of renal dysfunction in sepsis is currently attributed to altered perfusion, microcirculatory abnormalities and cellular alterations. To clarify these mechanisms, we characterized the changes in renal perfusion and cortex metabolism in a large animal model of sepsis. We studied 12 adult female sheep randomized to peritonitis-induced sepsis (n = 8) or to sham procedure (n = 4). A flow probe was positioned around the renal artery to measure renal blood flow (RBF). Laser Doppler was used to measure regional flow in the kidney cortex and medulla. A microdialysis probe was inserted into the renal cortex to measure cortical glucose, lactate, and pyruvate. Fluid resuscitation was provided to keep pulmonary artery occlusion pressure at baseline levels. All animals were observed for 18 h. Hypotension occurred after 9 h in the septic animals (P = 0.02 versus baseline). RBF and cortical flow were significantly lower than at baseline from 12 h in the septic animals (P = 0.01 and P = 0.03, respectively). Cortical lactate and pyruvate levels increased in the septic animals from 3 and from 6 h, respectively (both P = 0.02 versus baseline), and the L/P ratio from 15 h (P = 0.01). There was a correlation between cortical flow and cortical L/P ratio after shock onset (r = -0.60, P = 0.002) but not before. In this peritonitis model, sepsis was associated with metabolic alterations that may reflect early induction of cortical glycolysis. Septic shock was associated with reduced renal perfusion and decreased cortical and medullary blood flow, followed by signs of anaerobic metabolism in the cortex when flow reductions became critical. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Perfusion-weighted MR imaging in persistent hemiplegic migraine

    Energy Technology Data Exchange (ETDEWEB)

    Mourand, Isabelle; Menjot de Champfleur, Nicolas; Carra-Dalliere, Clarisse; Le Bars, Emmanuelle; Bonafe, Alain; Thouvenot, Eric [Hopital Gui de Chauliac, Service de Neuroradiologie, Montpellier (France); Roubertie, Agathe [Hopital Gui de Chauliac, Service de Neuropediatrie, Montpellier (France)

    2012-03-15

    Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks. Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated. Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI. PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis. (orig.)

  18. Perfusion-weighted MR imaging in persistent hemiplegic migraine

    International Nuclear Information System (INIS)

    Mourand, Isabelle; Menjot de Champfleur, Nicolas; Carra-Dalliere, Clarisse; Le Bars, Emmanuelle; Bonafe, Alain; Thouvenot, Eric; Roubertie, Agathe

    2012-01-01

    Hemiplegic migraine is a rare type of migraine that has an aura characterized by the presence of motor weakness, which may occasionally last up to several days, and then resolve without sequela. Pathogenesis of migraine remains unclear and, recently, perfusion-weighted imaging (PWI) has provided a non-invasive method to study hemodynamic changes during acute attacks. Two female patients were admitted in our hospital suffering from prolonged hemiparesis. In both cases, they underwent MRI examination using a 1.5 T magnet including axial diffusion-weighted and perfusion sequences. From each perfusion MRI acquisition two regions of interest were delineated on each hemisphere and, the index of flow, cerebral blood volume, mean transit time, and time to peak were recorded and asymmetry indices from each perfusion parameter were calculated. Perfusion alterations were detected during the attacks. In one case, we observed, after 3 h of left hemiparesia, hypoperfusion of the right hemisphere. In the other case, who presented a familial hemiplegic migraine attack, on the third day of a persistent aura consisting of right hemiplegia and aphasia, PWI revealed hyperperfusion of the left hemisphere. Asymmetry indices for temporal parameters (mean transit time and time to peak) were the most sensitive. These findings resolved spontaneously after the attacks without any permanent sequel or signs of cerebral ischemia on follow-up MRI. PWI should be indicated for patients with migraine attacks accompanied by auras to assess the sequential changes in cerebral perfusion and to better understand its pathogenesis. (orig.)

  19. Perfusion CT in acute stroke

    International Nuclear Information System (INIS)

    Eckert, Bernd; Roether, Joachim; Fiehler, Jens; Thomalla, Goetz

    2015-01-01

    Modern multislice CT scanners enable multimodal protocols including non-enhanced CT, CT angiography, and CT perfusion. A 64-slice CT scanner provides 4-cm coverage. To cover the whole brain, a 128 - 256-slice scanner is needed. The use of perfusion CT requires an optimized scan protocol in order to reduce exposure to radiation. As compared to non-enhanced CT and CT angiography, the use of CT perfusion increases detection rates of cerebral ischemia, especially small cortical ischemic lesions, while the detection of lacunar and infratentorial stroke lesions remains limited. Perfusion CT enables estimation of collateral flow in acute occlusion of large intra- or extracranial arteries. Currently, no established reliable thresholds are available for determining infarct core and penumbral tissue by CT perfusion. Moreover, perfusion parameters depend on the processing algorithms and the software used for calculation. However, a number of studies point towards a reduction of cerebral blood volume (CBV) below 2 ml/100 g as a critical threshold that identifies infarct core. Large CBV lesions are associated with poor outcome even in the context of recanalization. The extent of early ischemic signs on non-enhanced CT remains the main parameter from CT imaging to guide acute reperfusion treatment. Nevertheless, perfusion CT increases diagnostic and therapeutic certainty in the acute setting. Similar to stroke MRI, perfusion CT enables the identification of tissue at risk of infarction by the mismatch between infarct core and the larger area of critical hypoperfusion. Further insights into the validity of perfusion parameters are expected from ongoing trials of mechanical thrombectomy in stroke.

  20. Abnormal brain activation in excoriation (skin-picking) disorder

    DEFF Research Database (Denmark)

    Odlaug, Brian L.; Hampshire, Adam; Chamberlain, Samuel R

    2016-01-01

    encompassing bilateral dorsal striatum (maximal in right caudate), bilateral anterior cingulate and right medial frontal regions. These abnormalities were, for the most part, outside the dorsal planning network typically activated by executive planning tasks. Conclusions: Abnormalities of neural regions...

  1. Exercise myocardial perfusion imaging to evaluate inducible ischaemia in children with Kawasaki disease.

    Science.gov (United States)

    Kashyap, Raghava; Mittal, Bhagwant Rai; Bhattacharya, Anish; Manojkumar, Rohit; Singh, Surjit

    2011-02-01

    Kawasaki disease (KD) is an acute multi-system vasculitis of unknown aetiology, which occurs predominantly in infants and young children. Coronary artery abnormalities may occur in 15-25% of patients who are not treated in the acute phase of the disease with a high dose of intravenous immunoglobulin. Myocardial perfusion imaging is used as a modality to monitor the cardiovascular effects of the disease. The objective of our study was to assess the feasibility and results of exercise myocardial perfusion scintigraphy in children with Kawasaki disease. We performed stress myocardial perfusion imaging in 84 patients suffering from KD. The diagnosis of KD was based on the criteria laid down by the American Heart Association. Myocardial perfusion imaging was performed using either thallium or technetium-99m tetrofosmin. Physical exercise using the Bruce protocol was the most frequent cardiac stressor (74 patients) whereas in few patients (seven patients) dobutamine was used to increase the heart rate. Stress-induced reversible perfusion defects were found only in 12 of the total number of patients. Among these two had coronary artery abnormalities on echocardiography. Four of these patients had achieved adequate heart rate with stress. Two among these patients had a repeat imaging done after 1 year and the perfusion defects showed complete resolution in them. This study thus suggests that reversible perfusion defects are seen in asymptomatic patients with KD and that the presence of perfusion defects may not be associated with echocardiographic demonstration of coronary abnormalities. The treadmill test is a reasonable stress protocol for these patients.

  2. Perfusion measurement in acute pancreatitis using dynamic perfusion MDCT.

    Science.gov (United States)

    Bize, Pierre E; Platon, Alexandra; Becker, Christoph D; Poletti, Pierre-Alexandre

    2006-01-01

    Our objective was to determine whether MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis in the initial phase of the disease. One hundred six patients with abdominal pain were prospectively enrolled in this study. Patients were separated into two groups: P1 (severe) and P2 (mild) acute pancreatitis. Mean perfusion value was 24.8 mL/100 mL/min in the P1 group and 50.5 mL/100 mL/min in the P2 group (p = 0.0016, significant). Our preliminary data suggest that pancreatic perfusion measurement using MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis.

  3. Perfusion defects in pulmonary perfusion iodine maps: causes and semiology.

    Science.gov (United States)

    Bustos Fiore, A; González Vázquez, M; Trinidad López, C; Mera Fernández, D; Costas Álvarez, M

    2017-12-14

    to describe the usefulness of dual-energy CT for obtaining pulmonary perfusion maps to provide morphological and functional information in patients with pulmonary embolisms. To review the semiology of perfusion defects due to pulmonary embolism so they can be differentiated from perfusion defects due to other causes: alterations outside the range used in the iodine map caused by other diseases of the lung parenchyma or artifacts. CT angiography of the pulmonary arteries is the technique of choice for the diagnosis of pulmonary embolisms. New dual-energy CT scanners are useful for detecting perfusion defects secondary to complete or partial obstruction of pulmonary arteries and is most useful for detecting pulmonary embolisms in subsegmental branches. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Quantitative lung perfusion evaluation using Fourier decomposition perfusion MRI.

    Science.gov (United States)

    Kjørstad, Åsmund; Corteville, Dominique M R; Fischer, Andre; Henzler, Thomas; Schmid-Bindert, Gerald; Zöllner, Frank G; Schad, Lothar R

    2014-08-01

    To quantitatively evaluate lung perfusion using Fourier decomposition perfusion MRI. The Fourier decomposition (FD) method is a noninvasive method for assessing ventilation- and perfusion-related information in the lungs, where the perfusion maps in particular have shown promise for clinical use. However, the perfusion maps are nonquantitative and dimensionless, making follow-ups and direct comparisons between patients difficult. We present an approach to obtain physically meaningful and quantifiable perfusion maps using the FD method. The standard FD perfusion images are quantified by comparing the partially blood-filled pixels in the lung parenchyma with the fully blood-filled pixels in the aorta. The percentage of blood in a pixel is then combined with the temporal information, yielding quantitative blood flow values. The values of 10 healthy volunteers are compared with SEEPAGE measurements which have shown high consistency with dynamic contrast enhanced-MRI. All pulmonary blood flow (PBF) values are within the expected range. The two methods are in good agreement (mean difference = 0.2 mL/min/100 mL, mean absolute difference = 11 mL/min/100 mL, mean PBF-FD = 150 mL/min/100 mL, mean PBF-SEEPAGE = 151 mL/min/100 mL). The Bland-Altman plot shows a good spread of values, indicating no systematic bias between the methods. Quantitative lung perfusion can be obtained using the Fourier Decomposition method combined with a small amount of postprocessing. Copyright © 2013 Wiley Periodicals, Inc.

  5. Value of myocardial perfusion SPECT in pediatric population

    International Nuclear Information System (INIS)

    Massardo, T.; Coll, C.; Prat, H.; Gonzalez, P.; Doggenweiller, P.; Castillo, M.E.; Solis, A.

    2002-01-01

    Isotopic myocardial perfusion studies are less frequently used in children than in adults and their indications are also different. Our goal was to analyze retrospectively the experience with stress perfusion myocardial SPECT in pediatric population. Method: Since 1998 to 2001, ten studies were performed to 5 girls and 3 boys. Their mean age was 7±3 years ranging from 1-11. Three of them presented abnormal coronary arteries pre and post surgical intervention with or without coil; three had Kawasaki disease with coronary aneurysms and the other two, congenital cardiopathies (Cantrell pentalogy and great vessel transposition,both with posterior left ventricular hypokinesia post surgery). Stress was obtained using dipyridamole infusion (0.56 mg/kg) in 6 cases and treadmill exercise using Bruce protocol in 4. All those tests were well tolerated. Sestamibi Tc99m was selected in 80% of the cases and Tl 201 in the rest. Only 2 small children required anesthesia during SPECT acquisition. Results: Stress EKG did not demonstrated ischemia in any case. Coronary angiography was performed only in 50% of the patients, it was concordant with SPECT features in all, two of those patients presented transient perfusion defects (one Kawasaki and one abnormal coronary artery with a fistulae).The repaired pentalogy presented ischemia and septal infarction; in that patient echocardiographic hipokinesia was concordant with fixed hypoperfusion. One case with abnormal coronary plus mitral regurgitation (without isotopic ischemia) was submitted to embolization posteriorly, obtaining motion improvement. Clinical outcome was concordant with the presence or absence of isotopic ischemia in the rest of the patients. Conclusion: SPECT myocardial perfusion was helpful in the therapeutic approach and in prediction of outcome in children

  6. Effects of permanent dual chamber pacing on myocardial perfusion in symptomatic hypertrophic cardiomyopathy

    NARCIS (Netherlands)

    Posma, JL; Blanksma, PK; VanderWall, EE; Vaalburg, W; Crijns, HJGM; Lie, KI

    1996-01-01

    Objective-Angina and the presence of myocardial ischaemia are common in hypertrophic cardiomyopathy. Dual chamber pacing results in clinical improvement in these patients. This study evaluates the effects of permanent dual chamber pacing on absolute regional myocardial perfusion and perfusion

  7. Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients

    Energy Technology Data Exchange (ETDEWEB)

    Giordano, Jessica; Khung, Suonita; Remy, Jacques; Remy-Jardin, Martine [Hospital Calmette (EA 2694), Department of Thoracic Imaging, Lille (France); Duhamel, Alain [University Lille, CHU Lille, Department of Biostatistics, Lille (France); Hossein-Foucher, Claude; Bellevre, Dimitri [University Lille, CHU Lille, Department of Nuclear Medicine, Hospital Salengro, Lille (France); Lamblin, Nicolas [University Lille, CHU Lille, Department of Cardiology, Cardiology Hospital, Lille (France)

    2017-04-15

    To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations. Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12). CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p < 0.0001): (1) in group 1, 96.6 % of segments with abnormal perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2. Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy. (orig.)

  8. Multi-detector CT perfusion

    Directory of Open Access Journals (Sweden)

    Ashraf M. Enite

    2016-09-01

    Conclusion: CTP is a promising non-invasive technique assessing the efficacy, predicting early response to local treatment therapies and monitoring tumor recurrence. It assesses the degree of post therapy tumor perfusion especially the degree of arterialization.

  9. Prognostic significance of large perfusion defects on thallium-201 myocardial scintigraphy in dilated cardiomyopathy

    International Nuclear Information System (INIS)

    Takata, Jun; Doi, Yoshinori; Chikamori, Taishiro; Yonezawa, Yoshihiro; Hamashige, Naohisa; Kuzume, Osamu; Ozawa, Toshio

    1989-01-01

    To evaluate the prognostic significance of perfusion abnormalities, particularly large defects, in dilated cardiomyopathy (DCM), we performed thallium-201 myocardial scintigraphy and 24-hour ambulatory ECG monitoring in 27 patients. The abnormal scintigraphic patterns and the presence of ventricular tachycardia (VT) were correlated with causes of death during a follow-up period of 30.0±19.4 months. Eight patients had large defects (LD), 11 had multiple small defects (MSD), and eight had no defects (NL). The patients with LD had extensive ventricular akinesis in the region of the perfusion defect, significantly elevated LVEDP (LD 20.6±7.4 mmHg, MSD 15.5±7.6 mmHg, NL 10.3±2.3 mmHg: LD vs NL; p<0.01, MSD vs NL; p<0.05), and reduced ejection fraction (LD 23.9±9.1%, MSD 32.7±7.2%, NL 40.3±7.7%: LD vs MSD; p<0.05, MSD vs NL; p<0.01). VT was detected in 11 patients; among whom three had LD, six had MSD, and two had no defects. Among seven patients who died during follow-up (five of heart failure, one sudden death, and one non-cardiac death), five had LD and two had MSD. There were no deaths among patients without defects. Among 11 patients with VT, only one died suddenly. In conclusion, large scintigraphic defects correlated well with severe LV dysfunction, and this is an important variable in predicting outcomes in DCM. (author)

  10. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT.

    Directory of Open Access Journals (Sweden)

    Jun Zhang

    Full Text Available BACKGROUND/AIMS: The 256-slice CT enables the entire brain to be scanned in a single examination. We evaluated the application of 256-slice whole-brain CT perfusion (CTP in determining graft patency as well as investigating cerebral hemodynamic changes in Moyamoya disease before and after surgical revascularization. METHODS: Thirty-nine cases of Moyamoya disease were evaluated before and after surgical revascularization with 256-slice CT. Whole-brain perfusion images and dynamic 3D CT angiographic images generated from perfusion source data were obtained in all patients. Cerebral blood flow (CBF, cerebral blood volume (CBV, time to peak (TTP and mean transit time (MTT of one hemisphere in the region of middle cerebral artery (MCA distribution and contralateral mirroring areas were measured. Relative CTP values (rCBF, rCBV, rTTP, rMTT were also obtained. Differences in pre- and post- operation perfusion CT values were assessed with paired t test or matched-pairs signed-ranks test. RESULTS: Preoperative CBF, MTT and TTP of potential surgical side were significantly different from those of contralateral side (P<0.01 for all. All graft patencies were displayed using the 3D-CTA images. Postoperative CBF, rCBF and rCBV values of surgical side in the region of MCA were significantly higher than those before operation (P<0.01 for all. Postoperative MTT, TTP, rMTT and rTTP values of the surgical side in the region of MCA were significantly lower than those before operation (P<0.05 for all. CONCLUSION: The 256-slice whole-brain CTP can be used to evaluate cerebral hemodynamic changes in Moyamoya disease before and after surgery and the 3D-CTA is useful for assessing the abnormalities of intracranial arteries and graft patencies.

  11. Whole-brain CT perfusion and CT angiography assessment of Moyamoya disease before and after surgical revascularization: preliminary study with 256-slice CT.

    Science.gov (United States)

    Zhang, Jun; Wang, Jianhong; Geng, Daoying; Li, Yuxin; Song, Donglei; Gu, Yuxiang

    2013-01-01

    The 256-slice CT enables the entire brain to be scanned in a single examination. We evaluated the application of 256-slice whole-brain CT perfusion (CTP) in determining graft patency as well as investigating cerebral hemodynamic changes in Moyamoya disease before and after surgical revascularization. Thirty-nine cases of Moyamoya disease were evaluated before and after surgical revascularization with 256-slice CT. Whole-brain perfusion images and dynamic 3D CT angiographic images generated from perfusion source data were obtained in all patients. Cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP) and mean transit time (MTT) of one hemisphere in the region of middle cerebral artery (MCA) distribution and contralateral mirroring areas were measured. Relative CTP values (rCBF, rCBV, rTTP, rMTT) were also obtained. Differences in pre- and post- operation perfusion CT values were assessed with paired t test or matched-pairs signed-ranks test. Preoperative CBF, MTT and TTP of potential surgical side were significantly different from those of contralateral side (P<0.01 for all). All graft patencies were displayed using the 3D-CTA images. Postoperative CBF, rCBF and rCBV values of surgical side in the region of MCA were significantly higher than those before operation (P<0.01 for all). Postoperative MTT, TTP, rMTT and rTTP values of the surgical side in the region of MCA were significantly lower than those before operation (P<0.05 for all). The 256-slice whole-brain CTP can be used to evaluate cerebral hemodynamic changes in Moyamoya disease before and after surgery and the 3D-CTA is useful for assessing the abnormalities of intracranial arteries and graft patencies.

  12. Assessment of pulmonary parenchyma perfusion with FAIR in comparison with DCE-MRI-Initial results

    International Nuclear Information System (INIS)

    Fan Li; Liu Shiyuan; Sun Fei; Xiao Xiangsheng

    2009-01-01

    Objective: The aim of this study was to assess pulmonary parenchyma perfusion with flow-sensitive alternating inversion recovery (FAIR) in comparison with 3D dynamic contrast-enhanced (DCE) imaging in healthy volunteers and in patients with pulmonary embolism or lung cancer. Materials and methods: Sixteen healthy volunteers and 16 patients with pulmonary embolism (5 cases) or lung cancer (11 cases) were included in this study. Firstly, the optimized inversion time of FAIR (TI) was determined in 12 healthy volunteers. Then, FAIR imaging with the optimized TI was performed followed by DCE-MRI on the other 4 healthy volunteers and 16 patients. Tagging efficiency of lung and SNR of perfusion images were calculated with different TI values. In the comparison of FAIR with DCE-MRI, the homogeneity of FAIR and DCE-MRI perfusion was assessed. In the cases of perfusion abnormality, the contrast between normal lung and perfusion defects was quantified by calculating a normalized signal intensity ratio. Results: One thousand milliseconds was the optimal TI, which generated the highest lung tagging efficiency and second highest PBF SNR. In the volunteers, the signal intensity of perfusion images acquired with both FAIR and DCE-MRI was homogeneous. Wedged-shaped or triangle perfusion defects were visualized in five pulmonary embolisms and three lung cancer cases. There was no significant statistical difference in signal intensity ratio between FAIR and DCE-MRI (P > 0.05). In the rest of eight lung cancers, all the lesions showed low perfusion against the higher perfused pulmonary parenchyma in both FAIR and DCE-MRI. Conclusion: Pulmonary parenchyma perfusion imaging with FAIR was feasible, consistent and could obtain similar functional information to that from DCE-MRI.

  13. Altered brain perfusion patterns in wakefulness and slow-wave sleep in sleepwalkers.

    Science.gov (United States)

    Desjardins, Marie-Ève; Baril, Andrée-Ann; Soucy, Jean-Paul; Dang-Vu, Thien Thanh; Desautels, Alex; Petit, Dominique; Montplaisir, Jacques; Zadra, Antonio

    2018-03-03

    The present study assessed brain perfusion patterns with single photon emission computed tomography (SPECT) during sleepwalkers' post-sleep deprivation slow-wave sleep and resting-state wakefulness. Following a 24-hr period of sleep deprivation, 10 sleepwalkers and 10 sex- and age-matched controls were scanned with a high-resolution SPECT scanner. Participants were injected with99mTc-ECD after 2 minutes of stable slow-wave sleep within their first sleep cycle as well as during resting-state wakefulness, both after a subsequent 24-hr period of sleep deprivation. When compared to controls' brain perfusion patterns during both slow-wave sleep and resting-state wakefulness, sleepwalkers showed reduced regional cerebral perfusion in several bilateral frontal regions, including the superior frontal, middle frontal and medial frontal gyri. Moreover, reduced regional cerebral perfusion was also found in sleepwalkers' left postcentral gyrus, insula and superior temporal gyrus during slow-wave sleep compared to controls. During resting-state wakefulness compared to controls, reduced cerebral perfusion was also found in parietal and temporal regions of sleepwalkers' left hemisphere while the right parahippocampal gyrus showed increased regional cerebral perfusion. Our results reveal patterns of reduced regional cerebral perfusion in sleepwalkers' frontal and parietal areas when compared to controls, regions previously associated with slow-wave sleep generation and episode occurrence. Additionally, reduced perfusion in the dorsolateral prefrontal cortex and insula during recovery slow-wave sleep is consistent with clinical features of somnambulistic episodes, including impaired awareness and reduced pain perception. Altered regional cerebral perfusion patterns during sleepwalkers' resting-state wakefulness may be related to daytime functional anomalies in this population.

  14. Error analysis of the double-integral method for calculating brain blood perfusion from inert gas clearance data

    International Nuclear Information System (INIS)

    Smith, G.T.; Stokely, E.M.; Lewis, M.H.; Devous, M.D. Sr.; Bonte, F.J.

    1984-01-01

    A single-photon dynamic computer-assisted tomograph (DSPECT) has been built and is currently being used to evaluate regional cerebral blood perfusion in patients and volunteers. A computer simulation of the system was created to analyze the effects of data collection, Poisson noise, attenuation compensation, and the reconstruction technique now employed in the DSPECT. Several methods of attenuation compensation were used to generate perfusion images from both ideal and noisy data. The results indicate that the mean perfusion is calculated to within 10.4% accuracy for all perfusion rates in a region of interest if attenuation correction is used. Without attenuation correction, perfusions are underestimated by as much as 27%. The three correctors tested have different effects on the calculated perfusion value, depending on the location of the region of interest in the picture. The algorithm introduces random noise that is proportional to both the random error in the input data and the perfusion rate. Air-curve delay errors result in inaccuracies in the final perfusion picture that are proportional to perfusion rate. Physiological values (0.8-1.5) of the partition coefficient cause overestimation of both gray (0-34%) and white (7-67%) matter perfusion values. Compton scatter and collimator effects were not addressed in this study

  15. Error analysis of the double-integral method for calculating brain blood perfusion from inert gas clearance data.

    Science.gov (United States)

    Smith, G T; Stokely, E M; Lewis, M H; Devous, M D; Bonte, F J

    1984-03-01

    A single-photon dynamic computer-assisted tomograph (DSPECT) has been built and is currently being used to evaluate regional cerebral blood perfusion in patients and volunteers. A computer simulation of the system was created to analyze the effects of data collection, Poisson noise, attenuation compensation, and the reconstruction technique now employed in the DSPECT. Several methods of attenuation compensation were used to generate perfusion images from both ideal and noisy data. The results indicate that the mean perfusion is calculated to within 10.4% accuracy for all perfusion rates in a region of interest if attenuation correction is used. Without attenuation correction, perfusions are underestimated by as much as 27%. The three correctors tested have different effects on the calculated perfusion value, depending on the location of the region of interest in the picture. The algorithm introduces random noise that is proportional to both the random error in the input data and the perfusion rate. Air-curve delay errors result in inaccuracies in the final perfusion picture that are proportional to perfusion rate. Physiological values (0.8-1.5) of the partition coefficient cause overestimation of both gray (0-34%) and white (7-67%) matter perfusion values. Compton scatter and collimator effects were not addressed in this study.

