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Sample records for arterially perfused hindbrain

  1. An exploration of the control of micturition using a novel in situ arterially perfused rat preparation

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    Prajni eSadananda

    2011-05-01

    Full Text Available Our goal was to develop and refine a decerebrate arterially perfused rat preparation (DAPR that allows the complete bladder filling and voiding cycle to be investigated without some of the restrictions inherent with in vivo experimentation (e.g. ease and speed of set up (30mins, control over the extracellular milieu and free of anaesthetic agents. Both spontaneous (naturalistic bladder filling from ureters and evoked (in response to intravesical infusion voids were routinely and reproducibly observed which had similar pressure characteristics. The DAPR allows the simultaneous measurement of bladder intra-luminal pressure, external urinary sphincter electromyogram (EUS–EMG, pelvic afferent nerve activity, pudendal motor activity and permits excellent visualisation of the entire lower urinary tract, during typical rat filling and voiding responses. The voiding responses were modulated or eliminated by interventions at a number of levels including at the afferent terminal fields (intravesical capsaicin sensitisation-desensitisation, autonomic (ganglion blockade with hexamethonium and somatic motor (vecuronium block of the EUS outflow and required intact brainstem/hindbrain-spinal coordination (as demonstrated by sequential hindbrain transections. Both innocuous (eg perineal stimulation and noxious (tail/paw pinch somatic stimuli elicited an increase in EUS-EMG indicating intact sensory feedback loops. Spontaneous non-micturition contractions were observed between fluid infusions at a frequency and amplitude of 1.4±0.9 per minute and 1.4±0.3mmHg, respectively, and their amplitude increased when autonomic control was compromised. In conclusion, the DAPR is a tractable and useful model for the study of neural bladder control showing intact afferent signaling, spinal and hindbrain co-ordination and efferent control over the lower urinary tract end organs and can be extended to study bladder pathologies and trial novel treatments.

  2. The Relation Between Perfusion Pattern of Hepatic Artery Perfusion Scintigraphy and Response to Y-90 Microsphere Therapy

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    Bilge Volkan-Salancı

    2013-12-01

    Full Text Available Objective: Hepatic artery perfusion scintigraphy is a routine procedure for patient evaluation before Y-90 radiomicrosphere therapy and mostly used for prediction of extrahepatic leakage. Moreover, it also displays perfusion pattern of tumours, which is an important parameter on success of the therapy. The aim of this study is to assess the relation between the perfusion pattern on hepatic artery perfusion scintigraphy and radiomicrosphere therapy response. Methods: A total of 99 radiomicrosphere therapy applications were carried out in 80 patients (M/F: 55/25. Results: Heterogeneous and diffuse perfusion patterns were observed in 47 patients and 52 patients, respectively. The patients with diffuse perfusion pattern had better therapy response both on FDG PET/CT (p= 0.04 and CT (p=0.008 when compared to those with heterogenous perfusion pattern. Conclusion: Perfusion pattern observed on hepatic artery perfusion scintigraphy may be a successful predictor of early response to radiomicrosphere therapy

  3. Pulmonary artery perfusion versus no pulmonary perfusion during cardiopulmonary bypass in patients with COPD

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    Buggeskov, Katrine B; Sundskard, Martin M; Jonassen, Thomas;

    2016-01-01

    INTRODUCTION: Absence of pulmonary perfusion during cardiopulmonary bypass (CPB) may be associated with reduced postoperative oxygenation. Effects of active pulmonary artery perfusion were explored in patients with chronic obstructive pulmonary disease (COPD) undergoing cardiac surgery. METHODS: 90...... starting CPB and longitudinally in a mixed-effects model (MEM). Secondary outcomes were tracheal intubation time, serious adverse events, mortality, days alive outside the intensive care unit (ICU) and outside the hospital. RESULTS: 21 hours after starting CPB patients receiving pulmonary artery perfusion...... with normothermic oxygenated blood had a higher oxygenation index compared with no pulmonary perfusion (mean difference (MD) 0.94; 95% CI 0.05 to 1.83; p=0.04). The blood group had also a higher oxygenation index both longitudinally (MEM, p=0.009) and at 21 hours (MD 0.99; CI 0.29 to 1.69; p=0.007) compared...

  4. Computed tomography angiography and perfusion to assess coronary artery stenosis causing perfusion defects by single photon emission computed tomography

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    Rochitte, Carlos E; George, Richard T; Chen, Marcus Y

    2014-01-01

    AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed ...

  5. Carotid artery disease and low cerebral perfusion pressure

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    Schroeder, T; Utzon, N P; Aabech, J

    1990-01-01

    Direct internal carotid artery blood pressure measurements in patients undergoing carotid endarterectomy identified 49 patients, among 239 consecutive cases (21%), who had a reduction in perfusion pressure of 20% or more. The clinical history, objective findings and angiographic data were compared...... with those of a control group of a further 49 patients selected from the remaining patients operated on over the same period. The two groups were compared for short- and long-term outcome of surgery. We were unable to delineate a symptomatic neurological profile that identified patients with low perfusion...... pressures. Surgery in patients with low perfusion pressures seemed to be associated with an increased complication rate (12% versus 4%), although this was not statistically significant. Definite postoperative improvements in persisting neurological deficits were observed only in one patient. Long...

  6. Arterial and portal venous liver perfusion using selective spin labelling MRI

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    Schalkx, Hanke J.; Petersen, Esben T.; Veldhuis, Wouter B.; Leeuwen, Maarten S. van; Bosch, Maurice A.A.J. van den [University Medical Center Utrecht, Department of Radiology, HP E.01.132, Postbus 85500, Utrecht (Netherlands); Peters, Nicky H.G.M. [Atrium Medical Center Parkstad, Department of Radiology, Heerlen (Netherlands); Pluim, Josien P.W.; Stralen, Marijn van [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2015-06-01

    To investigate the feasibility of selective arterial and portal venous liver perfusion imaging with spin labelling (SL) MRI, allowing separate labelling of each blood supply. The portal venous perfusion was assessed with a pulsed EPISTAR technique and the arterial perfusion with a pseudo-continuous sequence. To explore precision and reproducibility, portal venous and arterial perfusion were separately quantified in 12 healthy volunteers pre- and postprandially (before and after meal intake). In a subgroup of 6 volunteers, the accuracy of the absolute portal perfusion and its relative postprandial change were compared with MRI flow measurements of the portal vein. The portal venous perfusion significantly increased from 63 ± 22 ml/100g/min preprandially to 132 ± 42 ml/100g/min postprandially. The arterial perfusion was lower with 35 ± 22 preprandially and 22 ± 30 ml/100g/min postprandially. The pre- and postprandial portal perfusion using SL correlated well with flow-based perfusion (r{sup 2} = 0.71). Moreover, postprandial perfusion change correlated well between SL- and flow-based quantification (r{sup 2} = 0.77). The SL results are in range with literature values. Selective spin labelling MRI of the portal venous and arterial blood supply successfully quantified liver perfusion. This non-invasive technique provides specific arterial and portal venous perfusion imaging and could benefit clinical settings where contrast agents are contraindicated. (orig.)

  7. Dynamic contrast-enhanced ultrasound and transient arterial occlusion for quantification of arterial perfusion reserve in peripheral arterial disease

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    Amarteifio, E., E-mail: erick.amarteifio@med.uni-heidelberg.de [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Wormsbecher, S. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Krix, M. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Bracco Imaging Germany, Konstanz (Germany); Demirel, S. [University Hospital of Heidelberg, Department of Vascular Surgery, Heidelberg (Germany); Braun, S. [Department of Biostatistics, German Cancer Research Center, Heidelberg (Germany); Delorme, S. [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Boeckler, D. [University Hospital of Heidelberg, Department of Vascular Surgery, Heidelberg (Germany); Kauczor, H.-U. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Weber, M.-A. [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Department of Radiology, German Cancer Research Center, Heidelberg (Germany)

    2012-11-15

    Objective: To quantify muscular micro-perfusion and arterial perfusion reserve in peripheral arterial disease (PAD) with dynamic contrast-enhanced ultrasound (CEUS) and transient arterial occlusion. Materials and methods: This study had local institutional review board approval and written informed consent was obtained from all subjects. We examined the dominant lower leg of 40 PAD Fontaine stage IIb patients (mean age, 65 years) and 40 healthy volunteers (mean age, 54 years) with CEUS (7 MHz; MI, 0.28) during continuous intravenous infusion of 4.8 mL microbubbles. Transient arterial occlusion at mid-thigh level simulated physical exercise. With time-CEUS-intensity curves obtained from regions of interest within calf muscles, we derived the maximum CEUS signal after occlusion (max) and its time (t{sub max}), slope to maximum (m), vascular response after occlusion (AUC{sub post}), and analysed accuracy, receiver operating characteristic (ROC) curves, and correlations with ankle-brachial index (ABI) and walking distance. Results: All parameters differed in PAD and volunteers (p < 0.014). In PAD, t{sub max} was delayed (31.2 {+-} 13.6 vs. 16.7 {+-} 8.5 s, p < 0.0001) and negatively correlated with ankle-brachial-index (r = -0.65). m was decreased in PAD (4.3 {+-} 4.6 mL/s vs. 13.1 {+-} 8.4 mL/s, p < 0.0001) and had highest diagnostic accuracy (sensitivity/specificity, 75%/93%) for detection of diminished muscular micro-perfusion in PAD (cut-off value, m < 5{approx}mL/s). Discriminant analysis and ROC curves revealed m, and AUC{sub post} as optimal parameter combination for diagnosing PAD and therefore impaired arterial perfusion reserve. Conclusions: Dynamic CEUS with transient arterial occlusion quantifies muscular micro-perfusion and arterial perfusion reserve. The technique is accurate to diagnose PAD.

  8. Twin Reversed Arterial Perfusion Sequence: A Rare Entity

    Science.gov (United States)

    Khanduri, Sachin; Chhabra, Saakshi; Raja, Anshul; Bhagat, Saurav

    2015-01-01

    Twin reversed arterial perfusion (TRAP) sequence is an extremely rare complication of monochorionic multi-fetal pregnancy, occurring once in 35,000 births. This condition is characterized by a malformed fetus without a cardiac pump being perfused by a structurally normal (pump) twin via an artery-to-artery anastomosis in a reverse direction. We report a case of a primigravida, who came for routine antenatal checkup to our hospital at 31 weeks gestational age. Ultrasound imaging and magnetic resonance imaging revealed twin monochorionic intrauterine pregnancy with a viable, normal-appearing first twin and amorphous structured second twin connected by umbilical vessels. The patient was monitored with weekly ultrasonography, echocardiography, and Doppler ultrasound examination to ascertain the well-being of the pump twin. She delivered successfully at term a normal live baby and an acardius acephalus fetus. Plain X-ray of the acardius acephalus fetus confirmed the absence of cephalic structures. The perinatal mortality of the pump twin ranges from 35 to 55%; hence, it is essential to diagnose the presence of a pump twin at an early gestational age through improved imaging techniques, so that intervention can be planned early in the pregnancy for a better outcome of the pump twin. PMID:25861543

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

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    Martin, Alastair J.; Alexander, Matthew D.; McCoy, David B.; Cooke, Daniel L.; Lillaney, Prasheel; Moftakhar, Parham; Amans, Matthew R.; Settecase, Fabio; Nicholson, Andrew; Dowd, Christopher F.; Halbach, Van V.; Higashida, Randall T.; McDermott, Michael W.; Saloner, David; Hetts, Steven W.

    2016-01-01

    Background and Purpose To evaluate the ability of IA MR perfusion to characterize meningioma blood supply. Methods 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. Results 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. PMID:27802268

  10. Can preoperative myocardial perfusion scintigraphy predict changes in left ventricular perfusion and function after coronary artery bypass graft surgery?

    DEFF Research Database (Denmark)

    Eckardt, Rozy; Kjeldsen, Bo Juel; Johansen, Allan;

    2012-01-01

    OBJECTIVESWe wanted to evaluate whether preoperative myocardial perfusion scintigraphy (MPS) could predict changes in cardiac symptoms and postoperative myocardial perfusion and left ventricular function after coronary artery bypass grafting (CABG).METHODSNinety-two patients with stable angina......%. Before CABG, one patient had normal perfusion; in the rest of them the defects were classified as follows: reversible (60%), partly reversible (27%) and irreversible (12%). Following CABG, 33% had normal perfusion; in the rest the defects were reversible in 29%, partly reversible in 12% and irreversible...... in 26%. Left ventricular ejection fraction (LVEF), which was normal before operation in 45%, improved in 40% of all patients. The increase in LVEF was not related to the preoperative pattern of perfusion defects. Of 30 patients with normalized perfusion after CABG, 29 (97%) had reversible defects...

  11. Is misery perfusion still a predictor of stroke in symptomatic major cerebral artery disease?

    Science.gov (United States)

    Yamauchi, Hiroshi; Higashi, Tatsuya; Kagawa, Shinya; Nishii, Ryuichi; Kudo, Takashi; Sugimoto, Kanji; Okazawa, Hidehiko; Fukuyama, Hidenao

    2012-08-01

    Studies in the 1990s demonstrated that misery perfusion is a predictor of subsequent stroke in medically treated patients with symptomatic major cerebral artery disease. A recent randomized controlled trial demonstrated no benefit of bypass surgery for such patients. In this light, outcome in patients with misery perfusion has regained interest. The purpose of this study was to determine whether misery perfusion is still a predictor of subsequent stroke despite recent improvements in medical treatment for secondary prevention of stroke, and if so, whether the predictive value of misery perfusion has changed in recent years. We prospectively studied 165 non-disabled patients with symptomatic atherosclerotic internal carotid artery or middle cerebral artery occlusive diseases who underwent positron emission tomography from 1999 to 2008. Misery perfusion was defined as decreased cerebral blood flow, increased oxygen extraction fraction and decreased ratio of cerebral blood flow to blood volume in the hemisphere supplied by the diseased artery. All patients were followed up for 2 years until stroke recurrence or death. Bypass surgery was performed in 19 of 35 patients with and 16 of 130 patients without misery perfusion. The 2-year incidence of ipsilateral ischaemic stroke was six and four patients with and without misery perfusion, including two and one after surgery, respectively (P misery perfusion and 12 patients without (P misery perfusion in whole sample was 6.3 (95% confidence interval 1.7-22.4, P misery perfusion or bypass surgery did not differ. Between these periods, patients without misery perfusion demonstrated a decrease in stroke rate (from 16.2% to 0%), but patients with misery perfusion did not (26.3 and 25.0%). In symptomatic major cerebral artery disease, misery perfusion remains a predictor of subsequent stroke, although the recurrence rate was lower than the previous study. In patients without misery perfusion, the risk of stroke was reduced

  12. Diagnostic value of transmural perfusion ratio derived from dynamic CT-based myocardial perfusion imaging for the detection of haemodynamically relevant coronary artery stenosis

    NARCIS (Netherlands)

    A. Coenen (Adriaan); M. Lubbers (Marisa); A. Kurata (Akira); A.K. Kono (Atsushi K.); A. Dedic (Admir); R.G. Chelu (Raluca Gabriela); M.L. Dijkshoorn (Marcel); Rossi, A. (Alexia); R.J.M. van Geuns (Robert Jan); K. Nieman (Koen)

    2016-01-01

    textabstractObjectives: To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Methods: Subjects with suspected or known coro

  13. Multi-delay arterial spin labeling perfusion MRI in moyamoya disease-comparison with CT perfusion imaging

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    Wang, Rui [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); University of Chinese Academy of Sciences, Graduate School, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States); Yu, Songlin [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); University of California Los Angeles, Department of Neurology, Los Angeles (United States); Alger, Jeffry R.; Wang, Danny J.J. [University of California Los Angeles, Department of Neurology, Los Angeles (United States); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States); Zuo, Zhentao; Wang, Bo [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); Chen, Juan [Beijing Hospital, Department of Radiology, Beijing (China); Wang, Rong; Zhao, Jizong [Capital Medical University, Department of Neurosurgery, Beijing Tiantan Hospital, Beijing (China); An, Jing [Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen (China); Xue, Rong [Chinese Academy of Sciences, State Key Laboratory of Brain and Cognitive Science, Beijing MRI Center for Brain Research, Institute of Biophysics, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Beijing (China); UCLA-Beijing Joint Center for Advanced Brain Imaging, Los Angeles, CA (United States)

    2014-05-15

    To present a multi-delay pseudo-continuous ASL (pCASL) protocol that offers simultaneous measurements of cerebral blood flow (CBF) and arterial transit time (ATT), and to study correlations between multi-delay pCASL and CT perfusion in moyamoya disease. A 4 post-labeling delay (PLD) pCASL protocol was applied on 17 patients with moyamoya disease who also underwent CT perfusion imaging. ATT was estimated using the multi-delay protocol and included in the calculation of CBF. ASL and CT perfusion images were rated for lesion severity/conspicuity. Pearson correlation coefficients were calculated across voxels between the two modalities in grey and white matter of each subject respectively and between normalized mean values of ASL and CT perfusion measures in major vascular territories. Significant associations between ASL and CT perfusion were detected using subjective ratings, voxel-wise analysis in grey and white matter and region of interest (ROI)-based analysis of normalized mean perfusion. The correlation between ASL CBF and CT perfusion was improved using the multi-delay pCASL protocol compared to CBF acquired at a single PLD of 2 s (P < 0.05). There is a correlation between perfusion data from ASL and CT perfusion imaging in patients with moyamoya disease. Multi-delay ASL can improve CBF quantification, which could be a prognostic imaging biomarker in patients with moyamoya disease. (orig.)

  14. Value of cerebral perfusion and vascular reserve for the treatment of symptomatic intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    Li'an Huang; Xuewen Song; Anding Xu

    2008-01-01

    BACKGROUND: It is crucial to understand cerebral perfusion and vascular reserve in stegnotic arterial blood-supply regions to treat ischemic cerebrovascular diseases. However, effects on symptomatic intracrani-al arterial stenosis (SICAS) need to be further studied in additional applications. OBJECTIVE: To evaluate and summarize the effects of cerebral perfusion and vascular reserve on the treatment of SICAS. RETRIEVAL STRATEGY: A computer-based online search of English language publications from January 2000 to July 2007 was conducted in PubMed to identify publications that addressed cerebral perfusion and vascular reserve of SICAS. Search key words were "intracranial stenosis, perfusion, brain reserve". Relevant data were also searched with the China Journal Net, using the same key words in Chinese from January 2000 to January 2007. In total, 101 articles were retrieved. Inclusion criteria: ① Articles describing the current status for the diagnosis and treatment of SICAS; ② Articles concerning research developments of cerebral perfusion and vascular reserve of SICAS. Exclusion criteria: duplicated articles. LITERATURE EVALUATION: This study included 21 articles of experimental studies and conference re-ports.DATA SYNTHESIS: When performing interventional surgery in SICAS patients, it is important to under-stand cerebral perfusion and vascular reserve in addition to knowing the clinical symptoms and degrees of arterial stenosis. In recent years, there are a growing number of reports on measurements of vascular reserve through the use of magnetic resonance perfusion imaging (MR-PWI). Investigations demonstrate cerebral perfusion and vascular reserve decrease in many SICAS patients. Many studies show that both improve after surgical intervention. CONCLUSION: Cerebral perfusion could provide direct evidence of whether ischemia has occurred in the brain. Because of lateral circulation and cerebral vascular reserve, intracranial vascular stenosis and/or decreased

  15. Middle cerebral artery occlusion in presence of low perfusion pressure increases infarct size in rats

    DEFF Research Database (Denmark)

    Sillesen, H; Nedergaard, Majken; Schroeder, T;

    1988-01-01

    A model was set up in order to evaluate the importance of hemispheric perfusion pressure when the middle cerebral artery (MCA) is occluded in anaesthetized rats. In 6 animals the internal carotid artery (ICA) was occluded prior to ipsilateral MCA occlusion; in 17 animals the MCA only was occluded...

  16. Foot CT perfusion in patients with peripheral arterial occlusive disease (PAOD): A feasibility study

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    Iezzi, R., E-mail: roberto.iezzi@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Santoro, M., E-mail: dott.santoromarco@gmail.com [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Dattesi, R., E-mail: robertadattesi@gmail.com [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); La Torre, M.F. [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Tinelli, G., E-mail: tinelli@rm.unicatt.it [Department of Vascular Surgery, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Snider, F., E-mail: fsnider@rm.unicatt.it [Department of Vascular Surgery, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Bonomo, L., E-mail: lbonomo@rm.unicatt.it [Department of Bioimaging and Radiological Sciences, Institute of Radiology, “A. Gemelli” Hospital – Catholic University, L.go A Gemelli 8, 00168 Rome (Italy)

    2013-09-15

    Purpose: To prospectively assess the technical feasibility and reproducibility of quantitative foot perfusion multidetector-row computed tomography (MDCT) in patients with peripheral occlusive artery disease (PAOD) and to evaluate perfusion parameters changes after endovascular treatment. Materials and methods: Institutional review board approval and informed patient consent were obtained. 10 patients older than 65 years (mean 74.1 years, range 66–95 years) with PAOD and who were referred to our department for single-limb endovascular treatment were enrolled prospectively. All patients underwent foot CT perfusion examinations before and within 72 h after endovascular treatment. A 64-row CT lightspeed VCT scanner (GE Medical Systems) was used with acquisition of eight contiguous 5-mm reconstructed sections (60-s acquisition time; 40 mL Iomeprol 400 mgI/mL, @4 mL/s). Data were analyzed by two blinded readers using commercially available software to calculate perfusion parameters. Inter-observer and intra-observer agreement of perfusion CT analysis was assessed using Bland–Altman analyses and intra-class correlation coefficient (ICC). Changes in perfusion parameters after endovascular treatment were assessed using Wilcoxon's test. Results: Good inter-observer and intra-observer agreement was obtained in all patients. Good agreement was obtained for perfusion parameters for the untreated foot and in repeated studies. By comparing perfusion parameters in the treated foot, a significantly shorter mean transit time (MTT) was obtained. Conclusions: Foot CT perfusion is a feasible and reproducible technique. A significant decrease of MTT between pre- and post-revascularization suggests improved flow in the below-the-knee arteries.

  17. Endotoxemia reduces cerebral perfusion but enhances dynamic cerebrovascular autoregulation at reduced arterial carbon dioxide tension*

    DEFF Research Database (Denmark)

    Brassard, Patrice; Kim, Yu-Sok; van Lieshout, Johannes

    2012-01-01

    OBJECTIVE:: The administration of endotoxin to healthy humans reduces cerebral blood flow but its influence on dynamic cerebral autoregulation remains unknown. We considered that a reduction in arterial carbon dioxide tension would attenuate cerebral perfusion and improve dynamic cerebral......-104] mm Hg; p = .75), but increased cardiac output (8.3 [6.1-9.5] L·min vs. 6.0 [4.5-8.2] L·min; p = .02) through an elevation in heart rate (82 ± 9 beats·min vs. 63 ± 10 beats·min; p arterial carbon dioxide tension (37 ± 5 mm Hg vs. 41 ± 2 mm Hg; p artery mean...... in arterial carbon dioxide tension explains the improved dynamic cerebral autoregulation and the reduced cerebral perfusion encountered in healthy subjects during endotoxemia....

  18. Renal perfusion scintiscan

    Science.gov (United States)

    Renal perfusion scintigraphy; Radionuclide renal perfusion scan; Perfusion scintiscan - renal; Scintiscan - renal perfusion ... supply the kidneys. This is a condition called renal artery stenosis. Significant renal artery stenosis may be ...

  19. Arterial spin labeling perfusion MRI in cerebral ischaemia

    NARCIS (Netherlands)

    Bokkers, R.P.H.

    2011-01-01

    Cerebral perfusion is the basis for the delivery of oxygen and nutrients to the brain. Brain tissue can become damaged when there is a shortage in the blood supply. Basic physiological functions such as synaptic transmission, the membrane ion pump and energy metabolism are disrupted and within minut

  20. Rapid identification of a major diffusion/perfusion mismatch in distal internal carotid artery or middle cerebral artery ischemic stroke

    Directory of Open Access Journals (Sweden)

    Hakimelahi Reza

    2012-11-01

    Full Text Available Abstract Background We tested the hypothesis that in patients with occlusion of the terminal internal carotid artery and/or the proximal middle cerebral artery, a diffusion abnormality of 70 ml or less is accompanied by a diffusion/perfusion mismatch of at least 100%. Methods Sixty-eight consecutive patients with terminal ICA and/or proximal MCA occlusions and who underwent diffusion/perfusion MRI within 24 hours of stroke onset were retrospectively identified. DWI and mean transit time (MTT volumes were measured. Prospectively, 48 consecutive patients were identified with the same inclusion criteria. DWI and time to peak (TTP lesion volumes were measured. A large mismatch volume was defined as an MTT or TTP abnormality at least twice the DWI lesion volume. Results In the retrospective study, 49 of 68 patients had a DWI lesion volume ≤ 70 ml (mean 20.2 ml; SEM 2.9 ml. A DWI/MTT mismatch of > 100% was observed in all 49 patients (P  100% was present in all 35 (P  Conclusions Acute stroke patients with major anterior circulation artery occlusion are exceedingly likely to have a major diffusion/perfusion mismatch if the diffusion lesion volume is 70 ml or less. This suggests that physiology-based patient assessments may be made using only vessel imaging and diffusion MRI as a simple alternative to perfusion imaging.