  16. Lung perfusion characteristics in pulmonary arterial hypertension (PAH) and peripheral forms of chronic thromboembolic pulmonary hypertension (pCTEPH): Dual-energy CT experience in 31 patients.

    Science.gov (United States)

    Giordano, Jessica; Khung, Suonita; Duhamel, Alain; Hossein-Foucher, Claude; Bellèvre, Dimitri; Lamblin, Nicolas; Remy, Jacques; Remy-Jardin, Martine

    2017-04-01

    To compare lung perfusion in PAH and pCTEPH on dual-energy CT (DECT) examinations. Thirty-one patients with PAH (group 1; n = 19) and pCTEPH (group 2; n = 12) underwent a dual-energy chest CTA with reconstruction of diagnostic and perfusion images. Perfusion alterations were analysed at a segmental level. V/Q scintigraphy was available in 22 patients (group 1: 13/19; group 2: 9/12). CT perfusion was abnormal in 52.6 % of group 1 patients and in 100 % of group 2 patients (p = 0.0051). The patterns of perfusion alteration significantly differed between the two groups (p perfusion showed patchy defects; (2) in group 2, the most frequent abnormalities consisted of patchy (58.5 %) and PE-type (37.5 %) defects. Paired comparison of CT perfusion and scintigraphy showed concordant findings in 76.9 % of group 1 (10/13) and 100 % of group 2 (9/9) patients, with a predominant or an exclusive patchy pattern in group 1 and a mixed pattern of abnormalities in group 2. Lung perfusion alterations at DECT are less frequent and more homogeneous in PAH than in pCTEPH, with a high level of concordant findings with V/Q scintigraphy. • Depiction of chronic pulmonary embolism exclusively located on peripheral arteries is difficult. • The main differential diagnosis of pCTEPH is PAH. • The pattern of DECT perfusion changes can help differentiate PAH and pCETPH. • In PAH, almost all segments with abnormal perfusion showed patchy defects. • In pCTEPH, patchy and PE-type defects were the most frequent abnormalities.

  17. Dynamic study on cerebral perfusion of the pentylenetetrazol kindling cats by SPECT

    International Nuclear Information System (INIS)

    Hou Min; Liu Xingdang; Wang Kaiyan

    2004-01-01

    Objective: To learn the change of cerebral perfusion in the pentylenetetrazol kindling cats during the development of epilepsy. Methods: firstly, we performed 12 basic 99m Tc- ethyl cysteinate dimmer (ECD) SPECT as auto-control before the cats were made into epileptic models. Then, according to seizure level of epileptic model, SPECT was performed when the cats began to seizure in the form of facial tic(level 1), nodding spasm (level 2), limb tonic seizures (level 3) and generalized tonic-clonic seizures(level 4). At the same time, we detected the EEG at each level of seizure in order to contrast with SPECT findings. Results:There is no abnormal SPECT finding of cats before using PTZ. The SPECT at each level of kindling: hyperperfusion in forehead and basal ganglia at level 1; more evident hyperperfusion in forehead at level 2; the hyperperfusion in forehead being weakened and another hyperperfusion appearing in deep parietal lobe at level 3; the hyperperfusion in forehead disappearing and the hyperfusion in deep parietal lobe becoming more obvious and a hypoperfusion beside it appearing at level 4. As the time going on, the hyperperfusion disappeared completely and the hypoperfusion became more and more clear. The SPECT findings are coincided with EEG findings. Conclusion: 1. During the kindling of cats, a regional hyperperfusion appeared in the cats' brain: at the stage of focal seizure, the cerebral perfusion increased in forehead and ganglia; at the stage of generalized seizure, the hyperperfusion region gradually moved from forehead to deep parietal lobe. 2. Once the model animal was completely kindled, there would be a fixed hypoperfusion region instead, which may be the epileptic focus. (authors)

  18. Resting Brain Perfusion and Selected Vascular Risk Factors in Healthy Elderly Subjects

    DEFF Research Database (Denmark)

    Henriksen, Otto M.; Jensen, Lars T; Krabbe, Katja

    2014-01-01

    with circulating homocysteine, but not with asymmetric dimethylarginine, dyslipidemia or the carotid intima-media thickness. The relative regional brain perfusion was associated with circulating homocysteine, with a relative parietal hypoperfusion and a frontal hyperperfusion. No effect on regional brain perfusion...... was observed for any of the other risk factors. A multiple regression model including homocysteine, caffeine, hematocrit and end-tidal PCO2, explained nearly half of the observed variability. CONCLUSION: Both intrinsic and extrinsic factors influenced global cerebral perfusion variation between subjects....... Further, the results suggest that the inverse relation between homocysteine and brain perfusion is owing to other mechanisms, than reflected by asymmetric dimethylarginine, and that homocysteine may be a marker of cerebral perfusion in aging brains....

  19. Regional left ventricular myocardial contraction abnormalities and asynchrony in patients with hypertrophic cardiomyopathy evaluated by magnetic resonance spatial modulation of magnetization myocardial tagging

    Energy Technology Data Exchange (ETDEWEB)

    Mishiro, Yuichiro; Oki, Takashi [Tokushima Univ. (Japan). School of Medicine; Iuchi, Arata [and others

    1999-06-01

    Global left ventricular (LV) pump function is generally preserved in patients with hypertrophic cardiomyopathy (HCM). However, it is unknown whether regional myocardial contractility is impaired, especially in nonhypertrophied regions. The purpose of this study was to evaluate regional LV myocardial contraction in patients with HCM using magnetic resonance (MR) spatial modulation of magnetization (SPAMM) myocardial tagging. The study group comprised 20 patients with asymmetric septal hypertrophy (HCM group) and 16 age-matched normal patients (control group), and data were collected using transthoracic M-mode and 2-dimensional echocardiography, and MR SPAMM myocardial tagging. The systolic strain ratio, maximum systolic strain velocity, and time from end-diastole to maximum systolic strain ({Delta}T) in the anterior, ventricular septal, inferior and lateral regions for 2 LV short-axis sections at the levels of the chordae tendineae and papillary muscles were measured at 50-ms intervals by MR myocardial tagging. The end-diastolic anterior and ventricular septal wall thicknesses and LV mass index were significantly different between the HCM and control groups. The systolic strain ratio for all 4 walls, particularly the anterior and ventricular septal regions, was significantly lower in the HCM group. In the HCM group, the maximum systolic strain velocity was significantly lower and {Delta}T was significantly shorter for all 4 walls, particularly the anterior and ventricular septal regions. The standard deviation for the {Delta}T, calculated from the {Delta}T for the 8 regions of the 2 LV short-axis sections, was significantly greater in the HCM group. In conclusion, regional LV myocardial contraction is impaired in both hypertrophied and nonhypertrophied regions, and systolic LV wall asynchrony occurs in patients with HCM. (author)

  20. Regional cerebral blood flow during mechanical hyperventilation in patients with acute bacterial meningitis

    DEFF Research Database (Denmark)

    Møller, Kirsten; Høgh, Peter; Larsen, Fin Stolze

    2000-01-01

    Mechanical hyperventilation is often instituted in patients with acute bacterial meningitis when increased intracranial pressure is suspected. However, the effect on regional cerebral blood flow (CBF) is unknown. In this study, we measured regional CBF (rCBF) in patients with acute bacterial...... meningitis before and during short-term hyperventilation. In 17 patients with acute bacterial meningitis, absolute rCBF (in ml/100 g min-1) was measured during baseline ventilation and hyperventilation by single-photon emission computed tomography (SPECT) using intravenous 133Xe bolus injection. Intravenous...... in the frontal and parietal cortex as well as in the basal ganglia. Focal perfusion abnormalities were present in 10 of 12 patients. Regional cerebral blood flow abnormalities are frequent in patients with acute bacterial meningitis. Short-term hyperventilation does not enhance these abnormalities....

  1. Tooth - abnormal colors

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003065.htm Tooth - abnormal colors To use the sharing features on this page, please enable JavaScript. Abnormal tooth color is any color other than white to yellowish- ...

  2. Urine - abnormal color

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003139.htm Urine - abnormal color To use the sharing features on this page, please enable JavaScript. The usual color of urine is straw-yellow. Abnormally colored urine ...

  3. Abnormal uterine bleeding

    Science.gov (United States)

    Anovulatory bleeding; Abnormal uterine bleeding - hormonal; Polymenorrhea - dysfunctional uterine bleeding ... ACOG committee opinion no. 557: Management of acute abnormal uterine bleeding in nonpregnant reproductive-aged women. Reaffirmed 2015. ACOG. ...

  4. Diagnostic accuracy of stress perfusion CMR in comparison with quantitative coronary angiography: fully quantitative, semiquantitative, and qualitative assessment.

    Science.gov (United States)

    Mordini, Federico E; Haddad, Tariq; Hsu, Li-Yueh; Kellman, Peter; Lowrey, Tracy B; Aletras, Anthony H; Bandettini, W Patricia; Arai, Andrew E

    2014-01-01

    This study's primary objective was to determine the sensitivity, specificity, and accuracy of fully quantitative stress perfusion cardiac magnetic resonance (CMR) versus a reference standard of quantitative coronary angiography. We hypothesized that fully quantitative analysis of stress perfusion CMR would have high diagnostic accuracy for identifying significant coronary artery stenosis and exceed the accuracy of semiquantitative measures of perfusion and qualitative interpretation. Relatively few studies apply fully quantitative CMR perfusion measures to patients with coronary disease and comparisons to semiquantitative and qualitative methods are limited. Dual bolus dipyridamole stress perfusion CMR exams were performed in 67 patients with clinical indications for assessment of myocardial ischemia. Stress perfusion images alone were analyzed with a fully quantitative perfusion (QP) method and 3 semiquantitative methods including contrast enhancement ratio, upslope index, and upslope integral. Comprehensive exams (cine imaging, stress/rest perfusion, late gadolinium enhancement) were analyzed qualitatively with 2 methods including the Duke algorithm and standard clinical interpretation. A 70% or greater stenosis by quantitative coronary angiography was considered abnormal. The optimum diagnostic threshold for QP determined by receiver-operating characteristic curve occurred when endocardial flow decreased to qualitative methods: Duke algorithm: 70%; and clinical interpretation: 78% (p quantitative stress perfusion CMR has high diagnostic accuracy for detecting obstructive coronary artery disease. QP outperforms semiquantitative measures of perfusion and qualitative methods that incorporate a combination of cine, perfusion, and late gadolinium enhancement imaging. These findings suggest a potential clinical role for quantitative stress perfusion CMR. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Direct myocardial perfusion imaging in valvular heart disease

    International Nuclear Information System (INIS)

    Soto, R.C.; Durante, M.L.; Villacorta, E.V.; Torres, J.F.; Monzon, O.P.

    1981-01-01

    Twenty two patients with rheumatic valvular heart disease - 21 having a history of heart failure - were studied using direct coronary injection of sup(99m)Tc labelled MAA particles during the course of hemodynamic and arteriographic studies. Myocardial perfusion deficit patterns have been shown to be consistent or indicative of either patchy, regional or gross ischemia. In patients with history of documented heart failure 90% (18 cases) had ischemic perfusion deficit in the involved ventricle. We conclude that diminished myocardial blood flow is an important mechanism contributing to the development of heart failure. (orig.) [de

  6. Frequencies and distributions of sex chromosome abnormalities in females with the Turner phenotype: a long-term retrospective study in the southern region of Turkey

    Science.gov (United States)

    Tanrıverdi, Nilgün; Demirhan, Osman; Süleymanova, Dilara; Pazarbaşı, Ayfer

    2017-11-13

    Background/aim: The genetic background of Turner syndrome (TS) is highly variable. The correlation between genotype and phenotype is not yet well understood. The aim of this study was to describe the frequencies and distributions of Turner karyotypes and to discuss the phenotype/genotype relation in a very large group of individuals with TS. Materials and methods: The karyotype results of 248 female participants were evaluated retrospectively.Results: Of 248 females with the Turner phenotype, 14.5% had normal karyotypes and 85.5% had Turner karyotypes. About 72.2% of the abnormalities were numerical aberrations and 27.8% were structural aberrations. The most frequent karyotype was monosomy X, which was found in 135 females (63.7%), followed by 44 mosaics (21%), 40 isochromosomes of the long and short arms of chromosome X (19.1%), and 17 deletions of the short and long arms of chromosome X (8.0%). One case of Robertsonian translocation and one case of mosaic TS with marker chromosome were detected. Conclusion: This study shows the frequency and distribution of karyotypes in females with TS. There is great value to be gleaned from studies of females with TS in furthering our understanding of the atypical clinical features associated with TS. Studies involving genetic analyses will be necessary to examine gene expression profiles in girls with TS and identify potential candidate genes underlying the atypical clinical features associated with TS.

  7. Associations between muscle perfusion and symptoms in knee osteoarthritis

    DEFF Research Database (Denmark)

    Bandak, E; Boesen, M; Bliddal, H

    2015-01-01

    a relatively rapid decline (washout pattern) relative to the total number of voxels within the muscle VOI. CONCLUSIONS: More widespread perfusion in the peri-articular knee muscles was associated with less pain in patients with KOA. These results give rise to investigations of the effects of exercise on muscle......OBJECTIVE: To investigate the association between muscle perfusion in the peri-articular knee muscles assessed by dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) and symptoms in patients with knee osteoarthritis (KOA). DESIGN: In a cross-sectional setting, muscle perfusion...... was quantified by DCE-MRI in KOA. Regions of interest (ROI) were drawn around the peri-articular muscles, summed and averaged into one single "Total Muscle Volume" volume of interest (VOI). Symptoms were assessed via the Knee injury and Osteoarthritis Outcome Score (KOOS) (0: worst; 100: best). RESULTS: DCE...

  8. Intrinsic brain abnormalities in young healthy adults with childhood trauma: A resting-state functional magnetic resonance imaging study of regional homogeneity and functional connectivity.

    Science.gov (United States)

    Lu, Shaojia; Gao, Weijia; Wei, Zhaoguo; Wang, Dandan; Hu, Shaohua; Huang, Manli; Xu, Yi; Li, Lingjiang

    2017-06-01

    Childhood trauma confers great risk for the development of multiple psychiatric disorders; however, the neural basis for this association is still unknown. The present resting-state functional magnetic resonance imaging study aimed to detect the effects of childhood trauma on brain function in a group of young healthy adults. In total, 24 healthy individuals with childhood trauma and 24 age- and sex-matched adults without childhood trauma were recruited. Each participant underwent resting-state functional magnetic resonance imaging scanning. Intra-regional brain activity was evaluated by regional homogeneity method and compared between groups. Areas with altered regional homogeneity were further selected as seeds in subsequent functional connectivity analysis. Statistical analyses were performed by setting current depression and anxiety as covariates. Adults with childhood trauma showed decreased regional homogeneity in bilateral superior temporal gyrus and insula, and the right inferior parietal lobule, as well as increased regional homogeneity in the right cerebellum and left middle temporal gyrus. Regional homogeneity values in the left middle temporal gyrus, right insula and right cerebellum were correlated with childhood trauma severity. In addition, individuals with childhood trauma also exhibited altered default mode network, cerebellum-default mode network and insula-default mode network connectivity when the left middle temporal gyrus, right cerebellum and right insula were selected as seed area, respectively. The present outcomes suggest that childhood trauma is associated with disturbed intrinsic brain function, especially the default mode network, in adults even without psychiatric diagnoses, which may mediate the relationship between childhood trauma and psychiatric disorders in later life.

  9. Lung perfusion scintigraphy by SPECT

    International Nuclear Information System (INIS)

    Hirayama, Takanobu

    1990-01-01

    The initial study reports the characteristic performance using lung segmental phantom filled in Tc-99m pertechnetate. To evaluate the segmental defect in lung perfusion scintigraphy, we applied Bull's-eye analysis in addition to planar image set. Bull's-eye analysis especially facilitated the interpretation in both middle and lower lobes. Subsequently, to evolute the clinical application of Bull's-eye analysis, pulmonary scintigraphy was performed on 10 normal subjects and 60 patients with several pulmonary diseases. Of interest, Bull's-eye analysis, however, encouraged the interpretation in both lower lobes. To calculate the extention and severity of perfusion defect, the present study describes Bull's-eye analysis. Quantitative scoring showed higher in patients with lung cancer than those with pulmonary tuberculosis. The present study focus that Bull's-eye analysis can be useful for evaluating perfusion in patients with a couple of pulmonary diseases. (author)

  10. Dynamic CT myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncological and Pathological Sciences, University of Rome “Sapienza”, Latina (Italy); Eid, Marwen [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States); Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Mangold, Stefanie [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Tuebingen (Germany); and others

    2016-10-15

    Highlights: • CT myocardial perfusion provides functional assessment of the myocardium. • CCTA is limited in determining the hemodynamic significance of coronary stenosis. • CT-MPI can accurately detect hemodynamically significant coronary artery stenosis. - Abstract: Non-invasive cardiac imaging has rapidly evolved during the last decade due to advancements in CT based technologies. Coronary CT angiography has been shown to reliably assess coronary anatomy and detect high risk coronary artery disease. However, this technique is limited to anatomical assessment, thus non-invasive techniques for functional assessment of the heart are necessary. CT myocardial perfusion is a new CT based technique that provides functional assessment of the myocardium and allows for a comprehensive assessment of coronary artery disease with a single modality when combined with CTA. This review aims to discuss dynamic CT myocardial perfusion as a new technique in the assessment of CAD.

  11. Placental perfusion - a human alternative

    DEFF Research Database (Denmark)

    Mose, Tina; Knudsen, Lisbeth E

    2006-01-01

    between the mother and foetus. Dual perfusion of a single cotyledon in the human placenta can contribute to a better understanding of the placental barrier, transport rate and mechanisms of different substances and placental metabolism. The perfusion system has recently been established in Copenhagen...... and represents a supplement and alternative to animal testing, bypassing the animal to human extrapolation. Placentas are readily obtainable from most births upon informed consent from the mothers and are considered a promising tissue alternative/supplement to animal experiments. The system is validated...... as a part of work package 2 of the integrated project ReProTect....

  12. Evaluation of renal transplant perfusion by functional imaging

    International Nuclear Information System (INIS)

    Nicoletti, R.

    1990-01-01

    Radionuclide angiography (RNA) is used as a noninvasive method for the evaluation of renal transplant perfusion. The computer processing method generally used, based on regions of interest, is unsatisfactory because it does not permit the regional differentiation of perfusion defects. Furthermore, the subjective delineation of the regions of interest introduces considerable inter-observer variation of results. We developed a processing method which is less operator-dependent and permits the evaluation of local defects; it is based on the concept of functional imaging. The method was evaluated in 62 patient examinations, which were subdivided into four groups: Normal transplant perfusion (23 examinations), acute tubular necrose (ATN) (16), cellular rejection (13), and vascular rejection (10). Quantitative results derived from profile curves were combined with visual estimation of the functional images and yielded a synoptic graph which allowed differentiation into three groups: Normal transplant perfusion (sensitivity 0.78, specificity 0.97), ATN or cellular rejection (sens. 0.83, spec. 0.82), and vascular rejection (sens. 0.90, spec. 0.92). (orig.)

  13. Decreased Lung Perfusion After Breast/Chest Wall Irradiation: Quantitative Results From a Prospective Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Liss, Adam L., E-mail: adamliss68@gmail.com [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Marsh, Robin B. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Kapadia, Nirav S. [Department of Radiation Oncology, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire (United States); McShan, Daniel L. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Rogers, Virginia E. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Balter, James M.; Moran, Jean M.; Brock, Kristy K.; Schipper, Matt J.; Jagsi, Reshma [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States); Griffith, Kent A. [Biostatistics Unit, University of Michigan, Ann Arbor, Michigan (United States); Flaherty, Kevin R. [Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan (United States); Frey, Kirk A. [Division of Nuclear Medicine, Department of Radiology, University of Michigan, Ann Arbor, Michigan (United States); Pierce, Lori J. [Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan (United States)

    2017-02-01

    Purpose: To quantify lung perfusion changes after breast/chest wall radiation therapy (RT) using pre- and post-RT single photon emission computed tomography/computed tomography (SPECT/CT) attenuation-corrected perfusion scans; and correlate decreased perfusion with adjuvant RT dose for breast cancer in a prospective clinical trial. Methods and Materials: As part of an institutional review board–approved trial studying the impact of RT technique on lung function in node-positive breast cancer, patients received breast/chest wall and regional nodal irradiation including superior internal mammary node RT to 50 to 52.2 Gy with a boost to the tumor bed/mastectomy scar. All patients underwent quantitative SPECT/CT lung perfusion scanning before RT and 1 year after RT. The SPECT/CT scans were co-registered, and the ratio of decreased perfusion after RT relative to the pre-RT perfusion scan was calculated to allow for direct comparison of SPECT/CT perfusion changes with delivered RT dose. The average ratio of decreased perfusion was calculated in 10-Gy dose increments from 0 to 60 Gy. Results: Fifty patients had complete lung SPECT/CT perfusion data available. No patient developed symptoms consistent with pulmonary toxicity. Nearly all patients demonstrated decreased perfusion in the left lung according to voxel-based analyses. The average ratio of lung perfusion deficits increased for each 10-Gy increment in radiation dose to the lung, with the largest changes in regions of lung that received 50 to 60 Gy (ratio 0.72 [95% confidence interval 0.64-0.79], P<.001) compared with the 0- to 10-Gy region. For each increase in 10 Gy to the left lung, the lung perfusion ratio decreased by 0.06 (P<.001). Conclusions: In the assessment of 50 patients with node-positive breast cancer treated with RT in a prospective clinical trial, decreased lung perfusion by SPECT/CT was demonstrated. Our study allowed for quantification of lung perfusion defects in a prospective cohort of

  14. Global gene expression profiles in brain regions reflecting abnormal neuronal and glial functions targeting myelin sheaths after 28-day exposure to cuprizone in rats

    International Nuclear Information System (INIS)

    Abe, Hajime; Saito, Fumiyo; Tanaka, Takeshi; Mizukami, Sayaka; Watanabe, Yousuke; Imatanaka, Nobuya; Akahori, Yumi; Yoshida, Toshinori; Shibutani, Makoto

    2016-01-01

    Both developmental and postpubertal cuprizone (CPZ) exposure impairs hippocampal neurogenesis in rats. We previously found that developmental CPZ exposure alters the expression of genes related to neurogenesis, myelination, and synaptic transmission in specific brain regions of offspring. Here, we examined neuronal and glial toxicity profiles in response to postpubertal CPZ exposure by using expression microarray analysis in the hippocampal dentate gyrus, corpus callosum, cerebral cortex, and cerebellar vermis of 5-week-old male rats exposed to 0, 120, and 600 mg/kg CPZ for 28 days. Genes showing transcript upregulation were subjected to immunohistochemical analysis. We found transcript expression alterations at 600 mg/kg for genes related to synaptic transmission, Ache and Prima1, and cell cycle regulation, Tfap4 and Cdkn1a, in the dentate gyrus, which showed aberrant neurogenesis in the subgranular zone. This dose downregulated myelination-related genes in multiple brain regions, whereas KLOTHO + oligodendrocyte density was decreased only in the corpus callosum. The corpus callosum showed an increase in transcript levels for inflammatory response-related genes and in the number of CD68 + microglia, MT + astrocytes, and TUNEL + apoptotic cells. These results suggest that postpubertal CPZ exposure targets synaptic transmission and cell cycle regulation to affect neurogenesis in the dentate gyrus. CPZ suppressed myelination in multiple brain regions and KLOTHO-mediated oligodendrocyte maturation only in the corpus callosum. The increased number of CD68 + microglia, MT + astrocytes, and TUNEL + apoptotic cells in the corpus callosum may be involved in the induction of KLOTHO + oligodendrocyte death and be a protective mechanism against myelin damage following CPZ exposure. - Highlights: • Target gene expression profiles were examined in rats after 28-day CPZ exposure. • Multiple brain region-specific global gene expression profiling was performed. • CPZ

  15. A 4D digital phantom for patient-specific simulation of brain CT perfusion protocols.

    Science.gov (United States)

    van den Boom, Rieneke; Manniesing, Rashindra; Oei, Marcel T H; van der Woude, Willem-Jan; Smit, Ewoud J; Laue, Hendrik O A; van Ginneken, Bram; Prokop, Mathias

    2014-07-01

    Optimizing CT brain perfusion protocols is a challenge because of the complex interaction between image acquisition, calculation of perfusion data, and patient hemodynamics. Several digital phantoms have been developed to avoid unnecessary patient exposure or suboptimum choice of parameters. The authors expand this idea by using realistic noise patterns and measured tissue attenuation curves representing patient-specific hemodynamics. The purpose of this work is to validate that this approach can realistically simulate mean perfusion values and noise on perfusion data for individual patients. The proposed 4D digital phantom consists of three major components: (1) a definition of the spatial structure of various brain tissues within the phantom, (2) measured tissue attenuation curves, and (3) measured noise patterns. Tissue attenuation curves were measured in patient data using regions of interest in gray matter and white matter. By assigning the tissue attenuation curves to the corresponding tissue curves within the phantom, patient-specific CTP acquisitions were retrospectively simulated. Noise patterns were acquired by repeatedly scanning an anthropomorphic skull phantom at various exposure settings. The authors selected 20 consecutive patients that were scanned for suspected ischemic stroke and constructed patient-specific 4D digital phantoms using the individual patients' hemodynamics. The perfusion maps of the patient data were compared with the digital phantom data. Agreement between phantom- and patient-derived data was determined for mean perfusion values and for standard deviation in de perfusion data using intraclass correlation coefficients (ICCs) and a linear fit. ICCs ranged between 0.92 and 0.99 for mean perfusion values. ICCs for the standard deviation in perfusion maps were between 0.86 and 0.93. Linear fitting yielded slope values between 0.90 and 1.06. A patient-specific 4D digital phantom allows for realistic simulation of mean values and

  16. Somatosensory abnormalities for painful and innocuous stimuli at the back and at a site distinct from the region of pain in chronic back pain patients.

    Science.gov (United States)

    Puta, Christian; Schulz, Birgit; Schoeler, Saskia; Magerl, Walter; Gabriel, Brunhild; Gabriel, Holger H W; Miltner, Wolfgang H R; Weiss, Thomas

    2013-01-01

    Chronic low back pain (CLBP) was shown to be associated with pathophysiological changes at several levels of the sensorimotor system. Changes in sensory thresholds have been reported but complete profiles of Quantitative Sensory Testing (QST) were only rarely obtained in CLBP patients. The aim of the present study was to investigate comprehensive QST profiles in CLBP at the painful site (back) and at a site distinct from their painful region (hand) and to compare these data with similar data in healthy controls. We found increased detection thresholds in CLBP patients compared to healthy controls for all innocuous stimuli at the back and extraterritorial to the painful region at the hand. Additionally, CLBP patients showed decreased pain thresholds at both sites. Importantly, there was no interaction between the investigated site and group, i.e. thresholds were changed both at the affected body site and for the site distinct from the painful region (hand). Our results demonstrate severe, widespread changes in somatosensory sensitivity in CLBP patients. These widespread changes point to alterations at higher levels of the neuraxis or/and to a vulnerability to nociceptive plasticity in CLBP patients.

  17. Somatosensory abnormalities for painful and innocuous stimuli at the back and at a site distinct from the region of pain in chronic back pain patients.

    Directory of Open Access Journals (Sweden)

    Christian Puta

    Full Text Available Chronic low back pain (CLBP was shown to be associated with pathophysiological changes at several levels of the sensorimotor system. Changes in sensory thresholds have been reported but complete profiles of Quantitative Sensory Testing (QST were only rarely obtained in CLBP patients. The aim of the present study was to investigate comprehensive QST profiles in CLBP at the painful site (back and at a site distinct from their painful region (hand and to compare these data with similar data in healthy controls. We found increased detection thresholds in CLBP patients compared to healthy controls for all innocuous stimuli at the back and extraterritorial to the painful region at the hand. Additionally, CLBP patients showed decreased pain thresholds at both sites. Importantly, there was no interaction between the investigated site and group, i.e. thresholds were changed both at the affected body site and for the site distinct from the painful region (hand. Our results demonstrate severe, widespread changes in somatosensory sensitivity in CLBP patients. These widespread changes point to alterations at higher levels of the neuraxis or/and to a vulnerability to nociceptive plasticity in CLBP patients.

  18. The relationship between regional microstructural abnormalities of the corpus callosum and physical and cognitive disability in relapsing–remitting multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Maria Eugenia Caligiuri

    2015-01-01

    Full Text Available Significant corpus callosum (CC involvement has been found in relapsing–remitting multiple sclerosis (RRMS, even if conventional magnetic resonance imaging measures have shown poor correlation with clinical disability measures. In this work, we tested the potential of multimodal imaging of the entire CC to explain physical and cognitive disability in 47 patients with RRMS. Values of thickness, fractional anisotropy (FA and mean diffusivity (MD were extracted from 50 regions of interest (ROIs sampled along the bundle. The relationships between clinical, neuropsychological and imaging variables were assessed by using Spearman's correlation. Multiple linear regression analysis was employed in order to identify the relative importance of imaging metrics in modeling different clinical variables. Regional fiber composition of the CC differentially explained the response variables (Expanded Disability Status Scale [EDSS], cognitive impairment. Increases in EDSS were explained by reductions in CC thickness and MD. Cognitive impairment was mainly explained by FA reductions in the genu and splenium. Regional CC imaging properties differentially explained disability within RRMS patients revealing strong, distinct patterns of correlation with clinical and cognitive status of patients affected by this specific clinical phenotype.

  19. Automatic assessment of cardiac perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Stegmann, Mikkel Bille; Larsson, Henrik B.W.

    2004-01-01

    In this paper, a method based on Active Appearance Models (AAM) is applied for automatic registration of myocardial perfusion MRI. A semi-quantitative perfusion assessment of the registered image sequences is presented. This includes the formation of perfusion maps for three parameters; maximum up...

  20. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[{sup 123}I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru [Nagoya City Univ. (Japan). Faculty of Medicine

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[{sup 123}I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author).

  1. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[123I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    International Nuclear Information System (INIS)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[ 123 I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author)

  2. Residual DNA double strand breaks in perfused but not in unperfused areas determine different radiosensitivity of tumours

    International Nuclear Information System (INIS)

    Menegakis, Apostolos; Eicheler, Wolfgang; Yaromina, Ala; Thames, Howard D.; Krause, Mechthild; Baumann, Michael

    2011-01-01

    Purpose: Micromilieu-dependent quantification of γH2AX after irradiation in vivo and correlation with local tumour control. Materials and methods: Local tumour control was evaluated after irradiation of FaDu and SKX xenografts with ambient single doses. γH2AX foci were quantified in perfused and unperfused regions after different irradiation doses and at different time points. Results: The TCD 50 of FaDu was 2-times higher compared to SKX (28.0 Gy [95% C.I. 24.6; 31.3 Gy] for FaDu; 14.9 Gy [10.9; 18.9] for SKX, p < 0.001). The induction of foci did not differ between the tumour models. Residual foci were twice higher in perfused SKX regions compared to FaDu, no difference was observed in the non-perfused region between both tumour models. The number of residual foci increased with a 2-times higher slope in perfused SKX-regions compared to FaDu, while no difference was detected in unperfused regions. Already within the perfused regions, this slope decreased with distance from perfused vessels. Conclusion: The dose-response of residual γH2AX foci is highly dependent on tumour cell oxygenation in well perfused areas. This dependence decreases further away from tumour vessels. Only γH2AX evaluation in perfused tumour areas can distinguish between the different radiocurability of the two tumour models.

  3. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of 18FDG and 13NH3

    International Nuclear Information System (INIS)

    Kuhl, D.E.; Engel, J. Jr.; Phelps, M.E.; Selin, C.

    1979-01-01

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after 18 F-fluorodeoxyglucose ( 18 FDG) and 13 N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients who had unilateral or focal electrical abnormalities, interictal 18 FDG scan patterns clearly showed localized regions of decreased (20% to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal 18 FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal 18 FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). 13 NH 3 distributions paralleled 18 FDG increases and decreases in abnormal zones, but 13 NH 3 differences were of lesser magnitude. When the relationship of 13 NH 3 uptake to local blood flow found in dog brain was applied as a correction to the patients' 13 NH 3 scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states

  4. Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience

    International Nuclear Information System (INIS)

    Federau, C.; Becce, F.; Maeder, P.; Meuli, R.; Sumer, S.; Wintermark, M.; O'Brien, K.

    2014-01-01

    Intravoxel incoherent motion (IVIM) imaging is an MRI perfusion technique that uses a diffusion-weighted sequence with multiple b values and a bi-compartmental signal model to measure the so-called pseudo-diffusion of blood caused by its passage through the microvascular network. The goal of the current study was to assess the feasibility of IVIM perfusion fraction imaging in patients with acute stroke. Images were collected in 17 patients with acute stroke. Exclusion criteria were onset of symptoms to imaging >5 days, hemorrhagic transformation, infratentorial lesions, small lesions 2 . Image quality was assessed by two radiologists, and quantitative analysis was performed in regions of interest placed in the stroke area, defined by thresholding the apparent diffusion coefficient maps, as well as in the contralateral region. IVIM perfusion fraction maps showed an area of decreased perfusion fraction f in the region of decreased apparent diffusion coefficient. Quantitative analysis showed a statistically significant decrease in both IVIM perfusion fraction f (0.026 ± 0.019 vs. 0.056 ± 0.025, p = 2.2 . 10 -6 ) and diffusion coefficient D compared with the contralateral side (3.9 ± 0.79 . 10 -4 vs. 7.5 ± 0.86 . 10 -4 mm 2 /s, p = 1.3 . 10 -20 ). IVIM perfusion fraction imaging is feasible in acute stroke. IVIM perfusion fraction is significantly reduced in the visible infarct. Further studies should evaluate the potential for IVIM to predict clinical outcome and treatment response. (orig.)

  5. Prader-Willi Critical Region, a Non-Translated, Imprinted Central Regulator of Bone Mass: Possible Role in Skeletal Abnormalities in Prader-Willi Syndrome.

    Directory of Open Access Journals (Sweden)

    Ee-Cheng Khor

    Full Text Available Prader-Willi Syndrome (PWS, a maternally imprinted disorder and leading cause of obesity, is characterised by insatiable appetite, poor muscle development, cognitive impairment, endocrine disturbance, short stature and osteoporosis. A number of causative loci have been located within the imprinted Prader-Willi Critical Region (PWCR, including a set of small non-translated nucleolar RNA's (snoRNA. Recently, micro-deletions in humans identified the snoRNA Snord116 as a critical contributor to the development of PWS exhibiting many of the classical symptoms of PWS. Here we show that loss of the PWCR which includes Snord116 in mice leads to a reduced bone mass phenotype, similar to that observed in humans. Consistent with reduced stature in PWS, PWCR KO mice showed delayed skeletal development, with shorter femurs and vertebrae, reduced bone size and mass in both sexes. The reduction in bone mass in PWCR KO mice was associated with deficiencies in cortical bone volume and cortical mineral apposition rate, with no change in cancellous bone. Importantly, while the length difference was corrected in aged mice, consistent with continued growth in rodents, reduced cortical bone formation was still evident, indicating continued osteoblastic suppression by loss of PWCR expression in skeletally mature mice. Interestingly, deletion of this region included deletion of the exclusively brain expressed Snord116 cluster and resulted in an upregulation in expression of both NPY and POMC mRNA in the arcuate nucleus. Importantly, the selective deletion of the PWCR only in NPY expressing neurons replicated the bone phenotype of PWCR KO mice. Taken together, PWCR deletion in mice, and specifically in NPY neurons, recapitulates the short stature and low BMD and aspects of the hormonal imbalance of PWS individuals. Moreover, it demonstrates for the first time, that a region encoding non-translated RNAs, expressed solely within the brain, can regulate bone mass in health

  6. Assesment of repeatability of myocardial perfusion 99mTc-MIBI SPECT images

    International Nuclear Information System (INIS)

    Dabrowski, A.; Wnuk, J.; Konieczna, S.; Teresinska, A.

    2004-01-01

    To our knowledge, the repeatability of the myocardial perfusion 99m Tc-MIBI SPECT studies has not been measured. The main aim of this study was to assess the repeatability of rest myocardial perfusion 99m Tc-MIBI SPECT imaging after two MIBI injections on separate days and two different time intervals between radiotracer injection and acquisition. The additional aim was to evaluate the influence of rest variability on the global stress-rest myocardial perfusion study diagnosis. One hundred and seventeen patients with rest perfusion worsening (in first rest investigation-SP1) in routine stress-rest 99m Tc-MIBI SPECT perfusion imaging were studied. The rest study was repeated on another day, 1 hour (second rest investigation-SP2) and 3 hours (third rest investigation-SP3) following the injection of the radiotracer. Regional myocardial perfusion was evaluated quantitatively, in 17 segments of the LV, compered among all the three rest studies (SP1, SP2, SP3) and additionally combined with stress study. Altogether 1939 segments were studied. In 1260 segments (65%) perfusion in all three rest images was equal. In 232 segments (12%) perfusion in both studies performed after the same radiotracer injection (SP2 and SP3) was equal (but different than in SP1 examination). In 99 segments (5%) with the same time interval between injection and acquisition, perfusion was equal (but different than in the third evaluation). Repeated rest studies (SP2 and SP3) were compared to segments with stress defect. In 58% of those defects perfusion in SP2 and SP3 was equal; in 66% of the patients with at least one moderate stress defect, the stress-rest SPECT study result was the same after SP2 and SP3. In the special population of patients with perfusion worse at rest than at stress, our results showed: 1) the repeatability of the segmental myocardial perfusion at rest was 65%; 2) 66% patients had the same results of perfusion examination independently of the rest study used for comparison

  7. [IV drug perfusions: safety principles].

    Science.gov (United States)

    Lelieur, Florence; Cabelguenne, Delphine; Marcel, Marie; Favier, Claudine; Piriou, Vincent

    2017-05-01

    An intravenous perfusion is a procedure which comprises infection and medication risks. To manage these risks, caregivers must respect, in addition to the usual hygiene rules, a series of best practices, ensuring the proper use and management of the medical devices and administered drugs. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Pulmonary ventilation/perfusion scan

    Science.gov (United States)

    ... to stop eating (fast), be on a special diet, or take any medicines before the test. A chest x-ray is usually done before or after a ventilation and perfusion scan. You wear a hospital gown or comfortable clothing that does not have ...

  9. A comparative analysis of pulmonary ventilation-perfusion imaging with pulmonary angiography in the diagnosis of pulmonary embolism

    International Nuclear Information System (INIS)

    Wang Jincheng; Mi Hongzhi; Wang Qian; Zhang Weijun; Lu Biao; Yang Hao; Ding Jian; Lu Yao

    2001-01-01

    Objective: To assess the value of ventilation-perfusion imaging in the diagnosis of pulmonary embolism (PE). Methods: Thirty consecutive patients with clinically suspected pulmonary embolism were studied, male: female 15:15, mean age was (36.2 +- 13.9) years. The chest radiograms were obtained in all 30 patients. All patients underwent radionuclide ventilation-perfusion imaging and pulmonary angiography. Results: Of the 30 patients, 22 with lobe, multiple segment or multi-subsegment perfusion defects and normal or nearly normal ventilation images were reported as PE. 20 of them were confirmed to be with PE by pulmonary angiography, 2 patients were not confirmed. Eight of 30 patients with multiple perfusion defects, ventilative abnormalities were reported as non-PE and the diagnoses were confirmed by pulmonary angiography. The sensitivity, specificity and accuracy of diagnosis of PE by ventilation-perfusion imaging was 100%, 80.0% and 93.3% respectively. Conclusions: (1) Ventilation-perfusion imaging is one of the most valuable methods in the diagnosis of PE. (2) The results suggest that pulmonary embolism can be diagnosed non-invasively in most patients on the basis of clinical manifestation, chest radiograms and ventilation-perfusion imaging findings. (3) Pulmonary angiography is required while clinical manifestation and ventilation-perfusion imaging findings are discordant with each other

  10. Assessment of the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level in patients with emphysema

    International Nuclear Information System (INIS)

    Ley-Zaporozhan, Julia; Ley, Sebastian; Eberhardt, Ralf; Weinheimer, Oliver; Fink, Christian; Puderbach, Michael; Eichinger, Monika; Herth, Felix; Kauczor, Hans-Ulrich

    2007-01-01

    Purpose: To assess the relationship between lung parenchymal destruction and impaired pulmonary perfusion on a lobar level using CT and MRI in patients with emphysema. Material and methods: Forty-five patients with severe emphysema (GOLD III and IV) underwent inspiratory 3D-HRCT and contrast-enhanced MR-perfusion (1.5T; 3.5 mm x 1.9 mm x 4 mm). 3D-HRCT data was analyzed using a software for detection and visualization of emphysema. Emphysema was categorized in four clusters with different volumes and presented as overlay on the CT. CT and lung perfusion were visually analyzed for three lobes on each side using a four-point-score to grade the abnormalities on CT (1: predominantly small emphysema-clusters to 4: >75% large emphysema-clusters) and MRI (1: normal perfusion to 4: no perfusion). Results: A total of 270 lobes were evaluated. At CT, the score was 1 for 9 lobes, 2 for 43, 3 for 77, and 4 for 141 lobes. At MRI, the score was 1 for 13 lobes, 2 for 45, 3 for 92, and 4 for 120 lobes. Matching of lung parenchymal destruction and reduced perfusion was found in 213 lobes (weighted kappa = 0.8). The score was higher on CT in 44, and higher on MRI in 13 lobes. Conclusion: 3D-HRCT and 3D MR-perfusion show a high lobar agreement between parenchymal destruction and reduction of perfusion in patients with severe emphysema

  11. Cardiovascular magnetic resonance: myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Nagel, E.; Al-Saadi, N.; Fleck, E. [Dept. of Internal Medicine/Cardiology, German Heart Inst. Berlin and Charite, Campus Virchow, Humboldt Univ. (Germany)

    2000-06-01

    There is growing evidence that the noninvasive assessment of myocardial perfusion with cardiovascular magnetic resonance is a valid and accurate tool for the assessment of ischemic heart disease and its introduction into routine clinical evaluation of patients is rapidly expected. Magnetic resonance measurements allow the evaluation of reversible and irreversible myocardial ischemia, the assessment of acute myocardial infarction, as well as the recognition and detection of viable myocardium. Magnetic resonance perfusion measurements are mainly performed with T1-shortening contrast agents such as gadolinium-DTPA either by visual analysis or based on the analyses of signal intensity time curves. For the detection of myocardial ischemia the first pass kinetics of a gadolinium-DTPA bolus and for the detection of myocardial necrosis and the definition of viable myocardium steady state distribution kinetics are assessed. Quantitative analysis of myocardial perfusion can be performed but requires complex modeling due to the characteristics of gadolinium-DTPA. Thus, semi-quantitative parameters are preferred. There is accumulating evidence in the literature that magnetic resonance imaging can be used for the detection of coronary artery stenosis with high diagnostic accuracy both with semi-quantitative or visual analysis. Myocardial infarction can be reliably detected and the infarcted area determined. Non-reperfused infarcted myocardium can be differentiated from reperfused myocardium by different enhancement patterns that correlates with viability. (orig.) [German] Die Magnetresonanztomographie (MR) erlangt bei der nichtinvasiven Diagnostik der koronaren Herzerkrankung eine zunehmende Bedeutung. Mit dieser Technik koennen sowohl die globale und regionale Myokardfunktion als auch die myokardiale Perfusion exakt beurteilt werden. Bisher liegen die meisten Daten fuer die Analyse von Wandbewegungsstoerun-gen unter Belastung vor, wobei sich eine deutliche diagnostische

  12. Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting

    International Nuclear Information System (INIS)

    Giubbini, Raffaele; Rossini, Pierluigi; Bertagna, Francesco; Bosio, Giovanni; Paghera, Barbara; Pizzocaro, Claudio; Canclini, Silvana; Terzi, Arturo; Germano, Guido

    2004-01-01

    The aim of this study was the evaluation of septal wall motion, perfusion and wall thickening after CABG in two groups of consecutive patients, one with grafted left anterior coronary artery and no history of myocardial infarction, and the other with previous anteroseptal myocardial infarction and impaired septal motion before surgery. The issue addressed was the ability of gated SPECT to differentiate between true paradoxical septal motion, characterised by paradoxical wall motion, depressed ejection fraction (EF), poor viability and compromised wall thickening, and pseudo-paradoxical motion, characterised by abnormal wall motion and regional EF but preserved perfusion and wall thickening. One hundred and thirty-two patients with previous anterior myocardial infarction, 82 patients with left anterior descending coronary disease and no history of myocardial infarction and 27 normal subjects underwent rest gated SPECT after 99m Tc-sestamibi injection, according to the standard QGS protocol. Quantitative regional EF, regional perfusion, regional wall motion and regional wall thickening were determined using a 20-segment model. Despite the presence of similar regional wall motion impairment in patients with and patients without septal infarction, in terms of regional EF (2.5%±3% vs 1.9%±4.9% p=NS) and inward septal motion (3±4.9 mm vs 2.3±6.1 mm p=NS), significant differences were observed in both perfusion (74.7%±6.2% vs 63.3%±13%, p>0.0001) and regional wall thickening (17.2%±7.4% vs 12.6%±7.2%, p>0.0001). Gated SPECT with perfusion tracers can reliably differentiate pseudo-paradoxical from true paradoxical septal motion in patients with previous CABG, and it may be the method of choice for evaluating left ventricular performance in this patient population. (orig.)

  13. Value of gated SPECT in the analysis of regional wall motion of the interventricular septum after coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Giubbini, Raffaele; Rossini, Pierluigi; Bertagna, Francesco; Bosio, Giovanni; Paghera, Barbara; Pizzocaro, Claudio; Canclini, Silvana; Terzi, Arturo [Spedali Civili di Brescia, Department of Nuclear Medicine, Brescia (Italy); Germano, Guido [Cedars-Sinai Medical Center, Artificial Intelligence Program, Department of Medicine, Los Angeles, CA (United States)

    2004-10-01

    The aim of this study was the evaluation of septal wall motion, perfusion and wall thickening after CABG in two groups of consecutive patients, one with grafted left anterior coronary artery and no history of myocardial infarction, and the other with previous anteroseptal myocardial infarction and impaired septal motion before surgery. The issue addressed was the ability of gated SPECT to differentiate between true paradoxical septal motion, characterised by paradoxical wall motion, depressed ejection fraction (EF), poor viability and compromised wall thickening, and pseudo-paradoxical motion, characterised by abnormal wall motion and regional EF but preserved perfusion and wall thickening. One hundred and thirty-two patients with previous anterior myocardial infarction, 82 patients with left anterior descending coronary disease and no history of myocardial infarction and 27 normal subjects underwent rest gated SPECT after {sup 99m}Tc-sestamibi injection, according to the standard QGS protocol. Quantitative regional EF, regional perfusion, regional wall motion and regional wall thickening were determined using a 20-segment model. Despite the presence of similar regional wall motion impairment in patients with and patients without septal infarction, in terms of regional EF (2.5%{+-}3% vs 1.9%{+-}4.9% p=NS) and inward septal motion (3{+-}4.9 mm vs 2.3{+-}6.1 mm p=NS), significant differences were observed in both perfusion (74.7%{+-}6.2% vs 63.3%{+-}13%, p>0.0001) and regional wall thickening (17.2%{+-}7.4% vs 12.6%{+-}7.2%, p>0.0001). Gated SPECT with perfusion tracers can reliably differentiate pseudo-paradoxical from true paradoxical septal motion in patients with previous CABG, and it may be the method of choice for evaluating left ventricular performance in this patient population. (orig.)