  1. Correcting partial volume artifacts of the arterial input function in quantitative cerebral perfusion MRI

    NARCIS (Netherlands)

    van Osch, MJP; Vonken, EJPA; Bakker, CJG; Viergever, MA

    2001-01-01

    To quantify cerebral perfusion with dynamic susceptibility contrast MRI (DSC-MRI), one needs to measure the arterial input function (AIF). Conventionally, one derives the contrast concentration from the DSC sequence by monitoring changes in either the amplitude or the phase signal on the assumption

  2. Pulmonary artery perfusion with HTK solution prevents lung injury in infants after cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    LI Jian-an; LIU Ying-long; LIU Jin-ping; LI Xiao-feng

    2010-01-01

    Background Pulmonary artery perfusion during cardiopulmonary bypass (CPB) is a novel adjunctive method, which can minimize the lung ischemic-reperfusion injury and inflammatory response. This study evaluated the protective effect of pulmonary perfusion with hypothermic HTK solution in corrections of congenital heart defects with pulmonary hypertension.Methods Between June 2009 and December 2009, 24 consecutive infants with congenital heart defects and pulmonary hypertension were randomly divided into perfused group (n=12) and control group (n=12). Oxygen index, alveolar-arterial O2gradient, serum levels of malondialchehyche (MDA), interleukin (IL)-6, -8, -10, soluble intercellular adhesion molecule-1(slCAM-1), and P-selectin were measured before commencement and serially for 48 hours after termination of bypass.Results Oxygenation values were better preserved in the perfused group than in the control group. The serum levels of IL-6 increased immediately after CPB in both groups and returned to baseline at 48 hours after CPB, but it was restored faster and earlier in the perfused group. The serum levels of IL-8, slCAM-1, and MDA remained at baseline at each point after CPB in the perfused group and elevated significantly immediately after CPB in the control group, except for sICAM-1.The serum level of IL-10 increased immediately after CPB and decreased to baseline at 48 hours after CPB in both groups, but the IL-10 level in the perfused group was significantly higher than in the control group at 12 hours after CPB.The serum P-selectin levels in the control group immediately after CPB were significantly higher than prebypass levels.Moreover, there were no significant differences in postoperative clinical characters, except for the intubated time.Conclusion In infants with congenital heart defects, pulmonary perfusion with hypothermic HTK solution during cardiopulmonary bypass could ameliorate lung function and reduce the inflammatory response.

  3. Comparison of arterial spin labeling and dynamic susceptibility contrast perfusion MRI in patients with acute stroke.

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    Yen-Chu Huang

    Full Text Available BACKGROUND: The aim of this study was to evaluate whether arterial spin labeling (ASL perfusion magnetic resonance imaging (MRI can reliably quantify perfusion deficit as compared to dynamic susceptibility contrast (DSC perfusion MRI. METHODS: Thirty-nine patients with acute ischemic stroke in the anterior circulation territory were recruited. All underwent ASL and DSC MRI perfusion scans within 30 hours after stroke onset and 31 patients underwent follow-up MRI scans. ASL cerebral blood flow (CBF and DSC time to maximum (T(max maps were used to calculate the perfusion defects. The ASL CBF lesion volume was compared to the DSC Tmax lesion volume by Pearson's correlation coefficient and likewise the ASL CBF and DSC T(max lesion volumes were compared to the final infarct sizes respectively. A repeated measures analysis of variance and least significant difference post hoc test was used to compare the mean lesion volumes among ASL CBF, DSC T(max >4-6 s and final infarct. RESULTS: Mean patient age was 72.6 years. The average time from stroke onset to MRI was 13.9 hours. The ASL lesion volume showed significant correlation with the DSC lesion volume for T(max >4, 5 and 6 s (r = 0.81, 0.82 and 0.80; p5 s (29.2 ml, p6 s (21.8 ml, p5 or 6 s were close to mean final infarct size. CONCLUSION: Quantitative measurement of ASL perfusion is well correlated with DSC perfusion. However, ASL perfusion may overestimate the perfusion defects and therefore further refinement of the true penumbra threshold and improved ASL technique are necessary before applying ASL in therapeutic trials.

  4. Arterial wall perfusion measured with photon counting spectral x-ray CT

    Science.gov (United States)

    Jorgensen, Steven M.; Korinek, Mark J.; Vercnocke, Andrew J.; Anderson, Jill L.; Halaweish, Ahmed; Leng, Shuai; McCollough, Cynthia H.; Ritman, Erik L.

    2016-10-01

    Early atherosclerosis changes perfusion of the arterial wall due to localized proliferation of the vasa vasorum. When contrast agent passes through the artery, some enters the vasa vasorum and increases radiopacity of the arterial wall. Technical challenges to detecting changes in vasa vasorum density include the thin arterial wall, partial volume averaging at the arterial lumen/wall interface and calcification within the wall. We used a photon-counting spectral CT scanner to study carotid arteries of anesthetized pigs and micro-CT of these arteries to quantify vasa vasorum density. The left carotid artery wall was injected with autologous blood to stimulate vasa vasorum angiogenesis. The scans were performed at 25-120 keV; the tube-current-time product was 550 mAs. A 60 mL bolus of iodine contrast agent was injected into the femoral vein at 5mL/s. Two seconds post injection, an axial scan was acquired at every 3 s over 60 s (i.e., 20 time points). Each time point acquired 28 contiguous transaxial slices with reconstructed voxels 0.16 x 0.16 x 1 mm3. Regions-of-interest in the outer 2/3 of the arterial wall and in the middle 2/3 of the lumen were drawn and their enhancements plotted versus time. Lumenal CT values peaked several seconds after injection and then returned towards baseline. Arterial wall CT values peaked concurrent to the lumen. The peak arterial wall enhancement in the left carotid arterial wall correlated with increased vasa vasorum density observed in micro-CT images of the isolated arteries.

  5. CT perfusion assessment of Moyamoya syndrome before and after direct revascularization (superficial temporal artery to middle cerebral artery bypass)

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Yueqin [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Hospital of Jining Medical College, CT Department, Jining (China); Xu, Wenjian [Hospital of Qingdao University, Department of Radiology, Qingdao (China); Guo, Xiang; Shi, Zhitao; Sun, Zhanguo; Wang, Jiehuan [Hospital of Jining Medical College, CT Department, Jining (China); Gao, Lingyun [Hospital of Jining Medical College, MR Department, Jining (China); Jin, Feng [Hospital of Jining Medical College, Department of Neurosurgery, Jining (China); Chen, Weijian; Yang, Yunjun [Hospital of Wenzhou Medical University, Department of Radiology, Wenzhou (China)

    2016-01-15

    To evaluate the utility of CT perfusion (CTP) for the assessment of superficial temporal artery-middle cerebral artery (STA-MCA) anastomosis in patients with Moyamoya syndrome (MMS). Twenty-four consecutive MMS patients, who underwent unilateral STA-MCA bypass surgery, received CTP before and after surgery. The relative perfusion parameter values of surgical hemispheres before treatment were compared with post-treatment values. All patients underwent CT angiography (CTA) before and after surgery in order to confirm the patency of bypass. The follow-up CTA after surgery clearly demonstrated 20 (20/24, 83.3 %) bypass arteries, whereas four (16.7 %) bypass arteries were occluded or very small. Postoperative rMTT and rTTP values (P < 0.05) of the surgical side were significantly lower than pre-operation. In patients (n = 20) with bypass patency, postoperative rCBF, rMTT and rTTP values (P < 0.05) of the surgical side were significantly improved. However, the differences of all parameters were not significant (P > 0.05) in the patients (n = 4) without bypass patency after revascularization. This study demonstrates that CTP can provide a crucial quantitative assessment of cerebral haemodynamic changes in MMS before and after STA-MCA anastomosis. (orig.)

  6. Validation and absolute quantification of MR perfusion compared with CT perfusion in patients with unilateral cerebral arterial stenosis

    Energy Technology Data Exchange (ETDEWEB)

    Chiu, Fang-Ying, E-mail: fychiou@hotmail.com [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan (China); Kao, Yi-Hsuan, E-mail: yhkao@ym.edu.tw [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan (China); Teng, Michael Mu Huo, E-mail: mhteng@gmail.com [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan (China); School of Medicine, National Yang-Ming University, Taipei City, Taiwan (China); Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (China); Chung, Hsiao-Wen, E-mail: chung@cc.ee.ntu.edu.tw [Department of Electrical Engineering, National Taiwan University, Taipei, Taiwan (China); Chang, Feng-Chi, E-mail: fcchang374@gmail.com [School of Medicine, National Yang-Ming University, Taipei City, Taiwan (China); Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (China); Cho, I-Chieh, E-mail: jessie8030@yahoo.com.tw [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan (China); Chen, Wen-Chun, E-mail: sky7408695@hotmail.com [Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan (China)

    2012-12-15

    Objective: The aim of the study was to assess absolute quantification of dynamic susceptibility contrast-enhanced magnetic resonance perfusion (MRP) comparing with computed tomography perfusion (CTP) in patients with unilateral stenosis. Materials and methods: We retrospectively post-processed MRP in 20 patients with unilateral occlusion or stenosis of >79% at the internal carotid artery or the middle cerebral artery (MCA). Absolute quantification of MRP was performed after applying the following techniques: cerebrospinal fluid removal, vessel removal, and automatic segmentation of brain to calculate the scaling factors to convert relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) values to absolute values. For comparison between MRP and CTP, we manually deposited regions of interest in bilateral MCA territories at the level containing the body of the lateral ventricle. Results: The correlation between MRP and CTP was best for mean transit time (MTT) (r = 0.83), followed by cerebral blood flow (CBF) (r = 0.52) and cerebral blood volume (CBV) (r = 0.43). There was no significant difference between CTP and MRP for CBV, CBF, and MTT on the lesion side, the contralateral side, the lesion-contralateral differences, or the lesion-to-contralateral ratios (P > 0.05). The mean differences between MRP and CTP were as follows: CBV −0.57 mL/100 g, CBF 2.50 mL/100 g/min, and MTT −0.90 s. Conclusion: Absolute quantification of MRP is possible. Using the proposed method, measured values of MRP and CTP had acceptable linear correlation and quantitative agreement.

  7. Initial experience in perfusion MR imaging of intracranial major artery occlusion with echo-planar technique

    Energy Technology Data Exchange (ETDEWEB)

    Tsuchiya, Kazuhiro; Mizutani, Yoshiyuki; Inaoka, Sayuki; Hachiya, Junichi [Kyorin Univ., Mitaka, Tokyo (Japan). School of Medicine

    1997-09-01

    The purpose of this study was to evaluate the usefulness of perfusion MR imaging using a single-shot echo-planar technique in occlusion of intracranial main arteries. Our patient group consisted of 16 patients with internal carotid artery occlusion (n=9), Moyamoya disease (n=4), and middle cerebral artery occlusion (n=3). We performed the echo-planar perfusion studies with a 1.5-T unit using a free-induction-decay-type echo-planar sequence. With a bolus injection of Gd-DTPA, 30 consecutive scans were obtained at 10 sections every 2 seconds. The data were analyzed in three ways: a time-intensity curves in the territory of the involved artery (n=16); semiquantitative flow map of each section representing signal changes due to passage of Gd-DTPA (n=15); and serial images at a selected section (n=7). The time intensity curves were abnormal in 13 patients. The peak of signal drop was delayed in all of them. Flow maps showed focal flow abnormalities in 11 patients, but they were apparently normal in 4 patients probably due to collateral flow. In serial images, delay in appearance and/or disappearance of Gd-DTPA was noted in 6 patients. In patients with occlusion of intracranial main arteries, MR single-shot echo-planar technique is of clinical use because it can provide information about hemodynamic changes in a short examination time, in multiple sections, and with good temporal resolution. (author)

  8. Quantification of renal allograft perfusion using arterial spin labeling MRI: initial results

    Energy Technology Data Exchange (ETDEWEB)

    Lanzman, Rotem S.; Wittsack, Hans-Joerg; Bilk, Philip; Kroepil, Patric; Blondin, Dirk [University Hospital Duesseldorf, Department of Radiology, Duesseldorf (Germany); Martirosian, Petros; Schick, Fritz [University Hospital Tuebingen, Section for Experimental Radiology, Department of Diagnostic Radiology, Tuebingen (Germany); Zgoura, Panagiota; Voiculescu, Adina [University Hospital Duesseldorf, Department of Nephrology, Duesseldorf (Germany)

    2010-06-15

    To quantify renal allograft perfusion in recipients with stable allograft function and acute decrease in allograft function using nonenhanced flow-sensitive alternating inversion recovery (FAIR)-TrueFISP arterial spin labeling (ASL) MR imaging. Following approval of the local ethics committee, 20 renal allograft recipients were included in this study. ASL perfusion measurement and an anatomical T2-weighted single-shot fast spin-echo (HASTE) sequence were performed on a 1.5-T scanner (Magnetom Avanto, Siemens, Erlangen, Germany). T2-weighted MR urography was performed in patients with suspected ureteral obstruction. Patients were assigned to three groups: group a, 6 patients with stable allograft function over the previous 4 months; group b, 7 patients with good allograft function who underwent transplantation during the previous 3 weeks; group c, 7 allograft recipients with an acute deterioration of renal function. Mean cortical perfusion values were 304.8 {+-} 34.4, 296.5 {+-} 44.1, and 181.9 {+-} 53.4 mg/100 ml/min for groups a, b and c, respectively. Reduction in cortical perfusion in group c was statistically significant. Our results indicate that ASL is a promising technique for nonenhanced quantification of cortical perfusion of renal allografts. Further studies are required to determine the clinical value of ASL for monitoring renal allograft recipients. (orig.)

  9. Improving perfusion quantification in arterial spin labeling for delayed arrival times by using optimized acquisition schemes

    Energy Technology Data Exchange (ETDEWEB)

    Kramme, Johanna [Fraunhofer MEVIS-Institute for Medical Image Computing, Bremen (Germany); Univ. Bremen (Germany). Faculty of Physics and Electronics; Gregori, Johannes [mediri GmbH, Heidelberg (Germany); Diehl, Volker [Fraunhofer MEVIS-Institute for Medical Image Computing, Bremen (Germany); ZEMODI (Zentrum fuer morderne Diagnostik), Bremen (Germany); Madai, Vince I.; Sobesky, Jan [Charite-Universitaetsmedizin Berlin (Germany). Center for Stroke Research Berlin (CSB); Charite-Universitaetsmedizin Berlin (Germany). Dept. of Neurology; Samson-Himmelstjerna, Frederico C. von [Fraunhofer MEVIS-Institute for Medical Image Computing, Bremen (Germany); Charite-Universitaetsmedizin Berlin (Germany). Center for Stroke Research Berlin (CSB); Charite-Universitaetsmedizin Berlin (Germany). Dept. of Neurology; Lentschig, Markus [ZEMODI (Zentrum fuer morderne Diagnostik), Bremen (Germany); Guenther, Matthias [Fraunhofer MEVIS-Institute for Medical Image Computing, Bremen (Germany); Univ. Bremen (Germany). Faculty of Physics and Electronics; mediri GmbH, Heidelberg (Germany)

    2015-07-01

    The improvement in Arterial Spin Labeling (ASL) perfusion quantification, especially for delayed bolus arrival times (BAT), with an acquisition redistribution scheme mitigating the T1 decay of the label in multi-TI ASL measurements is investigated. A multi inflow time (TI) 3D-GRASE sequence is presented which adapts the distribution of acquisitions accordingly, by keeping the scan time constant. The MR sequence increases the number of averages at long TIs and decreases their number at short TIs and thus compensating the T1 decay of the label. The improvement of perfusion quantification is evaluated in simulations as well as in-vivo in healthy volunteers and patients with prolonged BATs due to age or steno-occlusive disease. The improvement in perfusion quantification depends on BAT. At healthy BATs the differences are small, but become larger for longer BATs typically found in certain diseases. The relative error of perfusion is improved up to 30% at BATs > 1500 ms in comparison to the standard acquisition scheme. This adapted acquisition scheme improves the perfusion measurement in comparison to standard multi-TI ASL implementations. It provides relevant benefit in clinical conditions that cause prolonged BATs and is therefore of high clinical relevance for neuroimaging of steno-occlusive diseases.

  10. Acute changes in liver tumour perfusion measured non-invasively with arterial spin labelling

    Science.gov (United States)

    Johnson, S Peter; Ramasawmy, Rajiv; Campbell-Washburn, Adrienne E; Wells, Jack A; Robson, Mathew; Rajkumar, Vineeth; Lythgoe, Mark F; Pedley, R Barbara; Walker-Samuel, Simon

    2016-01-01

    Background: Non-invasive measures of tumour vascular perfusion are desirable, in order to assess response to vascular targeting (or modifying) therapies. In this study, hepatic arterial spin labelling (ASL) magnetic resonance imaging (MRI) was investigated to measure acute changes in perfusion of colorectal cancer in the liver, in response to vascular disruption therapy with OXi4503. Methods: SW1222 and LS174T tumours were established in the liver of MF1 nu/nu mice via intrasplenic injection. Perfusion and R2* MRI measurements were acquired with an Agilent 9.4T horizontal bore scanner, before and at 90 min after 40 mg kg−1 OXi4503. Results: A significant decrease in SW1222 tumour perfusion was observed (−43±33%, Pchange in tumour perfusion and the proximity to large vessels, with pre-treatment blood flow predictive of subsequent response. Histological evaluation confirmed the onset of necrosis and evidence of heterogeneous response between tumour deposits. Conclusions: Hepatic ASL-MRI can detect acute response to targeted tumour vascular disruption entirely non-invasively. Hepatic ASL of liver tumours has potential for use in a clinical setting. PMID:27031853

  11. Non-ischemic perfusion defects due to delayed arrival of contrast material on stress perfusion cardiac magnetic resonance imaging after coronary artery bypass graft surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yeo Koon; Park, Eun Ah; Park, Sang Joon; Cheon, Gi Jeong; Lee, Whal; Chung, Jin Wook; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of)

    2014-04-15

    Herein we report about the adenosine stress perfusion MR imaging findings of a 50-year-old man who exhibited two different perfusion defects resulting from two different mechanisms after a coronary artery bypass surgery. An invasive coronary angiography confirmed that one perfusion defect at the mid-anterior wall resulted from an ischemia due to graft stenosis. However, no stenosis was detected on the graft responsible for the mid-inferior wall showing the other perfusion defect. It was assumed that the perfusion defect at the mid-inferior wall resulted from delayed perfusion owing to the long pathway of the bypass graft. The semiquantitative analysis of corrected signal-time curves supported our speculation, demonstrating that the rest-to-stress ratio index of the maximal slope of the myocardial territory in question was similar to those of normal myocardium, whereas that of myocardium with the stenotic graft showed a typical ischemic pattern. A delayed perfusion during long graft pathway in a post-bypass graft patient can mimick a true perfusion defect on myocardial stress MR imaging. Radiologists should be aware of this knowledge to avoid misinterpretation of graft and myocardial status in post bypass surgery patients.

  12. Real-time ultrasound perfusion imaging in acute stroke: assessment of cerebral perfusion deficits related to arterial recanalization.

    Science.gov (United States)

    Bolognese, Manuel; Artemis, Dimitrios; Alonso, Angelika; Hennerici, Michael G; Meairs, Stephan; Kern, Rolf

    2013-05-01

    We investigated whether real-time ultrasound perfusion imaging (rt-UPI) is able to detect perfusion changes related to arterial recanalization in the acute phase of middle cerebral artery (MCA) stroke. Twenty-four patients with acute territorial MCA stroke were examined with rt-UPI and transcranial color-coded duplex ultrasound (TCCD). Ultrasound studies were consecutively performed within 24 h and 72-96 h after stroke onset. Real-time UPI parameters of bolus kinetics (time to peak, rt-TTP) and of refill kinetics (plateau A and slope β of the exponential replenishment curve) were calculated from regions of interest of ischemic versus normal brain tissue; these parameters were compared between early and follow-up examinations in patients who recanalized. At the early examination, there was a delay of rt-TTP in patients with MCA occlusion (rt-TTP [s]: 13.09 ± 3.21 vs. 10.16 ± 2.6; p = 0.01) and a lower value of the refill parameter β (β [1/s]: 0.62 ± 0.34 vs. 1.09 ± 0.58; p = 0.01) in ischemic compared with normal brain tissue, whereas there were no differences of the parameters A and Axβ. At follow-up, the delay of rt-TTP was reversible once recanalization of an underlying MCA obstruction was demonstrated: rt-TTP [s], 13.09 ± 3.21 at 24 h versus 10.95 ± 1.5 at 72-96 h (p = 0.03). Correspondingly, β showed a higher slope than at the first examination: β [1/s]: 0.55 ± 0.29 at 24 h versus 0.71 ± 0.27 at 72-96 h (p = 0.04). We conclude that real-time UPI can detect hemodynamic impairment in acute MCA occlusion and subsequent improvement following arterial recanalization. This offers the chance for bedside monitoring of the hemodynamic compromise (e.g. during therapeutic interventions such as systemic thrombolysis).

  13. Diabetes patients show different time-course of myocardial perfusion improvement after coronary artery bypass grafting

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J. J.; Seok, J. W.; Eo, J. S. [Seoul National University Hospital, Seoul (Korea, Republic of)] (and others)

    2005-07-01

    Diabetes mellitus is an independent risk factor of cardiovascular disease. Diabetes is known to cause microangiopathy. The microangiopathy is hardly detectable on the coronary angiography. Myocardial perfusion imaging shows the resultant perfusion status which reflects the microangiopathy. For patients who underwent revascularization, the microangiopathy could affect the myocardial perfusion improvement. Diabetes patients probably experience the different myocardial perfusion improvement as compared to the non-diabetes patients although they have similar angiographic findings. The aim of this study is to find out whether there is a time-course difference of perfusion improvement between the diabetes and non diabetes patients who showed patent angiographic findings after coronary artery grafting surgery (CABG). A total of 129 patients who underwent coronary artery bypass grafting surgery were enrolled in this study. Myocardial SPECTs performed at previous, short-term (3 month), and mid-term (1 year) to CABG. One-year follow up angiography was done 411{+-}121 days after surgery. Graft patency was determined according to the FitzGibbon et al. Segments were assigned to vascular territories using a 20 segment model. The segments of excellent patency were included in this study. Time course differences of concerned segments were analyzed using RMANOVA. The number of segments enrolled was 764 of diabetes and 1083 of non-diabetes. At short-term follow up, reversibility score was 2.8{+-}8.1% in diabetes and 0.3{+-}7.5% in non-diabetes. At long-term follow up, reversibility score was 1.8{+-}8.0% in diabetes and 0.1{+-}7.3% in non-diabetes. The time-course of reversibility score was significantly different between the diabetes and non diabetes (p<0.001) Diabetic segments showed high residual reversibility score than non-diabetic segments after CABG although the angiographic finding was patent in both groups. This result is maybe attributable to microangiopathy induced by

  14. Studies of Selective Arterial Perfusion plus Chemoembolization on Hepatic Metastasis from Rectal Cancer

    Institute of Scientific and Technical Information of China (English)

    Shiliang Tu; Jianhua Yuan; Gaoli Deng; Tingyang Hu; Quanjin Dong

    2007-01-01

    OBJECTIVE To develop an effectual method for treating hepatic metastasis from rectal cancer.METHODS A randomized control study of celiac artery perfusion plus transcatheter hepatic arterial chemoembolization (TACE) (observation group) and intravenous chemotherapy (control group) for 99 cases with hepatic metastasis from rectal cancer was performed. The perfusion was repeated once at 4 weeks after the first treatment of 52 cases in the observation group, and it was subsequently repeated at an interval of 2 or 3 months. Using intravenous administration, the perfusion was repeated once every 3 weeks with 47 cases in the control group.RESULTS Three months after treatment, the patients in the observation group who showed a relief or elimination of a former superior abdominal pain amounted to 70.6%, and those with a diminution of their intrahepatic mass reached 55.8%. In the control group, the patients with a relief or disappearance of hepatalgia reached 20%, and those with a diminution of their intrahepatic mass reached 10.6%. The 1, 2 and 3-year survival rates were 80.8%, 46.2% and 25.0% in the cases of the observation group and 61.7%, 19.1% and 4.3% in the control group, respectively.CONCLUSION For the patients who failed to receive a surgical operation on their hepatic metastasis from rectal cancer, celiac artery perfusion plus TACE is a more effective regimen for improvement of the clinical symptoms and extension of the survival time, compared to intravenous chemotherapy, and is a better choice for palliative therapy.