  14. Visual and SPM Analysis of Brain Perfusion SPECT in Patients of Dementia with Lewy Bodies with Clinical Correlation

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2003-01-01

    Dementia with Lewy bodies (DLB) is widely recognized as the second commonest form of degenerative dementia. Its core clinical features include persistent visual hallucinosis, fluctuating cognitive impairment and parkinsonism. We evaluated the brain perfusion of dementia with Lewy bodies by SPM analysis and correlated the findings with clinical symptom. Twelve DLB patients (mean age ; 68.88.3 yrs, K-MMSE ; 17.36) and 30 control subjects (mean age ; 60.17.7 yrs) were included. Control subjects were selected by 28 items of exclusion criteria and checked by brain CT or MRI except 3 subjects. Tc-99m HMPAO brain perfusion SPECT was performed and the image data were analyzed by visual interpretation and SPM99 as routine protocol. In visual analysis, 7 patients showed hypoperfusion in both frontal, temporal, parietal and occipital lobe, 2 patients in both frontal, temporal and parietal lobe, 2 patients in both temporal, parietal and occipital lobe, 1 patients in left temporal, parietal and occipital lobe. In SPM analysis (uncorrected p<0.01), significant hypoperfusion was shown in Lt inf. frontal gyrus (B no.47), both inf. parietal lobule (Rt B no.40), Rt parietal lobe (precuneus), both sup. temporal gyrus (Rt B no.42), Rt mid temporal gyrus, Lt transverse temporal gyrus (B no.41), both para hippocampal gyrus, Rt thalamus (pulvinar), both cingulate gyrus (Lt B no.24, Lt B no.25, Rt B no.23, Rt B no.24, Rt B no.33), Rt caudate body, both occipital lobe (cuneus, Lt B no.17, Rt B no.18). All patients had fluctuating cognition and parkinsonism, and 9 patients had visual hallucination. The result of SPM analysis was well correlated with visual interpretation and may be helpful to specify location to correlate with clinical symptom. Significant perfusion deficits in occipital region including visual cortex and visual association area are characteristic findings in DLB. Abnormalities in these areas may be important in understanding symptoms of visual hallucination and

  15. Visual and SPM Analysis of Brain Perfusion SPECT in Patients of Dementia with Lewy Bodies with Clinical Correlation

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

    2003-07-01

    Dementia with Lewy bodies (DLB) is widely recognized as the second commonest form of degenerative dementia. Its core clinical features include persistent visual hallucinosis, fluctuating cognitive impairment and parkinsonism. We evaluated the brain perfusion of dementia with Lewy bodies by SPM analysis and correlated the findings with clinical symptom. Twelve DLB patients (mean age ; 68.88.3 yrs, K-MMSE ; 17.36) and 30 control subjects (mean age ; 60.17.7 yrs) were included. Control subjects were selected by 28 items of exclusion criteria and checked by brain CT or MRI except 3 subjects. Tc-99m HMPAO brain perfusion SPECT was performed and the image data were analyzed by visual interpretation and SPM99 as routine protocol. In visual analysis, 7 patients showed hypoperfusion in both frontal, temporal, parietal and occipital lobe, 2 patients in both frontal, temporal and parietal lobe, 2 patients in both temporal, parietal and occipital lobe, 1 patients in left temporal, parietal and occipital lobe. In SPM analysis (uncorrected p<0.01), significant hypoperfusion was shown in Lt inf. frontal gyrus (B no.47), both inf. parietal lobule (Rt B no.40), Rt parietal lobe (precuneus), both sup. temporal gyrus (Rt B no.42), Rt mid temporal gyrus, Lt transverse temporal gyrus (B no.41), both para hippocampal gyrus, Rt thalamus (pulvinar), both cingulate gyrus (Lt B no.24, Lt B no.25, Rt B no.23, Rt B no.24, Rt B no.33), Rt caudate body, both occipital lobe (cuneus, Lt B no.17, Rt B no.18). All patients had fluctuating cognition and parkinsonism, and 9 patients had visual hallucination. The result of SPM analysis was well correlated with visual interpretation and may be helpful to specify location to correlate with clinical symptom. Significant perfusion deficits in occipital region including visual cortex and visual association area are characteristic findings in DLB. Abnormalities in these areas may be important in understanding symptoms of visual hallucination and

  16. Applications and interpretation of krypton 81m ventilation/technetium 99m macroaggregate perfusion lung scanning in childhood

    Science.gov (United States)

    Davies, Hugh Trevor Frimston

    Radionuclide ventilation perfusion lung scans now play an important part in the investigation of paediatric lung disease, providing a safe, noninvasive assessment of regional lung function in children with suspected pulmonary disease. In paediatric practice the most suitable radionuclides are Krypton 81m (Kr81m) and Technetium 99m (Tc99m), which are jointly used in the Kr81m ventilation/Tc99m macroaggregate perfusion lung scan (V/Q lung scan). The Kr81m ventilation scan involves a low radiation dose, requires little or no subject cooperation and because of the very short half life of Kr81m (13 seconds) the steady state image acquired during continuous inhalation of the radionuclide is considered to reflect regional distribution of ventilation. It is now the most important noninvasive method available for the investigation of the regional abnormalities of ventilation characteristic of many congenital and acquired paediatric respiratory diseases, such as diaphragmatic hernia, pulmonary sequestration, bronchopulmonary dysplasia, foreign body inhalation and bronchiectasis. It improves diagnostic accuracy, aids clinical decision making and is used to monitor the progress of disease and response to therapy. Theoretical analysis of the steady state Kr81m ventilation image suggests that it may only reflect regional ventilation when specific ventilation (ventilation per unit volume of lung) is within or below the normal adult range (1-3 L/L/min). At higher values such as those seen in neonates and infants (8-15 L/L/min) Kr81m activity may reflect regional lung volume rather than ventilation, a conclusion supported by the studies of Ciofetta et al. There is some controversy on this issue as animal studies have demonstrated that the Kr81m image reflects ventilation over a much wider range of specific ventilation (up to 13 L/L/min). A clinical study of sick infants and very young children is in agreement with this animal work and suggests that the steady state Kr81m image

  17. Myocardial perfusion imaging with thallium-201: correlation with coronary arteriography and electrocardiography

    Science.gov (United States)

    Sternberg, Leonard; Wald, Robert W.; Feiglin, David H.I.; Morch, John E.

    1978-01-01

    Myocardial perfusion imaging with thallium-201 and electrocardiography with the subject at rest and undergoing submaximal treadmill exercise were performed in 19 men and 3 women. Selective coronary arteriography and left ventriculography showed that 7 had normal coronary arteries and 15 had coronary artery disease. The 11 persons with electrocardiographic evidence of an old myocardial infarct (q waves) had a perfusion defect at rest in the area of the infarct and a segmental abnormality of wall motion apparent on the left ventriculogram corresponding to the perfusion defect. Myocardial perfusion imaging and electrocardiography were equally sensitive in detecting coronary artery disease in exercising individuals: perfusion defects were noted in 7 of the 15 persons with coronary artery disease, and diagnostic ST-segment depression was present in 8 of the 15. Combination of the results of the two tests with exercise permitted the identification of 11 of the 15 persons and improved the sensitivity. Combination of the results of rest and exercise imaging and electrocardiography permitted the identification of 94% of the patients with coronary artery disease. Myocardial perfusion imaging with 201TI in the subject at rest is a sensitive indicator of previous myocardial infarction. Imaging after the subject has exercised is a useful adjunct to conventional exercise electrocardiography, especially in those whose exercise electrocardiogram is non-interpretable. ImagesFIG. 1FIG. 2FIG. 3FIG. 4FIG. 5 PMID:630487

  18. Myocardial perfusion SPECT in diabetic patients for detection of coronary artery disease

    International Nuclear Information System (INIS)

    Saeed, M.A.; Fatima, S.; Fatmi, S.; Kureshi, S.

    2003-01-01

    The aim of this study was to evaluate the efficacy of myocardial SPECT perfusion scan in the diagnosis of coronary artery disease in diabetic patients. A total number of thirty diabetic patients (21 males, 9 females) were included in the study. All the patients had strong risk-factors for coronary artery disease (strong family history, chronic smokers, hyperlipidemia, history of chest pain). All patients underwent coronary angiography and stress/rest myocardial perfusion SPECT scans with Tc-99m MIBI (two days protocol). Twenty two patients had significant coronary artery stenosis and 8 had normal coronary arteries. Myocardial perfusion scintigraphy (MPS) was positive in 19 subjects out of the 22 patients with significant stenosis (Sensitivity 86.4%) and negative (false negative) in only three. Out of 8 patients with normal angiography 7 had normal MPS (Specificity 87.5%) whereas only one patient revealed abnormality in the myocardial perfusion study. When compared with coronary angiography the positive predictive value and negative predictive value for Tc-99m MIBI myocardial perfusion scan was 86.4% and 87.5% respectively. In conclusion, Tc-99m MIBI myocardial perfusion scintigraphy is a useful screening modality for the detection of coronary artery disease in diabetic patients. (author)

  19. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

    Energy Technology Data Exchange (ETDEWEB)

    Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

    2013-01-15

    Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

  20. Magnetic resonance perfusion imaging without contrast media

    International Nuclear Information System (INIS)

    Martirosian, Petros; Graf, Hansjoerg; Schick, Fritz; Boss, Andreas; Schraml, Christina; Schwenzer, Nina F.; Claussen, Claus D.

    2010-01-01

    Principles of magnetic resonance imaging techniques providing perfusion-related contrast weighting without administration of contrast media are reported and analysed systematically. Especially common approaches to arterial spin labelling (ASL) perfusion imaging allowing quantitative assessment of specific perfusion rates are described in detail. The potential of ASL for perfusion imaging was tested in several types of tissue. After a systematic comparison of technical aspects of continuous and pulsed ASL techniques the standard kinetic model and tissue properties of influence to quantitative measurements of perfusion are reported. For the applications demonstrated in this paper a flow-sensitive alternating inversion recovery (FAIR) ASL perfusion preparation approach followed by true fast imaging with steady precession (true FISP) data recording was developed and implemented on whole-body scanners operating at 0.2, 1.5 and 3 T for quantitative perfusion measurement in various types of tissue. ASL imaging provides a non-invasive tool for assessment of tissue perfusion rates in vivo. Images recorded from kidney, lung, brain, salivary gland and thyroid gland provide a spatial resolution of a few millimetres and sufficient signal to noise ratio in perfusion maps after 2-5 min of examination time. Newly developed ASL techniques provide especially high image quality and quantitative perfusion maps in tissues with relatively high perfusion rates (as also present in many tumours). Averaging of acquisitions and image subtraction procedures are mandatory, leading to the necessity of synchronization of data recording to breathing in abdominal and thoracic organs. (orig.)

  1. Safety of adenosine in stress cerebral perfusion imaging

    International Nuclear Information System (INIS)

    Hu Pengcheng; Gu Yushen; Liu Wenguan; Xiu Yan; Zhu Weimin; Chen Shuguang; Shi Hongcheng

    2009-01-01

    Objective: To evaluate the safety of adenosine as pharmacological stress agents in stress cerebral perfusion imaging. Methods: Eighty patients under investigation for suspected cerebral vessel disease were recruited. Each had a resting scan and a stress scan on different days. The adenosine stress protocol was as same as the protocol used in adenosine stress myocardial perfusion imaging. Subjective and objective side-effects were investigated during pharmacological stress procedure. Results: All patients completed the 6 min infusion protocol without premature termination on safety criteria or due to intolerable symptoms. 46 patients had mild side effects. 20 patients (25%) had dizziness, 12 patients (15%) had palpitation, 1 patient (1%) was hypotensive, 7 patients (9%) had dyspnoea, 4 patients (5%) felt hot, 3 patients (4%) had sweat, 4 patients (5%) had nausea, 6 patients (8%) had flushing, 19 patients (24%) had chest pain, 6 patients (8%) had abdomen pain, 3 patients (4%) had abnormal taste and 1 patient (1%) were thirsty. Transient ST change occurred in only 1 patient. Conclusion: Adenosine stress cerebral perfusion imaging is a safe diagnostic method with mild side effects. (authors)

  2. Estimation of pulmonary hypertension of congenital heart diseases in children by lung perfusion scintigraphy

    International Nuclear Information System (INIS)

    Zheng Jinghao; Zhang Shantong; Zeng Jiye; Jia Hongli; Ji Zhiying; Chen Siyi

    1993-01-01

    The authors report that changes in the distribution of pulmonary perfusion caused by gravitation effect, namely, changes in the total count ratios of the right against the left lung between right and left lateral decubitus positions (rt/lt) could estimate pulmonary hypertension using lung perfusion scintigraphy with 99m Tc-labelled macroaggregated albumin. The results showed: rt/lt was inversely related to mean pulmonary arterial pressure. It is concluded that the method is simple, safe, reproducible, unaffected by cardiac structural abnormality and valuable as a noninvasive approach for the estimation of pulmonary hypertension

  3. Defining Abnormally Low Tenders

    DEFF Research Database (Denmark)

    Ølykke, Grith Skovgaard; Nyström, Johan

    2017-01-01

    The concept of an abnormally low tender is not defined in EU public procurement law. This article takes an interdisciplinary law and economics approach to examine a dataset consisting of Swedish and Danish judgments and verdicts concerning the concept of an abnormally low tender. The purpose...

  4. The value of stress perfusion cardiovascular magnetic resonance imaging for patients referred from the adult congenital heart disease clinic: 5-year experience at the Toronto General Hospital.

    Science.gov (United States)

    Deva, Djeven P; Torres, Felipe S; Wald, Rachel M; Roche, S Lucy; Jimenez-Juan, Laura; Oechslin, Erwin N; Crean, Andrew M

    2014-10-01

    Vasodilator stress perfusion cardiovascular magnetic resonance imaging is a clinically useful tool for detection of clinically significant myocardial ischaemia in adults. We report our 5-year retrospective experience with perfusion cardiovascular magnetic resonance in a large, quarternary adult congenital heart disease centre. We reviewed all cases of perfusion cardiovascular magnetic resonance in patients referred from the adult congenital heart disease service. Dipyridamole stress perfusion cardiovascular magnetic resonance was undertaken on commercially available 1.5 and 3 T cardiovascular magnetic resonance scanners. Late gadolinium enhancement imaging was performed 8-10 minutes after completion of the rest perfusion sequence. Navigator whole-heart coronary magnetic resonance angiography was also performed where feasible. RESULTS of stress cardiovascular magnetic resonance were correlated with complementary imaging studies, surgery, and clinical outcomes. Over 5 years, we performed 34 stress perfusion cardiovascular magnetic resonance examinations (11 positive). In all, 84% of patients had further investigations for ischaemia in addition to cardiovascular magnetic resonance. Within a subgroup of 19 patients who had definitive alternative assessment of their coronary arteries, stress perfusion cardiovascular magnetic resonance demonstrated a sensitivity of 82% and specificity of 100%. Of the 34 studies, two were false negatives, in which the aetiology of ischaemia was extrinsic arterial compression rather than intrinsic coronary luminal narrowing. Coronary abnormalities were identified in 71% of cases who had coronary magnetic resonance angiography. Stress perfusion cardiovascular magnetic resonance is a useful and accurate tool for investigation of myocardial ischaemia in an adult congenital heart disease population with suspected non-atherosclerotic coronary abnormalities.

  5. Non-Invasive Renal Perfusion Imaging Using Arterial Spin Labeling MRI: Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Fabio Nery

    2018-01-01

    Full Text Available Tissue perfusion allows for delivery of oxygen and nutrients to tissues, and in the kidneys is also a key determinant of glomerular filtration. Quantification of regional renal perfusion provides a potential window into renal (patho physiology. However, non-invasive, practical, and robust methods to measure renal perfusion remain elusive, particularly in the clinic. Arterial spin labeling (ASL, a magnetic resonance imaging (MRI technique, is arguably the only available method with potential to meet all these needs. Recent developments suggest its viability for clinical application. This review addresses several of these developments and discusses remaining challenges with the emphasis on renal imaging in human subjects.

  6. Plant abnormality diagnosis device

    International Nuclear Information System (INIS)

    Saeki, Akira.

    1992-01-01

    The device of the present invention diagnose an abnormal event occurred in a large-scaled plant, such as a nuclear power plant. The device comprises the following four functions. (1) Abnormality candidates are estimated based on an intelligence base storing characteristics established between the characteristics/functions and physical amounts of the plant components, and detected abnormality and measured values. Among the candidates, one which coincidents with the measured value such as an actual process amount is judged as a first cause. (2) In addition, a real time plant behavior is estimated based on parameters determining a plant operation mode. The candidate for the abnormality cause is estimated by the comparison between the result of the estimation and the measured value such as a process amount. (3) Characteristics established between the characteristics/functions and the physical amount of the plant components are structured stepwise thereby identifying the first abnormality cause. (4) Inactuated or failed portions of the components for restoring the abnormality to normal state are identified based on the intelligence base simultaneously with the estimation for the first abnormality cause. (I.S.)

  7. Neuro-functional alteration in disorders of the encourage they cause with conducts self-mutilations study of cerebral regional perfusion starting from the technique of Neuro-SPECT Tc99-HMPAO

    International Nuclear Information System (INIS)

    Mena, Ismael; Correa, Rodrigo; Nader, Armando

    2007-01-01

    We report NeuroSPECT findings in mood disorders, including bipolar disorder, major depression and self-mutilation. We compare results in 29 patients with bipolar disorder complicated by self-mutilation, a group of 20 patients with bipolar disorder uncomplicated and 22 patients with mayor depression uncomplicated by self-mutilation. Among the NeuroSPECT findings we report the association of mood disorders and self-mutilation with hyper perfusion of the anterior-dorsal-ventral segment of both thalami concomitant with hypoperfusion in perilimbic cortex, namely areas 32, 24 (anterior cingulate gyrus) and 23 of Brodmann. Multiple reports in the literature relate both, in animals and man, self-mutilation with phenomena of hypoalghesia, anesthesia, or dysestesias and are the basis for our hypothesis linking dysfunction of limbic-thalamic circuits, associated with nocioceptive fibers, somato-psychic consciousness and self-mutilation phenomena

  8. Quantification of brain perfusion with tracers retained by the brain

    Energy Technology Data Exchange (ETDEWEB)

    Pupi, A.; Bacciottini, L.; De Cristofaro, M.T.R.; Formiconi, A.R.; Castagnoli, A. [Univ. of Florence (Italy)

    1991-12-31

    Almost a decade ago, tracers, labelled with {sup 123}I and {sup 99m}Tc, that are retained by the brain, started to be used for studies of regional brain perfusion (regional cerebral blood flow, rCBF). To date, these tracers have been used for brain perfusion imaging with SPECT in brain disorders as well as for physiological activation protocols. Only seldom, however, have they been used in protocols that quantitatively measure rCBF. Nevertheless, comparative studies with perfusion reference tracers have repeatedly demonstrated that the brain uptake of these brain-retained tracers is correlated to perfusion, the major determinant of the distribution of these tracers in the brain. The brain kinetics of {sup 99m}Tc HMPAO, which is the tracer most commonly used, was described with a two-compartment tissue model. The theoretical approach, which is, in itself, sufficient for modeling quantitative measurements with {sup 99m}Tc HMPAO, initially suggested the possibility of empirically narrowing the distance between the brain`s regional uptake of the tracer and rCBF with a linearization algorithm which uses the cerebellum as the reference region. The value of this empirical method is hampered by the fact that the cerebellum can be involved in cerebrovascular disease (i.e. cerebellar diaschisis) as well as in several other brain disorders (e.g. anxiety, and dementia of the Alzheimer type). It also was proposed that different reference regions (occipital, whole slice, or whole brain) should be selected in relation to the brain disorder under study. However, this approach does not solve the main problem because it does not equip us with a reliable tool to evaluate rCBF with a high predictive value, and, at the same time, to reduce intersubject variability. The solution would be to measure a quantitative parameter which directly reflects rCBF, such as the unidirectional influx constant of the freely diffusible flow-limited tracers. 45 refs., 3 figs., 1 tab.

  9. Dosimetry in myocardial perfusion imaging

    International Nuclear Information System (INIS)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C.

    2011-01-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  10. Dosimetry in myocardial perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Toledo, Janine M.; Trindade, Bruno; Ribeiro, Tarcisio P.C. [Universidade Federal de Minas Gerais (DEN/UFMG), Belo Horizonte (Brazil). Dept. de Engenharia Nuclear. Programa de Pos-Graduacao em Ciencias e Tecnicas Nucleares

    2011-07-01

    This paper conducts a dosimetric investigation on the myocardial perfusion image protocol, together with a literature reviewing, motivated by the significant statistic increasing on mortality, morbidity and disability associated with cardiovascular disease, surpassing infectious diseases. Nuclear Cardiology plays a role n the diagnostic functional evaluation of the heart and in the prognostic of patients with suspected or known cardiac ischemia. In the context of unstable myocardial ischemic syndrome, myocardial perfusion scintigraphy is a non-invasive procedure performed by administering a radiopharmaceutical targeted to the heart. As tool for this study are that the images obtained by thoracic angiotomography and abdominal aorta as a anatomic and functional information for model reproduction in SISCODES - System of Codes for Absorbed Dose Calculations based on Stochastic Methods. Data were manipulated in order to create a voxel computational model of the heart to be running in MCNP - Monte Carlo Neutron Particle Code. . It was assumed a homogeneous distribution of Tl-201 in cardiac muscle. Simulations of the transport of particles through the voxel and the interaction with the heart tissue were performed. As a result, the isodose curves in the heart model are displayed as well as the dose versus volume histogram of the heart muscle. We conclude that the present computational tools can generate doses distributed in myocardial perfusion. (author)

  11. Standardized perfusion value of the esophageal carcinoma and its correlation with quantitative CT perfusion parameter values.

    Science.gov (United States)

    Djuric-Stefanovic, A; Saranovic, Dj; Sobic-Saranovic, D; Masulovic, D; Artiko, V

    2015-03-01

    Standardized perfusion value (SPV) is a universal indicator of tissue perfusion, normalized to the whole-body perfusion, which was proposed to simplify, unify and allow the interchangeability among the perfusion measurements and comparison between the tumor perfusion and metabolism. The aims of our study were to assess the standardized perfusion value (SPV) of the esophageal carcinoma, and its correlation with quantitative CT perfusion measurements: blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) of the same tumor volume samples, which were obtained by deconvolution-based CT perfusion analysis. Forty CT perfusion studies of the esophageal cancer were analyzed, using the commercial deconvolution-based CT perfusion software (Perfusion 3.0, GE Healthcare). The SPV of the esophageal tumor and neighboring skeletal muscle were correlated with the corresponding mean tumor and muscle quantitative CT perfusion parameter values, using Spearman's rank correlation coefficient (rS). Median SPV of the esophageal carcinoma (7.1; range: 2.8-13.4) significantly differed from the SPV of the skeletal muscle (median: 1.0; range: 0.4-2.4), (Z=-5.511, pCT perfusion measurements and statistically significant correlation was proved. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Abnormally large magnetospheric electric field on 9 November 2004 ...

    Indian Academy of Sciences (India)

    There was a solar event around 1850 UT on 9th November 2004, associated with an abnormally large solar wind flow pressure and large southward interplanetary magnetic field, causing an abnormally large prompt penetration electric field between 1850 and 2100 UT. Abnormally large vertical F-region drifts by Jicamarca ...

  13. Liver Preservation by Aortic Perfusion Alone Compared With Preservation by Aortic Perfusion and Additional Arterial Ex Situ Back-Table Perfusion With Histidine-Tryptophan-Ketoglutarate Solution: A Prospective, Randomized, Controlled, Multicenter Study.

    Science.gov (United States)

    Otto, Gerd; Heise, Michael; Thies, Jochen; Pitton, Michael; Schneider, Jens; Kaiser, Gernot; Neuhaus, Peter; Kollmar, Otto; Barthels, Michael; Geks, Josef; Bechstein, Wolf Otto; Hellinger, Achim; Klempnauer, Jürgen; Padberg, Winfried; Frühauf, Nils; Ebbing, Andre; Mauer, Dietmar; Schneider, Astrid; Kwiecien, Robert; Kronfeld, Kai

    2017-07-01

    Arterial ex situ back-table perfusion (BP ) reportedly reduces ischemic-type biliary lesion after liver transplantation. We aimed to verify these findings in a prospective investigation. Our prospective, randomized, controlled, multicenter study involved livers retrieved from patients in 2 German regions, and compared the outcomes of standard aortic perfusion to those of aortic perfusion combined with arterial ex situ BP. The primary endpoint was the incidence of ischemic-type biliary lesions over a follow-up of 2 years after liver transplantation, whereas secondary endpoints included 2-year graft survival, initial graft damage as reflected by transaminase levels, and functional biliary parameters at 6 months after transplantation. A total of 75 livers preserved via standard aortic perfusion and 75 preserved via standard aortic perfusion plus arterial BP were treated using a standardized protocol. The incidence of clinically apparent biliary lesions after liver transplantation (n = 9 for both groups; P = 0.947), the 2-year graft survival rate (standard aortic perfusion, 74%; standard aortic perfusion plus arterial BP, 68%; P = 0.34), and incidence of initial graft injury did not differ between the 2 perfusion modes. Although 33 of the 77 patients with cholangiography workups exhibited injured bile ducts, only 10 had clinical symptoms. Contrary to previous findings, the present study indicated that additional ex situ BP did not prevent ischemic-type biliary lesions or ischemia-reperfusion injury after liver transplantation. Moreover, there was considerable discrepancy between cholangiography findings regarding bile duct changes and clinically apparent cholangiopathy after transplantation, which should be considered when assessing ischemic-type biliary lesions.

  14. Chromosomal Abnormalities in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2002-07-01

    Full Text Available The prevalence of fragile X syndrome, velocardiofacial syndrome (VCFS, and other cytogenetic abnormalities among 100 children (64 boys with combined type ADHD and normal intelligence was assessed at the NIMH and Georgetown University Medical Center.

  15. "Jeopardy" in Abnormal Psychology.

    Science.gov (United States)

    Keutzer, Carolin S.

    1993-01-01

    Describes the use of the board game, Jeopardy, in a college level abnormal psychology course. Finds increased student interaction and improved application of information. Reports generally favorable student evaluation of the technique. (CFR)

  16. Chromosomal abnormalities and autism

    Directory of Open Access Journals (Sweden)

    Farida El-Baz

    2016-01-01

    Conclusion: Chromosomal abnormalities were not detected in the studied autistic children, and so the relation between the genetics and autism still needs further work up with different study methods and techniques.

  17. A new clinical tool for the quantification of myocardial CT perfusion imaging in patients with suspected Ischemic Heart Disease

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz Muñoz, A.; Dux-Santoy Hurtado, L.; Rodriguez Palomares, J.L.; Piella Fenoy, G.

    2016-07-01

    In the clinical practice, the evaluation of myocardial perfusion by using Computed Tomography (CT) Imaging is usually performed visually or semi-quantitatively. The scarcity of quantitative perfusion data not always allows a proper diagnose of patients which are suspected of suffering from some diseases, such as Ischemic Heart Disease (IHD). In this work, a clinical tool for the automatic quantification of myocardial perfusion in patients with suspected IHD is proposed. Myocardial perfusion is assessed based on a combined diagnosis protocol (CT/CTP protocol) which involves the acquisition of two contrastenhanced CT images, one obtained at rest and another acquired under pharmacological stress. The clinical tool allows the automatic quantification of perfusion in different myocardial segments defined according to the 16-AHA-segmentation model of the left ventricle, by providing the mean of Hounsfield Units in those regions. Based on this analysis, the clinicians can compare the values at baseline and at hyperemia, and they can better determine hypoperfusion defects in patients with IHD. The validation of the clinical tool was performed by comparing automatic and manual perfusion measurements of 10 patients with suspected IHD who were previously assessed with Single Photon Emission Computed Tomography (SPECT) for perfusion analysis. A strong linear correlation was found between the automatic and manual results. Afterwards, perfusion defects obtained from CT/CTP protocol were compared to perfusion defects from SPECT, to assess the applicability of this clinical tool for the diagnosis of IHD. (Author)

  18. Abnormal sound detection device

    International Nuclear Information System (INIS)

    Yamada, Izumi; Matsui, Yuji.

    1995-01-01

    Only components synchronized with rotation of pumps are sampled from detected acoustic sounds, to judge the presence or absence of abnormality based on the magnitude of the synchronized components. A synchronized component sampling means can remove resonance sounds and other acoustic sounds generated at a synchronously with the rotation based on the knowledge that generated acoustic components in a normal state are a sort of resonance sounds and are not precisely synchronized with the number of rotation. On the other hand, abnormal sounds of a rotating body are often caused by compulsory force accompanying the rotation as a generation source, and the abnormal sounds can be detected by extracting only the rotation-synchronized components. Since components of normal acoustic sounds generated at present are discriminated from the detected sounds, reduction of the abnormal sounds due to a signal processing can be avoided and, as a result, abnormal sound detection sensitivity can be improved. Further, since it is adapted to discriminate the occurrence of the abnormal sound from the actually detected sounds, the other frequency components which are forecast but not generated actually are not removed, so that it is further effective for the improvement of detection sensitivity. (N.H.)

  19. Commercial software upgrades may significantly alter Perfusion CT parameter values in colorectal cancer

    International Nuclear Information System (INIS)

    Goh, Vicky; Shastry, Manu; Endozo, Raymondo; Groves, Ashley M.; Engledow, Alec; Peck, Jacqui; Reston, Jonathan; Wellsted, David M.; Rodriguez-Justo, Manuel; Taylor, Stuart A.; Halligan, Steve

    2011-01-01

    To determine how commercial software platform upgrades impact on derived parameters for colorectal cancer. Following ethical approval, 30 patients with suspected colorectal cancer underwent Perfusion CT using integrated 64 detector PET/CT before surgery. Analysis was performed using software based on modified distributed parameter analysis (Perfusion software version 4; Perfusion 4.0), then repeated using the previous version (Perfusion software version 3; Perfusion 3.0). Tumour blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability surface area product (PS) were determined for identical regions-of-interest. Slice-by-slice and 'whole tumour' variance was assessed by Bland-Altman analysis. Mean BF, BV and PS was 20.4%, 59.5%, and 106% higher, and MTT 14.3% shorter for Perfusion 4.0 than Perfusion 3.0. The mean difference (95% limits of agreement) were +13.5 (-44.9 to 72.0), +2.61 (-0.06 to 5.28), -1.23 (-6.83 to 4.36), and +14.2 (-4.43 to 32.8) for BF, BV, MTT and PS respectively. Within subject coefficient of variation was 36.6%, 38.0%, 27.4% and 60.6% for BF, BV, MTT and PS respectively indicating moderate to poor agreement. Software version upgrades of the same software platform may result in significantly different parameter values, requiring adjustments for cross-version comparison. (orig.)

  20. Monitoring Disease Activity in Patients with Aortitis and Chronic Periaortitis Undergoing Immunosuppressive Therapy by Perfusion CT.

    Science.gov (United States)

    Bier, Georg; Kurucay, Mustafa; Henes, Jörg; Xenitidis, Theodoros; Preibsch, Heike; Nikolaou, Konstantin; Horger, Marius

    2017-04-01

    To evaluate the role of perfusion CT for monitoring inflammatory activity in patients with aortitis and chronic periaortitis undergoing immunosuppressive therapy. Seventeen symptomatic patients (median age 68.5 years) who underwent perfusion-based computed tomography (CT) monitoring after diagnostic contrast-enhanced CT were retrospectively included in this study. Blood flow (BF), blood volume (BV), volume transfer constant (k-trans), time to peak, and mean transit time were determined by setting circular regions of interest in prominently thickened parts of the vessel wall or perfused surrounding tissue at sites where the perfusion CT color maps showed a maximum BF value. Differences in CT perfusion and, morphological parameters, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) were tested for significance during therapy. In all patients BF and BV dropped at second perfusion CT (P perfusion CT parameters in aortitis and chronic periaortitis undergoing immunosuppressive therapy dropped at different extent after therapy. Copyright © 2017 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. Deeper penetration of erythrocytes into the endothelial glycocalyx is associated with impaired microvascular perfusion.

    Directory of Open Access Journals (Sweden)

    Dae Hyun Lee

    Full Text Available Changes in endothelial glycocalyx are one of the earliest changes in development of cardiovascular disease. The endothelial glycocalyx is both an important biological modifier of interactions between flowing blood and the vessel wall, and a determinant of organ perfusion. We hypothesize that deeper penetration of erythrocytes into the glycocalyx is associated with reduced microvascular perfusion. The population-based prospective cohort study (the Netherlands Epidemiology of Obesity [NEO] study includes 6,673 middle-aged individuals (oversampling of overweight and obese individuals. Within this cohort, we have imaged the sublingual microvasculature of 915 participants using sidestream darkfield (SDF imaging together with a recently developed automated acquisition and analysis approach. Presence of RBC (as a marker of microvascular perfusion and perfused boundary region (PBR, a marker for endothelial glycocalyx barrier properties for RBC accessibility, were assessed in vessels between 5 and 25 µm RBC column width. A wide range of variability in PBR measurements, with a mean PBR of 2.14 µm (range: 1.43-2.86 µm, was observed. Linear regression analysis showed a marked association between PBR and microvascular perfusion, reflected by RBC filling percentage (regression coefficient β: -0.034; 95% confidence interval: -0.037 to -0.031. We conclude that microvascular beds with a thick ("healthy" glycocalyx (low PBR, reflects efficient perfusion of the microvascular bed. In contrast, a thin ("risk" glycocalyx (high PBR is associated with a less efficient and defective microvascular perfusion.

  2. Determinants of abnormal blood pressure response to exercise in coronary artery disease

    International Nuclear Information System (INIS)

    Hakki, A.H.; Munley, B.M.; Hadjimiltiades, S.; Meissner, M.D.; Iskandrian, A.S.

    1986-01-01

    This study assessed the determinants of exercise-induced abnormal systolic blood pressure (BP) response in 127 patients with documented coronary artery disease (CAD) who underwent exercise thallium-201 scintigraphy. Three types of systolic BP response to exercise were identified: an increase by more than 20 mm Hg (group I, n = 74); an increase by 20 mm Hg or less (group II, n = 36); and a decrease of at least 10 mm Hg (group III, n = 17). The 3 groups were not significantly different in age, gender or medications. The number of segments with perfusion defects was significantly higher in groups II and III than group I (group III, 2.9 +/- 1.5; group II, 2.9 +/- 2.1; and group I, 1.8 +/- 1.4, p = 0.009). Prior myocardial infarction, abnormal left ventricular ejection fraction, and multivessel CAD were more common in group III than in groups I and II. Stepwise discriminant analysis of 15 relevant clinical, angiographic and exercise scintigraphic descriptors showed that the number of thallium perfusion defects, abnormal LV ejection fraction at rest and multivessel CAD to be important predictors of hypotensive BP response. Multivariate analysis, however, showed that the number of thallium perfusion defects was the only important predictor of the hypotensive response. Thus, it is the functional significance of CAD assessed by the extent of thallium perfusion abnormalities rather than the extent of CAD or left ventricular dysfunction at rest that determines the systolic BP response to exercise

  3. Differences in 99mTc-HMPAO brain SPET perfusion imaging between Tourette's syndrome and chronic tic disorder in children

    International Nuclear Information System (INIS)

    Chiu, N.-T.; Lee, B.-F.; Chang, Y.-C.; Huang, C.-C.; Wang, S.-T.

    2001-01-01

    Early differential diagnosis between Tourette's syndrome and chronic tic disorder is difficult but important because both the outcome and the treatment of these two childhood-onset diseases are distinct. We assessed the sensitivity and specificity of brain single-photon emission tomography (SPET) perfusion imaging in distinguishing the two diseases, and characterized their different cerebral perfusion patterns. Twenty-seven children with Tourette's syndrome and 11 with chronic tic disorder (mean age 9.5 and 8.6 years, respectively) underwent brain SPET with technetium-99m hexamethylpropylene amine oxime (HMPAO). Visual interpretation and semi-quantitative analysis of SPET images were performed. On visual interpretation, 22 of 27 (82%) of the Tourette's syndrome group had lesions characterized by decreased perfusion. The left hemisphere was more frequently involved. None of the children with chronic tic disorder had a visible abnormality. Semi-quantitative analysis showed that, compared with children with chronic tic disorder, children with Tourette's syndrome had significantly lower perfusion in the left lateral temporal area and asymmetric perfusion in the dorsolateral frontal, lateral and medial temporal areas. In conclusion, using the visual approach, brain SPET perfusion imaging is sensitive and specific in differentiating Tourette's syndrome and chronic tic disorder. The perfusion difference between the two groups, demonstrated by semi-quantitative analysis, may be related more to the co-morbidity in Tourette's syndrome than to tics per se. (orig.)

  4. Structural and perfusion magnetic resonance imaging of the lung in cystic fibrosis

    International Nuclear Information System (INIS)

    Amaxopoulou, Christina; Gnannt, Ralph; Kellenberger, Christian J.; Higashigaito, Kai; Jung, Andreas

    2018-01-01

    Because of its absence of ionising radiation and possibility for obtaining functional information, MRI is promising for assessing lung disease in children who require repetitive imaging for long-term follow-up. To describe MRI findings in children with cystic fibrosis and evaluate semi-quantitative dynamic contrast-enhanced lung perfusion. We retrospectively compared lung MRI in 25 children and young adults with cystic fibrosis (median age 3.7 years) to 12 children (median age 2 years) imaged for other pathologies. MRI at 1.5 T included respiratory-gated sequences and contrast-enhanced lung perfusion imaging. We described and graded any morphologic change. Signal enhancement and time to peak values of perfusion abnormalities were compared to those of normally enhancing lung parenchyma. Frequent findings in patients with cystic fibrosis were bronchial wall thickening (24/25, 96%), areas of consolidation (22/25, 88%), enlarged lymph nodes (20/25, 80%), bronchiectasis (5/25, 20%) and mucus plugging (3/25, 12%). Compared to normally enhancing lung, perfusion defects (21/25, 84%), characterised by decreased enhancement, showed prolonged time to peak. Areas of consolidation showed increased enhancement. While time to peak of procedure-related atelectasis was not significantly different from that of normal lung, disease-related consolidation showed prolonged time to peak (P=0.01). Lung MRI demonstrates structural and perfusion abnormalities in children and young people with cystic fibrosis. Semi-quantitative assessment of dynamic contrast-enhanced perfusion imaging might allow differentiation between procedure-related atelectasis and disease-related consolidation. (orig.)

  5. Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT.

    Directory of Open Access Journals (Sweden)

    Seul Ki Lee

    Full Text Available With the increasing use of multi-detector CT, the number of detected cases with coronary-to-pulmonary artery fistula (CPAF has increased. Several previous studies reported severe cases of angina, but no appropriate tests to evaluate myocardial perfusion for patients with CPAF have been established. We evaluated the hemodynamic characteristics of CPAF using thallium-201 (Tl-201 single photon emission computed tomography (SPECT.Tl-201 SPECT was performed in 17 patients with CPAF, but without evidence of coronary artery disease on coronary computed tomography angiography (CCTA (age, 58.5±13.3 years; 8 men. Quantitative analysis of scintigraphic data was performed. Additionally, perfusion abnormalities were compared with CCTA findings. Medical records were obtained to define clinical data, diagnostic findings, symptoms, management, follow-up data, and major adverse cardiac events (MACE.Six patients (35.2% showed perfusion abnormalities on SPECT studies and could be classified as follows: 3 patients, no reversible ischemia (3/17, 17.6%; 1 patient, mild ischemia (1/17, 5.8%; and 2 patients, moderate ischemia (2/17, 11.7%. During the follow-up, ten patients (58.8% improved under medical management and 5 patients (29.4% underwent surgical ligation for CPAF with symptomatic improvement in 4 patients. Seven patients performed follow-up myocardial perfusion SPECT, and symptomatic improvement correlated well with scintigraphic perfusion improvement in 6 patients No MACE was observed.Tl-201 myocardial perfusion SPECT might be useful for determining the hemodynamic status and for risk stratification in patients with CPAF.

  6. Basic considerations in organ perfusion physiology.

    Science.gov (United States)

    Zimmerman, Michael A; Martin, Alicia; Hong, Johnny C

    2016-06-01

    Owing to a severe shortage of organs for patients with end-stage diseases, novel techniques in organ preservation and perfusion need to be studied and reviewed to increase the number of available organs for transplant. Many patients will die while waiting for an organ. To make organs from extended-criteria donors feasible, optimal conditions for pulsatile perfusion and the potential for organ reconditioning at implantation need to be addressed. Many techniques in organ preservation and perfusion are being studied. Several laboratories are studying the effects of temperature for organ perfusion. Two areas being studied are hypothermic and normothermic machine perfusion. In the area of organ preservation, new solutions are being studied such as a substrate-enriched, oxygen-saturated, and leukocyte-depleted perfusate to help with organ quality. Even with the strides being made in organ preservation and perfusion, there are still many unanswered questions. More studies will need to be done to find the optimal conditions for duration of perfusion in the cold phase, optimal perfusion solution, degree of oxygenation, and the addition of pharmacologic agents, to improve organ function and expand the organ pool.

  7. [CT perfusion in patients after EICMA in the postoperative period].

    Science.gov (United States)

    Grigor'eva, E V; Luk'ianchikov, V A; Tokarev, A S; Krylov, V V

    2014-01-01

    To evaluate the influence of the EICMA on the circulation of the brain in patients with unilateral occlusion of the internal carotid artery (ICA) in the late postoperative period using CT perfusion. Ten patients with unilateral internal carotid artery occlusion and stenosis of the opposite ICA 50-60%, with a history of a single ischemic stroke were examined. All patients underwent pre-and postoperative CT angiography of the brachiocephalic and intracranial arteries and CT perfusion. We also compared the results of neurological examinations preoperatively and during the year after the intervention. The neurological data during the first year after surgery demonstrated an improvement of neurological status and quality of life in all patients. Preoperative CT perfusion showed the patchy decrease in the cerebral blood flow (CBF) to 18 ml/100 g/min (average of 44-56 ml/100 g/min) and increase in the mean transit time (MTT) to 7.2 s (normally less 6c) in all cases on the side of occlusion. The most susceptible to chronic ischemic changes was the frontal region, temporal and parietooccipital regions were affected to a lesser extent. Due to stenosis of the opposite ICA, minimum CBF of the cortex in the opposite hemisphere was 24 ml/100 g/min and MTT was increased to 5.6 s. Six months after the applying of EICMA, the significant improvement of CT perfusion was noted on the side of the anastomosis in all patients: an increase in CBF (at least 44 ml/100 g/min) and MTT reduction (up to 6.1s in the frontal region), as well as the "synchronization" of CBF and CBV in similar areas of the cerebral cortex of the right and left hemisphere. CT perfusion in the late postoperative period after applying EICMA in patients with unilateral ICA occlusion demonstrates not only changes of the cerebral perfusion on the side of the occlusion, but also the increased collateral blood flow of the cortex in both hemispheres, which significantly improves brain blood flow generally within 6-12 months

  8. Pulmonary perfusion scintigraphy in the evaluation of the severity of bronchopulmonary dysplasia

    International Nuclear Information System (INIS)

    Soler, C.; Figueras, J.; Roca, I.; Perez, J.M.; Jimenez, R.

    1997-01-01

    Objective. The objectives of this study were to analyze the changes in pulmonary perfusion in bronchopulmonary dysplasia (BPD) and to assess the advantages of this method in evaluating the severity of BPD. Patients and methods. The study group was made up of 10 children with BPD, matched with a control group of 12 children. The criteria for matching were birth weight, gestational age and need for ventilation for more than 3 days. Clinical and roentgenographic scoring systems were applied on the 21st day of life. At 6 months of corrected age, clinical evolutive severity was evaluated and a pulmonary perfusion scintigraphy using technetium-99 was performed in each child. The scintigraphic findings were classified in five categories ranging from normal to severely affected, depending on the degree and localization of perfusion abnormalities. Another score was obtained by assigning a value from 1 to 5 to each pulmonary lobe, depending on the concentration of the tracer. Results. The study of clinical, roentgenographic and evolutive scores always showed higher values in children with BPD, with good correlation between methods (P < 0.001). In the BPD group, abnormal lung perfusion patterns were more frequent and more severe (P < 0.05), the lobe scoring was higher (P < 0.05), and a lower count rate was found (P < 0.01). Conclusion. Pulmonary scintigraphy is a useful technique in evaluating the severity of BPD. (orig.). With 1 fig., 3 tabs

  9. Pulmonary perfusion scintigraphy in the evaluation of the severity of bronchopulmonary dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Soler, C. [Neonatal Unit, Dept. of Pediatrics, Casa Maternitat Hospital, Clinical Hospital and Sant Joan de Deu Hospital, Univ. of Barcelona (Spain); Figueras, J. [Neonatal Unit, Dept. of Pediatrics, Casa Maternitat Hospital, Clinical Hospital and Sant Joan de Deu Hospital, Univ. of Barcelona (Spain)]|[Servicio de Neonatologia, Hospital Clinico, Barcelona (Spain); Roca, I. [Nuclear Medicine Unit, Autonomous Univ. of Barcelona (Spain); Perez, J.M. [Neonatal Unit, Dept. of Pediatrics, Casa Maternitat Hospital, Clinical Hospital and Sant Joan de Deu Hospital, Univ. of Barcelona (Spain); Jimenez, R. [Neonatal Unit, Dept. of Pediatrics, Casa Maternitat Hospital, Clinical Hospital and Sant Joan de Deu Hospital, Univ. of Barcelona (Spain)

    1997-01-01

    Objective. The objectives of this study were to analyze the changes in pulmonary perfusion in bronchopulmonary dysplasia (BPD) and to assess the advantages of this method in evaluating the severity of BPD. Patients and methods. The study group was made up of 10 children with BPD, matched with a control group of 12 children. The criteria for matching were birth weight, gestational age and need for ventilation for more than 3 days. Clinical and roentgenographic scoring systems were applied on the 21st day of life. At 6 months of corrected age, clinical evolutive severity was evaluated and a pulmonary perfusion scintigraphy using technetium-99 was performed in each child. The scintigraphic findings were classified in five categories ranging from normal to severely affected, depending on the degree and localization of perfusion abnormalities. Another score was obtained by assigning a value from 1 to 5 to each pulmonary lobe, depending on the concentration of the tracer. Results. The study of clinical, roentgenographic and evolutive scores always showed higher values in children with BPD, with good correlation between methods (P < 0.001). In the BPD group, abnormal lung perfusion patterns were more frequent and more severe (P < 0.05), the lobe scoring was higher (P < 0.05), and a lower count rate was found (P < 0.01). Conclusion. Pulmonary scintigraphy is a useful technique in evaluating the severity of BPD. (orig.). With 1 fig., 3 tabs.

  10. Variation in heart rate influences the assessment of transient ischemic dilation in myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Leslie, William D; Levin, Daniel P; Demeter, Sandor J

    2007-01-01

    Transient arrhythmias can affect transient ischemic dilation (TID) ratios. This study was initiated to evaluate the frequency and effect of normal heart rate change on TID measures in routine clinical practice. Consecutive patients undergoing stress/rest sestamibi gated myocardial perfusion scintigraphy were studied (N = 407). Heart rate at the time of stress and rest imaging were recorded. TID ratios were analyzed in relation to absolute change in heart rate (stress minus rest) for subjects with normal perfusion and systolic function (Group 1, N = 169) and those with abnormalities in perfusion and/or function (Group 2, N = 238). In Group 1, mean TID ratio was inversely correlated with the change in heart rate (r = -0.47, P < 0.0001). For every increase of 10 BPM in heart rate change, the TID ratio decreased by approximately 0.06 (95% confidence interval 0.04–0.07). In Group 2, multiple linear regression demonstrated that the change in heart rate (beta = -0.25, P < 0.0001) and the summed difference score (beta = 0.36, P < 0.0001) were independent predictors of the TID ratio. Normal variation in heart rate between the stress and rest components of myocardial perfusion scans is common and can influence TID ratios in patients with normal and abnormal cardiac scans

  11. Comparing slow- versus high-speed CT for attenuation correction of cardiac SPECT perfusion studies.

    Science.gov (United States)

    Wells, R Glenn; Soueidan, Karen; Vanderwerf, Karen; Ruddy, Terrence D

    2012-08-01

    For SPECT, CT-based attenuation correction is preferred. Many different models of CT are available with SPECT/CT systems. Our study compares clinical cardiac SPECT images that were attenuation corrected using slow-rotation CT and high-speed CT transmission scans. We evaluated 59 rest/stress perfusion studies from patients who had undergone both a SPECT/CT with a slow-rotation CT and a perfusion study on a PET/CT camera equipped with a high-speed CT scanner. Each SPECT study was reconstructed with transmission maps from both CT scans and the relative perfusion was assessed using semi-automated software. The summed stress/rest/and difference scores (SSS/SRS/SDS) were compared as well as the test classification. The intraclass correlation coefficients for the SSS, SRS, and SDS were 0.97, 0.96, and 0.80 respectively. There were no significant differences in the mean SSS, SRS, or SDS with the use of either CT for attenuation corrections. Classifying SSS > 3 as abnormal, there was 97% concordance (κ = 0.88). Classifying SDS > 1 as abnormal, there was 95% concordance (κ = 0.54). A McNemar's test showed no significant differences. There were no significant differences between using a high-speed CT and using a slow-rotation CT for attenuation correction of SPECT myocardial perfusion images.

  12. Assessment of the myocardial perfusion pattern in patients with multivessel coronary artery disease

    International Nuclear Information System (INIS)

    Iskandrian, A.S.; Hakki, A.H.; Segal, B.L.; Kane, S.A.; Amenta, A.

    1983-01-01

    A total of 42 symptomatic patients with coronary artery disease involving two or three vessels were studied using exercise thallium-201 myocardial scintigraphy. Qualitative analysis of the images predicted multivessel disease in 75% of the patients with two-vessel disease and in 82% of the patients with three-vessel disease. Quantitative analysis of the size of the perfusion defect indicated that approximately 40% of the left ventricular perimeter showed abnormal perfusion pattern during stress in these patients, and there was no significant difference in the size of the defect in patients with two-vessel disease or three-vessel disease (41 +/- 17% vs 42 +/- 14%, respectively, mean +/- SD). The exercise heart rate, exercise ECG response, and severity of narrowing did not correlate with the size of the perfusion defect. Patients with anterior infarction had larger defects in the distribution of the left anterior descending artery than those without infarction. Collaterals offered partial protection during exercise only when they were not jeopardized. This study confirms the value of qualitative analysis of exercise thallium-201 imaging in predicting multivessel disease, and describes a simple method of assessing the extent of perfusion abnormalities during stress in patients with multivessel disease. The results may be important in patient management and prognosis

  13. Estimating myocardial perfusion from dynamic contrast-enhanced CMR with a model-independent deconvolution method

    Directory of Open Access Journals (Sweden)

    Kadrmas Dan J

    2008-11-01

    Full Text Available Abstract Background Model-independent analysis with B-spline regularization has been used to quantify myocardial blood flow (perfusion in dynamic contrast-enhanced cardiovascular magnetic resonance (CMR studies. However, the model-independent approach has not been extensively evaluated to determine how the contrast-to-noise ratio between blood and tissue enhancement affects estimates of myocardial perfusion and the degree to which the regularization is dependent on the noise in the measured enhancement data. We investigated these questions with a model-independent analysis method that uses iterative minimization and a temporal smoothness regularizer. Perfusion estimates using this method were compared to results from dynamic 13N-ammonia PET. Results An iterative model-independent analysis method was developed and tested to estimate regional and pixelwise myocardial perfusion in five normal subjects imaged with a saturation recovery turboFLASH sequence at 3 T CMR. Estimates of myocardial perfusion using model-independent analysis are dependent on the choice of the regularization weight parameter, which increases nonlinearly to handle large decreases in the contrast-to-noise ratio of the measured tissue enhancement data. Quantitative perfusion estimates in five subjects imaged with 3 T CMR were 1.1 ± 0.8 ml/min/g at rest and 3.1 ± 1.7 ml/min/g at adenosine stress. The perfusion estimates correlated with dynamic 13N-ammonia PET (y = 0.90x + 0.24, r = 0.85 and were similar to results from other validated CMR studies. Conclusion This work shows that a model-independent analysis method that uses iterative minimization and temporal regularization can be used to quantify myocardial perfusion with dynamic contrast-enhanced perfusion CMR. Results from this method are robust to choices in the regularization weight parameter over relatively large ranges in the contrast-to-noise ratio of the tissue enhancement data.