  15. Passive graft perfusion in off-pump coronary artery bypass grafting

    Institute of Scientific and Technical Information of China (English)

    LU Feng; JI Bing-yang; LIU Jin-ping; LIU Ming-zheng; WANG Gu-yan; HU Sheng-shou

    2007-01-01

    Background Myocardial protection during off-pump coronary artery bypass grafting (OPCABG) is a multifactorial problem in which maintaining stable systemic hemodynamics is very important. In this study passive graft perfusion (PGP) was applied to investigate the effect during and after OPCABG as evaluated by cardiac troponin I (CTnl) and hemodynamic indexes.Methods Thirty first-time patients underwent OPCABG under one surgeon. They were randomly divided into two groups: The passive graft perfusion group (PGP, n=15) received distal coronary perfusion during the anastomosis and immediate graft perfusion after the distal anastomosis. The control group, no graft perfusion group, (NGP, n=15)received no graft perfusion after the distal anastomosis. The results of the two protocols were evaluated by concentration of CTnl and hemodynamic indexes before induction and after operation.Results There were no statistically significant differences between these two groups in their perioperation parameters.The level of CTnl increased postoperatively, reached its peak at 6 hours (P<0.05) and recovered by the 6 days postoperative. Compared with the control group the concentration of CTnl in the PGP group was significantly lower at 6 and 24 hours (P<0.01). Compared with the NGP group, cardiac index (Cl) in the PGP group was higher at 12 and 24 hours after operation (P<0.05). The period of mechanical ventilation was significantly shorter in the PGP group than in the NGP group (P<0.05).Conclusion PGP can increase the flow to the myocardium and shorten the heart ischemia time, thus maintain stable systemic hemodynamics, supply a satisfactory Cl after surgery and improve surgery outcome.

  16. Nitric oxide permits hypoxia-induced lymphatic perfusion by controlling arterial-lymphatic conduits in zebrafish and glass catfish

    DEFF Research Database (Denmark)

    Dahl Ejby Jensen, Lasse; Cao, Renhai; Hedlund, Eva-Maria;

    2009-01-01

    and lymphatic perfusion. Here we show in the adult zebrafish and glass catfish (Kryptopterus bicirrhis) that blood-lymphatic conduits directly connect arterial vessels to the lymphatic system. Under hypoxic conditions, arterial-lymphatic conduits (ALCs) became highly dilated and linearized by NO...

  17. Assessment of Myocardial Perfusion and Systolic Function in Patients with Coronary Artery Disease after Coronary Artery Bypass Surgery by Myocardial Contrast Echocardiography and Two-dimensional Strain Echocardiography

    Institute of Scientific and Technical Information of China (English)

    Rong LIU; Youbin DENG; Xiaojun BI; Yani LIU; Li XIONG; Liuping CHEN

    2009-01-01

    The clinically applied value of myocardial perfusion and systolic function in patients with coronary artery disease after coronary artery bypass surgery using real-time myocardial contrast echo-cardiography (RT-MCE) combined with two-dimensional strain echocardiography was assessed.Twenty patients underwent intravenous RT-MCE by intravenous injections of Sono Vue before and after coronary artery bypass surgery. Two-dimensional images were recorded from the left ventricular four-chamber view, two-chamber view and the apical view before, and two weeks and three months af-ter coronary artery bypass surgery, and the peak systolic longitudinal strain was measured. The results showed that myocardial perfusion was significantly increased after coronary artery bypass surgery in about 71.6% segments. In the group that myocardial perfusion was improved, the peak systolic longitu-dinal strain three months after bypass surgery was significantly higher than that before operation [(-15.78±5.91)% vs (-10.45±8.31)%, P0.05]. It was con-cluded that whether or not the improvement of myocardial perfusion can mirror the recovery trend of regional systolic function, two-dimensional strain echocardiography can observe dynamic change of re-gional systolic function. The combination of myocardial perfusion with two-dimensional strain echocar-diography can more accurately assess the curative effectiveness of coronary artery bypass surgery.

  18. Intraoperative perfusion contrast echocardiography. Initial experience during coronary artery bypass grafting.

    Science.gov (United States)

    Kabas, J S; Kisslo, J; Flick, C L; Johnson, S H; Craig, D M; Stanley, T E; Smith, P K

    1990-03-01

    Intraoperative evaluation of the effectiveness of myocardial revascularization has been limited by an inability to assess regional myocardial perfusion. Microbubbles of sonicated diatrizoate sodium and diatrizoate meglumine (Renografin) have been an effective echocardiographic contrast agent and have been employed clinically during cardiac catheterization. This recent development in contrast-enhanced two-dimensional echocardiography permits real-time imaging of transmural myocardial blood flow but has not been evaluated in the operating room. This study represents the initial surgical application of this directed technique and was designed to evaluate the safety and efficacy of intraoperative perfusion contrast echocardiography in assessing the results of coronary artery bypass grafting. Twenty men with significant coronary artery disease ranging in age from 49 to 73 years were studied. Direct contrast agent injection into completed saphenous vein bypass grafts caused the myocardium supplied by each graft to be well delineated and provided a tomographic view of contrast distribution. The enhanced region was well correlated with the size and distribution of the native vessel. Rapid contrast washout (less than 20 seconds) indicated satisfactory regional perfusion. Contrast echocardiography prolonged the operation less than 10 minutes and did not result in any perioperative complications.

  19. Arterial spin-labelling perfusion MRI and outcome in neonates with hypoxic-ischemic encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Vis, Jill B. de; Hendrikse, Jeroen [University Medical Center Utrecht, Department of Radiology, HP E 01.132, P.O. Box 85500, Utrecht (Netherlands); Petersen, Esben T. [University Medical Center Utrecht, Department of Radiology, HP E 01.132, P.O. Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiotherapy, Utrecht (Netherlands); Vries, Linda S. de; Bel, Frank van; Alderliesten, Thomas; Negro, Simona; Groenendaal, Floris; Benders, Manon J.N.L. [Wilhelmina Children' s Hospital/University Medical Center Utrecht, Department of Neonatology, Utrecht (Netherlands)

    2015-01-15

    Hyperperfusion may be related to outcome in neonates with hypoxic-ischemic encephalopathy (HIE). The purpose of this study was to evaluate whether arterial spin labelling (ASL) perfusion is associated with outcome in neonates with HIE and to compare the predictive value of ASL MRI to known MRI predictive markers. Twenty-eight neonates diagnosed with HIE and assessed with MR imaging (conventional MRI, diffusion-weighted MRI, MR spectroscopy [MRS], and ASL MRI) were included. Perfusion in the basal ganglia and thalami was measured. Outcome at 9 or 18 months of age was scored as either adverse (death or cerebral palsy) or favourable. The median (range) perfusion in the basal ganglia and thalami (BGT) was 63 (28-108) ml/100 g/min in the neonates with adverse outcome and 28 (12-51) ml/100 g/min in the infants with favourable outcome (p < 0.01). The area-under-the-curve was 0.92 for ASL MRI, 0.97 for MRI score, 0.96 for Lac/NAA and 0.92 for ADC in the BGT. The combination of Lac/NAA and ASL MRI results was the best predictor of outcome (r {sup 2} = 0.86, p < 0.001). Higher ASL perfusion values in neonates with HIE are associated with a worse neurodevelopmental outcome. A combination of the MRS and ASL MRI information is the best predictor of outcome. (orig.)

  20. A multimodal imaging study on spatial pattern of cerebral perfusion change caused by symptomatic unilateral carotid artery stenosis

    Directory of Open Access Journals (Sweden)

    Jian-rui LI

    2015-03-01

    Full Text Available Objective To investigate the spatial pattern of cerebral perfusion decrease resulting from symptomatic unilateral carotid artery stenosis and to assess the relationship between degrees of stenosis and cerebral blood flow (CBF.  Methods CT angiography (CTA and arterial spin labeling (ASL MRI cerebral perfusion were performed in 22 patients with symptomatic unilateral carotid artery stenosis. Diagnosis of carotid artery stenosis and measurement of stenosis degrees was performed by using CTA; cerebral perfusion was determined by ASL. Voxel-based analysis (VBA were applied to observe perfusion changes in patients with mild stenosis and moderate to severe stenosis, and spatial pattern of cerebral perfusion changes caused by carotid artery stenosis. Analysis based on region of interest (ROI was used to explore the relationship between degrees of stenosis and CBF. Results Twenty-two patients with symptomatic unilateral carotid artery stenosis (13 in the left side and 9 in the right included 13 cases with mild stenosis and 9 cases with moderate to severe stenosis. Compared to those with mild stenosis, patients with moderate to severe stenosis showed reduced CBF in bilateral (especially in the affected side parietal lobes (t = - 2.382, P = 0.014, frontal lobes (t = - 2.354, P = 0.015 and centrum semiovale (t = - 2.283, P = 0.017, and was basically located in bilateral cerebral watershed area. Furthermore, perfusion in these areas was negatively correlated with the degree of stenosis (r = - 0.479, P = 0.024.  Conclusions Symptomatic unilateral carotid artery stenosis may result in cerebral perfusion decreases in bilateral (particularly in the affected side watershed area and cerebral blood flow is negatively correlated with the degree of stenosis. DOI: 10.3969/j.issn.1672-6731.2015.02.006

  1. Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

    Science.gov (United States)

    Bauer, Stefan; Savundra, James

    2013-01-01

    We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained without the ulnar and radial artery. Arterial manipulation and tube insertion outside a specialist centre bears the risk of increased morbidity and potential microembolism and must therefore not be attempted.

  2. In vivo visualization of the PICA perfusion territory with super-selective pseudo-continuous arterial spin labeling MRI.

    Science.gov (United States)

    Hartkamp, Nolan S; De Cocker, Laurens J; Helle, Michael; van Osch, Matthias J P; Kappelle, L Jaap; Bokkers, Reinoud P H; Hendrikse, Jeroen

    2013-12-01

    In this work a method is described to discern the perfusion territories in the cerebellum that are exclusively supplied by either or both vertebral arteries. In normal vascular anatomy the posterior inferior cerebellar artery (PICA) is supplied exclusively by its ipsilateral vertebral artery. The perfusion territories of the vertebral arteries were determined in 14 healthy subjects by means of a super-selective pseudo-continuous ASL sequence on a 3T MRI scanner. Data is presented to show the feasibility of determining the PICA perfusion territory. In 10 subjects it was possible to accurately determine both PICA perfusion territories. In two subjects it was possible to determine the perfusion territory of one PICA. Examples in which it was not possible to accurately determine the PICA territory are also given. Additionally, the high variability of the extent of the PICA territory is illustrated using a statistical map. The posterior surface of the cerebellum is entirely supplied by the PICA in six subjects. The most posterior part of the superior surface is supplied by the PICA in eight subjects, and the inferior half of the anterior surface in six subjects. The inferior part of the vermis is supplied by the PICA in all subjects. Two subjects were found with interhemispheric blood flow to both tonsils from one PICA without contribution from the contralateral PICA. With the method as presented, clinicians may in the future accurately classify cerebellar infarcts according to affected perfusion territories, which might be helpful in the decision whether a stenosis should be considered symptomatic.

  3. Twin Reversed Arterial Perfusion (TRAP Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings

    Directory of Open Access Journals (Sweden)

    Buyukkaya

    2015-07-01

    Full Text Available Twin reversed arterial perfusion (TRAP sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

  4. Twin Reversed Arterial Perfusion (TRAP) Sequence; Characteristic Gray-Scale and Doppler Ultrasonography Findings.

    Science.gov (United States)

    Buyukkaya, Ayla; Tekbas, Guven; Buyukkaya, Ramazan

    2015-07-01

    Twin reversed arterial perfusion (TRAP) sequence is a syndrome with poor prognosis, seen only in monochorionic monozygotic twin pregnancies. The incidence is one in 35.000 births and one in 100 monozygotic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus. Mortality is usually due to heart failure or premature labor caused by polyhydramnios of pump fetus. Herein, we report a case of TRAP sequence that emphasizes the importance of gray-scale and color Doppler imaging in the diagnosis and management of TRAP sequence.

  5. Identification of residual ischemia in the occluded coronary artery irrigation area using myocardial perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Baškot Branislav

    2007-01-01

    Full Text Available Background. Inspite the indisputable significance of coronarography, the implications of a revealed stenosis - and how close it is to occlusion could vary in regard to its physiological importance. Myocardial perfusion scintigraphy (MPS possibility to prove and objectivise the presence of ischemia and myocardial viability within an occlusion found coronarographically is especially significant since it makes possible to the clinician to choose an adequate therapy. Case report. We reported a 43- year-old male patient who had been hospitalized to another institution due to acute myocardial infarction (AMI of posterolateral localisation. Following the acute AMI stage the ergometric test per Bruce protocole was performed, negative to ischemic heart disease, while multislice computed tomography showed no significant changes on the coronary arteries. The performed one-day-protocole MPS showed a massive area of residual ischemia within myocardial infarction (MI type culprit lesion of the posterolateral zone starting from the subapical level to the basal cross-section. According to the MPS findings coronarography was indicated due to a revascularisation assessment. The performed coronarography revealed an occlusion of the circumflex coronary artery (CCA right after the division of obtuse branch (OB that presented discretely in the distal parts from the homo- and heterocolaterals. The distal portion of CCA presented discretely out off the right coronary artery (RCA. Echocardiography confirmed an ejection fraction of 50% with hypokinesia of inferior and posterior walls, as well as the septum, showing a mild reduction of the general contractility. Flows through confluences were well. A month after MI a percutane coronary intervention (PCI was performed with the implantation of a drug-releasing stent (Taxus. Early after PCI (within two weeks a control MPS was done to evaluate the effects of the therapy giving the normal findings of myocardial perfusion

  6. Reduction in cerebral perfusion after heroin administration: a resting state arterial spin labeling study.

    Directory of Open Access Journals (Sweden)

    Niklaus Denier

    Full Text Available Heroin dependence is a chronic relapsing brain disorder, characterized by the compulsion to seek and use heroin. Heroin itself has a strong potential to produce subjective experiences characterized by intense euphoria, relaxation and release from craving. The neurofunctional foundations of these perceived effects are not well known. In this study, we have used pharmacological magnetic resonance imaging (phMRI in 15 heroin-dependent patients from a stable heroin-assisted treatment program to observe the steady state effects of heroin (60 min after administration. Patients were scanned in a cross-over and placebo controlled design. They received an injection of their regular dose of heroin or saline (placebo before or after the scan. As phMRI method, we used a pulsed arterial spin labeling (ASL sequence based on a flow-sensitive alternating inversion recovery (FAIR spin labeling scheme combined with a single-shot 3D GRASE (gradient-spin echo readout on a 3 Tesla scanner. Analysis was performed with Statistical Parametric Mapping (SPM 8, using a general linear model for whole brain comparison between the heroin and placebo conditions. We found that compared to placebo, heroin was associated with reduced perfusion in the left anterior cingulate cortex (ACC, the left medial prefrontal cortex (mPFC and in the insula (both hemispheres. Analysis of extracted perfusion values indicate strong effect sizes and no gender related differences. Reduced perfusion in these brain areas may indicate self- and emotional regulation effects of heroin in maintenance treatment.

  7. Arterial Input Function Placement for Accurate CT Perfusion Map Construction in Acute Stroke

    Science.gov (United States)

    Ferreira, Rafael M.; Lev, Michael H.; Goldmakher, Gregory V.; Kamalian, Shahmir; Schaefer, Pamela W.; Furie, Karen L.; Gonzalez, R. Gilberto; Sanelli, Pina C.

    2013-01-01

    OBJECTIVE The objective of our study was to evaluate the effect of varying arterial input function (AIF) placement on the qualitative and quantitative CT perfusion parameters. MATERIALS AND METHODS Retrospective analysis of CT perfusion data was performed on 14 acute stroke patients with a proximal middle cerebral artery (MCA) clot. Cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) maps were constructed using a systematic method by varying only the AIF placement in four positions relative to the MCA clot including proximal and distal to the clot in the ipsilateral and contralateral hemispheres. Two postprocessing software programs were used to evaluate the effect of AIF placement on perfusion parameters using a delay-insensitive deconvolution method compared with a standard deconvolution method. RESULTS One hundred sixty-eight CT perfusion maps were constructed for each software package. Both software programs generated a mean CBF at the infarct core of < 12 mL/100 g/min and a mean CBV of < 2 mL/100 g for AIF placement proximal to the clot in the ipsilateral hemisphere and proximal and distal to the clot in the contralateral hemisphere. For AIF placement distal to the clot in the ipsilateral hemisphere, the mean CBF significantly increased to 17.3 mL/100 g/min with delay-insensitive software and to 19.4 mL/100 g/min with standard software (p < 0.05). The mean MTT was significantly decreased for this AIF position. Furthermore, this AIF position yielded qualitatively different parametric maps, being most pronounced with MTT and CBF. Overall, CBV was least affected by AIF location. CONCLUSION For postprocessing of accurate quantitative CT perfusion maps, laterality of the AIF location is less important than avoiding AIF placement distal to the clot as detected on CT angiography. This pitfall is less severe with deconvolution-based software programs using a delay-insensitive technique than with those using a standard deconvolution

  8. From monster to twin reversed arterial perfusion: a history of acardiac twins.

    Science.gov (United States)

    Obladen, Michael

    2010-05-01

    A human being born without heart and head, i.e., the acardius/acranius malformation, has been described since antiquity. Superstition and fear made it a mystical disorder, a sign of God's wrath. The inquisition ruled that acranic infants should not be baptized and located the soul in the brain. Acardia was not associated with twin gestation until the reports of Mery in 1720 and Winslow in 1740. In 1850, Meckel identified the pathogenetic mechanism as reversed perfusion due to large arterio-arterial and veno-venous anastomoses; he believed the heart would fail to develop or arrest during development, and the acardiac fetus would be maintained by arterial perfusion from the pump twin. In 1859, Claudius articulated that after normal initial development, the heart degenerates when reversed flow in the aorta leads to thrombosis. Today, it is assumed that both mechanisms may exist. With the advent of prenatal ultrasound diagnosis and radiofrequency ablation of the acardiac twin's circulation, it became possible to save the pump twin.

  9. 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...

  10. Whole-brain perfusion imaging with balanced steady-state free precession arterial spin labeling.

    Science.gov (United States)

    Han, Paul Kyu; Ye, Jong Chul; Kim, Eung Yeop; Choi, Seung Hong; Park, Sung-Hong

    2016-03-01

    Recently, balanced steady-state free precession (bSSFP) readout has been proposed for arterial spin labeling (ASL) perfusion imaging to reduce susceptibility artifacts at a relatively high spatial resolution and signal-to-noise ratio (SNR). However, the main limitation of bSSFP-ASL is the low spatial coverage. In this work, methods to increase the spatial coverage of bSSFP-ASL are proposed for distortion-free, high-resolution, whole-brain perfusion imaging. Three strategies of (i) segmentation, (ii) compressed sensing (CS) and (iii) a hybrid approach combining the two methods were tested to increase the spatial coverage of pseudo-continuous ASL (pCASL) with three-dimensional bSSFP readout. The spatial coverage was increased by factors of two, four and six using each of the three approaches, whilst maintaining the same total scan time (5.3 min). The number of segments and/or CS acceleration rate (R) correspondingly increased to maintain the same bSSFP readout time (1.2 s). The segmentation approach allowed whole-brain perfusion imaging for pCASL-bSSFP with no penalty in SNR and/or total scan time. The CS approach increased the spatial coverage of pCASL-bSSFP whilst maintaining the temporal resolution, with minimal impact on the image quality. The hybrid approach provided compromised effects between the two methods. Balanced SSFP-based ASL allows the acquisition of perfusion images with wide spatial coverage, high spatial resolution and SNR, and reduced susceptibility artifacts, and thus may become a good choice for clinical and neurological studies. Copyright © 2015 John Wiley & Sons, Ltd.

  11. Dopaminergic Therapy Modulates Cortical Perfusion in Parkinson Disease With and Without Dementia According to Arterial Spin Labeled Perfusion Magnetic Resonance Imaging.

    Science.gov (United States)

    Lin, Wei-Che; Chen, Pei-Chin; Huang, Yung-Cheng; Tsai, Nai-Wen; Chen, Hsiu-Ling; Wang, Hung-Chen; Lin, Tsu-Kung; Chou, Kun-Hsien; Chen, Meng-Hsiang; Chen, Yi-Wen; Lu, Cheng-Hsien

    2016-02-01

    Arterial spin labeling (ASL) magnetic resonance imaging analyses allow for the quantification of altered cerebral blood flow, and provide a novel means of examining the impact of dopaminergic treatments. The authors examined the cerebral perfusion differences among 17 Parkinson disease (PD) patients, 17 PD with dementia (PDD) patients, and 17 healthy controls and used ASL-MRI to assess the effects of dopaminergic therapies on perfusion in the patients. The authors demonstrated progressive widespread cortical hypoperfusion in PD and PDD and robust effects for the dopaminergic therapies. Specifically, dopaminergic medications further decreased frontal lobe and cerebellum perfusion in the PD and PDD groups, respectively. These patterns of hypoperfusion could be related to cognitive dysfunctions and disease severity. Furthermore, desensitization to dopaminergic therapies in terms of cortical perfusion was found as the disease progressed, supporting the concept that long-term therapies are associated with the therapeutic window narrowing. The highly sensitive pharmaceutical response of ASL allows clinicians and researchers to easily and effectively quantify the absolute perfusion status, which might prove helpful for therapeutic planning.

  12. Temporary arterial stenting in a full-house spaghetti wrist injury in a remote rural setting: benefit for hand perfusion or risk of increased morbidity?

    OpenAIRE

    Bauer, Stefan; Savundra, James

    2013-01-01

    We report a case of temporary arterial plastic tube stenting of the ulnar and radial artery in a complete spaghetti wrist injury in a remote rural setting. Exploration in a specialist centre 18 h postinjury revealed that the tubes were clotted off with adjacent thrombi but hand perfusion was maintained. Intimal damage required vein grafting of both arteries 24 h postinjury. Hand perfusion was not compromised at follow-up. This case highlights that arterial hand perfusion can be maintained wit...

  13. Assessment of Hyperperfusion by Brain Perfusion SPECT in Transient Neurological Deterioration after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Won; Kim, Yu Kyeong; Lee, Sang Mi; Eo, Jae Sun; Oh, Chang Wan; Lee, Won Woo; Paeng, Jin Chul; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-08-15

    Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery.middle cerebral artery (STA-MCA) anastomosis surgery. A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: 50{+-}16 yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of

  14. Imaging findings and cerebral perfusion in arterial ischemic stroke due to transient cerebral arteriopathy in children; Achados de imagem e perfusao arterial cerebral em acidente vascular cerebral isquemico devido a arteriopatia transitoria em crianca

    Energy Technology Data Exchange (ETDEWEB)

    Barbosa Junior, Alcino Alves, E-mail: alcinojr@uol.com.br [Departamento de Diagnostico por Imagem, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Ellovitch, Saada Resende de Souza [Neuropediatria, Hospital Israelita Albert Einstein - HIAE, Sao Paulo, SP (Brazil); Pincerato, Rita de Cassia Maciel [Hospital Samaritano, Sao Paulo, SP (Brazil)

    2012-04-15

    We report the case of a 4-year-old female child who developed an arterial ischemic stroke in the left middle cerebral artery territory, due to a proximal stenosis of the supraclinoid internal carotid artery, most probably related to transient cerebral arteriopathy of childhood. Computed tomography scan, magnetic resonance imaging, perfusion magnetic resonance and magnetic resonance angiography are presented, as well as follow-up by magnetic resonance and magnetic resonance angiography exams. Changes in cerebral perfusion and diffusion-perfusion mismatch call attention. As far as we know, this is the first report of magnetic resonance perfusion findings in transient cerebral arteriopathy. (author)

  15. Angiography-based prediction of outcome after coronary artery bypass surgery versus changes in myocardial perfusion scintigraphy

    DEFF Research Database (Denmark)

    Eckardt, Rozy; Kjeldsen, Bo Juel; Haghfelt, Torben;

    2011-01-01

    The present study compared the clinical prediction of the effect of coronary artery bypass grafting (CABG) on coronary blood flow and left ventricular ejection fraction (LVEF) with changes in gated myocardial perfusion scintigraphy. A prospective group of 92 patients underwent myocardial perfusion...... predicted and observed regional changes in coronary blood flow and perfusion defects were poor. LVEF increased (by over five ejection fraction units) in almost half of the patients, but with no correlation between the predicted and the observed changes. Based on clinical and angiographic findings...... scintigraphy before and 6 months after CABG, the results being kept secret from the surgeon. Based on clinical and angiographic findings, the surgeons filled in a questionnaire indicating the predicted changes in coronary blood flow in each of the three coronary artery territories and in the LVEF. Symptomatic...

  16. Septal myocardial perfusion imaging with thallium-201 in the diagnosis of proximal left anterior descending coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Pichard, A.D.; Wiener, I.; Martinez, E.; Horowitz, S.; Patterson, R.; Meller, J.; Goldsmith, S.J.; Gorlin, R.; Herman, M.V.