  14. Myocardial performance and perfusion during exercise in patients with coronary artery disease caused by Kawasaki disease

    International Nuclear Information System (INIS)

    Paridon, S.M.; Ross, R.D.; Kuhns, L.R.; Pinsky, W.W.

    1990-01-01

    For a study of the natural history of coronary artery lesions after Kawasaki disease and their effect on myocardial blood flow reserve with exercise, five such patients underwent exercise testing on a bicycle. Oxygen consumption, carbon dioxide production, minute ventilation, and electrocardiograms were monitored continuously. Thallium-201 scintigraphy was performed for all patients. One patient stopped exercise before exhaustion of cardiovascular reserve but had no evidence of myocardial perfusion abnormalities. Four patients terminated exercise because of exhaustion of cardiovascular reserve; one had normal cardiovascular reserve and thallium scintiscans, but the remaining patients had diminished cardiovascular reserve. Thallium scintigrams showed myocardial ischemia in two and infarction in one. No patient had exercise-induced electrocardiographic changes. These results indicate that patients with residual coronary artery lesions after Kawasaki disease frequently have reduced cardiovascular reserve during exercise. The addition of thallium scintigraphy and metabolic measurements to exercise testing improved the detection of exercise-induced abnormalities of myocardial perfusion

  15. Differentiation between diverticulitis and colorectal cancer: quantitative CT perfusion measurements versus morphologic criteria--initial experience.

    Science.gov (United States)

    Goh, Vicky; Halligan, Steve; Taylor, Stuart A; Burling, David; Bassett, Paul; Bartram, Clive I

    2007-02-01

    To determine whether computed tomographic (CT) perfusion measurements in prospectively recruited patients can be used to differentiate between diverticulitis and colorectal cancer and to compare this discrimination with that of standard morphologic criteria. After institutional review board approval and written informed consent were obtained, 60 patients (24 men, 36 women; mean age, 69 years; range, 33.5-90.4 years; 20 patients with cancer, 20 with diverticulitis, and 20 with inactive diverticular disease) underwent CT perfusion imaging at the level of the colonic abnormality, and perfusion parameters were calculated. Analysis of variance was used to investigate any differences in perfusion between the patient groups. Two independent observers also analyzed an abdominopelvic CT study obtained immediately after the CT perfusion study and noted standard morphologic criteria for differential diagnosis. The sensitivity and specificity of CT perfusion measurements for determining the diagnostic category were compared with morphologic criteria by means of multivariate analysis to identify the most discriminatory criteria. Mean blood volume, blood flow, transit time, and permeability were significantly different between patients with cancer and those with diverticulitis (P diagnostic category were blood volume, transit time, permeability, and presence of pericolonic nodes (P = .05, .02, .04, and .02, respectively). Blood volume and blood flow each had a sensitivity of 80% and had specificity of 70% and 75%, respectively, for cancer in comparison with standard morphologic criteria: less than 5 cm of bowel involvement (45% sensitivity, 95% specificity), presence of a mass (85% sensitivity, 90% specificity), pericolonic inflammation (75% sensitivity, 5% specificity), and pericolonic nodes (90% sensitivity, 45% specificity). CT perfusion measurements enable differentiation and better discrimination, in comparison with morphologic criteria, between cancer and diverticulitis

  16. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...

  17. Schizophrenia patients differentiation based on MR vascular perfusion and volumetric imaging

    Science.gov (United States)

    Spanier, A. B.; Joskowicz, L.; Moshel, S.; Israeli, D.

    2015-03-01

    Candecomp/Parafac Decomposition (CPD) has emerged as a framework for modeling N-way arrays (higher-order matrices). CPD is naturally well suited for the analysis of data sets comprised of observations of a function of multiple discrete indices. In this study we evaluate the prospects of using CPD for modeling MRI brain properties (i.e. brain volume and gray-level) for schizophrenia diagnosis. Taking into account that 3D imaging data consists of millions of pixels per patient, the diagnosis of a schizophrenia patient based on pixel analysis constitutes a methodological challenge (e.g. multiple comparison problem). We show that the CPD could potentially be used as a dimensionality redaction method and as a discriminator between schizophrenia patients and match control, using the gradient of pre- and post Gd-T1-weighted MRI data, which is strongly correlated with cerebral blood perfusion. Our approach was tested on 68 MRI scans: 40 first-episode schizophrenia patients and 28 matched controls. The CPD subject's scores exhibit statistically significant result (P schizophrenia with MRI, the results suggest that the CPD could potentially be used to discriminate between schizophrenia patients and matched control. In addition, the CPD model suggests for brain regions that might exhibit abnormalities in schizophrenia patients for future research.

  18. Association of frontal gray matter volume and cerebral perfusion in heroin addiction: A multimodal neuroimaging study

    Directory of Open Access Journals (Sweden)

    Niklaus eDenier

    2013-10-01

    Full Text Available Structure and function in the human healthy brain are closely related. In patients with chronic heroin exposure, brain imaging studies have identified long-lasting changes in gray matter (GM volume. More recently, we showed that acute application of heroin in dependent pa-tients results in hypoperfusion of fronto-temporal areas compared with the placebo condition. However, the relationship between structural and cerebral blood flow (CBF changes in heroin addiction has not yet been investigated. Moreover, it is not known whether there is any interaction between the chronic structural changes and the short and long term effects on per-fusion caused by heroin. Using a double-blind, within-subject design, heroin or placebo (saline was administrated to 15 heroin-dependent patients from a stable heroin-assisted treat-ment program, in order to observe acute short-term effects. Arterial spin labeling (ASL was used to calculate perfusion quantification maps in both treatment conditions, while Voxel Based Morphometry (VBM was conducted to calculate regional GM density. VBM and ASL data were used to calculate homologous correlation fields by Biological Parametric Mapping (BPM. We correlated each perfusion condition (heroin and placebo separately with a VBM sample that was identical for the two treatment conditions. It was assumed that heroin-associated perfusion is manifested in short term effects, while placebo-associated perfusion is more related to long term effects. Correlation analyses revealed a significant positive correlation in frontal and temporal areas between GM and both perfusion conditions (heroin and placebo. The heroin-associated perfusion was also negatively correlated with GM in the left thalamus and right cuneus. These findings indicate that, in heroin-dependent patients, low GM volume is positively associated with low perfusion within fronto-temporal regions.

  19. Topographic distribution of pulmonary ventilation and perfusion in the horse

    International Nuclear Information System (INIS)

    Amis, T.C.; Pascoe, J.R.; Hornof, W.

    1984-01-01

    The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion

  20. Topographic distribution of pulmonary ventilation and perfusion in the horse

    Energy Technology Data Exchange (ETDEWEB)

    Amis, T.C.; Pascoe, J.R.; Hornof, W.

    1984-08-01

    The regional distribution of ventilation to perfusion ratios (VA/Q) in the lungs of 8 healthy standing Thoroughbred geldings (4.4 +/- 1.5 years, 465.7 +/- 46.6 kg) was studied, using steady-state inhalation and IV infusion of the radioactive gas krypton-81m. The VA/Q was uniformly distributed within a vertical lung strip centered over the 9th rib on the right side. Ventilation per unit of alveolar volume (V/VA) assessed from the clearance of inhaled radioactive gas in 5 horses increased from 0.49 +/- 0.13 (arbitrary units) in nondependent lung zones to 1.45 +/- 0.16 in dependent lung zones. Seemingly, a vertical gradient of pulmonary ventilation exists in the horse that is matched by a similar gradient of perfusion.

  1. Clinical indications for Thallium-201 myocardial perfusion scanning

    International Nuclear Information System (INIS)

    Dunn, R.J.; Kelly, D.T.

    1982-01-01

    Thallium-201 myocardial perfusion scanning can assess regional myocardial perfusion non-invasively. As it is both time-consuming and expensive its use should be restricted to specific diagnostic problems. The clinical indications in known or suspected coronary artery disease are reviewed. In suspected coronary artery disease thallium scanning is most useful in patients with chest pain when the exercise ECG is uninterpretable, in men with probable angina but a negative exercise ECG, or conversely a positive exercise ECG without typical angina, and in women with probable angina and either a positive or a negative exercise ECG. In known coronary artery disease, thallium scanning may help determine the functional significance of a coronary obstruction found at angiography and may determine the site of myocardial ischaemia when multiple obstructions are present

  2. Methodology for ventilation/perfusion SPECT

    DEFF Research Database (Denmark)

    Bajc, Marika; Neilly, Brian; Miniati, Massimo

    2010-01-01

    radiolabeled liquid aerosols are not restricted to the presence of obstructive lung disease. Radiolabeled macroaggregated human albumin is the imaging agent of choice for perfusion scintigraphy. An optimal combination of nuclide activities and acquisition times for ventilation and perfusion, collimators......Ventilation/perfusion single-photon emission computed tomography (V/Q SPECT) is the scintigraphic technique of choice for the diagnosis of pulmonary embolism and many other disorders that affect lung function. Data from recent ventilation studies show that the theoretic advantages of Technegas over......, and imaging matrix yields an adequate V/Q SPECT study in approximately 20 minutes of imaging time. The recommended protocol based on the patient remaining in an unchanged position during the initial ventilation study and the perfusion study allows presentation of matching ventilation and perfusion slices...

  3. Isoattenuating insulinomas at biphasic contrast-enhanced CT: frequency, clinicopathologic features and perfusion characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Zhu, Liang; Xue, Hua-dan; Sun, Hao; Wang, Xuan; He, Yong-lan; Jin, Zheng-yu [Peking Union Medical College Hospital, Department of Radiology, Beijing (China); Zhao, Yu-pei [Peking Union Medical College Hospital, Department of General Surgery, Beijing (China)

    2016-10-15

    We aimed to determine the frequency of isoattenuating insulinomas, to investigate their clinicopathological features and to assess their regional pancreatic perfusion characteristics. Institutional review board approval was obtained, and patient informed consent was waived. From July 2010 to June 2014, 170 patients (66 male, 104 female) with endogenous hyperinsulinemic hypoglycemia underwent biphasic contrast-enhanced CT before surgery, and 129 of those patients also received preoperative whole-pancreas CT perfusion. A total of 181 tumours were proved histopathologically after surgery. Enhancement pattern and regional pancreatic perfusion characteristics were analyzed. Clinical features, tumour size and pathological grading were investigated. The frequency of isoattenuating tumours was 24.9 %. Tumour size and WHO grading was not significantly different between isoattenuating and hyperattenuating tumours. Tumour-free regions had identical blood flow (BF) regardless of their location (p = 0.35). Isoattenuating tumour-harbouring regions had lower BF compared with hyperattenuating tumour-harbouring regions; both showed higher BF compared with tumour-free neighbourhood regions (all p < 0.01). For patients with isoattenuating tumours, the overall hospital stay was longer (p < 0.01). A substantial subset of insulinomas were isoattenuating on biphasic CT. CT perfusion showed higher BF in tumour-harbouring regions compared to tumour-free regions, providing a clue for tumour regionalization. (orig.)

  4. Contrast-enhanced CT- and MRI-based perfusion assessment for pulmonary diseases: basics and clinical applications.

    Science.gov (United States)

    Ohno, Yoshiharu; Koyama, Hisanobu; Lee, Ho Yun; Miura, Sachiko; Yoshikawa, Takeshi; Sugimura, Kazuro

    2016-01-01

    Assessment of regional pulmonary perfusion as well as nodule and tumor perfusions in various pulmonary diseases are currently performed by means of nuclear medicine studies requiring radioactive macroaggregates, dual-energy computed tomography (CT), and dynamic first-pass contrast-enhanced perfusion CT techniques and unenhanced and dynamic first-pass contrast enhanced perfusion magnetic resonance imaging (MRI), as well as time-resolved three-dimensional or four-dimensional contrast-enhanced magnetic resonance angiography (MRA). Perfusion scintigraphy, single-photon emission tomography (SPECT) and SPECT fused with CT have been established as clinically available scintigraphic methods; however, they are limited by perfusion information with poor spatial resolution and other shortcomings. Although positron emission tomography with 15O water can measure absolute pulmonary perfusion, it requires a cyclotron for generation of a tracer with an extremely short half-life (2 min), and can only be performed for academic purposes. Therefore, clinicians are concentrating their efforts on the application of CT-based and MRI-based quantitative and qualitative perfusion assessment to various pulmonary diseases. This review article covers 1) the basics of dual-energy CT and dynamic first-pass contrast-enhanced perfusion CT techniques, 2) the basics of time-resolved contrast-enhanced MRA and dynamic first-pass contrast-enhanced perfusion MRI, and 3) clinical applications of contrast-enhanced CT- and MRI-based perfusion assessment for patients with pulmonary nodule, lung cancer, and pulmonary vascular diseases. We believe that these new techniques can be useful in routine clinical practice for not only thoracic oncology patients, but also patients with different pulmonary vascular diseases.

  5. Brain Perfusion Changes in Intracerebral Hemorrhage

    International Nuclear Information System (INIS)

    Mititelu, R.; Mazilu, C.; Ghita, S.; Rimbu, A.; Marinescu, G.; Codorean, I.; Bajenaru, O.

    2006-01-01

    Full text: Purpose: Despite the latest advances in medical treatment and neuro critical care, patients suffering spontaneous intracerebral hemorrhage (SICH) still have a very poor prognosis, with a greater mortality and larger neurological deficits at the survivors than for ischemic stroke. Many authors have shown that there are many mechanisms involved in the pathology of SICH: edema, ischemia, inflammation, apoptosis. All of these factors are affecting brain tissue surrounding hematoma and are responsible of the progressive neurological deterioration; most of these damages are not revealed by anatomical imaging techniques. The aim of our study was to asses the role of brain perfusion SPECT in demonstrating perfusion changes in SICH patients. Method: 17 SICH pts were studied. All pts underwent same day CT and brain SPECT with 99mTcHMPAO, 24h-5d from onset of stroke. Results: 14/17 pts showed a larger perfusion defect than expected after CT. In 2 pts hematoma diameter was comparable on CT and SPECT; 1pt had quasinormal aspect of SPECT study. In pts with larger defects, SPECT revealed a large cold spot with similar size compared with CT, and a surrounding hypo perfused area. 6/17 pts revealed cortical hyper perfusion adjacent to hypo perfused area and corresponding to a normal-appearing brain tissue on CT. In 3 pts we found crossed cerebellar diaskisis.In 2 pts we found cortical hypo perfused area in the contralateral cortex, with normal appearing brain tissue on CT. Conclusions: Brain perfusion SPECT revealed different types of perfusion changes in the brain tissue surrounding hematoma. These areas contain viable brain tissue that may be a target for future ne uroprotective strategies. Further studies are definitely required to demonstrate prognostic significance of these changes, but we can conclude that brain perfusion SPECT can play an important role in SICH, by early demonstrating functional changes responsible of clinical deterioration, thus allowing prompt

  6. Nitrofurantoin and congenital abnormalities

    DEFF Research Database (Denmark)

    Czeizel, A.E.; Rockenbauer, M.; Sørensen, Henrik Toft

    2001-01-01

    Objective: To study human teratogenic potential of oral nitrofurantoin treatment during pregnancy. Materials and Methods: Pair analysis of cases with congenital abnormalities and matched population controls in the population-based dataset of the Hungarian Case-Control Surveillance of Congenital...

  7. CT of pleural abnormalities

    International Nuclear Information System (INIS)

    Webb, W.R.

    1995-01-01

    Briefly discussed were CT diagnosis of pleural thickening, CT technique for examining the pleura or pleuro-pulmonary disease, diagnosis of pleural collections, diagnosis of pleural fluid abnormalities in patients with pneumonia, pleural neoplasms, malignant (diffuse) mesothelioma, metastases, local fibrous tumor of the pleura (benign mesothelioma) (21 refs.)

  8. Chromosomal abnormalities and autism

    African Journals Online (AJOL)

    Farida El-Baz

    2015-06-19

    Jun 19, 2015 ... ORIGINAL ARTICLE. Chromosomal abnormalities and autism. Farida El-Baz a. , Mohamed Saad Zaghloul a. , Ezzat El Sobky a. ,. Reham M Elhossiny a,. *, Heba Salah a. , Neveen Ezy Abdelaziz b a Pediatric Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt b Children with Special ...

  9. Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

    DEFF Research Database (Denmark)

    Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

    2015-01-01

    To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...... stenosis assessed by MDCT angiography and semi-quantitative myocardial MDCT perfusion in 200 symptomatic patients. The perfusion index (PI = mean myocardial attenuation density/mean left ventricular lumen attenuation density) at rest and during adenosine stress, the myocardial perfusion reserve (MPR...... = stress - PI/rest - PI), and the transmural perfusion ratio (TPR = subendocardium/subepicardium) were calculated. A coronary artery stenosis ≥50 % was present in 49 patients (25 %). Rest-PI and rest-TPR values were similar in patients with and without a coronary artery stenosis ≥50 %, whereas stress...

  10. Perfusion CT in acute stroke: effectiveness of automatically-generated colour maps.

    Science.gov (United States)

    Ukmar, Maja; Degrassi, Ferruccio; Pozzi Mucelli, Roberta Antea; Neri, Francesca; Mucelli, Fabio Pozzi; Cova, Maria Assunta

    2017-04-01

    To evaluate the accuracy of perfusion CT (pCT) in the definition of the infarcted core and the penumbra, comparing the data obtained from the evaluation of parametric maps [cerebral blood volume (CBV), cerebral blood flow (CBF) and mean transit time (MTT)] with software-generated colour maps. A retrospective analysis was performed to identify patients with suspected acute ischaemic strokes and who had undergone unenhanced CT and pCT carried out within 4.5 h from the onset of the symptoms. A qualitative evaluation of the CBV, CBF and MTT maps was performed, followed by an analysis of the colour maps automatically generated by the software. 26 patients were identified, but a direct CT follow-up was performed only on 19 patients after 24-48 h. In the qualitative analysis, 14 patients showed perfusion abnormalities. Specifically, 29 perfusion deficit areas were detected, of which 15 areas suggested the penumbra and the remaining 14 areas suggested the infarct. As for automatically software-generated maps, 12 patients showed perfusion abnormalities. 25 perfusion deficit areas were identified, 15 areas of which suggested the penumbra and the other 10 areas the infarct. The McNemar's test showed no statistically significant difference between the two methods of evaluation in highlighting infarcted areas proved later at CT follow-up. We demonstrated how pCT provides good diagnostic accuracy in the identification of acute ischaemic lesions. The limits of identification of the lesions mainly lie at the pons level and in the basal ganglia area. Qualitative analysis has proven to be more efficient in identification of perfusion lesions in comparison with software-generated maps. However, software-generated maps have proven to be very useful in the emergency setting. Advances in knowledge: The use of CT perfusion is requested in increasingly more patients in order to optimize the treatment, thanks also to the technological evolution of CT, which now allows a whole

  11. Prematurity and brain perfusion: Arterial spin labeling MRI.

    Science.gov (United States)

    Tortora, Domenico; Mattei, Peter Angelo; Navarra, Riccardo; Panara, Valentina; Salomone, Rita; Rossi, Andrea; Detre, John A; Caulo, Massimo

    2017-01-01

    Abnormal brain perfusion is a critical mechanism in neonatal brain injury. The aim of the present study was to compare Cerebral Blood Flow (CBF) evaluated with ASL MRI in three groups of neonates: preterms without brain lesions on MRI (PN), preterms with periventricular white matter lesions (PNp) and term neonates with normal MRI (TN). The correlation between CBF and clinical outcome was explored. The institutional review board approved this prospective study and waived informed consent. The perfusion ASL data from 49 consecutive preterm neonates (PN) studied at term-equivalent age and 15 TN were evaluated. Statistically significant differences in gray matter CBF were evaluated by using a linear mixed-model analysis and Mann-Whitney U test. Logistic regression analysis was used to assess the relation between CBF and neuromotor outcome at 12 months. Comparison of means indicated that the CBF of the whole brain were significantly higher in PN compared to TN ( P  = 0.011). This difference remained significant when considering the frontal ( P  = 0.038), parietal ( P  = 0.002), temporal ( P  = 0.030), occipital ( P  = 0.041) and cerebellar ( P  = 0.010) gray matter. In the PN group, lower CBF in basal ganglia was associated with a worse neuromotor outcome ( P  = 0.012). ASL MRI demonstrated differences in brain perfusion of the basal ganglia between PN and TN. In PN, a positive correlation between CBF and neuromotor outcome was demonstrated in this area.

  12. Thallium-201 myocardial perfusion imaging in infants and children. Value in distinguishing anomalous left coronary artery from congestive cardiomyopathy.

    Science.gov (United States)

    Gutgesell, H P; Pinsky, W W; DePuey, E G

    1980-03-01

    In infants and children, anomalous origin of the left coronary artery (ALCA) from the pulmonary artery may be difficult to distinguish from congestive cardiomyopathy (CCM) of other causes. We performed thallium-201 myocardial perfusion imaging in seven children with ALCA and in nine with CCM to study the usefulness of this technique in distinguishing between these lesions. Localized abnormalities of thallium uptake were present in each of the seven patients with ALCA, including two asymptomatic 4-year-old children. Thallium distribution was normal in five patients with CCM, diffusely irregular in three, and was absent in the lateral and posterobasal portions of the left ventricle in one patient. We conclude that thallium-201 imaging is a sensitive noninvasive method of detecting ALCA. However, perfusion abnormalities are not limited to patients with coronary artery abnormalities, and may be present in patients with myocardial ischemia or infarction of other causes.

  13. Differences in perfusion parameters between upper and lower lumbar vertebral segments with dynamic contrast-enhanced MRI (DCE MRI)

    Energy Technology Data Exchange (ETDEWEB)

    Savvopoulou, Vasiliki; Vlahos, Lampros; Moulopoulos, Lia Angela [University of Athens, Areteion Hospital, Department of Radiology, Medical School, Athens (Greece); Maris, Thomas G. [University of Crete, Deparment of Medical Physics, Faculty of Medicine, Heraklion (Greece)

    2008-09-15

    To investigate the influence of age, sex and spinal level on perfusion parameters of normal lumbar bone marrow with dynamic contrast-enhanced MRI (DCE MRI). Sixty-seven subjects referred for evaluation of low back pain or sciatica underwent DCE MRI of the lumbar spine. After subtraction of dynamic images, a region of interest (ROI) was placed on each lumbar vertebral body of all subjects, and time intensity curves were generated. Consequently, perfusion parameters were calculated. Statistical analysis was performed to search for perfusion differences among lumbar vertebrae and in relation to age and sex. Upper (L1, L2) and lower (L3, L4, L5) vertebrae showed significant differences in perfusion parameters (p<0.05). Vertebrae of subjects younger than 50 years showed significantly higher perfusion compared to vertebrae of older ones (p<0.05). Vertebrae of females demonstrated significantly increased perfusion compared to those of males of corresponding age (p<0.05). All perfusion parameters, except for washout (WOUT), showed a mild linear correlation with age. Time to maximum slope (TMSP) and time to peak (TTPK) showed the same correlation with sex (0.22perfusion of the upper compared to the lower lumbar spine, of younger compared to older subjects and of females compared to males. (orig.)

  14. Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study

    International Nuclear Information System (INIS)

    Sarubbo, Silvio; Latini, Francesco; Cavallo, Michele; Ceruti, Stefano; Chieregato, Arturo; D'Esterre, Christopher; Western Ontario Univ., London, ON; Lee, Ting-Yim; Western Ontario Univ., London, ON; Fainardi, Enrico; Azienda Ospedaliera Univ., Ferrara

    2014-01-01

    Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty. We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in multiple cortical circular regions positioned in cranioplasty-treated and contralateral hemispheres. Neither complications associated with cranioplasty nor changes in outcome were observed. On the treated side, CBF and CBV values were higher before and 7 days after cranioplasty than at 3 months after surgery, whereas MTT values were lower at 7 days than at 3 months after surgical treatment. Our results indicate that cortical perfusion progressively declines in the cranioplasty treated hemisphere but remains stable in the contralateral hemisphere after surgery and suggest that CTP can represent a promising tool for a longitudinal analysis of hemodynamic abnormalities occurring in TBI patients after cranioplasty. In addition, these data imply a possible role of cranioplasty in restoring flow to meet the prevailing metabolic demand. (orig.)