    1981-07-01

    The use of myocardial perfusion imaging (MPI) to identify obstructive coronary disease of the left anterior descending coronary artery proximal to the first septal perforator (prox LAD) was studied in 60 patients. Perfusion of the septum and anteroapical areas with thallium-201 injected during exercise was compared to results of coronary arteriography. Septal MPI defect was found in 92.3% of patients with obstruction of the proximal LAD, 27.7% of patients with obstruction of LAD distal to first septal perforator, 0% in patients with obstructions involving right or circumflex arteries, and in 10.5% of patients without coronary disease. Anteroapical MPI defects were found with similar frequency in the three groups with obstructive coronary disease. Septal MPI defect had a sensitivity of 92.3% and specificity of 85.4% in the diagnosis of proximal LAD disease. Normal septal perfusion with thallium-201 virtually excluded proximal LAD disease.

  17. Absolute Versus Relative Myocardial Blood Flow by Dynamic CT Myocardial Perfusion Imaging in Patients With Anatomic Coronary Artery Disease

    NARCIS (Netherlands)

    Wichmann, Julian L.; Meinel, Felix G.; Schoepf, U. Joseph; Lo, Gladys G.; Choe, Yeon Hyeon; Wang, Yining; Vliegenthart, Rozemarijn; Varga-Szemes, Akos; Muscogiuri, Giuseppe; Cannao, Paola M.; De Cecco, Carlo N.

    2015-01-01

    OBJECTIVE. The purpose of this study was to evaluate differences in the diagnostic accuracy of absolute and relative territorial myocardial blood flow (MBF) derived from stress dynamic CT myocardial perfusion imaging (MPI) for the detection of significant coronary artery stenosis. MATERIALS AND METH

  18. Selective pulmonary artery perfusion for the treatment of primary lung cancer : Improved drug exposure of the lung

    NARCIS (Netherlands)

    van Putte, Bart P.; Grootenboers, Marco; van Boven, Wim-Jan; van Oosterhout, M.; Pasterkamp, Gerard; Folkerts, Gert; Schramel, Franz

    2009-01-01

    Introduction: Selective pulmonary artery perfusion (SPAP) is an experimental drug infusion method for the treatment of lung cancer that aims to achieve more effective T(umour) and lymph N(ode) down-staging. The aim of this experiment was to compare drug uptake of gemcitabine and carboplatin during S

  19. Skeletal muscle perfusion and stem cell delivery in muscle disorders using intra-femoral artery canulation in mice.

    Science.gov (United States)

    Matthias, Nadine; Hunt, Samuel D; Wu, Jianbo; Darabi, Radbod

    2015-11-15

    Muscular dystrophies are among major inherited muscle disorders characterized by progressive muscle damage and fibrosis with no definitive cure. Recently, gene or cell based therapies have been developed to restore the missing gene expression or replace the damaged tissues. In order to test the efficiency of these therapies in mice models of muscular dystrophies, the arterial route of delivery is very advantageous as it provides uniform muscle exposure to the therapeutic agents or cells. Although there are few reports of arterial delivery of the therapeutic agents or cells in mice, there is no in-depth description and evaluation of its efficacy in perfusion of downstream muscles. This study is aimed to develop a practical method for intra-femoral artery perfusion in mice and to evaluate perfusion efficiency using near-infrared-fluorescence (NIRF) imaging as well as histology following stem cell delivery. Our results provide a practical guide to perform this delicate method in mice. By using a sensitive fluorescent dye, different muscle groups of the hindlimb have been evaluated for proper perfusion. As the final step, we have validated the efficiency of arterial cell delivery into muscles using human iPS-derived myogenic cells in an immunodeficient mouse model for Duchenne muscular dystrophy (NSG-mdx(4cv)).

  20. High coronary artery calcium score affects clinical outcome despite normal stress myocardial perfusion imaging and normal left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Madsen, Claus Juul; Andersen, Kim F; Zerahn, Bo

    2013-01-01

    Normal myocardial perfusion imaging (MPI) indicates a low risk for cardiac death and new ischaemic events. However, the impact of normal MPI combined with a high coronary artery calcium score (CACS) is not clear. The aims of this study were to evaluate the risk of severely elevated CACS...

  1. Corrections of arterial input function for dynamic H215O PET to assess perfusion of pelvic tumours: arterial blood sampling versus image extraction

    Science.gov (United States)

    Lüdemann, L.; Sreenivasa, G.; Michel, R.; Rosner, C.; Plotkin, M.; Felix, R.; Wust, P.; Amthauer, H.

    2006-06-01

    Assessment of perfusion with 15O-labelled water (H215O) requires measurement of the arterial input function (AIF). The arterial time activity curve (TAC) measured using the peripheral sampling scheme requires corrections for delay and dispersion. In this study, parametrizations with and without arterial spillover correction for fitting of the tissue curve are evaluated. Additionally, a completely noninvasive method for generation of the AIF from a dynamic positron emission tomography (PET) acquisition is applied to assess perfusion of pelvic tumours. This method uses a volume of interest (VOI) to extract the TAC from the femoral artery. The VOI TAC is corrected for spillover using a separate tissue TAC and for recovery by determining the recovery coefficient on a coregistered CT data set. The techniques were applied in five patients with pelvic tumours who underwent a total of 11 examinations. Delay and dispersion correction of the blood TAC without arterial spillover correction yielded in seven examinations solutions inconsistent with physiology. Correction of arterial spillover increased the fitting accuracy and yielded consistent results in all patients. Generation of an AIF from PET image data was investigated as an alternative to arterial blood sampling and was shown to have an intrinsic potential to determine the AIF noninvasively and reproducibly. The AIF extracted from a VOI in a dynamic PET scan was similar in shape to the blood AIF but yielded significantly higher tissue perfusion values (mean of 104.0 ± 52.0%) and lower partition coefficients (-31.6 ± 24.2%). The perfusion values and partition coefficients determined with the VOI technique have to be corrected in order to compare the results with those of studies using a blood AIF.

  2. Quantifying Cerebellum Grey Matter and White Matter Perfusion Using Pulsed Arterial Spin Labeling

    Directory of Open Access Journals (Sweden)

    Xiufeng Li

    2014-01-01

    Full Text Available To facilitate quantification of cerebellum cerebral blood flow (CBF, studies were performed to systematically optimize arterial spin labeling (ASL parameters for measuring cerebellum perfusion, segment cerebellum to obtain separate CBF values for grey matter (GM and white matter (WM, and compare FAIR ASST to PICORE. Cerebellum GM and WM CBF were measured with optimized ASL parameters using FAIR ASST and PICORE in five subjects. Influence of volume averaging in voxels on cerebellar grey and white matter boundaries was minimized by high-probability threshold masks. Cerebellar CBF values determined by FAIR ASST were 43.8 ± 5.1 mL/100 g/min for GM and 27.6 ± 4.5 mL/100 g/min for WM. Quantitative perfusion studies indicated that CBF in cerebellum GM is 1.6 times greater than that in cerebellum WM. Compared to PICORE, FAIR ASST produced similar CBF estimations but less subtraction error and lower temporal, spatial, and intersubject variability. These are important advantages for detecting group and/or condition differences in CBF values.

  3. Human brain: reliability and reproducibility of pulsed arterial spin-labeling perfusion MR imaging.

    Science.gov (United States)

    Jahng, Geon-Ho; Song, Enmin; Zhu, Xiao-Ping; Matson, Gerald B; Weiner, Michael W; Schuff, Norbert

    2005-03-01

    The Committee of Human Research of the University of California San Francisco approved this study, and all volunteers provided written informed consent. The goal of this study was to prospectively determine the global and regional reliability and reproducibility of noninvasive brain perfusion measurements obtained with different pulsed arterial spin-labeling (ASL) magnetic resonance (MR) imaging methods and to determine the extent to which within-subject variability and random noise limit reliability and reproducibility. Thirteen healthy volunteers were examined twice within 2 hours. The pulsed ASL methods compared in this study differ mainly with regard to magnetization transfer and eddy current effects. There were two main results: (a) Pulsed ASL MR imaging consistently had high measurement reliability (intraclass correlation coefficients greater than 0.75) and reproducibility (coefficients of variation less than 8.5%), and (b) random noise rather than within-subject variability limited reliability and reproducibility. It was concluded that low signal-to-noise ratios substantially limit the reliability and reproducibility of perfusion measurements.

  4. Arterial Spin Labeling Perfusion Study in the Patients with Subacute Mild Traumatic Brain Injury.

    Directory of Open Access Journals (Sweden)

    Che-Ming Lin

    Full Text Available This study uses a MRI technique, three-dimension pulse continuous arterial spin labeling (3D-PCASL, to measure the patient's cerebral blood flow (CBF at the subacute stage of mild traumatic brain injury (MTBI in order to analyze the relationship between cerebral blood flow and neurocognitive deficits.To provide the relationship between cortical CBF and neuropsychological dysfunction for the subacute MTBI patients.After MTBI, perfusion MR imaging technique (3D-PCASL measures the CBF of MTBI patients (n = 23 within 1 month and that of normal controls (n = 22 to determine the quantity and location of perfusion defect. The correlation between CBF abnormalities and cognitive deficits was elucidated by combining the results of the neuropsychological tests of the patients.We observed a substantial reduction in CBF in the bilateral frontal and left occipital cortex as compared with the normal persons. In addition, there were correlation between post concussive symptoms (including dizziness and simulator sickness and CBF in the hypoperfused areas. The more severe symptom was correlated with higher CBF in bilateral frontal and left occipital lobes.First, this study determined that despite no significant abnormality detected on conventional CT and MRI studies, hypoperfusion was observed in MTBI group using 3D-PCASL technique in subacute stage, which suggested that this approach may increase sensitivity to MTBI. Second, the correlation between CBF and the severity of post concussive symptoms suggested that changes in cerebral hemodynamics may play a role in pathophysiology underlies the symptoms.

  5. Biphasic threat to femoral head perfusion in abduction: arterial hypoperfusion and venous congestion

    Energy Technology Data Exchange (ETDEWEB)

    Yousefzadeh, David K. [Comer Children' s Hospital, Department of Radiology, Chicago, IL (United States); University of Chicago, Department of Radiology, Chicago, IL (United States); Jaramillo, Diego [Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States); Johnson, Neil [Cincinnati Children' s Hospital, Department of Radiology, Cincinnati, OH (United States); Doerger, Kirk [Radiology Associates of Northern Kentucky, Crestview Hills, KY (United States); Sullivan, Christopher [University of Chicago, Department of Surgery, Chicago, IL (United States)

    2010-09-15

    Hip abduction can cause avascular necrosis (AVN) of the femoral head in infants. To compare the US perfusion pattern of femoral head cartilage in neutral position with that in different degrees and duration of abduction, testing the venous congestion theory of post-abduction ischemia. In 20 neonates, the Doppler flow characteristics of the posterosuperior (PS) branch of the femoral head cartilage feeding vessels were evaluated in neutral and at 30 , 45 , and 60 abduction. In three neonates the leg was held in 45-degree abduction and flow was assessed at 5, 10, and 15 min. Male/female ratio was 11/9 with a mean age of 1.86 {+-} 0.7 weeks. The peak systolic velocities (PSV) declined in all three degrees of abduction. After 15 min of 45-degree abduction, the mean PSV declined and showed an absent or reversed diastolic component and undetectable venous return. No perfusion was detected at 60-degree abduction. Abduction-induced femoral head ischemia is biphasic and degree- and duration-dependent. In phase I there is arterial hypoperfusion and in phase II there is venous congestion. A new pathogeneses for femoral head ischemia is offered. (orig.)

  6. Hyperbaric oxygenation effects determination in the therapy of chronic occlusive lower extremities arteries disease by the use of perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Zoranović Uroš

    2010-01-01

    Full Text Available Background/Aim. Hyperbaric oxygenation (HBO is a medical treatment of a patient with 100% oxygen inspiration under the pressure higher than atmospheric in a special unit designed to let the whole patient's body rest in a chamber. The aim of the study was to determine the effect of the application of HBO treatment on the patient's lower extremities with chonic inoperabile occlusive disease by measning the parameters of perfusion scintigraphy (perfusion reserve, relative perfusion. Methods. This investigation included 22 patients (19 males and 3 famales. Following clinical assessment of lower extremities condition according to the skin appearance and its adnexa, claudication distance was performed. Clinical condition was graded by the use of 5-point nominal scale. In all of the patients 99mTctetraphosmine lower extremities scintigraphy was done ten days prior to the treatment start and ten days after the treatment with HBO. Lower legs were imaged from the posterior view. Prior to imaging the patients were obligatory lying approximately half an hour. Results. In 18 (86% of the patients there was an improvement manifested as better subjective condition and better skin and its adnexa appearance. Following HBO treatment there was a statistically significant change in collecting the radiopharmac at rest. This finding indicates an increased viability of muscles as well as an increased perfusion reserve. Perfusion reserve mean values increased from 39.99 to 50.86%, and from 38.46 to 49.33% for the right and the left lower leg, respectively. This parameter clearly indicates favorable effects of HBO treatment pertaining neoangiogenesis and, consequently, increased viability of the lower leg muscles. It was also obvious in visual analysis of the obtained images. Conclusion. The obtained results confirm that muscle perfusion measured by the parameters of perfusion scintigraphy using 99mTc-tetrophosmine (perfusion reserve, relative perfusion in patients with

  7. Safety and efficacy of distal perfusion catheterization to prevent limb ischemia after common femoral artery cannulation for extracorporeal membrane oxygenation

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Chang Ho; Seong, Nak Jong; Yoon, Chang Jin [Dept. of Radiology, Seoul National University Bundang Hospital, Seongnam (Korea, Republic of)

    2016-06-15

    The extracorporeal membrane oxygenation (ECMO) cannula has the potential for obstructing flow to the lower limb, thus causing severe ischemia and possible limb loss. We evaluated the safety and clinical efficacy of percutaneous distal perfusion catheterization in preventing limb ischemia. Between March 2013 and February 2015, 28 patients with distal perfusion catheterization after ECMO were included in this retrospective study. The technical success was evaluated by Doppler ultrasound at the popliteal level after saline injection via distal perfusion catheter. Clinical success was assessed when at least one of the following conditions was met: restoration of continuous peripheral limb oximetry value or presence of distal arterial pulse on Doppler ultrasound evaluation or resolution of early ischemic sign after connecting the catheter with ECMO. Twenty-six patients with early ischemia were successfully cannulated with a distal perfusion catheter (92.8%). Clinical success was achieved in 12/28 (42.8%) patients; 8/10 (80.0%) patients with survival duration exceeding 7 days and 4/18 (22.2%) patients with survival duration less than 7 days, respectively. A percutaneous distal perfusion catheter placement was a feasible tool with safety and efficacy in preventing lower limb ischemia for patients with prolonged common femoral arterial cannulation for ECMO.

  8. Study on Treatment of Primary Hepatic Carcinoma by Arterial Perfusion Embolization with Zedoary Turmeric Oil

    Institute of Scientific and Technical Information of China (English)

    程剑华; 常纲; 吴万垠; 杨志钢; 孟凡喆; 徐凯; 李柳宁; 朱迪盈; 陈春泳; 罗海英

    2001-01-01

    To evaluate the effect, side-effect and prospect of hepatic arterial perfusion embolization (HAPE) with Zedoary turmeric oil (ZTO) in treating primary hepatic carcinoma (PHC).Methods: Clinical study was carried out by administration of 1-3 ml ZTO through arterial catheter to induce embolism in 32 patients of PHC, and compared with 32 patients treated by hepatic arterial perfusion embolization with chemical agents (HAPE-C) in the control group. The Chinese herbal medicine was given orally to both groups according to Syndrome Differentiation of TCM. In the experimental study, transplantation hepatic carcinoma model was established in 40 rats. They were randomly divided into the treated group and the control group, 20 in each group, and were perfused with 10 mg/kg ZTO and 0.2-0.3 ml normal saline respectively to observe the effect of treatment.Results: The effect of treatment in the ZTO group was CR in 1 case and PR in 13 cases, the total effective rate being 43.75%, with AFP negative reversed in 7 cases, titer decreased in 7; while in the control group it was PR in 10 cases, the total effective rate being 31.25%, AFP negative reversed in 5, titer decreased in 2, and the difference of therapeutic effect between the two groups was insignificant (P>0.05). The post-perfusion thrombotic syndrome occurrence, with the symptoms of fever, abdominal pain, vomiting, etc. in the two groups was similar, but no bone marrow inhibition occurred in the ZTO group, which was different from the control group (P<0.01, P<0.05). The mean survival time, median survival time, 1-, 2-, 3- and 4-year survival rate in the ZTO group was 13.84 months, 10 months, 37.5%, 18.87%, 9.70% and 6.4% respectively, and in the control group, 8.03 months, 6 months, 15.6%, 6.27%, 0% and 0% respectively, the mean survival time, median survival time and 1-year survival rate in the ZTO group were significantly superior to those in the control group (P<0.05). Experimental study showed that the effect in the

  9. Impact of myocardial perfusion imaging on in-hospital coronary angiography and revascularization of patients with suspected coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    HAN Ping-ping; HE Zuo-xiang; TIAN Yue-qin; FANG Wei; YANG Min-fu; ZHANG Xiao-li; SHEN Rui; SUN Xiao-xin; QIAO Shu-bin; YANG Yue-jin

    2011-01-01

    Background Noninvasive cardiac imaging is now central to the diagnosis and management of patients with moderate probability for coronary artery disease. The aim of this study was to assess the impact of stress myocardial perfusion single photon emission computerized tomography (SPECT) on in-hospital coronary angiography and revascularization for such patients.Methods Between January 2005 and June 2007, 1053 consecutive in-hospital patients (423 women, the average age of (57.2±11.2) years) with suspected coronary artery disease but without any prior interventional treatment were retrospectively analyzed. All patients underwent a 2-day stress/rest 99m Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion SPECT, including 984 exercise test and 69 adenosine test.Results Overall, stress/rest myocardial perfusion SPECT was normal in 973 patients (92.4%) and abnormal in 80 patients (7.6%). A total of 190 patients underwent coronary angiography, 46 underwent percutaneous coronary intervention and 10 coronary artery bypass grafting during hospitalization. From the whole perspective, only 14.7% of patients with normal SPECT underwent coronary angiography, so did 58.8% of patients with abnormal SPECT (x2=97.0,P<0.001); furthermore, the rates of revascularization in patients with normal and abnormal SPECT were 2.8% and 36.3%,respectively (27 out of 973 vs. 29 out of 80, x2=157.9, P<0.001). The extent and severity of ischemia did not add more predictive value for subsequent coronary angiography, but did have impact on revascularization. Multivariate analysis showed that reversible perfusion defect was the most predictive variable for referral rate to coronary angiography (odds ratio=7.5, P<0.001).Conclusions Abnormal myocardial perfusion SPECT is a powerful referral for in-hospital coronary angiography and revascularization during the same hospitalization. Thus, stress/rest SPECT is an effective gatekeeper for early coronary angiography and invasive treatment for

  10. Evaluation of tumor blood flow after feeder embolization in meningiomas by arterial spin-labeling perfusion magnetic resonance imaging.

    Science.gov (United States)

    Kawaji, Hiroshi; Koizumi, Shinichiro; Sakai, Naoto; Yamasaki, Tomohiro; Hiramatsu, Hisaya; Kanoko, Yusuke; Kamiya, Mika; Yamashita, Shuhei; Takehara, Yasuo; Sakahara, Harumi; Namba, Hiroki

    2013-10-01

    Preoperative embolization changes the amount of blood flow and pattern of flow distribution in meningioma. Tumor blood flow was investigated in eight meningioma patients before and after embolization using arterial spin-labeling (ASL) perfusion imaging. Although blood flow was significantly reduced in the whole tumor after embolization, changes in flow distribution patterns varied from one case to another. The findings suggest that evaluation of post-embolization tumor blood flow by ASL perfusion imaging would be useful in the surgical planning of meningioma.

  11. Reproducibility of rest and exercise stress contrast-enhanced calf perfusion magnetic resonance imaging in peripheral arterial disease

    Directory of Open Access Journals (Sweden)

    Jiji Ronny S

    2013-01-01

    Full Text Available Abstract Background The purpose was to determine the reproducibility and utility of rest, exercise, and perfusion reserve (PR measures by contrast-enhanced (CE calf perfusion magnetic resonance imaging (MRI of the calf in normal subjects (NL and patients with peripheral arterial disease (PAD. Methods Eleven PAD patients with claudication (ankle-brachial index 0.67 ±0.14 and 16 age-matched NL underwent symptom-limited CE-MRI using a pedal ergometer. Tissue perfusion and arterial input were measured at rest and peak exercise after injection of 0.1 mM/kg of gadolinium-diethylnetriamine pentaacetic acid (Gd-DTPA. Tissue function (TF and arterial input function (AIF measurements were made from the slope of time-intensity curves in muscle and artery, respectively, and normalized to proton density signal to correct for coil inhomogeneity. Perfusion index (PI = TF/AIF. Perfusion reserve (PR = exercise TF/ rest TF. Intraclass correlation coefficient (ICC was calculated from 11 NL and 10 PAD with repeated MRI on a different day. Results Resting TF was low in NL and PAD (mean ± SD 0.25 ± 0.18 vs 0.35 ± 0.71, p = 0.59 but reproducible (ICC 0.76. Exercise TF was higher in NL than PAD (5.5 ± 3.2 vs. 3.4 ± 1.6, p = 0.04. Perfusion reserve was similar between groups and highly variable (28.6 ± 19.8 vs. 42.6 ± 41.0, p = 0.26. Exercise TF and PI were reproducible measures (ICC 0.63 and 0.60, respectively. Conclusion Although rest measures are reproducible, they are quite low, do not distinguish NL from PAD, and lead to variability in perfusion reserve measures. Exercise TF and PI are the most reproducible MRI perfusion measures in PAD for use in clinical trials.

  12. Coronary flow reserve evaluated by {sup 201}Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ishino, Yoichi; Nakata, Hajime [Univ. of Occupational and Environmental Health, Kitakyusyu, Fukuoka (Japan)

    2000-11-01

    We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by {sup 201}Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

  13. Comparison of partial volume effects in arterial and venous contrast curves in CT brain perfusion imaging.

    Directory of Open Access Journals (Sweden)

    Alan J Riordan

    Full Text Available PURPOSE: In brain CT perfusion (CTP, the arterial contrast bolus is scaled to have the same area under the curve (AUC as the venous outflow to correct for partial volume effects (PVE. This scaling is based on the assumption that large veins are unaffected by PVE. Measurement of the internal carotid artery (ICA, usually unaffected by PVE due to its large diameter, may avoid the need for partial volume correction. The aims of this work are to examine i the assumptions behind PVE correction and ii the potential of selecting the ICA obviating correction for PVE. METHODS: The AUC of the ICA and sagittal sinus were measured in CTP datasets from 52 patients. The AUCs were determined by i using commercial CTP software based on a Gaussian curve-fitting to the time attenuation curve, and ii by simple integration of the time attenuation curve over a time interval. In addition, frames acquired up to 3 minutes after first bolus passage were used to examine the ratio of arterial and venous enhancement. The impact of selecting the ICA without PVE correction was illustrated by reporting cerebral blood volume (CBV measurements. RESULTS: In 49 of 52 patients, the AUC of the ICA was significantly larger than that of the sagittal sinus (p = 0.017. Measured after the first pass bolus, contrast enhancement remained 50% higher in the ICA just after the first pass bolus, and 30% higher 3 minutes later. CBV measurements were significantly lowered when the ICA was used without PVE correction. CONCLUSIONS: Contradicting the assumptions underlying PVE correction, contrast in the ICA was significantly higher than in the sagittal sinus, even 3 minutes after the first pass of the contrast bolus. PVE correction might lead to overestimation of CBV if the CBV is calculated using the AUC of the time attenuation curves.

  14. Arterial spin labelling MRI for assessment of cerebral perfusion in children with moyamoya disease: comparison with dynamic susceptibility contrast MRI

    Energy Technology Data Exchange (ETDEWEB)

    Goetti, Robert [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland); University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); O' Gorman, Ruth [University Children' s Hospital Zurich, Center for MR Research, Zurich (Switzerland); Khan, Nadia [University Children' s Hospital Zurich, Moyamoya Center, Division of Neurosurgery, Department of Surgery, Zurich (Switzerland); Kellenberger, Christian J.; Scheer, Ianina [University Children' s Hospital Zurich, Department of Diagnostic Imaging, Zurich (Switzerland)

    2013-05-15

    This study seeks to evaluate the diagnostic accuracy of cerebral perfusion imaging with arterial spin labelling (ASL) MR imaging in children with moyamoya disease compared to dynamic susceptibility contrast (DSC) imaging. Ten children (7 females; age, 9.2 {+-} 5.4 years) with moyamoya disease underwent cerebral perfusion imaging with ASL and DSC on a 3-T MRI scanner in the same session. Cerebral perfusion images were acquired with ASL (pulsed continuous 3D ASL sequence, 32 axial slices, TR = 5.5 s, TE = 25 ms, FOV = 24 cm, matrix = 128 x 128) and DSC (gradient echo EPI sequence, 35 volumes of 28 axial slices, TR = 2,000 ms, TE = 36 ms, FOV = 24 cm, matrix = 96 x 96, 0.2 ml/kg Gd-DOTA). Cerebral blood flow maps were generated. ASL and DSC images were qualitatively assessed regarding perfusion of left and right ACA, MCA, and PCA territories by two independent readers using a 3-point-Likert scale and quantitative relative cerebral blood flow (rCBF) was calculated. Correlation between ASL and DSC for qualitative and quantitative assessment and the accuracy of ASL for the detection of reduced perfusion per territory with DSC serving as the standard of reference were calculated. With a good interreader agreement ({kappa} = 0.62) qualitative perfusion assessment with ASL and DSC showed a strong and significant correlation ({rho} = 0.77; p < 0.001), as did quantitative rCBF (r = 0.79; p < 0.001). ASL showed a sensitivity, specificity and accuracy of 94 %, 93 %, and 93 % for the detection of reduced perfusion per territory. In children with moyamoya disease, unenhanced ASL enables the detection of reduced perfusion per vascular territory with a good accuracy compared to contrast-enhanced DSC. (orig.)

  15. Dual-energy CT angiography of chronic thromboembolic disease: Can it help recognize links between the severity of pulmonary arterial obstruction and perfusion defects?

    Energy Technology Data Exchange (ETDEWEB)

    Renard, Benoit [Department of Thoracic Imaging, Hospital Calmette, University Centre of Lille (EA 2694), Boulevard Jules Leclercq, 59037 Lille cedex (France); Remy-Jardin, Martine, E-mail: mremy-jardin@chru-lille.fr [Department of Thoracic Imaging, Hospital Calmette, University Centre of Lille (EA 2694), Boulevard Jules Leclercq, 59037 Lille cedex (France); Santangelo, Teresa; Faivre, Jean-Baptiste; Tacelli, Nunzia; Remy, Jacques [Department of Thoracic Imaging, Hospital Calmette, University Centre of Lille (EA 2694), Boulevard Jules Leclercq, 59037 Lille cedex (France); Duhamel, Alain [Department of Biostatistics, University Centre of Lille (EA 2694), 59037 Lille cedex (France)

    2011-09-15

    Purpose: To evaluate whether dual-energy CT angiography (DE-CTA) could identify links between morphologic and functional abnormalities in chronic pulmonary thromboembolism (CPTE). Materials and methods: Seventeen consecutive patients with CPTE without underlying cardio-respiratory disease were investigated with DE-CTA. Two series of images were generated: (a) transverse diagnostic scans (i.e., contiguous 1-mm thick averaged images from both tubes), and (b) perfusion scans (i.e., images of the iodine content within the microcirculation; 4-mm thick MIPs). Two radiologists evaluated by consensus the presence of: (a) pulmonary vascular features of CPTE and abnormally dilated systemic arteries on diagnostic CT scans, and (b) perfusion defects of embolic type on perfusion scans. Results: Diagnostic examinations showed a total of 166 pulmonary arteries (166/833; 19.9%) with features of CPTE, more frequent at the level of peripheral than central arteries (8.94 vs 0.82; p < 0.0001), including severe stenosis with partial (97/166; 58.4%) or complete (20/166; 12.0%) obstruction, webs and bands (37/166; 22.3%), partial filling defects without stenosis (7/166; 4.2%), focal stenosis (4/166; 2.4%) and abrupt vessel narrowing (1/166; 0.6%). Perfusion examinations showed 39 perfusion defects in 8 patients (median number: 4.9; range: 1-11). The most severe pulmonary arterial features of CPTE were seen with a significantly higher frequency in segments with perfusion defects than in segments with normal perfusion (p < 0.0001). Enlarged systemic arteries were observed with a significantly higher frequency ipsilateral to lungs with perfusion defects (9/12; 75%) compared with lungs without perfusion defects (5/22; 22.7%) (p = 0.004). Conclusion: Dual-energy CTA demonstrates links between the severity of pulmonary arterial obstruction and perfusion impairment, influenced by the degree of development of the systemic collateral supply.

  16. Quantitative 3D pulmonary MR-perfusion in patients with pulmonary arterial hypertension: Correlation with invasive pressure measurements

    Energy Technology Data Exchange (ETDEWEB)

    Ley, Sebastian [Department of Pediatric Radiology, Children' s Hospital University Heidelberg, Im Neuenheimer Feld 153, 69120 Heidelberg (Germany) and Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)]. E-mail: ley@gmx.net; Mereles, Derliz [Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Risse, Frank [Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Gruenig, Ekkehard [Internal Medicine III, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg (Germany); Ley-Zaporozhan, Julia [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Tecer, Zueleyha [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Puderbach, Michael [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Fink, Christian [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany); Department of Clinical Radiology, University Medical Center Grosshadern, Ludwigs-Maximilians-University, Munich (Germany); Kauczor, Hans-Ulrich [Department of Radiology (E010), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg (Germany)

    2007-02-15

    Purpose: Pathological changes of the peripheral pulmonary arteries induce pulmonary arterial hypertension (PAH). Aim of this study was to quantitatively assess the effect of PAH on pulmonary perfusion by 3D-MR-perfusion techniques and to compare findings to healthy controls. Furthermore, quantitative perfusion data were correlated with invasive pressure measurements. Material and methods: Five volunteers and 20 PAH patients (WHO class II or III) were examined using a 1.5 T MR scanner. Measurement of pulmonary perfusion was done in an inspiratory breathhold (FLASH3D; 3.5 mm x 1.9 mm x 4 mm; TA per 3D dataset 1.5 s). Injection of contrast media (0.1 mmol Gd-DTPA/kg BW) and image acquisition were started simultaneously. Evaluation of 3D perfusion was done using singular value decomposition. Lung borders were outlined manually. Each lung volume was divided into three regions (anterior, middle, posterior), and the following parameters were assessed: Time-to-Peak (TTP), blood flow (PBF), blood volume (PBV), and mean transit time (MTT). In 10 patients invasive pulmonary artery pressure measurements were available and correlated to the perfusion measurements. Results: In both, controls and patients, an anterior-to-posterior gradient with higher PBF and PBV posterior was observed. In the posterior lung region, a significant difference (p < 0.05) was found for TTP (12 s versus 16 s) and MTT (4 s versus 6 s) between volunteers and patients. PBF and PBV were lower in patients than in volunteers (i.e. dorsal regions: 124 versus 180 ml/100 ml/min and 10 versus 12 ml/100 ml), but the difference failed to be significant. The ratio of PBF and PBV between the posterior and the middle or ventral regions showed no difference between both groups. A moderate linear correlation between mean pulmonary arterial pressure (mPAP) and PBV (r = 0.51) and MTT (r = 0.56) was found. Conclusion: The only measurable effect of PAH on pulmonary perfusion is a prolonging of the MTT. There is only a

  17. Quantification of myocardial perfusion using cardiac magnetic resonance imaging correlates significantly to rubidium-82 positron emission tomography in patients with severe coronary artery disease

    DEFF Research Database (Denmark)

    Qayyum, Abbas A; Hasbak, Philip; Larsson, Henrik B W

    2014-01-01

    INTRODUCTION: Aim was to compare absolute myocardial perfusion using cardiac magnetic resonance imaging (CMRI) based on Tikhonov's procedure of deconvolution and rubidium-82 positron emission tomography (Rb-82 PET). MATERIALS AND METHODS: Fourteen patients with coronary artery stenosis underwent ...

  18. Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease

    Directory of Open Access Journals (Sweden)

    Ehtisham Javed

    2010-05-01

    Full Text Available Abstract Aim Evaluation of the diagnostic accuracy of stress perfusion cardiovascular magnetic resonance for the diagnosis of significant obstructive coronary artery disease (CAD through meta-analysis of the available data. Methodology Original articles in any language published before July 2009 were selected from available databases (MEDLINE, Cochrane Library and BioMedCentral using the combined search terms of magnetic resonance, perfusion, and coronary angiography; with the exploded term coronary artery disease. Statistical analysis was only performed on studies that: (1 used a [greater than or equal to] 1.5 Tesla MR scanner; (2 employed invasive coronary angiography as the reference standard for diagnosing significant obstructive CAD, defined as a [greater than or equal to] 50% diameter stenosis; and (3 provided sufficient data to permit analysis. Results From the 263 citations identified, 55 relevant original articles were selected. Only 35 fulfilled all of the inclusion criteria, and of these 26 presented data on patient-based analysis. The overall patient-based analysis demonstrated a sensitivity of 89% (95% CI: 88-91%, and a specificity of 80% (95% CI: 78-83%. Adenosine stress perfusion CMR had better sensitivity than with dipyridamole (90% (88-92% versus 86% (80-90%, P = 0.022, and a tendency to a better specificity (81% (78-84% versus 77% (71-82%, P = 0.065. Conclusion Stress perfusion CMR is highly sensitive for detection of CAD but its specificity remains moderate.

  19. Extra cardiac activity detected on myocardial perfusion scintigraphy after intra-arterial injection of 99mTc-MIBI

    DEFF Research Database (Denmark)

    Afzelius, Pia; Henriksen, Jens H

    2008-01-01

    , prolongation of the study and interference of the extra cardiac activity with the cardiac image reconstructions. Whole-body scintigraphy disclosed an arterial flow distribution of activity to skeletal muscles in left shoulder and upper limb. CONCLUSION: Accidentally injected radiotracer retrogradely...... (dipyridamol) imaging and followed by rest imaging day 2 was performed. RESULTS: On day 2, when rest perfusion scintigraphy was carried out, extra cardiac activity was present in the left part of thorax and in the left upper extremity resulting in reduced accumulation of 99mTc-MIBI in cardiac tissue...... into the arterial system resulted in an unusual extra cardiac activity interfering with later image processing....

  20. Effect of Diltiazem on Coronary Artery Flow and Myocardial Perfusion in Patients With Isolated Coronary Artery Ectasia and Either Stable Angina Pectoris or Positive Myocardial Ischemic Stress Test.

    Science.gov (United States)

    Ozcan, Ozgur Ulas; Atmaca, Yusuf; Goksuluk, Huseyin; Akbulut, Irem Muge; Ozyuncu, Nil; Ersoy, Nedret; Erol, Cetin

    2015-10-15

    Isolated coronary artery ectasia (CAE) may be associated with stable or unstable coronary events despite the absence of epicardial coronary stenosis. Impaired coronary flow dynamics and myocardial perfusion have been demonstrated in stable patients with ectatic coronary arteries. We aimed to assess whether epicardial flow and tissue-level perfusion would be improved by diltiazem in myocardial regions subtended by the ectatic coronary arteries in patients with isolated CAE. A total of 60 patients with isolated CAE were identified of 9,780 patients who underwent elective coronary angiography. Patients were randomized to 5 mg of intracoronary diltiazem or saline. Coronary blood flow of the microvascular network was assessed using myocardial blush grade (MBG) technique. The thrombolysis in myocardial infarction (TIMI) flow grade and TIMI frame count (TFC) were used to assess epicardial coronary flow. MBG (from 2.4 to 2.6, p = 0.02), TIMI flow grades (from 2.4 to 2.8, p flow grade; and from 35 to 33, p = 0.43 for TFC). Diltiazem provided amelioration of the altered coronary flow dynamics, which was suggested as the pathophysiological influence of CAE. In conclusion, the favorable effects of the diltiazem on myocardial perfusion were observed at both epicardial and tissue levels.

  1. 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

  2. MRI findings in multifetal pregnancies complicated by twin reversed arterial perfusion sequence (TRAP)

    Energy Technology Data Exchange (ETDEWEB)

    Guimaraes, Carolina V.A.; Kline-Fath, Beth M.; Linam, Leann E.; Calvo Garcia, Maria A.; Rubio, Eva I. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Lim, Foong-Yen [Cincinnati Children' s Hospital Medical Center, Division of Pediatric Surgery, Cincinnati, OH (United States)

    2011-06-15

    Twin reversed arterial perfusion sequence (TRAP) is a rare complication in multifetal monochorionic pregnancies in which a normal ''pump'' twin provides circulation to an abnormal acardiac co-twin, resulting in high-output cardiac dysfunction in the pump twin. To define fetal MRI findings of TRAP sequence. Fetal MR images were retrospectively reviewed in 35 pregnancies complicated by TRAP sequence. Abnormalities of the pump twin, acardiac twin, umbilical cord, placenta and amniotic fluid were reviewed. Acardiac twins were classified as: acephalus (51%), anceps (40%), amorphus (9%), acormus (0%). Common findings in acardiac twins include subcutaneous edema (77%), absent cardiac structures (86%), absent or abnormal thoracic cavity (100%), abnormal abdominal organs (100%), superior limbs absent (46%) or abnormal (51%), and inferior limbs present but abnormal (83%). There were pump twin findings of cardiac dysfunction in 43% and intracranial ischemic changes in 3%. Umbilical cord anomalies were present in 97%. Acardiac twins present with a predictable pattern of malformation with poorly developed superior structures, more normally formed inferior structures and absent or rudimentary heart. Although usually absent, abnormal heart structures can be seen and do not exclude TRAP sequence. Pump twins are commonly normal with exception of findings of cardiac dysfunction and possible brain ischemia. (orig.)

  3. Impact of primary percutaneous coronary intervention on blood perfusion in nonculprit artery in patients with anterior ST elevation myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    WANG Jian; LIU Jing-hua; ZHENG Bin; ZHANG Ming; WANG Shao-ping; ZHENG Ze

    2013-01-01

    Background Recent studies have demonstrated that epicardial flow in nonculprit arteries,which has been assumed to be normal,was slowed in the setting of ST-elevation myocardial infarction (STEMI).However,the impact of primary percutaneous coronary intervention (PCI) on blood perfusion in nonculprit arteries in patients with STEMI has not been clarified.The purpose of this study was to investigate the impact of primary PCI on blood perfusion in nonculprit arteries in patients with STEMI and correlated clinical factors.Methods A total of 117 patients with anterior wall STEMI,the culprit artery being the left anterior descending artery (LAD),undergoing primary PCI (the study group) and 100 patients with normal coronary angiography (the control group) were enrolled.To observe the differences of corrected TIMI frame count (cTFC) and myocardial blush grade (MBG) before and after primary PCI in both culprit and nonculprit arteries,the left circumflex coronary artery (LCX),cTFC and MBG in the LAD and LCX were measured in the study group and control group.The study group was divided into three groups; reflow in the culprit artery group (the R group),no reflow in culprit artery group (the NR group),and no reflow in both the culprit artery and nonculprit artery group (the NRB group) according to MBG grade.The level of serum C-reactive protein (CRP),catecholamine,and fibroblast growth factor-21 (FGF21) were assayed.The clinical and angiographic characteristics were also analyzed.Results cTFC (28.1±24.3 vs.20.3±19.3,P <0.05) and MBG in the LCX were different in the study group compared to the control group before primary PCI.cTFC (25.2±22.3 vs.28.1±24.3,P <0.05) and the MBG level in the LCX were improved after successful primary PCI,but were not recovered to the normal level.Patients with no reflow in the culprit artery had a higher incidence of no-reflow in the nonculprit artery (78% vs.19%,P <0.0001),and the levels of CRP ((3.29±1.31) mg/dl vs.(2.51±1.14) mg

  4. An improvement of cerebral hemodynamics in a newly developed perfusion area evaluated by intra-arterial SPECT following vascular reconstructive surgery

    Energy Technology Data Exchange (ETDEWEB)

    Nochide, Ichiro [Ehime Univ., Shigenobu (Japan). School of Medicine

    1999-06-01

    The purpose of this study was to evaluate the changes in regional cerebral blood flow (rCBF) and vascular reserve ({Delta}CBF) responding to acetazolamide loading by {sup 133}Xe SPECT. In combination, this study assessed the newly developed region of cerebral perfusion via bypass arteries after surgical vascular reconstruction in 11 hemispheres of 11 patients with atherosclerotic arterial occlusive disease and adult onset moyamoya disease. In patients with atherosclerotic occlusive disease, the cerebral perfusion from bypass arteries mainly developed in the preoperatively low {Delta}CBF territory. Although rCBF did not significantly alter after vascular reconstruction, preoperatively low {Delta}CBF was significantly improved to the normal range in the promotion of postoperatively newly born perfusion from bypass arteries. In 21 hemispheres of 13 patients with adult onset moyamoya disease, the postoperatively newly born perfusion from bypass arteries was significantly developed in the regions with either preoperative low rCBF or low {Delta}CBF. Although both rCBF and {Delta}CBF were significantly improved after the operation, {Delta}CBF was not restored satisfactorily up to the normal range in contrast to the sufficient increase of rCBF, even where the perfusion from the bypass artery was observed after the reconstructive surgeries. Vascular reconstructive surgeries were beneficial for the improvement of {Delta}CBF in the atherosclerotic arterial occlusive disease and rCBF in the adult-onset moyamoya disease, respectively. (author)

  5. Thyroid perfusion imaging as a diagnostic tool in Graves' disease. Arterial spin labeling magnetic resonance imaging vs. colour-coded Doppler ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Muessig, K. [University Hospital of Duesseldorf (Germany). Dept. of Metabolic Diseases; Leibniz Center for Diabetes Research, Duesseldorf (Germany). Inst. for Clinical Diabetology; University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Schraml, C.; Schwenzer, N.F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology; Rietig, R.; Balletshofer, B. [University Hospital of Tuebingen (Germany). Div. of Endocrinology, Diabetes, Nephrology, Angiology, and Clinical Chemistry; Martirosian, P.; Haering, H.U.; Schick, F. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Section on Experimental Radiology; Claussen, C.D. [University Hospital of Tuebingen (Germany). Dept. of Radiology, Diagnostic and Interventional Radiology

    2012-12-15

    Purpose: Though increased thyroid perfusion assessed by colour-coded Doppler ultrasound (CDUS) is characteristic of Graves' disease (GD), sometimes perfusion assessment by CDUS is not possible. In these cases, arterial spin labelling (ASL), a novel magnetic resonance imaging (MRI) technique allowing non-invasive thyroid perfusion quantification, may have additional diagnostic value. We aimed to evaluate the potential of ASL-MRI for assessment of increased blood perfusion in patients with GD compared to CDUS. Materials and Methods: Thyroid perfusion was measured by CDUS (volume flow rate calculated from pulsed wave Doppler signals and vessel diameter) and ASL-MRI at 1.5 T in 7 patients with GD and 10 healthy controls. Results: In patients with GD, average perfusion in both thyroid lobes was markedly increased compared to controls. Both techniques applied for volume related perfusion as well as absolute volume flow in thyroid feeding vessels provided similar results (all p = 0.0008). Using a cut-off value of 22 ml/min for the volume flow rate assessed by CDUS in the four feeding vessels allowed discrimination between patients with GD and controls in all cases. After adjusting thyroid perfusion for the differences in organ volume, both CDUS and ASL revealed also complete discrimination between health and disease. Conclusion: Thyroid perfusion measurement by ASL-MRI reliably discriminate GD from normal thyroid glands. In patients in whom thyroid arteries cannot be depicted by CDUS for technical or anatomical reasons, ASL-MRI may have additional diagnostic value. (orig.)

  6. Mapping the dynamics of brain perfusion using functional ultrasound in a rat model of transient middle cerebral artery occlusion.

    Science.gov (United States)

    Brunner, Clément; Isabel, Clothilde; Martin, Abraham; Dussaux, Clara; Savoye, Anne; Emmrich, Julius; Montaldo, Gabriel; Mas, Jean-Louis; Baron, Jean-Claude; Urban, Alan

    2017-01-01

    Following middle cerebral artery occlusion, tissue outcome ranges from normal to infarcted depending on depth and duration of hypoperfusion as well as occurrence and efficiency of reperfusion. However, the precise time course of these changes in relation to tissue and behavioral outcome remains unsettled. To address these issues, a three-dimensional wide field-of-view and real-time quantitative functional imaging technique able to map perfusion in the rodent brain would be desirable. Here, we applied functional ultrasound imaging, a novel approach to map relative cerebral blood volume without contrast agent, in a rat model of brief proximal transient middle cerebral artery occlusion to assess perfusion in penetrating arterioles and venules acutely and over six days thanks to a thinned-skull preparation. Functional ultrasound imaging efficiently mapped the acute changes in relative cerebral blood volume during occlusion and following reperfusion with high spatial resolution (100 µm), notably documenting marked focal decreases during occlusion, and was able to chart the fine dynamics of tissue reperfusion (rate: one frame/5 s) in the individual rat. No behavioral and only mild post-mortem immunofluorescence changes were observed. Our study suggests functional ultrasound is a particularly well-adapted imaging technique to study cerebral perfusion in acute experimental stroke longitudinally from the hyper-acute up to the chronic stage in the same subject.

  7. High accuracy of arterial spin labeling perfusion imaging in differentiation of pilomyxoid from pilocytic astrocytoma

    Energy Technology Data Exchange (ETDEWEB)

    Nabavizadeh, S.A.; Assadsangabi, R.; Hajmomenian, M.; Vossough, A. [Perelman School of Medicine of the University of Pennsylvania, Department of Radiology, Children' s Hospital of Philadelphia, Philadelphia, PA (United States); Santi, M. [Perelman School of Medicine of the University of Pennsylvania, Department of Pathology, Children' s Hospital of Philadelphia, Philadelphia, PA (United States)

    2015-05-01

    Pilomyxoid astrocytoma (PMA) is a relatively new tumor entity which has been added to the 2007 WHO Classification of tumors of the central nervous system. The goal of this study is to utilize arterial spin labeling (ASL) perfusion imaging to differentiate PMA from pilocytic astrocytoma (PA). Pulsed ASL and conventional MRI sequences of patients with PMA and PA in the past 5 years were retrospectively evaluated. Patients with history of radiation or treatment with anti-angiogenic drugs were excluded. A total of 24 patients (9 PMA, 15 PA) were included. There were statistically significant differences between PMA and PA in mean tumor/gray matter (GM) cerebral blood flow (CBF) ratios (1.3 vs 0.4, p < 0.001) and maximum tumor/GM CBF ratio (2.3 vs 1, p < 0.001). Area under the receiver operating characteristic (ROC) curves for differentiation of PMA from PA was 0.91 using mean tumor CBF, 0.95 using mean tumor/GM CBF ratios, and 0.89 using maximum tumor/GM CBF. Using a threshold value of 0.91, the mean tumor/GM CBF ratio was able to diagnose PMA with 77 % sensitivity, 100 % specificity, and a threshold value of 0.7, provided 88 % sensitivity and 86 % specificity. There was no statistically significant difference between the two tumors in enhancement pattern (p = 0.33), internal architecture (p = 0.15), or apparent diffusion coefficient (ADC) values (p = 0.07). ASL imaging has high accuracy in differentiating PMA from PA. The result of this study may have important applications in prognostication and treatment planning especially in patients with less accessible tumors such as hypothalamic-chiasmatic gliomas. (orig.)

  8. Prediction of cerebral hyperperfusion syndrome after carotid artery stenting by CT perfusion imaging with acetazolamide challenge

    Energy Technology Data Exchange (ETDEWEB)

    Yoshie, Tomohide; Ueda, Toshihiro; Takada, Tatsuro; Nogoshi, Shinji; Fukano, Takayuki [St. Marianna University Toyoko Hospital, Department of Strokology, Stroke Center, Kawasaki (Japan); Hasegawa, Yasuhiro [St. Marianna University School of Medicine, Department of Internal Medicine, Division of Neurology, Kawasaki (Japan)

    2016-03-15

    Cerebral hyperperfusion syndrome (HPS) is an uncommon but serious complication of carotid artery stenting (CAS). The purpose of this study was to investigate the efficacy of CT perfusion imaging (CTP) with acetazolamide challenge to identify patients at risk for HPS after CAS. We retrospectively analyzed 113 patients who underwent CTP with rest and acetazolamide challenge before CAS. CTP maps were assessed for absolute and relative cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), and change of each parameter before and after acetazolamide challenge. Patients were divided into two groups according to the HPS after the CAS. Receiver-operating characteristic (ROC) curve analysis was performed to determine the most accurate CTP parameter for the prediction of HPS. Nine of 113 patients had HPS. There were significant differences for absolute and relative values of resting CBF (p = 0.001 and p = 0.026), resting MTT (p < 0.001 and p = 0.004), post-acetazolamide CBF (p < 0.001 and p = 0.001), post-acetazolamide MTT (p < 0.001 and p = 0.002), and %changes of CBF (p = 0.009) between the HPS and non-HPS groups. ROC curve analysis showed that the CTP parameters with the maximal area under the receiver-operating characteristic curve (AUC) for HPS was the absolute value of post-acetazolamide MTT (AUC 0.909) and the absolute value of resting MTT (AUC 0.896). Pretreatment CTP with acetazolamide challenge could identify patients at risk for HPS after CAS. Although the CTP parameter that most accurately identified patients at risk for HPS was the absolute value of post-acetazolamide MTT, resting MTT was sufficiently accurate. (orig.)