  15. Temporal changes in CT perfusion values before and after cranioplasty in patients without symptoms related to external decompression: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Sarubbo, Silvio [' ' S. Chiara' ' Hospital, Neurosurgery Unit, Department of Neurosciences, Trento (Italy); ' ' S. Anna' ' University Hospital, Department of Medical and Surgical Sciences of Communication and Behavior, Clinics of Neurology, Ferrara (Italy); Latini, Francesco; Cavallo, Michele [' ' S. Anna' ' University Hospital, Neurosurgery Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Ceruti, Stefano [' ' S. Anna' ' University Hospital, Neuroradiology Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Chieregato, Arturo [' ' Careggi' ' University Hospital, Neurocritical Care Unit, Department of Neuroscience, Firenze (Italy); D' Esterre, Christopher [Calgary Univ., Calgary, AB (Canada). Foothills Medical Centre; Western Ontario Univ., London, ON (Canada). Imaging Research Lab.; Lee, Ting-Yim [Western Ontario Univ., London, ON (Canada). Imaging Research Lab.; Western Ontario Univ., London, ON (Canada). Imaging Program; Fainardi, Enrico [' ' S. Anna' ' University Hospital, Neuroradiology Unit, Department of Neuroscience and Rehabilitation, Ferrara (Italy); Azienda Ospedaliera Univ., Ferrara (Italy). Unita Operativa di Neuroradiologia

    2014-03-15

    Little is known about hemodynamic disturbances affecting cerebral hemispheres in traumatic brain injury (TBI) after cranioplasty. We prospectively investigated six stable TBI patients who underwent cranioplasty more than 90 days after effective decompressive craniectomy. Computerized tomography perfusion (CTP) studies and evaluation of clinical outcome were performed for each patient before cranioplasty and at 7 days and 3 months after surgery. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were measured in multiple cortical circular regions positioned in cranioplasty-treated and contralateral hemispheres. Neither complications associated with cranioplasty nor changes in outcome were observed. On the treated side, CBF and CBV values were higher before and 7 days after cranioplasty than at 3 months after surgery, whereas MTT values were lower at 7 days than at 3 months after surgical treatment. Our results indicate that cortical perfusion progressively declines in the cranioplasty treated hemisphere but remains stable in the contralateral hemisphere after surgery and suggest that CTP can represent a promising tool for a longitudinal analysis of hemodynamic abnormalities occurring in TBI patients after cranioplasty. In addition, these data imply a possible role of cranioplasty in restoring flow to meet the prevailing metabolic demand. (orig.)

  16. Esophageal blood flow in the cat. Normal distribution and effects of acid perfusion

    International Nuclear Information System (INIS)

    Hollwarth, M.E.; Smith, M.; Kvietys, P.R.; Granger, D.N.

    1986-01-01

    The radioactive microsphere technique was used to estimate blood flow to different regions of the esophagus and to adjacent regions of the stomach before and after perfusion of the esophagus with hydrochloric acid (pH 1.5) for 5 min. Under resting conditions total blood flow, as well as blood flow to the mucosal-submucosal layer and the muscular layer, to both sphincters was significantly higher than to the esophageal body. Blood flow to the adjacent regions of the stomach was significantly higher than esophageal blood flow. Acid perfusion resulted in a large increase in total blood flow in both sphincters and the lower esophageal body. Gastric blood flow was not altered by acid perfusion. The esophageal hyperemia resulted primarily from an increase in blood flow to the muscular layer; mucosal-submucosal blood flow was increased only in the lower esophageal sphincter. The present study indicates that short periods (5 min) of gastroesophageal reflux may increase esophageal blood flow

  17. Simulation evaluation of quantitative myocardial perfusion assessment from cardiac CT

    Science.gov (United States)

    Bindschadler, Michael; Modgil, Dimple; Branch, Kelley R.; La Riviere, Patrick J.; Alessio, Adam M.

    2014-03-01

    Contrast enhancement on cardiac CT provides valuable information about myocardial perfusion and methods have been proposed to assess perfusion with static and dynamic acquisitions. There is a lack of knowledge and consensus on the appropriate approach to ensure 1) sufficient diagnostic accuracy for clinical decisions and 2) low radiation doses for patient safety. This work developed a thorough dynamic CT simulation and several accepted blood flow estimation techniques to evaluate the performance of perfusion assessment across a range of acquisition and estimation scenarios. Cardiac CT acquisitions were simulated for a range of flow states (Flow = 0.5, 1, 2, 3 ml/g/min, cardiac output = 3,5,8 L/min). CT acquisitions were simulated with a validated CT simulator incorporating polyenergetic data acquisition and realistic x-ray flux levels for dynamic acquisitions with a range of scenarios including 1, 2, 3 sec sampling for 30 sec with 25, 70, 140 mAs. Images were generated using conventional image reconstruction with additional image-based beam hardening correction to account for iodine content. Time attenuation curves were extracted for multiple regions around the myocardium and used to estimate flow. In total, 2,700 independent realizations of dynamic sequences were generated and multiple MBF estimation methods were applied to each of these. Evaluation of quantitative kinetic modeling yielded blood flow estimates with an root mean square error (RMSE) of ~0.6 ml/g/min averaged across multiple scenarios. Semi-quantitative modeling and qualitative static imaging resulted in significantly more error (RMSE = ~1.2 and ~1.2 ml/min/g respectively). For quantitative methods, dose reduction through reduced temporal sampling or reduced tube current had comparable impact on the MBF estimate fidelity. On average, half dose acquisitions increased the RMSE of estimates by only 18% suggesting that substantial dose reductions can be employed in the context of quantitative myocardial

  18. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    Science.gov (United States)

    Lee, Taek-Soo; Frey, Eric C.; Tsui, Benjamin M. W.

    2015-04-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99mTc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  19. Development of 4D mathematical observer models for the task-based evaluation of gated myocardial perfusion SPECT

    International Nuclear Information System (INIS)

    Lee, Taek-Soo; Frey, Eric C; Tsui, Benjamin M W

    2015-01-01

    This paper presents two 4D mathematical observer models for the detection of motion defects in 4D gated medical images. Their performance was compared with results from human observers in detecting a regional motion abnormality in simulated 4D gated myocardial perfusion (MP) SPECT images. The first 4D mathematical observer model extends the conventional channelized Hotelling observer (CHO) based on a set of 2D spatial channels and the second is a proposed model that uses a set of 4D space-time channels. Simulated projection data were generated using the 4D NURBS-based cardiac-torso (NCAT) phantom with 16 gates/cardiac cycle. The activity distribution modelled uptake of 99m Tc MIBI with normal perfusion and a regional wall motion defect. An analytical projector was used in the simulation and the filtered backprojection (FBP) algorithm was used in image reconstruction followed by spatial and temporal low-pass filtering with various cut-off frequencies. Then, we extracted 2D image slices from each time frame and reorganized them into a set of cine images. For the first model, we applied 2D spatial channels to the cine images and generated a set of feature vectors that were stacked for the images from different slices of the heart. The process was repeated for each of the 1,024 noise realizations, and CHO and receiver operating characteristics (ROC) analysis methodologies were applied to the ensemble of the feature vectors to compute areas under the ROC curves (AUCs). For the second model, a set of 4D space-time channels was developed and applied to the sets of cine images to produce space-time feature vectors to which the CHO methodology was applied. The AUC values of the second model showed better agreement (Spearman’s rank correlation (SRC) coefficient = 0.8) to human observer results than those from the first model (SRC coefficient = 0.4). The agreement with human observers indicates the proposed 4D mathematical observer model provides a good predictor of the

  20. Diagnosis of regional cerebral blood flow abnormalities using SPECT: agreement between individualized statistical parametric maps and visual inspection by nuclear medicine physicians with different levels of expertise in nuclear neurology

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, Euclides Timoteo da, E-mail: euclidestimoteo@uol.com.b [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer. Dept. de Medicina Nuclear; Buchpiguel, Carlos Alberto [Hospital do Coracao, Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Nitrini, Ricardo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Dept. de Neurologia; Tazima, Sergio [Hospital Alemao Oswaldo Cruz (HAOC), Sao Paulo, SP (Brazil). Dept. de Medicina Nuclear; Peres, Stela Verzinhase [Fundacao Pio XII, Barretos, SP (Brazil). Hospital de Cancer; Busatto Filho, Geraldo [Universidade de Sao Paulo (USP), SP (Brazil). Faculdade de Medicina. Div. de Medicina Nuclear

    2009-07-01

    Introduction: visual analysis is widely used to interpret regional cerebral blood flow (rCBF) SPECT images in clinical practice despite its limitations. Automated methods are employed to investigate between-group rCBF differences in research studies but have rarely been explored in individual analyses. Objectives: to compare visual inspection by nuclear physicians with the automated statistical parametric mapping program using a SPECT dataset of patients with neurological disorders and normal control images. Methods: using statistical parametric mapping, 14 SPECT images from patients with various neurological disorders were compared individually with a databank of 32 normal images using a statistical threshold of p<0.05 (corrected for multiple comparisons at the level of individual voxels or clusters). Statistical parametric mapping results were compared with visual analyses by a nuclear physician highly experienced in neurology (A) as well as a nuclear physician with a general background of experience (B) who independently classified images as normal or altered, and determined the location of changes and the severity. Results: of the 32 images of the normal databank, 4 generated maps showing rCBF abnormalities (p<0.05, corrected). Among the 14 images from patients with neurological disorders, 13 showed rCBF alterations. Statistical parametric mapping and physician A completely agreed on 84.37% and 64.28% of cases from the normal databank and neurological disorders, respectively. The agreement between statistical parametric mapping and ratings of physician B were lower (71.18% and 35.71%, respectively). Conclusion: statistical parametric mapping replicated the findings described by the more experienced nuclear physician. This finding suggests that automated methods for individually analyzing rCBF SPECT images may be a valuable resource to complement visual inspection in clinical practice. (author)

  1. Intravoxel incoherent motion perfusion imaging in acute stroke: initial clinical experience

    Energy Technology Data Exchange (ETDEWEB)

    Federau, C.; Becce, F.; Maeder, P.; Meuli, R. [Centre Hospitalier Universitaire Vaudois (CHUV) and University of Lausanne, Department of Diagnostic and Interventional Radiology, Lausanne (Switzerland); Sumer, S.; Wintermark, M. [University of Virginia, Neuroradiology Division, Department of Radiology, Charlottesville, VA (United States); O' Brien, K. [University of Geneva, Center for Biomedical Imaging (CIBM), Geneva (Switzerland)

    2014-08-15

    Intravoxel incoherent motion (IVIM) imaging is an MRI perfusion technique that uses a diffusion-weighted sequence with multiple b values and a bi-compartmental signal model to measure the so-called pseudo-diffusion of blood caused by its passage through the microvascular network. The goal of the current study was to assess the feasibility of IVIM perfusion fraction imaging in patients with acute stroke. Images were collected in 17 patients with acute stroke. Exclusion criteria were onset of symptoms to imaging >5 days, hemorrhagic transformation, infratentorial lesions, small lesions <0.5 cm in minimal diameter and hemodynamic instability. IVIM imaging was performed at 3 T, using a standard spin-echo Stejskal-Tanner pulsed gradients diffusion-weighted sequence, using 16 b values from 0 to 900 s/mm{sup 2}. Image quality was assessed by two radiologists, and quantitative analysis was performed in regions of interest placed in the stroke area, defined by thresholding the apparent diffusion coefficient maps, as well as in the contralateral region. IVIM perfusion fraction maps showed an area of decreased perfusion fraction f in the region of decreased apparent diffusion coefficient. Quantitative analysis showed a statistically significant decrease in both IVIM perfusion fraction f (0.026 ± 0.019 vs. 0.056 ± 0.025, p = 2.2 . 10{sup -6}) and diffusion coefficient D compared with the contralateral side (3.9 ± 0.79 . 10{sup -4} vs. 7.5 ± 0.86 . 10{sup -4} mm{sup 2}/s, p = 1.3 . 10{sup -20}). IVIM perfusion fraction imaging is feasible in acute stroke. IVIM perfusion fraction is significantly reduced in the visible infarct. Further studies should evaluate the potential for IVIM to predict clinical outcome and treatment response. (orig.)

  2. Effect of caffeine on ischemia detection by adenosine single-photon emission computed tomography perfusion imaging.

    Science.gov (United States)

    Zoghbi, Gilbert J; Htay, Thien; Aqel, Raed; Blackmon, Linda; Heo, Jaekyeong; Iskandrian, Ami E

    2006-06-06

    The purpose of this research was to study the effect of one cup of coffee taken 1 h before adenosine stress on the results of myocardial perfusion imaging. Caffeine is believed to attenuate the coronary hyperemic response to adenosine by competitive blockade of the A2a receptor. Caffeine is commonly withheld before adenosine single-photon emission computed tomography (SPECT) perfusion imaging so as not to mask ischemia detection. We studied the effect of one 8-oz cup of coffee taken 1 h before adenosine stress in patients who had demonstrable reversible defects on adenosine SPECT perfusion imaging performed while off caffeine. There were 22 men and 8 women, age 64 +/- 9 years. The blood level of caffeine 1 h after intake was 3.1 +/- 1.6 mg/l. There were two patients with ST-segment depression before and one after caffeine intake (p = NS). The summed stress score (SSS) based on 17 segments (scale of 0 to 3, 3 being normal) was 44 +/- 5 before and 45 +/- 5 after caffeine (p = NS). The summed difference score was 3.8 +/- 1.9 before and. 3.9 +/- 2.3 after caffeine (p = NS), reflecting that around 50% of the perfusion abnormality was reversible before and after caffeine. Using polar maps, the perfusion abnormality was 12 +/- 10% at baseline and 12 +/- 10% after caffeine (p = NS) in agreement with SSS. The left ventricular ejection fraction by gated SPECT was 50 +/- 13% at baseline and 51 +/- 13 % after caffeine (p = NS). A cup of coffee does not mask the presence or severity of reversible defects induced by adenosine SPECT imaging.

  3. Differential Diagnosis of Lymphadenopathy in the Neck Spaces in a CT Perfusion Study

    Energy Technology Data Exchange (ETDEWEB)

    Rhee, Sun Jung; Hong, Hyun Sook; Lee, Eun Hye; Lee, Min Hee [Dept. of Radiology, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of); Park, Jung Mi [Dept. of Nuclear Science, Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon (Korea, Republic of)

    2011-11-15

    To evaluate the CT perfusion parameters for differentiating between a benign and malignant lymphadenopathy in the neck spaces. Seventeen patients with cervical lymphadenopathy underwent perfusion CT. Perfusion parameters, including blood flow (BF), blood volume (BV), permeability index (PI), and mean transit time, were calculated at the regions of interest in the enlarged lymph nodes (LNs). The enlarged LNs were diagnosed by fine needle aspiration, surgical excision, and clinical follow-up. The LNs were classified as either reactive hyperplasia (n = 26), metastatic LNs (n = 11), or LNs of lymphoma (n = 14). Significant differences were found for BF, BV, and PI among the three groups (p < 0.05). Reactive hyperplasia had a significantly higher BF than metastatic LN (p < 0.0167). The LNs of lymphoma had a significantly lower BF, BV, and PI than reactive hyperplasia (p < 0.0167). No significant difference was observed between the metastatic LNs of the head and neck cancer and LNs of lymphoma for all perfusion parameters. In patients with head and neck cancer, perfusion CT is not useful for differentiating between metastatic LNs and inflammatory reactive hyperplasia. However, perfusion CT can be useful for differentiating between LNs of lymphoma and reactive hyperplasia.

  4. Dynamic CT perfusion imaging of the myocardium: a technical note on improvement of image quality.

    Directory of Open Access Journals (Sweden)

    Daniela Muenzel

    Full Text Available OBJECTIVE: To improve image and diagnostic quality in dynamic CT myocardial perfusion imaging (MPI by using motion compensation and a spatio-temporal filter. METHODS: Dynamic CT MPI was performed using a 256-slice multidetector computed tomography scanner (MDCT. Data from two different patients-with and without myocardial perfusion defects-were evaluated to illustrate potential improvements for MPI (institutional review board approved. Three datasets for each patient were generated: (i original data (ii motion compensated data and (iii motion compensated data with spatio-temporal filtering performed. In addition to the visual assessment of the tomographic slices, noise and contrast-to-noise-ratio (CNR were measured for all data. Perfusion analysis was performed using time-density curves with regions-of-interest (ROI placed in normal and hypoperfused myocardium. Precision in definition of normal and hypoperfused areas was determined in corresponding coloured perfusion maps. RESULTS: The use of motion compensation followed by spatio-temporal filtering resulted in better alignment of the cardiac volumes over time leading to a more consistent perfusion quantification and improved detection of the extend of perfusion defects. Additionally image noise was reduced by 78.5%, with CNR improvements by a factor of 4.7. The average effective radiation dose estimate was 7.1±1.1 mSv. CONCLUSION: The use of motion compensation and spatio-temporal smoothing will result in improved quantification of dynamic CT MPI using a latest generation CT scanner.

  5. Dynamic CT Perfusion Imaging of the Myocardium: A Technical Note on Improvement of Image Quality

    Science.gov (United States)

    Gramer, Bettina; Leber, Vivian; Vembar, Mani; Schmitt, Holger; Wildgruber, Moritz; Fingerle, Alexander A.; Rummeny, Ernst J.; Huber, Armin; Noël, Peter B.

    2013-01-01

    Objective To improve image and diagnostic quality in dynamic CT myocardial perfusion imaging (MPI) by using motion compensation and a spatio-temporal filter. Methods Dynamic CT MPI was performed using a 256-slice multidetector computed tomography scanner (MDCT). Data from two different patients–with and without myocardial perfusion defects–were evaluated to illustrate potential improvements for MPI (institutional review board approved). Three datasets for each patient were generated: (i) original data (ii) motion compensated data and (iii) motion compensated data with spatio-temporal filtering performed. In addition to the visual assessment of the tomographic slices, noise and contrast-to-noise-ratio (CNR) were measured for all data. Perfusion analysis was performed using time-density curves with regions-of-interest (ROI) placed in normal and hypoperfused myocardium. Precision in definition of normal and hypoperfused areas was determined in corresponding coloured perfusion maps. Results The use of motion compensation followed by spatio-temporal filtering resulted in better alignment of the cardiac volumes over time leading to a more consistent perfusion quantification and improved detection of the extend of perfusion defects. Additionally image noise was reduced by 78.5%, with CNR improvements by a factor of 4.7. The average effective radiation dose estimate was 7.1±1.1 mSv. Conclusion The use of motion compensation and spatio-temporal smoothing will result in improved quantification of dynamic CT MPI using a latest generation CT scanner. PMID:24130697

  6. Assessment of cardiac function using myocardial perfusion imaging technique on SPECT with 99mTc sestamibi

    Science.gov (United States)

    Gani, M. R. A.; Nazir, F.; Pawiro, S. A.; Soejoko, D. S.

    2016-03-01

    Suspicion on coronary heart disease can be confirmed by observing the function of left ventricle cardiac muscle with Myocardial Perfusion Imaging techniques. The function perfusion itself is indicated by the uptake of radiopharmaceutical tracer. The 31 patients were studied undergoing the MPI examination on Gatot Soebroto Hospital using 99mTc-sestamibi radiopharmaceutical with stress and rest conditions. Stress was stimulated by physical exercise or pharmacological agent. After two hours, the patient did rest condition on the same day. The difference of uptake percentage between stress and rest conditions will be used to determine the malfunction of perfusion due to ischemic or infarct. Degradation of cardiac function was determined based on the image-based assessment of five segments of left ventricle cardiac. As a result, 8 (25.8%) patients had normal myocardial perfusion and 11 (35.5%) patients suspected for having partial ischemia. Total ischemia occurred to 8 (25.8%) patients with reversible and irreversible ischemia and the remaining 4 (12.9%) patients for partial infarct with characteristic the percentage of perfusion ≤50%. It is concluded that MPI technique of image-based assessment on uptake percentage difference between stress and rest conditions can be employed to predict abnormal perfusion as complementary information to diagnose the cardiac function.

  7. Quantification of myocardial perfusion based on signal intensity of flow sensitized MRI

    Science.gov (United States)

    Abeykoon, Sumeda B.

    The quantitative assessment of perfusion is important for early recognition of a variety of heart diseases, determination of disease severity and their cure. In conventional approach of measuring cardiac perfusion by arterial spin labeling, the relative difference in the apparent T1 relaxation times in response to selective and non-selective inversion of blood entering the region of interest is related to perfusion via a two-compartment tissue model. But accurate determination of T1 in small animal hearts is difficult and prone to errors due to long scan times. The purpose of this study is to develop a fast, robust and simple method to quantitatively assess myocardial perfusion using arterial spin labeling. The proposed method is based on signal intensities (SI) of inversion recovery slice-select, non-select and steady-state images. Especially in this method data are acquired at a single inversion time and at short repetition times. This study began by investigating the accuracy of assessment of perfusion using a two compartment system. First, determination of perfusion by T1 and SI were implemented to a simple, two-compartment phantom model. Mathematical model developed for full spin exchange models (in-vivo experiments) by solving a modified Bloch equation was modified to develop mathematical models (T1 and SI) for a phantom (zero spin exchange). The phantom result at different flow rates shows remarkable evidence of accuracy of the two-compartment model and SI, T1 methods: the SI method has less propagation error and less scan time. Next, twelve healthy C57BL/6 mice were scanned for quantitative perfusion assessment and three of them were repeatedly scanned at three different time points for a reproducibility test. The myocardial perfusion of healthy mice obtained by the SI-method, 5.7+/-1.6 ml/g/min, was similar (p=0.38) to that obtained by the conventional T1 method, 5.6+/- 2.3 ml/g/min. The reproducibility of the SI method shows acceptable results: the

  8. Local cortical hypoperfusion imaged with CT perfusion during postictal Todd's paresis

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, Marlon S.; Binder, Devin K. [University of California, Department of Neurological Surgery, Irvine, CA (United States); Smith, Wade S. [University of California, Department of Neurology, San Francisco, CA (United States); Wintermark, Max; Dillon, William P. [University of California, Department of Radiology, San Francisco, CA (United States)

    2008-05-15

    Postictal ('Todd's') paralysis, or 'epileptic hemiplegia,' is a well-known complication of focal or generalized epileptic seizures. However, it is unclear whether the pathophysiology of Todd's paralysis is related to alterations in cerebral perfusion. We report CT perfusion findings in a patient presenting with postictal aphasia and right hemiparesis. A 62-year-old woman with a history of alcohol abuse, closed head injury and posttraumatic epilepsy, presented with acute onset aphasia and right hemiparesis. A non-contrast head CT scan demonstrated no acute hemorrhage. Left hemispheric ischemia was suspected, and the patient was considered for acute thrombolytic therapy. MRI revealed a subtle increase in signal intensity involving the left medial temporal, hippocampal and parahippocampal regions on both T2-weighted FLAIR and diffusion-weighted sequences. CT angiography and CT perfusion study were performed. The CT perfusion study and CT angiography demonstrated a dramatic reduction in cerebral blood flow and blood volume involving the entire left hemisphere, but with relative symmetry of mean transit time, ruling out a large vessel occlusion. Clinical resolution of the aphasia and hemiparesis occurred within a few hours, and correlated with normalization of perfusion to the left hemisphere (detected by MR perfusion). This unique case is the first in which clinical evidence of Todd's paralysis has been correlated with reversible postictal hemispheric changes on CT and MR perfusion studies. This is important because CT perfusion study is being used more and more in the diagnosis of acute stroke, and one needs to be careful to not misinterpret the data. (orig.)

  9. Local cortical hypoperfusion imaged with CT perfusion during postictal Todd's paresis

    International Nuclear Information System (INIS)

    Mathews, Marlon S.; Binder, Devin K.; Smith, Wade S.; Wintermark, Max; Dillon, William P.

    2008-01-01

    Postictal (''Todd's'') paralysis, or ''epileptic hemiplegia,'' is a well-known complication of focal or generalized epileptic seizures. However, it is unclear whether the pathophysiology of Todd's paralysis is related to alterations in cerebral perfusion. We report CT perfusion findings in a patient presenting with postictal aphasia and right hemiparesis. A 62-year-old woman with a history of alcohol abuse, closed head injury and posttraumatic epilepsy, presented with acute onset aphasia and right hemiparesis. A non-contrast head CT scan demonstrated no acute hemorrhage. Left hemispheric ischemia was suspected, and the patient was considered for acute thrombolytic therapy. MRI revealed a subtle increase in signal intensity involving the left medial temporal, hippocampal and parahippocampal regions on both T2-weighted FLAIR and diffusion-weighted sequences. CT angiography and CT perfusion study were performed. The CT perfusion study and CT angiography demonstrated a dramatic reduction in cerebral blood flow and blood volume involving the entire left hemisphere, but with relative symmetry of mean transit time, ruling out a large vessel occlusion. Clinical resolution of the aphasia and hemiparesis occurred within a few hours, and correlated with normalization of perfusion to the left hemisphere (detected by MR perfusion). This unique case is the first in which clinical evidence of Todd's paralysis has been correlated with reversible postictal hemispheric changes on CT and MR perfusion studies. This is important because CT perfusion study is being used more and more in the diagnosis of acute stroke, and one needs to be careful to not misinterpret the data. (orig.)

  10. Hepatic perfusion parameters of contrast-enhanced ultrasonography correlate with the severity of chronic liver disease.