  9. The attention network changes in breast cancer patients receiving neoadjuvant chemotherapy: Evidence from an arterial spin labeling perfusion study

    Science.gov (United States)

    Chen, Xingui; He, Xiaoxuan; Tao, Longxiang; Cheng, Huaidong; Li, Jingjing; Zhang, Jingjie; Qiu, Bensheng; Yu, Yongqiang; Wang, Kai

    2017-01-01

    To investigate the neural mechanisms underlying attention deficits that are related to neoadjuvant chemotherapy in combination with cerebral perfusion. Thirty one patients with breast cancer who were scheduled to receive neoadjuvant chemotherapy and 34 healthy control subjects were included. The patients completed two assessments of the attention network tasks (ANT), neuropsychological background tests, and the arterial spin labeling scan, which were performed before neoadjuvant chemotherapy and after completing chemotherapy. After neoadjuvant chemotherapy, the patients exhibited reduced performance in the alerting and executive control attention networks but not the orienting network (p breast cancer. The results demonstrated that neoadjuvant chemotherapy influences hemodynamic activity in different brain areas through increasing cerebral perfusion, which reduces the attention abilities in breast cancer patients. PMID:28209975

  10. Midbrain and Hindbrain Involvement in Lissencephaly

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap

    2009-02-01

    Full Text Available Involvement of the midbrain and hindbrain (MHB in the various groups of lissencephalies was examined in an MRI study of 111 patients (aged 1 day to 32 years; mean 5 years 4 months studied at University of California San Francisco, and centers in France, Belgium, and Turkey.

  11. THE VALUE OF 99mTc-MIBI MYOCARDIAL PERFUSION SPECT IMAGING IN DETECTING CORONARY ARTERY DISEASE IN PATIENTS WITH VALVULAR DISEASE BEFORE OPERATION

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. The aim of this study was to detect coronary artery disease using99m Tc-MIBI myocardial perfusion imaging in patients with valvular disease.Methods. Thirty patients with valvular disease confirmed by echocardiography underwent 99mTc-MIBI myocardial perfusion imaging using multiSPECT 1h after stress test (exercise, dipyridamole or dobutamine test) and were performed coronary angiography within 1 month before valvular operation.Results.For 29 out of the 30 patients, the results of 99mTc-MIBI myocardial perfusion imaging were similar with those of coronary angiography, the concordance rate was 96.7% and the negative predictability was 100%.Conclusion.99m Tc-MIBI myocardial perfusion imaging is a reliable non-invasive method for detecting coronary artery disease in patients with valvular disease and so as to draw up suitable operation programs for them.

  12. Perfusion Assessment with the SPY System after Arterial Venous Reversal for Upper Extremity Ischemia

    Directory of Open Access Journals (Sweden)

    Darrell Brooks, MD

    2014-07-01

    Conclusions: AVR effectively reestablished blood flow in patients with terminal upper extremity ischemia. ICG angiography with SPY technology revealed that, in most cases, kinetic curves, timing, and patterns of perfusion gradually normalized over several PODs.

  13. Endocardial-epicardial distribution of myocardial perfusion reserve assessed by multidetector computed tomography in symptomatic patients without significant coronary artery disease

    DEFF Research Database (Denmark)

    Kühl, Jørgen Tobias; George, Richard T; Mehra, Vishal C

    2016-01-01

    (MPR) in humans. We aimed to test the hypothesis that MPR in all myocardial layers is determined by age, gender, and cardiovascular risk profile in patients with ischaemic symptoms or equivalent but without obstructive coronary artery disease (CAD). METHODS AND RESULTS: A total of 149 patients enrolled...... in endocardial-epicardial distribution of perfusion reserve may be demonstrated with static CT perfusion. Low MPR in all myocardial layers was observed specifically in obese patients....

  14. 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

    = 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......-PI, stress-TPR and MPR were significantly reduced in patients with a stenosis ≥50 % (p ... during stress in patients with ≥50 % stenosis. In a broad spectrum of stenosis severity groups, TPR at rest remained unchanged until the group of patients with total occlusions, whereas TPR during stress decreased progressively when a threshold of 50 % was superseded. In this study we establish...

  15. UTP induces vascular responses in the isolated and perfused canine epicardial coronary artery via UTP-preferring P2Y receptors

    OpenAIRE

    Matsumoto, Takako; Nakane, Tokio; Chiba, Shigetoshi

    1997-01-01

    Vasoconstrictor responses of the isolated and perfused canine epicardial coronary artery to uridine 5′-triphosphate (UTP) were analysed pharmacologically.At basal perfusion pressure, UTP induced vasoconstriction in a dose-related manner and the vasoconstriction was sometimes followed by a slight vasodilatation at large doses (more than 10 nmol). The rank order of potency for vasoconstriction was UTP=UDP>ATP>TTP⩾ITP>> UMP. At raised perfusion pressure by 20 mM KCl, the vasoconstriction was not...

  16. Myocardial perfusion imaging with higenamine hydrochloride stress studies in diagnosis of coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    周维

    2013-01-01

    Objective To evaluate the stress test efficacy and safety of higenamine hydrochloride,MPI studies were performed in patients with coronary artery disease. Methods Sixty-eight patients with suspected coronary artery

  17. Non-invasive assessment of functionally relevant coronary artery stenoses with quantitative CT perfusion: preliminary clinical experiences

    Energy Technology Data Exchange (ETDEWEB)

    So, Aaron [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); Wisenberg, Gerald [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); University of Western Ontario, Medical Imaging, London, Ontario (Canada); London Health Sciences Centre, Cardiology, London, Ontario (Canada); Islam, Ali; Amann, Justin; Romano, Walter [University of Western Ontario, Medical Imaging, London, Ontario (Canada); St. Joseph' s Health Care, Radiology, London, Ontario (Canada); Brown, James; Humen, Dennis; Jablonsky, George [London Health Sciences Centre, Cardiology, London, Ontario (Canada); Li, Jian-Ying; Hsieh, Jiang [GE Healthcare, CT Engineering, Waukesha, Wisconsin (United States); Lee, Ting-Yim [Lawson Health Research Institute, Imaging Program, London, Ontario (Canada); Robarts Research Institute, Imaging Research Laboratories, London, Ontario (Canada); University of Western Ontario, Medical Biophysics, London, Ontario (Canada); University of Western Ontario, Medical Imaging, London, Ontario (Canada)

    2012-01-15

    We developed a quantitative Dynamic Contrast-Enhanced CT (DCE-CT) technique for measuring Myocardial Perfusion Reserve (MPR) and Volume Reserve (MVR) and studied their relationship with coronary stenosis. Twenty-six patients with Coronary Artery Disease (CAD) were recruited. Degree of stenosis in each coronary artery was classified from catheter-based angiograms as Non-Stenosed (NS, angiographically normal or mildly irregular), Moderately Stenosed (MS, 50-80% reduction in luminal diameter), Severely Stenosed (SS, >80%) and SS with Collaterals (SSC). DCE-CT at rest and after dipyridamole infusion was performed using 64-slice CT. Mid-diastolic heart images were corrected for beam hardening and analyzed using proprietary software to calculate Myocardial Blood Flow (MBF, in mLmin{sup -1}100 g{sup -1}) and Blood Volume (MBV, in mL100 g{sup -1}) parametric maps. MPR and MVR in each coronary territory were calculated by dividing MBF and MBV after pharmacological stress by their respective baseline values. MPR and MVR in MS and SS territories were significantly lower than those of NS territories (p < 0.05 for all). Logistic regression analysis identified MPR MVR as the best predictor of {>=}50% coronary lesion than MPR or MVR alone. DCE-CT imaging with quantitative CT perfusion analysis could be useful for detecting coronary stenoses that are functionally significant. (orig.)

  18. The relationship between exercise-induced muscle fatigue, arterial blood flow and muscle perfusion after 56 days local muscle unloading.

    Science.gov (United States)

    Weber, Tobias; Ducos, Michel; Mulder, Edwin; Beijer, Åsa; Herrera, Frankyn; Zange, Jochen; Degens, Hans; Bloch, Wilhelm; Rittweger, Jörn

    2014-05-01

    In the light of the dynamic nature of habitual plantar flexor activity, we utilized an incremental isokinetic exercise test (IIET) to assess the work-related power deficit (WoRPD) as a measure for exercise-induced muscle fatigue before and after prolonged calf muscle unloading and in relation to arterial blood flow and muscle perfusion. Eleven male subjects (31 ± 6 years) wore the HEPHAISTOS unloading orthosis unilaterally for 56 days. It allows habitual ambulation while greatly reducing plantar flexor activity and torque production. Endpoint measurements encompassed arterial blood flow, measured in the femoral artery using Doppler ultrasound, oxygenation of the soleus muscle assessed by near-infrared spectroscopy, lactate concentrations determined in capillary blood and muscle activity using soleus muscle surface electromyography. Furthermore, soleus muscle biopsies were taken to investigate morphological muscle changes. After the intervention, maximal isokinetic torque was reduced by 23·4 ± 8·2% (PBlood flow, tissue oxygenation, lactate concentrations and EMG median frequency kinematics during the exercise test were comparable before and after the intervention, whereas the increase of RMS in response to IIET was less following the intervention (P = 0·03). In conclusion, following submaximal isokinetic muscle work exercise-induced muscle fatigue is unaffected after prolonged local muscle unloading. The observation that arterial blood flow was maintained may underlie the unchanged fatigability.

  19. Quantitative cerebral perfusion assessment using microscope-integrated analysis of intraoperative indocyanine green fluorescence angiography versus positron emission tomography in superficial temporal artery to middle cerebral artery anastomosis

    Directory of Open Access Journals (Sweden)

    Shinya Kobayashi

    2014-01-01

    Full Text Available Background: Intraoperative qualitative indocyanine green (ICG angiography has been used in cerebrovascular surgery. Hyperperfusion may lead to neurological complications after superficial temporal artery to middle cerebral artery (STA-MCA anastomosis. The purpose of this study is to quantitatively evaluate intraoperative cerebral perfusion using microscope-integrated dynamic ICG fluorescence analysis, and to assess whether this value predicts hyperperfusion syndrome (HPS after STA-MCA anastomosis. Methods: Ten patients undergoing STA-MCA anastomosis due to unilateral major cerebral artery occlusive disease were included. Ten patients with normal cerebral perfusion served as controls. The ICG transit curve from six regions of interest (ROIs on the cortex, corresponding to ROIs on positron emission tomography (PET study, was recorded. Maximum intensity (I MAX , cerebral blood flow index (CBFi, rise time (RT, and time to peak (TTP were evaluated. Results: RT/TTP, but not I MAX or CBFi, could differentiate between control and study subjects. RT/TTP correlated (|r| = 0.534-0.807; P < 0.01 with mean transit time (MTT/MTT ratio in the ipsilateral to contralateral hemisphere by PET study. Bland-Altman analysis showed a wide limit of agreement between RT and MTT and between TTP and MTT. The ratio of RT before and after bypass procedures was significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.60 ± 0.032 and 0.80 ± 0.056, respectively; P = 0.017. The ratio of TTP was also significantly lower in patients with postoperative HPS than in patients without postoperative HPS (0.64 ± 0.081 and 0.85 ± 0.095, respectively; P = 0.017. Conclusions: Time-dependent intraoperative parameters from the ICG transit curve provide quantitative information regarding cerebral circulation time with quality and utility comparable to information obtained by PET. These parameters may help predict the occurrence of postoperative

  20. Myocardial CT perfusion imaging and SPECT for the diagnosis of coronary artery disease

    DEFF Research Database (Denmark)

    George, Richard T; Mehra, Vishal C; Chen, Marcus Y;

    2014-01-01

    . MATERIALS AND METHODS: This study was approved by the institutional review board. Written informed consent was obtained from all patients. Sixteen centers enrolled 381 patients from November 2009 to July 2011. Patients underwent rest and adenosine stress CT perfusion imaging and rest and either exercise...... or pharmacologic stress SPECT before and within 60 days of coronary angiography. Images from CT perfusion imaging, SPECT, and coronary angiography were interpreted at blinded, independent core laboratories. The primary diagnostic parameter was the area under the receiver operating characteristic curve (Az...

  1. Incremental value of myocardial perfusion over coronary angiography by spectral computed tomography in patients with intermediate to high likelihood of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Carrascosa, Patricia M., E-mail: investigacion@diagnosticomaipu.com.ar; Deviggiano, Alejandro; Capunay, Carlos; Campisi, Roxana; López Munain, Marina de; Vallejos, Javier; Tajer, Carlos; Rodriguez-Granillo, Gaston A.

    2015-04-15

    Highlights: •We evaluated myocardial perfusion by dual energy computed tomography (DECT). •We included patients with intermediate to high likelihood of coronary artery disease. •Stress myocardial perfusion by DECT had a reliable accuracy for the detection of ischemia. •Stress myocardial perfusion with DECT showed an incremental value over anatomical evaluation. •DECT imaging was associated to a significant reduction in radiation dose compared to SPECT. -- Abstract: Purpose: We sought to explore the diagnostic performance of dual energy computed tomography (DECT) for the evaluation of myocardial perfusion in patients with intermediate to high likelihood of coronary artery disease (CAD). Materials and methods: Consecutive patients with known or suspected CAD referred for myocardial perfusion imaging by single-photon emission computed tomography (SPECT) constituted the study population and were scanned using a DECT scanner equipped with gemstone detectors for spectral imaging, and a SPECT. The same pharmacological stress was used for both scans. Results: Twenty-five patients were prospectively included in the study protocol. The mean age was 63.4 ± 10.6 years. The total mean effective radiation dose was 7.5 ± 1.2 mSv with DECT and 8.2 ± 1.7 mSv with SPECT (p = 0.007). A total of 425 left ventricular segments were evaluated by DECT, showing a reliable accuracy for the detection of reversible perfusion defects [area under ROC curve (AUC) 0.84 (0.80–0.87)]. Furthermore, adding stress myocardial perfusion provided a significant incremental value over anatomical evaluation alone by computed tomography coronary angiography [AUC 0.70 (0.65–0.74), p = 0.003]. Conclusions: In this pilot investigation, stress myocardial perfusion by DECT demonstrated a significant incremental value over anatomical evaluation alone by CTCA for the detection of reversible perfusion defects.

  2. Quantification of myocardial perfusion using cardiac magnetic resonance imaging correlates significantly to rubidium-82 positron emission tomography in patients with severe coronary artery disease: A preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Qayyum, Abbas A., E-mail: abbas.ali.qayyum@regionh.dk [Department of Cardiology and Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Hasbak, Philip, E-mail: philip.hasbak@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Larsson, Henrik B.W., E-mail: henrik.larsson@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Functional Imaging Unit, Diagnostic Department, Glostrup Hospital, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Ndr. Ringvej 57, 2600 Copenhagen (Denmark); Christensen, Thomas E., E-mail: thomas.emil.christensen@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Ghotbi, Adam A., E-mail: adam.ali.ghotbi@regionh.dk [Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); Mathiasen, Anders B., E-mail: anders.b.mathiasen@gmail.com [Department of Cardiology and Cardiac Catheterization Laboratory 2014, The Heart Centre, Rigshospitalet, University Hospital of Copenhagen and Faculty of Health Sciences, Copenhagen University, Blegdamsvej 9, 2100 Copenhagen (Denmark); and others

    2014-07-15

    Introduction: Aim was to compare absolute myocardial perfusion using cardiac magnetic resonance imaging (CMRI) based on Tikhonov's procedure of deconvolution and rubidium-82 positron emission tomography (Rb-82 PET). Materials and methods: Fourteen patients with coronary artery stenosis underwent rest and adenosine stress imaging by 1.5-Tesla MR Scanner and a mCT/PET 64-slice Scanner. CMRI were analyzed based on Tikhonov's procedure of deconvolution without specifying an explicit compartment model using our own software. PET images were analyzed using standard clinical software. CMRI and PET data was compared with Spearman's rho and Bland–Altman analysis. Results: CMRI results were strongly and significantly correlated with PET results for the absolute global myocardial perfusion differences (r = 0.805, p = 0.001) and for global myocardial perfusion reserve (MPR) (r = 0.886, p < 0.001). At vessel territorial level, CMRI results were also significantly correlated with absolute PET myocardial perfusion differences (r = 0.737, p < 0.001) and MPR (r = 0.818, p < 0.001). Each vessel territory had similar strong correlation for absolute myocardial perfusion differences (right coronary artery (RCA): r = 0.787, p = 0.001; left anterior descending artery (LAD): r = 0.796, p = 0.001; left circumflex artery (LCX): r = 0.880, p < 0.001) and for MPR (RCA: r = 0.895, p < 0.001; LAD: r = 0.886, p < 0.001; LCX: r = 0.886, p < 0.001). Conclusion: On a global and vessel territorial basis, CMRI-measured absolute myocardial perfusion differences and MPR were strongly and significantly correlated with the Rb-82 PET findings.

  3. Arterial spin labeling-fast imaging with steady-state free precession (ASL-FISP): a rapid and quantitative perfusion technique for high-field MRI.

    Science.gov (United States)

    Gao, Ying; Goodnough, Candida L; Erokwu, Bernadette O; Farr, George W; Darrah, Rebecca; Lu, Lan; Dell, Katherine M; Yu, Xin; Flask, Chris A

    2014-08-01

    Arterial spin labeling (ASL) is a valuable non-contrast perfusion MRI technique with numerous clinical applications. Many previous ASL MRI studies have utilized either echo-planar imaging (EPI) or true fast imaging with steady-state free precession (true FISP) readouts, which are prone to off-resonance artifacts on high-field MRI scanners. We have developed a rapid ASL-FISP MRI acquisition for high-field preclinical MRI scanners providing perfusion-weighted images with little or no artifacts in less than 2 s. In this initial implementation, a flow-sensitive alternating inversion recovery (FAIR) ASL preparation was combined with a rapid, centrically encoded FISP readout. Validation studies on healthy C57/BL6 mice provided consistent estimation of in vivo mouse brain perfusion at 7 and 9.4 T (249 ± 38 and 241 ± 17 mL/min/100 g, respectively). The utility of this method was further demonstrated in the detection of significant perfusion deficits in a C57/BL6 mouse model of ischemic stroke. Reasonable kidney perfusion estimates were also obtained for a healthy C57/BL6 mouse exhibiting differential perfusion in the renal cortex and medulla. Overall, the ASL-FISP technique provides a rapid and quantitative in vivo assessment of tissue perfusion for high-field MRI scanners with minimal image artifacts.

  4. Predicting tumor response in patient with metastatic liver cancer to hepatic artery infusion chemotherapy. Evaluation with {sup 99m}Tc-MAA SPECT hepatic artery perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Linfeng; Nakagawa, Tetsuya; Higashi, Kotaro; Okimura, Tetsuro; Yamamoto, Itaru [Kanazawa Medical Univ., Uchinada, Ishikawa (Japan)

    1996-09-01

    {sup 99m}Tc-MAA planar and SPECT hepatic artery perfusion scintigraphy were performed in 25 patients with metastatic liver cancer. A total of 42 metastatic nodules were evaluated on SPECT. Twenty five of 42 metastatic nodules showed positive uptake; 17 showed negative uptake. The results indicate that there is no significant quantitative correlation between the {sup 99m}Tc-MAA uptake ratio of metastatic nodules and the regression of metastatic nodules determined by CT scan. However, there is a statistically significant difference in the regression of metastatic nodule between the {sup 99m}Tc-MAA of uptake positive group and negative group. It means that a positive uptake of {sup 99m}Tc-MAA of tumor predicts a trend of better response to chemotherapy. (author)

  5. Evaluation of patients with coronary artery disease during exercise: the relation between extent of disease and perfusion deficit.

    Science.gov (United States)

    Hakki, A H; DePace, N; Iskandrian, A S

    1984-01-01

    The purpose of this study was to assess the relation between the extent of coronary artery disease (CAD) and size of exercise-induced myocardial hypoperfusion in 79 patients with angiographically documented CAD. None of the patients had Q-wave myocardial infarction. Fifty patients had one-vessel disease, ten had two-vessel disease, and 19 patients had three-vessel or left main disease. From a scintigraphic functional standpoint, patients were classified into two groups: 28 patients (35%) had large perfusion defects and 51 patients (65%) had small defects. The size of the thallium-201 perfusion defect during exercise was assessed as the perimeter of the defect in each projection expressed as a percentage abnormality of the total left ventricular perimeter in that projection. The average abnormality from the three projections was used in the final analysis. Eleven patients with large defects (39%) had one-vessel disease and 12 patients with small defects (24%) had multivessel disease. Stepwise multivariate discriminate analysis identified the number of diseased vessels (F = 13.9), the change in systolic blood pressure from rest to exercise (F = 10.8), the exercise heart rate (F = 9.1), and exercise electrocardiographic response (F = 7.8) as significant associates of the size of the perfusion defect (predictive accuracy = 70%). We conclude that the size of hypoperfused myocardium during exercise is variable in patients with CAD. Discriminate analysis identified the extent of CAD, exercise heart rate, change in systolic pressure from rest to exercise, and exercise electrocardiographic response as significant associates of the size of the defect.

  6. Evaluation of patients with coronary artery disease during exercise: the relation between extent of disease and perfusion deficit

    Energy Technology Data Exchange (ETDEWEB)

    Hakki, A.H.; DePace, N.; Iskandrian, A.S.

    1984-01-01

    The purpose of this study was to assess the relation between the extent of coronary artery disease (CAD) and size of exercise-induced myocardial hypoperfusion in 79 patients with angiographically documented CAD. None of the patients had Q-wave myocardial infarction. Fifty patients had one-vessel disease, ten had two-vessel disease, and 19 patients had three-vessel or left main disease. From a scintigraphic functional standpoint, patients were classified into two groups: 28 patients (35%) had large perfusion defects and 51 patients (65%) had small defects. The size of the thallium-201 perfusion defect during exercise was assessed as the perimeter of the defect in each projection expressed as a percentage abnormality of the total left ventricular perimeter in that projection. The average abnormality from the three projections was used in the final analysis. Eleven patients with large defects (39%) had one-vessel disease and 12 patients with small defects (24%) had multivessel disease. Stepwise multivariate discriminate analysis identified the number of diseased vessels (F . 13.9), the change in systolic blood pressure from rest to exercise (F . 10.8), the exercise heart rate (F . 9.1), and exercise electrocardiographic response (F . 7.8) as significant associates of the size of the perfusion defect (predictive accuracy . 70%). We conclude that the size of hypoperfused myocardium during exercise is variable in patients with CAD. Discriminate analysis identified the extent of CAD, exercise heart rate, change in systolic pressure from rest to exercise, and exercise electrocardiographic response as significant associates of the size of the defect.

  7. A pilot study on diagnosis of coronary artery disease using computed tomography first-pass myocardial perfusion imaging at rest

    Institute of Scientific and Technical Information of China (English)

    Qi WANG; Jing QIN; Lu-yue GAI; Yun-dai CHEN; Wei DONG; Zhi-wei GUAN; Zhi-guo WANG; Zhi-jun SUN; Jia-he TIAN

    2011-01-01

    Background: Although computed tomography coronary angiography (CTCA) can identify coronary stenosis, little data exists on the ability of multislice computed tomography (MSCT) to detect myocardial perfusion defects at rest. Methods: In 33 patients with diagnosed or suspected coronary artery disease (CAD), CTCA using retrospective electrocardiography (ECG) gating at rest and invasive coronary angiography (ICA) was performed. The 2D myocardial images were reconstructed in diastolic and systolic phases using the same raw data for CTCA. CT values of the myocardium were used as an estimate of myocardial enhancement, which were shown by color mapping. Myocardial ischemia was defined as a pattern of transient endocardial hypo-enhancement at systole and normal enhancement at diastole. The results of ICA were taken as the reference standard. Results: When a diameter reduction of more than 50% in ICA was used as diagnostic criteria of CAD, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CT first-pass myocardial perfusion imaging (MPI) at rest were 0.85, 0.67, 0.92, and 0.50 per patient, respectively, and 0.58, 0.93, 0.85, and 0.76 per vessel, respectively. Conclusions: CT first-pass MPI at rest could detect CAD patients, which could become a practical and convenient way to detect ischemia, consequently offering the ability for MSCT to act as a "one stop shop" for the diagnosis of CAD.

  8. Regional myocardial perfusion in patients with atherosclerotic coronary artery disease, at rest and during angina pectoris induced by tachycardia

    Energy Technology Data Exchange (ETDEWEB)

    Maseri, A.; L' Abbate, A.; Pesola, A.; Michelassi, C.; Marzilli, M.; De Nes, M.

    1977-03-01

    We studied regional myocardial perfusion by scintigraphic computer-assisted analysis of initial distribution, washout rates, and residual activity of /sup 133/Xe injected into the left coronary artery of four patients with normal arteriograms and 14 patients with coronary stenosis. At rest, residual activity in poststenotic regions was always greater than in control regions, but initial washout rates were not slower. During angina, following xenon injections, the amount of indicator distributed to the poststenotic regions was markedly reduced; the increase of the initial washout rates was smaller than in control regions relative to rest, and residual activity was higher. Initial washout rates did not differ as much as from those of normal myocardium because in severe ischemia too little indicator is deposited initially in these regions to produce a change of any magnitude. Indeed, when angina was induced immediately after the xenon injection, poststenotic washout rates became much slower during angina than at rest, a finding that implicates functional factors in impairing poststenotic myocardial perfusion during angina.

  9. Liver cancer arterial perfusion modelling and CFD boundary conditions methodology: a case study of the haemodynamics of a patient-specific hepatic artery in literature-based healthy and tumour-bearing liver scenarios.

    Science.gov (United States)

    Aramburu, Jorge; Antón, Raúl; Rivas, Alejandro; Ramos, Juan Carlos; Sangro, Bruno; Bilbao, José Ignacio

    2016-11-01

    Some of the latest treatments for unresectable liver malignancies (primary or metastatic tumours), which include bland embolisation, chemoembolisation, and radioembolisation, among others, take advantage of the increased arterial blood supply to the tumours to locally attack them. A better understanding of the factors that influence this transport may help improve the therapeutic procedures by taking advantage of flow patterns or by designing catheters and infusion systems that result in the injected beads having increased access to the tumour vasculature. Computational analyses may help understand the haemodynamic patterns and embolic-microsphere transport through the hepatic arteries. In addition, physiological inflow and outflow boundary conditions are essential in order to reliably represent the blood flow through arteries. This study presents a liver cancer arterial perfusion model based on a literature review and derives boundary conditions for tumour-bearing liver-feeding hepatic arteries based on the arterial perfusion characteristics of normal and tumorous liver segment tissue masses and the hepatic artery branching configuration. Literature-based healthy and tumour-bearing realistic scenarios are created and haemodynamically analysed for the same patient-specific hepatic artery. As a result, this study provides boundary conditions for computational fluid dynamics simulations that will allow researchers to numerically study, for example, various intravascular devices used for liver disease intra-arterial treatments with different cancer scenarios. Copyright © 2016 John Wiley & Sons, Ltd.

  10. Improved myocardial perfusion after transmyocardial laser revascularization in a patient with microvascular coronary artery disease

    Directory of Open Access Journals (Sweden)

    Peyman Mesbah Oskui

    2014-03-01

    Full Text Available We report the case of a 59-year-old woman who presented with symptoms of angina that was refractory to medical management. Although her cardiac catheterization revealed microvascular coronary artery disease, her symptoms were refractory to optimal medical management that included ranolazine. After undergoing transmyocardial revascularization, her myocardial ischemia completely resolved and her symptoms dramatically improved. This case suggests that combination of ranolazine and transmyocardial revascularization can be applied to patients with microvascular coronary artery disease.

  11. Feasibility of Using Pseudo-Continuous Arterial Spin Labeling Perfusion in a Geriatric Population at 1.5 Tesla.

    Directory of Open Access Journals (Sweden)

    Sigurdur Sigurdsson

    Full Text Available To evaluate the feasibility of using pseudo-continuous arterial spin labeling (pCASL perfusion in a geriatric population at 1.5-Tesla.In 17 participants (mean age 78.8±1.63 years we assessed; 1 inter-session repeatability and reliability of resting state perfusion in 27 brain regions; 2 brain activation using finger-tapping as a means to evaluate the ability to detect flow differences; 3 reliability by comparing cerebral blood flow (CBF with pCASL to CBF with phase contrast (PC-MR.The CBF (mean±standard deviation (SD for the whole brain grey matter (GM was 40.6±8.4 and 41.4±8.7 ml/100g/min for the first and second scan respectively. The within-subject standard deviation (SDw, the repeatability index (RI and intra-class correlation coefficient (ICC across the 27 regions ranged from 1.1 to 7.9, 2.2 to 15.5 and 0.35 to 0.98 respectively. For whole brain GM the SDw, RI and ICC were 1.6, 3.2 and 0.96 respectively. The between-subject standard deviation (SDB was larger than the SDw for all regions. Comparison of CBF at rest and activation on a voxel level showed significantly higher perfusion during finger tapping in the motor- and somatosensory regions. The mean CBF for whole brain GM was 40.6±8.4 ml/100g/min at rest and 42.6±8.6 ml/100g/min during activation. Finally the reliability of pCASL against the reference standard of PC-MR was high (ICC = 0.80. The mean CBF for whole brain measured with PC-MRI was 54.3±10.1 ml/100g/min and 38.3±7.8 ml/100g/min with pCASL.The results demonstrate moderate to high levels of repeatability and reliability for most brain regions, comparable to what has been reported for younger populations. The performance of pCASL at 1.5-Tesla shows that region-specific perfusion measurements with this technique are feasible in studies of a geriatric population.

  12. [Abnormal cerebral blood flow distributions during the post-ictal phase of febrile status epilepticus in three pediatric patients measured by arterial spin labeling perfusion MRI].

    Science.gov (United States)

    Hirano, Keiko; Fukuda, Tokiko

    2016-05-01

    The ability to visualize brain perfusion is important for identifying epileptic foci. We present three pediatric cases showing asymmetrical cerebral blood flow (CBF) distributions during the post-ictal phase of febrile status epilepticus measured by arterial spin labeling (ASL) perfusion MRI. During the acute phase, regional CBF measurements in the areas considered including epileptic foci were higher than in the corresponding area of the contralateral hemisphere, though the exact quantitative value varied between cases. We could not identify the correct epileptogenic foci, because those ASL images were taken after the prolonged and extraordinary activation of neurons in the affected area. During the recovery phase, the differences reduced and the average regional CBF measurement was 54.6 ± 6.1 ml/100 g per minute, which was a little less than the number of previous ASL studies. ASL perfusion MRI imaging provides a method for evaluating regional CBF by using magnetically labeled arterial blood water as an endogenous tracer. With this technique, we can repeatedly evaluate both the brain structure and the level of perfusion at the same time. ASL is noninvasive and easily accessible, and therefore it could become a routine tool for assessment of perfusion in daily practice of pediatric neurology.

  13. Tissue-Muscle Perfusion Scintigraphy of the Lower Limbs in a Patient with Type 2 Diabetes Mellitus and Peripheral Arterial Disease

    Directory of Open Access Journals (Sweden)

    Irfan Ahmet

    2016-02-01

    Full Text Available The estimation of tissue perfusion as a hemodynamic consequence of peripheral arterial disease (PAD in diabetic patients is of great importance in the management of these patients.We present a noninvasive, functional method of 99mTc-MIBI (methoxy-isobutyl-isonitrile tissue-muscle perfusion scintigraphy (TMPS of the lower limbs, which assesses tissue perfusion in basal conditions (“rest” study and exercise conditions (“stress” study. Emphasis is given on perfusion reserve (PR as an important indicator of preservation of microcirculation and its local autoregulatory mechanisms in PAD. We present a case of a 71-year-old male diabetic patient with skin ulcers of the right foot and an ankle-brachial index >1.2 (0.9-1.1. Dynamic phase TMPS of the lower limbs showed decreased and late arterial vascularization of the right calf (RC with lower percentage of radioactivity in the 1st minute: RC 66%, left calf (LC 84%. PR was borderline with a value of 57% for LC and decreased for RC (42%. Functional assessment of hemodynamic consequences of PAD is important in evaluating both advanced and early PAD, especially the asymptomatic form. The method used to determine the TMPS of the lower limbs, can differentiate subtle changes in microcirculation and tissue perfusion

  14. Tissue-Muscle Perfusion Scintigraphy of the Lower Limbs in a Patient with Type 2 Diabetes Mellitus and Peripheral Arterial Disease

    Science.gov (United States)

    Manevska, Nevena; Gjorceva, Daniela Pop; Ahmeti, Irfan; Todorovska, Lidija; Stojanoski, Sinisa; Kocovska, Marina Zdraveska

    2016-01-01

    The estimation of tissue perfusion as a hemodynamic consequence of peripheral arterial disease (PAD) in diabetic patients is of great importance in the management of these patients.We present a noninvasive, functional method of 99mTc-MIBI (methoxy-isobutyl-isonitrile) tissue-muscle perfusion scintigraphy (TMPS) of the lower limbs, which assesses tissue perfusion in basal conditions (“rest” study) and exercise conditions (“stress” study). Emphasis is given on perfusion reserve (PR) as an important indicator of preservation of microcirculation and its local autoregulatory mechanisms in PAD. We present a case of a 71-year-old male diabetic patient with skin ulcers of the right foot and an ankle-brachial index >1.2 (0.9-1.1). Dynamic phase TMPS of the lower limbs showed decreased and late arterial vascularization of the right calf (RC) with lower percentage of radioactivity in the 1st minute: RC 66%, left calf (LC) 84%. PR was borderline with a value of 57% for LC and decreased for RC (42%). Functional assessment of hemodynamic consequences of PAD is important in evaluating both advanced and early PAD, especially the asymptomatic form. The method used to determine the TMPS of the lower limbs, can differentiate subtle changes in microcirculation and tissue perfusion. PMID:27299288

  15. Contractile responses to ergotamine and dihydroergotamine in the perfused middle cerebral artery of rat

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer; Nilsson, Elisabeth; Edvinsson, Lars

    2007-01-01

    mmHg and luminally perfused. All vessels used attained spontaneous contractile tone (34.9+/-1.8% of resting tone) and responded to luminal adenosine triphosphate (ATP) with dilatation (24.1+/-4.0%), which showed functioning endothelium. Luminally added ergotamine or DHE induced maximal contractions...... no significant effect. Using a myograph technique, isolated ring segments of the MCA with intact endothelium were mounted on two metal wires. Neither agonist caused relaxation of resting vessels, however, they both responded by weak contractile responses (26+/-3% of submaximal contractile capacity relative to 60...

  16. Incremental value of contrast myocardial perfusion to detect intermediate versus severe coronary artery stenosis during stress-echocardiography

    Directory of Open Access Journals (Sweden)

    Ugo Fabrizio

    2010-05-01

    Full Text Available Abstract Background We aimed to compare the incremental value of contrast myocardial perfusion imaging (MPI for the detection of intermediate versus severe coronary artery stenosis during dipyridamole-atropine echocardiography (DASE. Wall motion (WM assessment during stress-echocardiography demonstrates suboptimal sensitivity to detect coronary artery disease (CAD, particularly in patients with isolated intermediate (50%-70% coronary stenosis. Methods We performed DASE with MPI in 150 patients with a suspected chest pain syndrome who were given clinical indication to coronary angiography. Results and discussion When CAD was defined as the presence of a ≥50% stenosis, the addition of MPI increased sensitivity (+30% and decreased specificity (-14%, with a final increase in total diagnostic accuracy (+16%, p Conclusions The addition of MPI on top of WM analysis during DASE increases the diagnostic sensitivity to detect obstructive CAD, whatever its definition (≥50% or > 70% stenosis, but it is mainly driven by the sensitivity increase in the intermediate group (50%-70% stenosis. The total diagnostic accuracy increased only when defining CAD as ≥50% stenosis, since in patients with severe stenosis (> 70% the decrease in specificity is not counterbalanced by the minor sensitivity increase.

  17. Functional Relevance of Coronary Artery Disease by Cardiac Magnetic Resonance and Cardiac Computed Tomography: Myocardial Perfusion and Fractional Flow Reserve

    Directory of Open Access Journals (Sweden)

    Gianluca Pontone

    2015-01-01

    Full Text Available Coronary artery disease (CAD is one of the leading causes of morbidity and mortality and it is responsible for an increasing resource burden. The identification of patients at high risk for adverse events is crucial to select those who will receive the greatest benefit from revascularization. To this aim, several non-invasive functional imaging modalities are usually used as gatekeeper to invasive coronary angiography, but the diagnostic yield of elective invasive coronary angiography remains unfortunately low. Stress myocardial perfusion imaging by cardiac magnetic resonance (stress-CMR has emerged as an accurate technique for diagnosis and prognostic stratification of the patients with known or suspected CAD thanks to high spatial and temporal resolution, absence of ionizing radiation, and the multiparametric value including the assessment of cardiac anatomy, function, and viability. On the other side, cardiac computed tomography (CCT has emerged as unique technique providing coronary arteries anatomy and more recently, due to the introduction of stress-CCT and noninvasive fractional flow reserve (FFR-CT, functional relevance of CAD in a single shot scan. The current review evaluates the technical aspects and clinical experience of stress-CMR and CCT in the evaluation of functional relevance of CAD discussing the strength and weakness of each approach.

  18. Arterial pressure variations as parameters of brain perfusion in response to central blood volume depletion and repletion

    Directory of Open Access Journals (Sweden)

    Anne-Sophie G.T. Bronzwaer

    2014-04-01

    Full Text Available Rationale:A critical reduction in central blood volume (CBV is often characterized by hemodynamic instability. Restoration of a volume deficit may be established by goal-directed fluid therapy guided by respiration-related variation in systolic- and pulse pressure (SPV and PPV. Stroke volume index (SVI serves as a surrogate end-point of a fluid challenge but tissue perfusion itself has not been addressed. Objective: To delineate the relationship between arterial pressure variations, SVI and regional brain perfusion during CBV depletion and repletion in spontaneously breathing volunteers. Methods: This study quantified in 14 healthy subjects (11 male the effects of CBV depletion (by 30 and 70 degrees passive head-up tilt (HUT and a fluid challenge (by tilt back on CBV (thoracic admittance, mean middle cerebral artery (MCA blood flow velocity (Vmean, SVI, cardiac index (CI , PPV and SPV. Results: PPV (103±89%, p< 0.05 and SPV (136±117%, p< 0.05 increased with progression of central hypovolemia manifested by a reduction in thoracic admittance (11±5%, p< 0.001, SVI (28±6%, p< 0.001, CI (6±8%, p< 0.001 and MCAVmean (17±7%, p< 0.05 but not in arterial pressure. The reduction in MCAVmean correlated to the fall in SVI (R2=0.52, p< 0.0001 and inversely to PPV and SPV (R2=0.46 (p< 0.0001 and R2=0.45 (p< 0.0001, respectively. PPV and SPV predicted a ≥15% reduction in MCAVmean and SVI with comparable sensitivity (67%/ 67% vs. 63%/ 68% respectively and specificity (89%/94% vs. 89%/94%, respectively. A rapid fluid challenge by tilt-back restored all parameters to baseline values within one minute. Conclusion: In spontaneously breathing subjects, a reduction in MCAVmean was related to an increase in PPV and SPV during graded CBV depletion and repletion. Specifically, PPV and SPV predicted changes in both SVI and MCAVmean with comparable sensitivity and specificity, however the predictive value is limited in spontaneously breathing subjects.

  19. Near-infrared laparoscopy for real-time intra-operative arterial and lymphatic perfusion imaging.

    LENUS (Irish Health Repository)

    Cahill, R A

    2012-02-01

    Multimodal laparoscopic imaging systems possessing the capability for extended spectrum irradiation and visualization within a unified camera system are now available to provide enhanced intracorporeal operative anatomic and dynamic perfusion assessment and potentially augmented patient outcome. While ultraviolet-range energies have limited penetration and hence are probably more useful for endoscopic mucosal interrogation, the near-infrared (NIR) spectrum is of greater potential utility for the purposes of examining inducible fluorescence in abdominopelvic tissue that can be achieved by administration of specific tracer agents, either directly into the circulation (e.g. for anastomotic perfusion assessment at the time of stapling) or into the lymphatic system (e.g. for lymph basin road-mapping and\\/or focussed target nodal assessment). This technology is also capable of supplementing anatomic recognition of the biliary system while implantable fibres can also be inserted intraoperatively for the purpose of safeguarding vital structures such as the oesphagus and ureters especially in difficult reoperations. It is likely that this technological capability will find a clear and common indication in colorectal specialist and general surgical departments worldwide in the near future.

  20. An arterially perfused nose-olfactory bulb preparation of the rat.

    Science.gov (United States)

    Pérez de los Cobos Pallarés, Fernando; Stanić, Davor; Farmer, David; Dutschmann, Mathias; Egger, Veronica

    2015-09-01

    A main feature of the mammalian olfactory bulb network is the presence of various rhythmic activities, in particular, gamma, beta, and theta oscillations, with the latter coupled to the respiratory rhythm. Interactions between those oscillations as well as the spatial distribution of network activation are likely to determine olfactory coding. Here, we describe a novel semi-intact perfused nose-olfactory bulb-brain stem preparation in rats with both a preserved olfactory epithelium and brain stem, which could be particularly suitable for the study of oscillatory activity and spatial odor mapping within the olfactory bulb, in particular, in hitherto inaccessible locations. In the perfused olfactory bulb, we observed robust spontaneous oscillations, mostly in the theta range. Odor application resulted in an increase in oscillatory power in higher frequency ranges, stimulus-locked local field potentials, and excitation or inhibition of individual bulbar neurons, similar to odor responses reported from in vivo recordings. Thus our method constitutes the first viable in situ preparation of a mammalian system that uses airborne odor stimuli and preserves these characteristic features of odor processing. This preparation will allow the use of highly invasive experimental procedures and the application of techniques such as patch-clamp recording, high-resolution imaging, and optogenetics within the entire olfactory bulb.

  1. Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Yuoness, Salem A.; Goha, Ahmed M.; Romsa, Jonathan G.; Akincioglu, Cigdem; Warrington, James C.; Datta, Sudip; Gambhir, Sanjay; Urbain, Jean-Luc C.; Vezina, William C. [London Health Sciences Centre, Department of Nuclear Medicine, London, ON (Canada); Massel, David R. [London Health Sciences Centre, Division of Cardiology, London, ON (Canada); Martell, Rafael [Private Practice, London, ON (Canada)

    2015-09-15

    Myocardial perfusion imaging (MPI) has limitations in the presence of balanced multivessel disease (MVD) and left main (LM) coronary artery disease, occasionally resulting in false-normal results despite the high cardiovascular risk associated with this condition. The purpose of this study was to assess the incidence of severe coronary artery disease (CAD) in the presence of a very high Agatston coronary artery calcium (CAC) score (>1,000) in stable symptomatic patients without known CAD but with normal MPI results. A total of 2,659 prospectively acquired consecutive patients were referred for MPI and evaluation of CAC score by CT. Of this patient population, 8 % (222/2,659) had ischemia without myocardial infarction (MI) on MPI and 11 % (298/2,659) had abnormal MPI (MI and/or ischemia). On presentation 1 % of the patients (26/2,659) were symptomatic, had a CAC score >1,000 and normal MPI results. The definition of normal MPI was strict and included a normal hemodynamic response without ischemic ECG changes and normal imaging, particularly absence of transient ischemic dilation. All of these 26 patients with a CAC score >1,000 and normal MPI findings underwent cardiac catheterization. Of these 26 patients, 58 % (15/26) had severe disease (≥70 % stenosis) leading to revascularization. Of this group, 47 % (7/15) underwent percutaneous intervention, and 53 % (8/15) underwent coronary artery bypass grafting. All of these 15 patients had either MVD (14/15) or LM coronary artery disease (1/15), and represented 0.6 % (15/2,659) of all referred patients (95 % CI 0.3 - 0.9 %). The majority, 90 % (8/9), had severe CAD with typical chest pain. A very high CAC score (>1,000) with normal MPI in a small subset of symptomatically stable patients was associated with a moderate incidence of severe CAD (95 % CI 37 - 77 %). Larger studies and/or a meta-analysis of small studies are needed to more precisely estimate the incidence of CAD in this population. This study also supports

  2. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and Power Doppler ultrasound.

    Science.gov (United States)

    T, Hotfiel; B, Swoboda; S, Krinner; C, Grim; M, Engelhardt; M, Uder; R, Hei

    2016-09-23

    Foam rolling has been developed as a popular intervention in training and rehabilitation. However, evidence on its effects on the cellular and physiological level is lacking. The aim of this study was to assess the effect of foam rolling on arterial blood flow of the lateral thigh. Twenty-one healthy participants (age 25 ± 2 years, height 177 ± 9 cm, body weight 74 ± 9 kg) were recruited from the medical and sports faculty. Arterial tissue perfusion was determined by spectral Doppler and power Doppler ultrasound, represented as peak flow (Vmax), time average velocity maximum (TAMx), time average velocity mean (TAMn), and resistive index (RI), and with semiquantitative grading that was assessed by four blind-folded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 min and 30 min post intervention). The trochanteric region, mid portion, and distal tibial insertion of the lateral thigh were representative for data analysis. Arterial blood flow of the lateral thigh increased significantly following foam rolling exercises compared to baseline (p<0.05). We detected a relative increase in Vmax of 73.6% (0 min) and 52.7 % (30 min) (p<0.001), in TAMx of 53.2% (p<0.001) and 38.3 % (p=0.002), and in TAMn of 84.4% (p<0.001) and 68.2 % (p<0.001). Semiquantitative Power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 min compared to 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

  3. Selective renal vasodilation and active renal artery perfusion improve renal function in dogs with acute heart failure.

    Science.gov (United States)

    Suehiro, K; Shimizu, J; Yi, G H; Gu, A; Wang, J; Keren, G; Burkhoff, D

    2001-09-01

    Renal failure is common in heart failure due to renovascular constriction and hypotension. We tested whether selective pharmacological renal artery vasodilation and active renal artery perfusion (ARP) could improve renal function without adverse effects on systemic blood pressure in a canine model of acute heart failure (AHF). AHF was induced by coronary microembolization in 16 adult mongrel dogs. In five dogs, selective intrarenal (IR) papaverine (1, 2, and 4 mg/min) was administered into the left renal artery. In six dogs, ARP was performed in the left renal artery to normalize mean renal arterial pressure followed by administration of IR papaverine (2 mg/min). In five dogs, ARP plus intravenous furosemide was tested. Urine output (UO) and cortical renal blood flow decreased during AHF and were restored by 2 mg/min IR papaverine (UO: baseline 4.2 +/- 0.6, AHF 1.6 +/- 1.3, IR papaverine 5.8 +/- 1.1 ml/15 min; cortical blood flow: baseline 4.3 +/- 0.2, AHF 2.4 +/- 0.6, IR papaverine 4.2 +/- 1.2 ml/min/g) with no significant change in aortic pressure. ARP also increased urine output and cortical renal blood flow (UO: baseline 5.0 +/- 1.1, AHF 0.5 +/- 0.4, ARP 3.8 +/- 3.1 ml/15 min; cortical blood flow: baseline 4.0 +/- 0.5, AHF 2.0 +/- 0.8, ARP 3.52 +/- 1.1 ml/min/g). A combination of these methods in AHF further increased urine output to twice the normal baseline (10.5 +/- 7.5 ml/15 min). Addition of furosemide synergistically increased UO above that achieved with ARP alone (5.5 +/- 2.6 versus 40.3 +/- 24.7 ml/15 min, p = 0.03). In conclusion, ARP and selective renal vasodilation may effectively promote salt and water excretion in the setting of heart failure, particularly when systemic blood pressure is low.

  4. 320-Multidetector row whole-head dynamic subtracted CT angiography and whole-brain CT perfusion before and after carotid artery stenting: Technical note

    Energy Technology Data Exchange (ETDEWEB)

    San Millan Ruiz, Diego, E-mail: dsanmil1@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Murphy, Kieran, E-mail: KMURPHY@jhmi.ed [Division of Interventional Neuroradiology, Department of Radiology, The Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States); Gailloud, Philippe, E-mail: pgailloud@cerebrovascular.ne [Division of Interventional Neuroradiology, Department of Radiology, Johns Hopkins Hospital, 600 North Wolfe Street, B-100, Baltimore, MD 21287 (United States)

    2010-06-15

    Introduction: Multidetector CT (MDCT) is increasingly used for the investigation of neurovascular disorders, but restricted z-axis coverage (3.2 cm for 64-MDCT) currently limits perfusion to a small portion of the brain close to the circle of Willis, and precludes dynamic angiographic appreciation of the entire brain circulation. We illustrate the clinical potential of recently developed 320-MDCT extending the z-axis coverage to 16 cm in a patient with symptomatic carotid artery stenosis. Methods: In a 74-year-old patient presenting with critical symptomatic stenosis of the left CCA, pre- and post-carotid artery stenting whole-head subtracted dynamic MDCT angiography and perfusion were obtained in addition to CT angiography of the supra-aortic trunks. Both whole-head subtracted MDCT angiography and perfusion demonstrated delayed left ICA circulation, which normalized after carotid stenting. Discussion: 320-MDCT offers unprecedented z-axis coverage allowing for whole-brain perfusion and subtracted dynamic angiography of the entire intracranial circulation. These innovations can consolidate the role of MDCT as a first intention imaging technique for cerebrovascular disorders, in particular for the acute management of stroke.

  5. Pre-procedural combined coronary angiography and stress myocardial perfusion imaging using 320-detector CT in unprotected left main and ostial left anterior descending artery intervention.

    Science.gov (United States)

    Ko, Brian S; Crossett, Marcus; Seneviratne, Sujith K

    2015-07-01

    Pre-procedural anatomic and functional coronary assessment plays a crucial role in selection of patients suitable for unprotected left main percutaneous coronary intervention. Combined coronary computed tomography angiography and adenosine stress computed tomography myocardial perfusion imaging is a non-invasive technique which may provide this information. This is the first report describing its use to assist patient selection and procedural planning prior to elective left main and ostial left anterior descending artery coronary intervention.