    Science.gov (United States)

    Liu, Dong; Qian, Linxue; Wang, Jinrui; Hu, Xiangdong; Qiu, Lanyan

    2014-11-01

    In the study described here, we introduced a new ratio acquired with contrast-enhanced ultrasonography (CEUS): a liver parenchyma blood supply ratio that differentiates arterial and portal phases. Our purpose was to determine whether this ratio and other liver parenchyma perfusion parameters acquired with CEUS can be correlated with the severity of chronic liver disease. Twelve patients with non-cirrhotic chronic liver disease, 35 patients with cirrhosis (child class A: n = 10; child class B: n = 13; child class C: n = 12) and 21 healthy volunteers were examined by CEUS. Time-intensity curves were drawn for regions of interest located in liver parenchyma and right kidney cortex using QLAB quantification software. The arterial and portal phases were differentiated by the time to the maximum enhancement of right kidney and liver parenchyma perfusion data acquired from the time-intensity curves: the intensity of liver parenchyma perfused by hepatic arterial flow (I(ap)), the intensity of total perfusion of liver parenchyma (I(peak)), the intensity of liver parenchyma perfused by portal venous flow (I(pp)) and the ratio of portal perfusion to total perfusion of liver parenchyma expressed by the parameters I(pp)/I(peak), I(peak), I(pp) and I(pp)/I(peak) significantly decreased in patients with cirrhosis and in patients with non-cirrhotic chronic liver disease, whereas Iap increased. The parameters I(pp), I(peak), I(pp)/I(peak) and Iap correlated with the severity of chronic liver disease (r = -0.938, p Liver parenchyma perfusion parameters obtained by CEUS were correlated with the severity of chronic liver disease and have the potential to assess cirrhosis non-invasively. Copyright © 2014 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  11. Quantitative assessment of the brain perfusion using the short-lived isotope 195m-Au

    International Nuclear Information System (INIS)

    Lindner, P.; Nickel, O.

    1985-01-01

    The possibilities of quantitatively assessing the brain perfusion on the basis of a modified transit time theory, using the favourable properties of the ultrashort-lived isotope 195m-Au, are shown. The intravascular deposition of the isotope 195m-Au enables quantitative brain perfusion studies based on both the dorsal and lateral projection. The 195m-Au isotope has a half-life of 30 sec and is able to be eluated from the 195m-Hg 195m-Au generator (Byk-Mallinckrodt). The quantification of brain perfusion (in terms of ml/min/100 g) is based on a recently published theory for non-diffusing radio-indicators, using a first-pass technique. This method of quantification corresponds to a modification of the transit time theory from Maier and Zierler (1) and accounts for the influences of dispersion and recirculation of an intravenously injected non-diffused tracer bolus (2, 3). The energy spectrum of the eluate from the generator shows two lines of high intensity at 262 keV and 68 keV. The low-energy peak is suited for the lateral view, i.e. brain perfusion studies of one hemisphere, without a significant 'look-through-effect'. The high-energy peak is successfully used for dorsal projections of brain perfusion studies. An examination takes less time than one minute and can be repeated after three minutes. Dynamic brain perfusion studies enable parametric images of the quantitative regional brain perfusion distribution, or the reciprocal mean transit times, to be obtained by calculation. Infarcted areas are able to be visualized with high sensitivity. Quantitative perfusion patterns during activation of the visual centre are detectable. The advantages of this method are discussed. (orig.) [de

  12. Neurological abnormalities predict disability

    DEFF Research Database (Denmark)

    Poggesi, Anna; Gouw, Alida; van der Flier, Wiesje

    2014-01-01

    To investigate the role of neurological abnormalities and magnetic resonance imaging (MRI) lesions in predicting global functional decline in a cohort of initially independent-living elderly subjects. The Leukoaraiosis And DISability (LADIS) Study, involving 11 European centres, was primarily aimed...... at evaluating age-related white matter changes (ARWMC) as an independent predictor of the transition to disability (according to Instrumental Activities of Daily Living scale) or death in independent elderly subjects that were followed up for 3 years. At baseline, a standardized neurological examination.......0 years, 45 % males), 327 (51.7 %) presented at the initial visit with ≥1 neurological abnormality and 242 (38 %) reached the main study outcome. Cox regression analyses, adjusting for MRI features and other determinants of functional decline, showed that the baseline presence of any neurological...

  13. Abnormal thermography in Parkinson's disease.

    Science.gov (United States)

    Antonio-Rubio, I; Madrid-Navarro, C J; Salazar-López, E; Pérez-Navarro, M J; Sáez-Zea, C; Gómez-Milán, E; Mínguez-Castellanos, A; Escamilla-Sevilla, F

    2015-08-01

    An autonomic denervation and abnormal vasomotor reflex in the skin have been described in Parkinson's disease (PD) and might be evaluable using thermography with cold stress test. A cross-sectional pilot study was undertaken in 35 adults: 15 patients with PD and abnormal [(123)I]-metaiodobenzylguanidine cardiac scintigraphy and 20 healthy controls. Baseline thermography of both hands was obtained before immersing one in cold water (3 ± 1 °C) for 2 min. Continuous thermography was performed in: non-immersed hand (right or with lesser motor involvement) during immersion of the contralateral hand and for 6 min afterward; and contralateral immersed hand for 6 min post-immersion. The region of interest was the dorsal skin of the third finger, distal phalanx. PD patients showed a lower mean baseline hand temperature (p = 0.037) and greater thermal difference between dorsum of wrist and third finger (p = 0.036) and between hands (p = 0.0001) versus controls, regardless of the motor laterality. Both tests evidenced an adequate capacity to differentiate between groups: in the non-immersed hand, the PD patients did not show the normal cooling pattern or final thermal overshoot observed in controls (F = 5.29; p = 0.001), and there was an AUC of 0.897 (95%CI 0.796-0.998) for this cooling; in the immersed hand, thermal recovery at 6 min post-immersion was lesser in patients (29 ± 17% vs. 55 ± 28%, p = 0.002), with an AUC of 0.810 (95%CI 0.662-0.958). PD patients reveal abnormal skin thermal responses in thermography with cold stress test, suggesting cutaneous autonomic dysfunction. This simple technique may be useful to evaluate autonomic dysfunction in PD. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul

    2000-01-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.=20

  15. Magnetic resonance first-pass perfusion imaging: overview and perspectives.

    Science.gov (United States)

    Zenovich, A; Muehling, O M; Panse, P M; Jerosch-Herold, M; Wilke, N

    2001-01-01

    The data from clinical studies with quantitative MR first-pass perfusion imaging suggests that this technique outperforms SPECT--widely available clinical imaging tool--in sensitivity and specificity. Moreover, MRFP imaging may be combined with the assessment of global and segmental function of the heart and regional wall thickening, and in addition, performed with pharmacological stress agents. The inter- and intra-observer reproducibility of quantitative MRFP is comparable with clinically used nuclear medicine techniques. MRFP measurements can discern collateral myocardium and are able to identify small changes in myocardial blood flow and myocardial perfusion reserve (the ratio of stress blood flow over resting). MRFP imaging has been mainly used in context of coronary artery disease but many other exciting areas in clinical cardiology are awaiting of new insights that can be accomplished with this technique. Trials are needed to obtain the approval of the contrast agent (Gd-DTPA) and perfusion sequences by the Food and Drug Administration and to establish reimbursement procedures with the third-party insurance companies and health maintenance organizations.

  16. 99mTc-HMPAO perfusion indices and brain-mapping in stroke patients

    International Nuclear Information System (INIS)

    Minchev, D.; Klisarova, A.

    1997-01-01

    It is the purpose of the study to establish correlations between 99mTc-HMPAO (hexamethylpropylenaminoxym) perfusion indices and changes in brain-mapping among patients with acute stroke. Forty-six patients with definitely proved stroke syndrome are investigated in the first 72 hours and 15 days after the onset of cerebrovascular accident using clinical, neuro-physiological and 99mTc-HMPAO SPECT methods. Regional and hemispheric perfusion asymmetry correlate with the brain-mapping cerebral disturbance (p < 0.001). In patients presenting focal hypoperfusion there is a significant correlation between perfusion indices and local EEG disturbance (r = 0.87). The dynamic study demonstrates a significant correlation between perfusion indices and electrical cerebral disturbance in the first 72 hours after the onset of the cerebrovascular accident. Fifteen days later no such correlation is documented. The obtained results demonstrate the essential practical bearing of 99mTc-HMPAO SPECT indices on the objective assessment of perfusion hemispheric and regional asymmetry in stroke patients, and the possibility of being used for indirect estimation of the regional cerebral blood flow in acute stroke patients against the background of visual and quantitative EEG changes (author)

  17. Equipment abnormality monitoring device

    International Nuclear Information System (INIS)

    Ando, Yasumasa

    1991-01-01

    When an operator hears sounds in a plantsite, the operator compares normal sounds of equipment which he previously heard and remembered with sounds he actually hears, to judge if they are normal or abnormal. According to the method, there is a worry that abnormal conditions can not be appropriately judged in a case where the number of objective equipments is increased and in a case that the sounds are changed gradually slightly. Then, the device of the present invention comprises a plurality of monitors for monitoring the operation sound of equipments, a recording/reproducing device for recording and reproducing the signals, a selection device for selecting the reproducing signals among the recorded signals, an acoustic device for converting the signals to sounds, a switching device for switching the signals to be transmitted to the acoustic device between to signals of the monitor and the recording/reproducing signals. The abnormality of the equipments can be determined easily by comparing the sounds representing the operation conditions of equipments for controlling the plant operation and the sounds recorded in their normal conditions. (N.H.)

  18. Correlation analysis of dual-energy CT iodine maps with quantitative pulmonary perfusion MRI.

    Science.gov (United States)

    Hansmann, Jan; Apfaltrer, Paul; Zoellner, Frank G; Henzler, Thomas; Meyer, Mathias; Weisser, Gerald; Schoenberg, Stefan O; Attenberger, Ulrike I

    2013-05-28

    To correlate dual-energy computed tomography (DECT) pulmonary angiography derived iodine maps with parameter maps of quantitative pulmonary perfusion magnetic resonance imaging (MRI). Eighteen patients with pulmonary perfusion defects detected on DECT derived iodine maps were included in this prospective study and additionally underwent time-resolved contrast-enhanced pulmonary MRI [dynamic contrast enhanced (DCE)-MRI]. DCE-MRI data were quantitatively analyzed using a pixel-by-pixel deconvolution analysis calculating regional pulmonary blood flow (PBF), pulmonary blood volume (PBV) and mean transit time (MTT) in visually normal lung parenchyma and perfusion defects. Perfusion parameters were correlated to mean attenuation values of normal lung and perfusion defects on DECT iodine maps. Two readers rated the concordance of perfusion defects in a visual analysis using a 5-point Likert-scale (1 = no correlation, 5 = excellent correlation). In visually normal pulmonary tissue mean DECT and MRI values were: 22.6 ± 8.3 Hounsfield units (HU); PBF: 58.8 ± 36.0 mL/100 mL per minute; PBV: 16.6 ± 8.5 mL; MTT: 17.1 ± 10.3 s. In areas with restricted perfusion mean DECT and MRI values were: 4.0 ± 3.9 HU; PBF: 10.3 ± 5.5 mL/100 mL per minute, PBV: 5 ± 4 mL, MTT: 21.6 ± 14.0 s. The differences between visually normal parenchyma and areas of restricted perfusion were statistically significant for PBF, PBV and DECT (P < 0.0001). No linear correlation was found between MRI perfusion parameters and attenuation values of DECT iodine maps (PBF: r = 0.35, P = 0.15; PBV: r = 0.34, P = 0.16; MTT: r = 0.41, P = 0.08). Visual analysis revealed a moderate correlation between perfusion defects on DECT iodine maps and the parameter maps of DCE-MRI (mean score 3.6, κ 0.45). There is a moderate visual but not statistically significant correlation between DECT iodine maps and perfusion parameter maps of DCE-MRI.

  19. Dilated cardiomyopathy - approach made simplified with myocardial perfusion scintigraphy and cardiac viability studies

    International Nuclear Information System (INIS)

    Pawar, Shwetal; Maitra, R.; Tilve, G.H.

    2010-01-01

    Full text: To differentiate the ischemic vs nonischemic dilated cardiomyopathy and to assess myocardial viability in the ischemic cardiomyopathy. Materials and Methods: 34 patients (24 males and 10 females) with dilated cardiomyopathy diagnosed on echocardiography with reduced left ventricular ejection fraction and global hypokinesia were included between the period of Jan 2009 and July 2010. All the patients underwent rest myocardial perfusion scintigraphy first; 45 minutes after intravenous injection of 7 mCi of 99m Tc MIBI. The stress myocardial perfusion imaging (after physical stress or gm/kg/min; 6 min infusion) was pharmacological stress with adenosine; 140 performed in the patients with normal perfusion at rest. The 18 F FDG (5 mCi) cardiac viability studies were performed in patient with abnormal rest myocardial perfusion. The images were acquired on GE Infinia systems and processed on Emory toolbox (ECT) to study the ischemia and viability. Results: The mean left ventricular ejection fraction was found to be 27.38% at rest. The stress and rest perfusion scintigraphy was carried out in 20/34(58%) patients in whom 9(45%) patients underwent pharmacological stress with Inj adenosine and 11(55%) patients underwent physical stress. The stress induced ischemia was diagnosed in 12(60%) patients and infarct in 2(10%) patients with mixed ischemia and infarct pattern in 2(10%) patients. The nonischemic cause was diagnosed in 4 patients. The cardiac viability study was carried out in 14/34 (42%) patients with 6(42%) viable, 5(35%) nonviable and 3(21%) mixed viable and nonviable patterns were identified. Conclusion: The myocardial perfusion scintigraphy was the simplified approach for differentiating ischemic verses nonischemic dilated cardiomyopathy with addition of cardiac viability study ( 18 FDG) made it one stop shop for the complete work-up of patients for further management

  20. Measurement of regional cerebral blood flow with single photon emission computed tomography in patients with aphasia

    International Nuclear Information System (INIS)

    Reischies, F.M.; Muellmann, A.; Hedde, J.P.; Freie Univ. Berlin; Christe, W.

    1984-01-01

    5 cases are demonstrated of patients with aphasia whose brain perfusion as measured regionally by SPECT using 133 Xe was correlated to the lesions seen in the CT study. Perfusion reductions exceeded the CT visible lesions, such as, that in cortical lesions perfusion in the region of basal ganglia is diminished and vice versa. The findings are discussed in relation to recent work on brain perfusion and metabolism. (orig.) [de

  1. Single-photon emission computed tomography myocardial perfusion imaging-assessed stress perfusion defect severity is associated with mortality independent of ethnicity in an Asian population.

    Science.gov (United States)

    Chin, Chee Tang; Gao, Fei; Keng, Felix Y J; Shah, Bimal R; Koh, Angela S; Tan, Ru San; Chua, Terrance S J

    2014-12-01

    Ischemic heart disease is growing by epidemic proportions in Asia. Among patients in Western populations with similar myocardial perfusion imaging (MPI) ischemia severity, ethnicity is independently associated with mortality. We aimed to determine the differential prognostic value of MPI abnormality severity among three major Asian ethnic groups. From 16,921 consecutive patients, we used summed stress score to define increasing abnormal scan severity groups (minimal, mild, moderate, and severe) among Chinese, Indian, and Malay patients. We determined mortality from the national death registry. Using multivariable Cox regression models, we examined the association between ethnicity and mortality. Chinese patients were older than Indians or Malays. Annual all-cause death rates increased with increasing abnormal scan severity in all three ethnicities. After adjustment, ethnicity was not associated with mortality. With Chinese as the reference group, adjusted hazard ratio and 95% CI for Malays and Indians were 1.29 (0.95-1.77) and 1.06 (0.74-1.50) in the minimally abnormal scan group, and 1.20 (0.75-1.91) and 0.82 (0.47-1.45) in the severely abnormal scan group, respectively. Mortality risk is related to the severity of scan abnormality and is independent of ethnicity in Asians. Our findings emphasize the continued utility of MPI in guiding risk stratification in Asia.

  2. Regional cerebral blood flow of the patients with schizophrenia. A study using 99mTc-ECD SPECT at rest and activation

    International Nuclear Information System (INIS)

    Hu Ping; Wu Kening; Zeng Shiquan; Lin Zengtao; Yu Jinlong

    1996-01-01

    Regional cerebral blood flow (rCBF) changes of the patients with schizophrenia were observed. 99m Tc-ECD SPECT was performed on 22 patients with schizophrenia and 10 healthy volunteers at rest and activation with a cognitive task: a modified Wisconsin Card Sorting Test. At rest state, only 4 patients have abnormal rCBF pattern: left hemisphere over-perfusion relative to the right. A significant relative activation deficit in the left inferior prefrontal region was revealed in the patients during activation. The patients with schizophrenia may have frontal lobe dysfunction

  3. Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy

    International Nuclear Information System (INIS)

    Sabiniewicz, R.; Chojnicki, M.; Alszewicz-Baranowska, J.; Erecinski, J.; Romanowicz, G.; Lass, P.; Bandurski, T.

    2002-01-01

    The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The disturbances in lung perfusion (mostly in the left lung) were show by means of lung perfusion scintigraphy in 43 (49%) of patients. In 27 of them heart catheterisation has been performed. Angiography revealed stenosis of the lung artery branch in 15/43 (34.9%) patients with abnormal perfusion lung scan and in 4/44 (9%) in patients with normal perfusion lung scan. Intervention procedures were carried out on 10 patients. Lung perfusion scintigraphy may prove a valuable, non-invasive screening tool in the assessment of patients after TOF repair, although both false-negative and false positive results may happen. Therefore, it should play an auxiliary role together with other diagnostic modalities. (author)

  4. Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

    International Nuclear Information System (INIS)

    Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika; Monbaron, David; Ruiz, Juan; Koehli, Melanie

    2005-01-01

    Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, 99m Tc-sestamibi, 201 Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS≥4) was observed in 49 (37%) patients (SSS=4.9±8.4, SDS=2.4±4.7), reversible perfusion defects (SDS≥2) in 40 (30%) patients [SSS=13.3±10.9; SDS=8.0±5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9±11.3; SDS=7.4±1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify these patients with a

  5. Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Monbaron, David; Ruiz, Juan [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland); Koehli, Melanie [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland)

    2005-01-01

    Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, {sup 99m}Tc-sestamibi, {sup 201}Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS{>=}4) was observed in 49 (37%) patients (SSS=4.9{+-}8.4, SDS=2.4{+-}4.7), reversible perfusion defects (SDS{>=}2) in 40 (30%) patients [SSS=13.3{+-}10.9; SDS=8.0{+-}5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9{+-}11.3; SDS=7.4{+-}1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify

  6. Assessment of foot perfusion in patients with a diabetic foot ulcer.

    Science.gov (United States)

    Forsythe, Rachael O; Hinchliffe, Robert J

    2016-01-01

    Assessment of foot perfusion is a vital step in the management of patients with diabetic foot ulceration, in order to understand the risk of amputation and likelihood of wound healing. Underlying peripheral artery disease is a common finding in patients with foot ulceration and is associated with poor outcomes. Assessment of foot perfusion should therefore focus on identifying the presence of peripheral artery disease and to subsequently estimate the effect this may have on wound healing. Assessment of perfusion can be difficult because of the often complex, diffuse and distal nature of peripheral artery disease in patients with diabetes, as well as poor collateralisation and heavy vascular calcification. Conventional methods of assessing tissue perfusion in the peripheral circulation may be unreliable in patients with diabetes, and it may therefore be difficult to determine the extent to which poor perfusion contributes to foot ulceration. Anatomical data obtained on cross-sectional imaging is important but must be combined with measurements of tissue perfusion (such as transcutaneous oxygen tension) in order to understand the global and regional perfusion deficit present in a patient with diabetic foot ulceration. Ankle-brachial pressure index is routinely used to screen for peripheral artery disease, but its use in patients with diabetes is limited in the presence of neuropathy and medial arterial calcification. Toe pressure index may be more useful because of the relative sparing of pedal arteries from medial calcification but may not always be possible in patients with ulceration. Fluorescence angiography is a non-invasive technique that can provide rapid quantitative information about regional tissue perfusion; capillaroscopy, iontophoresis and hyperspectral imaging may also be useful in assessing physiological perfusion but are not widely available. There may be a future role for specialized perfusion imaging of these patients, including magnetic resonance

  7. Feeling Abnormal: Simulation of Deviancy in Abnormal and Exceptionality Courses.

    Science.gov (United States)

    Fernald, Charles D.

    1980-01-01

    Describes activity in which student in abnormal psychology and psychology of exceptional children classes personally experience being judged abnormal. The experience allows the students to remember relevant research, become sensitized to the feelings of individuals classified as deviant, and use caution in classifying individuals as abnormal.…

  8. Abnormal glucose tolerance and lipid abnormalities in Indian ...

    African Journals Online (AJOL)

    Discussion. Regardless of varying diagnostic classification, abnormal glucose tolerance is a well-documented risk factor. 16 Abnormalities in. Because ofthe small number offemale MI survivors, the effect of obesity and abnormal glucose tolerance on lipid levels was studied in the male patients only. There was no significant.

  9. Myocardial perfusion in type 2 diabetes with left ventricular hypertrophy: normalisation by acute angiotensin-converting enzyme inhibition

    Energy Technology Data Exchange (ETDEWEB)

    Hesse, Birger; Meyer, Christian; Hove, Jens D.; Holm, Soeren; Kofoed, Klaus F. [Department of Clinical Physiology and Nuclear Medicine, KF 4011, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen (Denmark); Nielsen, Flemming S.; Sato, Asako; Parving, Hans-Henrik [Steno Diabetes Center, Gentofte (Denmark); Bang, Lia E.; Svendsen, Tage L. [Department of Internal Medicine, Naestved County Hospital (Denmark); Opie, Lionel H. [Department of Medicine, Cape Heart Center, University of Cape Town (South Africa)

    2004-03-01

    The purpose of this study was to assess whether acute angiotensin-converting enzyme (ACE) inhibition would improve myocardial perfusion and perfusion reserve in a subpopulation of normotensive patients with diabetes and left ventricular hypertrophy (LVH), both independent risk factors of coronary disease. Using positron emission tomography (PET), we investigated the response of regional myocardial perfusion to acute ACE inhibition with i.v. infusion of perindoprilat (vs saline infusion as control, minimum interval 3 days) in 12 diabetic patients with LVH. Myocardial perfusion was quantified with PET using nitrogen-13 ammonia infused at rest and during dipyridamole hyperaemia. Twelve healthy control subjects were included in the study, five of whom were also studied with perindoprilat. Mean blood pressure in normo-albuminuric, asymptomatic patients was 123{+-}7/65{+-}9 mmHg. Compared with controls, maximal perfusion was reduced in patients (1.8{+-}0.6 vs 2.5{+-}1.0 ml min{sup -1} g{sup -1}; P<0.05), and perfusion reserve was also lower, at borderline significance (2.7{+-}1.0 vs 3.6{+-}1.3; P=0.059). During perindoprilat infusion, myocardial perfusion reserve in patients increased to 3.9{+-}0.9 (P<0.001) due to normalisation of maximal perfusion (2.3{+-}0.5 ml min{sup -1} g{sup -1}, P<0.01). In the five control subjects both resting and hyperaemic perfusion remained unchanged during perindoprilat infusion. It is concluded that acute ACE inhibition with perindoprilat improves maximal achieved myocardial perfusion in non-hypertensive patients with diabetes and LVH. (orig.)

  10. Influence of the arm position in myocardial perfusion imaging acquisition

    Directory of Open Access Journals (Sweden)

    Marisa Izaki

    2014-07-01

    Full Text Available Objective: despite the technologic advances in myocardial perfusion imaging, we keep using an uncomfortable and sometimes impracticable patient position - supine with arms raised above the head (U. The purpose of this study was to investigate whether perfusion and functional cardiac gated SPECT scan results of acquisition U are equivalent to another position modality: supine with arms down at the sides of the trunk (D. Methods and Results: we performed U acquisition and in sequence D acquisition in 120 patients (pts using a one-day MPI (rest-gated/stress, with 99mTc-sestamibi (370 MBq and 1110 MBq. Images were processed by the iterative reconstruction method (OSEM. Rest (R and stress (S studies were scored using 17-segments model. Functional parameters (left ventricular ejection fraction, and volumes were automatically obtained by the quantitative gated SPECT (QGS program. According to the degree of stress defects observed in U study, the patients were categorized in two subgroups: normal (SSS ≤ 3 or 3 or ≥ 5%. Shoulder/back pain occurred in 23.3% of U patients and in 5% of D. No significant differences between U and D were found for SSS (p = 0.82 and SRS (p = 0.74 in normal group. In abnormal group, good correlation was found between U and D modes for SSS (Rho = 0.95, p = 0.0001 and SRS (Rho = 0.96 p = 0.0001, but the mean SSS (12.53 ± 7.54 and SRS (10.60 ± 7.08 values of D were significantly lower (p < 0.05 than SSS (13.43 ± 6.81 and SRS (11.33 ± 6.97 of U mode. Function measurements presented good correlations, except for end-diastolic volume (p = 0.0001. Conclusion: although D mode appears to be more comfortable and presented a good correlation with U values of SSS and SRS, in abnormal pts, the extent and severity of defects can be underestimated. Considering clinical implications of an accurate perfusion measurement, the acquisition with the arms down should be avoided.