  6. 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 PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

  7. SPECT myocardial perfusion imaging. Long-term prognostic value in diabetic patients with and without coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Koehli, M. [Dept. of Endocrinology, Diabetology and Metabolism, Univ. Hospital Lausanne (Switzerland); Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Monbaron, D.; Gaillard, R.C.; Ruiz, J. [Dept. of Endocrinology, Diabetology and Metabolism, Univ. Hospital Lausanne (Switzerland); Prior, J.O.; Bischof Delaloye, A. [Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Calcagni, M.L. [Dept. of Nuclear Medicine, Univ. Hospital Lausanne (Switzerland); Dept. of Cardiology, Univ. Hospital Lausanne (Switzerland); Fivaz-Arbane, M.; Stauffer, J.C. [Inst. of Nuclear Medicine, Univ. Cattolica del Sacro Cuore, Roma (Italy)

    2006-07-01

    Aim: To determine the long-term prognostic value of SPECT myocardial perfusion imaging (MPI) for the occurrence of cardiovascular events in diabetic patients. Patients, methods: SPECT MPI of 210 consecutive Caucasian diabetic patients were analysed using Kaplan-Meier event-free survival curve and independent predictors were determined by Cox multivariate analyses. Results: Follow-up was complete in 200 (95%) patients with a median period of 3.0 years (0.8-5.0). The population was composed of 114 (57%) men, age 65 {+-} 10 years, 181 (90.5%) type 2 diabetes mellitus, 50 (25%) with a history of coronary artery disease (CAD) and 98 (49%) presenting chest pain prior to MPI. The prevalence of abnormal MPI was 58%. Patients with a normal MPI had neither cardiac death, nor myocardial infarction, independently of a history of coronary artery disease or chest pain. Among the independent predictors of cardiac death and myocardial infarction, the strongest was abnormal MPI (p < 0.0001), followed by history of CAD (Hazard Ratio (HR) = 15.9; p = 0.0001), diabetic retinopathy (HR = 10.0; p = 0.001) and inability to exercise (HR = 7.7; p = 0.02). Patients with normal MPI had a low revascularisation rate of 2.4% during the follow-up period. Compared to normal MPI, cardiovascular events increased 5.2 fold for reversible defects, 8.5 fold for fixed defects and 20.1 fold for the association of both defects. Conclusion: Diabetic patients with normal MPI had on excellent prognosis independently of history of CAD. On the opposite, an abnormal MPI led to a > 5-fold increase in cardiovascular events. This emphasizes the value of SPECT MPI in predicting and risk-stratifying cardiovascular events in diabetic patients. (orig.)

  8. Increased perfusion pressure enhances the expression of endothelin (ETB) and angiotensin II (AT1, AT2) receptors in rat mesenteric artery smooth muscle cells

    DEFF Research Database (Denmark)

    Lindstedt, Isak; Xu, Cang-Bao; Zhang, Yaping;

    2009-01-01

    and luminally perfused in a perfusion chamber. After either exposure to no ("organ culture" (0 mmHg)), normal (85/75 mmHg) or high pressure (160/150 mmHg) at constant flow for 1-17 h, the vessel segments were snap frozen and real-time polymerase chain reaction was performed to quantify the ET- and AT-receptor m......In the present study, we hypothesized that changes in perfusion pressure result in altered expression of mRNA and protein encoding for the ETA-, ETB-, AT1- and AT2-receptors in rat mesenteric vessels. Segments of the rat mesenteric artery were cannulated with glass micropipettes, pressurized......RNA content, or immersed in a fixative solution, dehydrated, frozen, cut in a cryostat and immunohistology stained for ET- and AT-receptor protein. The mRNA expressions of ETB and of AT2 were significantly enhanced in vessels exposed to high perfusion pressure, compared with normal and no perfusion pressure...

  9. Target hepatic artery regional chemotherapy and bevacizumab perfusion in liver metastatic colorectal cancer after failure of first-line or second-line systemic chemotherapy.

    Science.gov (United States)

    Chen, Hui; Zhang, Ji; Cao, Guang; Liu, Peng; Xu, Haifeng; Wang, Xiaodong; Zhu, Xu; Gao, Song; Guo, Jianhai; Zhu, Linzhong; Zhang, Pengjun

    2016-02-01

    Colorectal cancer liver metastasis (CRLM) is a refractory disease after failure of first-line or second-line chemotherapy. Bevacizumab is recommended as first-line therapy for advanced colorectal cancer, but is unproven in CRLM through the hepatic artery. We report favorable outcomes with targeted vessel regional chemotherapy (TVRC) for liver metastatic gastric cancer. TVRC with FOLFOX and bevacizumab perfusion through the hepatic artery was attempted for CRLM for efficacy and safety evaluation. In a single-institution retrospective observational study, 246 patients with CRLM after at least first-line or second-line failure of systemic chemotherapy received TVRC with FOLFOX (i.e. oxaliplatin, leucovorin, and 5-fluorouracil). Of 246 patients, 63 were enrolled into two groups: group 1 (n=30) received bevacizumab and TVRC following tumor progression during previous TVRC treatments; group 2 (n=33) received TVRC plus bevacizumab for CRLM on initiating TVRC. There were no significant differences in the median survival time (14.7 vs. 13.2 months, P=0.367), although the median time to progression was significant (3.3 vs. 5.5 months, P=0.026) between groups. No severe adverse events related to TVRC plus bevacizumab perfusion occurred. Target vessel regional chemotherapy with FOLFOX plus bevacizumab perfusion through the hepatic artery was effective and safe in CRLM. The optimal combination of TVRC and bevacizumab needs further confirmation in future phase II-III clinical trials.

  10. Diagnostic performance of stress myocardial perfusion imaging for coronary artery disease: a systematic review and meta-analysis

    Energy Technology Data Exchange (ETDEWEB)

    Jong, Marcus C. de; Genders, Tessa S.S. [Erasmus MC - University Medical Center Rotterdam, Departments of Epidemiology and Radiology, P.O. Box 2040, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Geuns, Robert-Jan van [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands); Moelker, Adriaan [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Hunink, M.G.M. [Erasmus MC - University Medical Center Rotterdam, Departments of Epidemiology and Radiology, P.O. Box 2040, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Harvard University, Department of Health Policy and Management, Harvard School of Public Health, Boston (United States)

    2012-09-15

    To determine and compare the diagnostic performance of stress myocardial perfusion imaging (MPI) for the diagnosis of obstructive coronary artery disease (CAD), using conventional coronary angiography (CCA) as the reference standard. We searched Medline and Embase for literature that evaluated stress MPI for the diagnosis of obstructive CAD using magnetic resonance imaging (MRI), contrast-enhanced echocardiography (ECHO), single-photon emission computed tomography (SPECT) and positron emission tomography (PET). All pooled analyses were based on random effects models. Articles on MRI yielded a total of 2,970 patients from 28 studies, articles on ECHO yielded a sample size of 795 from 10 studies, articles on SPECT yielded 1,323 from 13 studies. For CAD defined as either at least 50 %, at least 70 % or at least 75 % lumen diameter reduction on CCA, the natural logarithms of the diagnostic odds ratio (lnDOR) for MRI (3.63; 95 % CI 3.26-4.00) was significantly higher compared to that of SPECT (2.76; 95 % CI 2.28-3.25; P = 0.006) and that of ECHO (2.83; 95 % CI 2.29-3.37; P = 0.02). There was no significant difference between the lnDOR of SPECT and ECHO (P = 0.52). Our results suggest that MRI is superior for the diagnosis of obstructive CAD compared with ECHO and SPECT. ECHO and SPECT demonstrated similar diagnostic performance. (orig.)

  11. Assessment of hepatocellular carcinoma vascularity before and after transcatheter arterial chemoembolization by using first pass perfusion weighted MR imaging

    Institute of Scientific and Technical Information of China (English)

    Jun-Gong Zhao; Gan-Sheng Feng; Xiang-Quan Kong; Xin Li; Ming-Hua Li; Ying-Sheng Cheng

    2004-01-01

    AIM: To assess the vascularity of hepatocellular carcinoma (HCC)before and after transcatheter arterial chemoembolization (TACE) with the quantitative parameters obtained by first pass perfusion weighted MR imaging (FP-MRI).METHODS: Seventeen consecutive patients with one to three lesions in liver underwent FP-MRI before treatment.FP-MRI was also performed one, three, six, nine months,and one year after TACE. The baseline signal intensity (SO)of pre-TACE and one month after TACE was analyzed, the vascularity of HCC assessed by steepest slope of the signal intensity versus time curves (SS) was blindly correlated with their DSA feature and clinical outcome.RESULT: No significant difference was found on baseline signal intensity (SO) between pre-TACE and one month after TACE (F=0.309, P=0.583), The SS (mean, 32% per second) of lesion one month after TACE was lower than that of pre-TACE (mean, 69% per second), but with no statistical significance (F=3.067, P=0.092). When local recurrence occurred, the time intensity curves became steeper. The vascularity of HCC before and after TACE graded by SS closely correlated with that by DSA (K=0.453, P<0.05).CONCLUSION: FP-MRI is a useful criterion for selecting effective interventional treatment for patients with HCC in their initial treatment and during follow up.

  12. Comparison of exercise electrocardiography and stress perfusion CMR for the detection of coronary artery disease in women

    Directory of Open Access Journals (Sweden)

    Greulich Simon

    2012-06-01

    Full Text Available Abstract Background Exercise electrocardiography (ECG is frequently used in the work-up of patients with suspected coronary artery disease (CAD, however the accuracy is reduced in women. Cardiovascular magnetic resonance (CMR stress testing can accurately diagnose CAD in women. To date, a direct comparison of CMR to ECG has not been performed. Methods and results We prospectively enrolled 88 consecutive women with chest pain or other symptoms suggestive of CAD. Patients underwent a comprehensive clinical evaluation, exercise ECG, a CMR stress test including perfusion and infarct imaging, and x-ray coronary angiography (CA within 24 hours. CAD was defined as stenosis ≥70% on quantitative analysis of CA. Exercise ECG, CMR and CA was completed in 68 females (age 66.4 ± 8.8 years, number of CAD risk factors 3.5 ± 1.4. The prevalence of CAD on CA was 29%. The Duke treadmill score (DTS in the entire group was −3.0 ± 5.4 and was similar in those with and without CAD (−4.5 ± 5.8 and −2.4 ± 5.1; P = 0.12. Sensitivity, specificity and accuracy for CAD diagnosis was higher for CMR compared with exercise ECG (sensitivities 85% and 50%, P = 0.02, specificities 94% and 73%, P = 0.01, and accuracies 91% and 66%, P = 0.0007, respectively. Even after applying the DTS the accuracy of CMR was higher compared to exercise ECG (area under ROC curve 0.94 ± 0.03 vs 0.56 ± 0.07; P = 0.0001. Conclusions In women with intermediate-to-high risk for CAD who are able to exercise and have interpretable resting ECG, CMR stress perfusion imaging has higher accuracy for the detection of relevant obstruction of the epicardial coronaries when directly compared to exercise ECG.

  13. Exercise radionuclide ventriculography in prediction of multivessel coronary artery disease and myocardial perfusion abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Masakane, Ikuto; Tono-oka, Ichiro; Meguro, Mitsuhiko; Hoshi, Hikaru; Takeishi, Yasuchika; Chiba, Junya; Abe, Shinya; Tsuiki, Kai (Yamagata Univ. (Japan). School of Medicine); Yasui, Shoji

    1991-01-01

    In an attempt to increase the diagnostic accuracy of exercise radionuclide ventriculography in coronary artery disease (CAD), various parameters obtained were evaluated by multivariable discriminant analysis in 94 patients with suspected CAD. Both exercise thallium 201 myocardial scintigraphy and coronary arteriography were used as the reference standards. In predicting multivessel CAD, the following 9 parameters were judged as effective: pressure volume ratio at exercise, change of left ventricular ejection fraction, wall motion score at rest, change of endsystolic volume, heart rate at exercise, average blood pressure at rest, enddiastolic pressure index at exercise, maximum ejection fraction at exercise, and endsystolic volume index at exercise. The diagnostic accuracy was 81%. Effective parameters for predicting permanent defect (a detection rate of 84%) were: wall motion score at rest, maximum filling rate at exercise, heart rate at rest, change of the maximum filling rate, average blood pressure at rest, and pressure volume ratio at rest. Change in wall motion, heart rate at rest, and change in pressure volume ratio at exercise were effective in predicting transient defect with a detection rate of 76%. Diagnostic accuracy of exercise radionuclide ventriculography could be even more increased by overall evaluation of parameters obtained. (N.K.).

  14. Evaluation of the effect of myocardial perfusion after percutaneous coronary intervention in coronary artery disease by using intracoronary myocardial contrast echocardiography and two other angiographic techniques

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; LIU Zheng; YANG Li; HUANG Lan; JIN Jun; SONG Yaoming; GENG Zhaohua; YU Xuejun; QIN Jun; ZHAO Gang; GAO Yunhua

    2007-01-01

    Detection of abnormal myocardial perfusion is crucial to the prognosis of patients with coronary artery disease (CAD) after they have undergone percutaneous coronary intervention (PCI).The objective of this study is to evaluate the effect of myocardial perfusion by three different methods-intra-coronary myocardial contrast echocardiography (ICMCE),corrected thrombolysis in myocardial infarction frame count (CTFC),and coronary blood flow velocity (BFV)-and to determine the value of these different methods in the evaluation of the effect of myocardial perfusion post-PCI.For the study sixty-eight patients were divided into four groups based on selective coronary angiography results:group A (normal coronary artery),group B (75%-95% coronary artery stenosis),group C (coronary artery stenosis > 95%) and group D (acute total coronary occlusion).The effect of myocardial reperfusion was evaluated using the above mentioned three methods 15 min after PCI.IC-MCE was also performed before PCI in group D.The quantitative parameters of MCE involved:contrast peak intensity,time to peak intensity and area under the curve,representing myocardial blood volume,reperfusion velocity and myocardial blood flow,respectively.No difference was found in CTFC between the coronary artery stenosis group and the normal group.BFV was slower in group D than in group A (P < 0.05).The myocardial blood volume and the myocardial blood flow of the IC-MCE quantitative parameters were markedly lower in group C compared with those in group A (P < 0.05),and there were significant differences in the three MCE parameters between group D and group A (P < 0.05).For those patients with acute or total occlusion,the levels of myocardial perfusion before and after PCI were similar,as determined by IC-MCE and visually analyzed from 61 segments (P < 0.05).Quantitative IC-MCE evaluation of myocardial reperfusion is more accurate than with the other two methods.Moreover,with qualitative IC-MCE the level of

  15. The effect of CO sub 2 on pulmonary artery pressure (P sub pa ) over time in the isolated perfused rabbit lung

    Energy Technology Data Exchange (ETDEWEB)

    Reynolds, P.; Shayevitz, J. (Univ. of Michigan, Ann Arbor (United States))

    1991-03-11

    The isolated perfused rabbit lung model is used in studies of pulmonary hemodynamics, structure, and function under conditions closely resembling those which occur in living animals. The purpose of this study is to observe changes in P{sub pa} in response to differing concentrations of CO{sub 2} over time. After rapid exsanguination a tracheostomy was performed. Cannulas were secured in the main pulmonary artery and the left atrium. The lungs were perfused with Krebs-Henseleit buffer mixed with blood at a rate of 120 ml/min with recirculation. The temperature of the perfusate was maintained between 35 and 38C. The lungs were then ventilated with 5% CO{sub 2} in air with a tidal volume of 10 ml/kg at 20 breaths/min. CO{sub 2} was altered randomly by ventilating the lungs 2, 5 or 10% CO{sub 2} in air. Metabolic acidosis was corrected with NaHCO{sub 3}. In the first two hour period after lung perfusion was begun, the model was allowed to stabilize at each CO{sub 2} concentration, and pH, pCO{sub 2}, pO{sub 2}, and base excess were determined at each P{sub pa}. All measurements were repeated in the second period beginning two hours after lung perfusion was started. P{sub pa} was plotted against pH for each animal in both early and late phases, and simple regression analysis was performed. The slopes and the y intercepts for the data sets in both groups were compared using one factor ANOVA, and were found to be significantly different, implying a statistical difference between regression lines. In the early phase this model behaves like the in vivo lung, i.e. hypercarbia appears to increase, while hypocarbia decreases, P{sub pa}. During the late phase of lung perfusion the opposite occurs.

  16. Comparison of transient arterial occlusion and muscle exercise provocation for assessment of perfusion reserve in skeletal muscle with real-time contrast-enhanced ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Krix, Martin, E-mail: martin.krix@kabelbw.de [German Cancer Research Center, Research Program Imaging and Radiooncology, Department of Radiology, INF 280, D-69120 Heidelberg (Germany); Bracco Imaging Germany, Max-Stromeyer-Str. 116, D-78467 Konstanz (Germany); Krakowski-Roosen, Holger [German Cancer Research Center, Department of Translational Oncology, INF 280, D-69120 Heidelberg (Germany); Armarteifio, Erick [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, D-69120 Heidelberg (Germany); Fuerstenberger, Susanne [University Hospital of Heidelberg, Department of Vascular Surgery, INF 110, D-69120 Heidelberg (Germany); Delorme, Stefan [German Cancer Research Center, Research Program Imaging and Radiooncology, Department of Radiology, INF 280, D-69120 Heidelberg (Germany); Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital of Heidelberg, Department of Diagnostic and Interventional Radiology, INF 110, D-69120 Heidelberg (Germany)

    2011-06-15

    Objective: Contrast-enhanced ultrasound (CEUS) is able to quantify muscle perfusion and changes in perfusion due to muscle exercise in real-time. However, reliable measurement of standardized muscle exercise is difficult to perform in clinical examinations. We compared perfusion reserve assessed by CEUS after transient arterial occlusion and exercise to find the most suitable measurement for clinical application. Methods: Contrast pulse sequencing (7 MHz) during continuous IV infusion of SonoVue (4.8 mL/300 s) was used in 8 healthy volunteers to monitor muscle perfusion of the gastrocnemius muscle during transient (1 min) arterial occlusion produced by a thigh cuff of a venous occlusion plethysmograph. Isometric muscle exercise (50% of individual maximum strength for 20 s) was subsequently performed during the same examination, and several CEUS parameters obtained from ultrasound-signal-intensity-time curves and its calculation errors were compared. Results: The mean maximum local blood volume after occlusion was 13.9 [{approx}mL] (range, 4.5-28.8 [{approx}mL]), and similar values were measured after sub-maximum exercise 13.8 [{approx}mL], (range, 4.6-22.2 [{approx}mL]. The areas under the curve during reperfusion vs. recovery were also similar (515.2 {+-} 257.5 compared to 482.2 {+-} 187.5 [{approx}mL s]) with a strong correlation (r = 0.65), as were the times to maximum (15.3 s vs. 15.9 s), with a significantly smaller variation for the occlusion method ({+-}2.1 s vs. {+-}9.0 s, p = 0.03). The mean errors for all calculated CEUS parameters were lower for the occlusion method than for the exercise test. Conclusions: CEUS muscle perfusion measurements can be easily performed after transient arterial occlusion. It delivers data which are comparable to CEUS measurements after muscle exercise but with a higher robustness. This method can be easily applied in clinical examination of patients with e.g. PAOD or diabetic microvessel diseases to assess perfusion reserve.

  17. Stability of MR brain-perfusion measurement using arterial spin labeling

    Energy Technology Data Exchange (ETDEWEB)

    Petr, Jan; Hofheinz, Frank; Platzek, Ivan; Schramm, Georg; Van Den Hoff, Jorg [Helmholtz-Center Dresden-Rossendorf, PET Center, Institute of Radiopharmaceutical Cancer Research (Germany)

    2015-05-18

    Arterial spin labeling (ASL) is an MR technique for assessment of cerebral blood flow (CBF) that does not require use of contrast agents which makes it a less invasive alternative to the 15O-H2O-PET measurement. The repeatability of ASL has been studied extensively but mainly in young healthy volunteers. We have tested repeatability of ASL under realistic clinical conditions in elderly brain tumor patients acquired with a Philips Ingenuity TF PET/MR in the context of an ongoing 11C-Methionine PET/MR study. Twenty three patients (age 54.8±13.0 y) were scanned on two or more session. The patients underwent 6 weeks of concurrent radiochemotherapy with Temozolomide between the first session and second measurement. The mean relative difference of gray matter CBF was 18.6% between the first two session and 13.0% for the second session and further on. The mean gray matter CBF was 46.6±7.2 mL/min/100 g on the first sessions and there was a significant decrease of 9.8% between first and second session (p=0.027). In summary, the ASL presents measurement of CBF with reasonable repeatability also in elderly patients under clinical conditions when it is not possible to control for all sources of variation. Significant decrease of CBF in healthy tissue was observed after the radiochemotherapy. Prospectively, the ASL data together with the also acquired 11C-Methionine PET will be evaluated regarding their separate and combined ability to predict patient outcome and effectiveness of the performed radiochemotherapy.

  18. Utility of susceptibility-weighted imaging and arterial spin perfusion imaging in pediatric brain arteriovenous shunting

    Energy Technology Data Exchange (ETDEWEB)

    Nabavizadeh, Seyed Ali; Edgar, J.C.; Vossough, Arastoo [University of Pennsylvania, Department of Radiology, Philadelphia, PA (United States); Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-10-15

    The objectives of the study are to investigate the application of susceptibility-weighted imaging (SWI) and arterial spin labeling (ASL) imaging in the assessment of shunting and the draining veins in pediatric patients with arteriovenous shunting and compare the utility of SWI and ASL with conventional MR and digital subtraction angiography (DSA). This study is a retrospective study of 19 pediatric patients with arteriovenous shunting on brain MRI who were also evaluated with DSA. We assessed the ability of conventional MRI sequences, susceptibility magnitude images, phase-filtered SWI images, and pulsed ASL images in the detection of arteriovenous (AV) shunting, number of draining veins and drainage pathways in comparison to DSA. The mean number of detected draining veins on DSA (3.63) was significantly higher compared to SWI phase-filtered image (mean = 2.72), susceptibility magnitude image (mean = 2.92), ASL (mean = 1.76) and conventional MRI (2.47) (p < 0.05). Pairwise comparison of DSA difference scores (i.e., difference between MR modalities in the number of missed draining veins) revealed no difference between the MR modalities (p > 0.05). ASL was the only method that correctly identified superficial and deep venous drainage in all patients. Regarding detection of shunting, ASL, SWI phase-filtered, and magnitude images demonstrated shunting in 100, 83, and 84 % of patients, respectively. SWI depicts a higher number of draining vein compared to conventional MR pulse sequences. ASL is a sensitive approach in showing 100 % sensitivity in the detection of AV shunting and in the diagnosis of the pattern of venous drainage. The present findings suggest the added utility of both SWI and ASL in the assessment of AV shunting. (orig.)

  19. A comparative study of perfusion CT and 99mTc-Hmpao spect measurement to assess cerebrovascular reserve capacity in patients with internal carotid artery occlusion

    Directory of Open Access Journals (Sweden)

    Eicker S

    2011-11-01

    Full Text Available Abstract Background and purpose Patients with internal carotid artery (ICA occlusion can demonstrate impaired cerebral vascular reserve (CVR. The detection of CVR using single photon emission CT (SPECT is nowadays widely accepted as a predictor in the diagnostic pathway in patients considered for cerebral revascularization. Recently perfusion CT (PCT gained widely acceptance in stroke imaging The present study was aimed at comparing the results of perfusion CT (PCT and 99mTc-HMPAO SPECT with acetazolamide challenge in patients with ICA occlusion. Methods 13 patients were included in the prospective evaluation. Both PCT and 99mTc-HMPAO SPECT were performed before and after the administration of acetazolamide. In detail, regional cerebral blood flow (rCBF, regional cerebral blood volume (rCBV, adapted time to peak (Tmax and mean transit times (MTT were compared with SPECT data. Results 99mTc-HMPAO SPECT demonstrated an impairment of CVR in six patients. A preserved CVR was present in seven patients. All patients with impaired CVR proven by SPECT had a delayed MTT (mean +2.98 s and a delayed Tmax (mean + 5.9 s, (both p Conclusion The prospective study demonstrated a highly significant correlation of perfusion parameters as' detected by 99mTc-HMPAO SPECT and the Tmax as detected by PCT in patients with ICA occlusion. Therefore this easy-to-perform technique seems to be an adequate method for the evaluation of cerebral perfusion in patients with ICA occlusion.

  20. Validation of a method to differentiate arterial and venous vessels in CT perfusion data using linear combinations of quantitative time-density curve characteristics

    Energy Technology Data Exchange (ETDEWEB)

    Havla, Lukas; Schneider, Moritz; Dietrich, Olaf [Ludwig-Maximilians-University Hospital Munich, Josef Lissner Laboratory for Biomedical Imaging, Institute for Clinical Radiology, Munich (Germany); Thierfelder, Kolja M.; Beyer, Sebastian E.; Ertl-Wagner, Birgit; Sommer, Wieland H. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

    2015-10-15

    We aimed to develop and evaluate a new method that reliably differentiates between cerebral arteries and veins using voxel-wise CT-perfusion-derived parameters. Fourteen consecutive patients with suspected stroke but without pathological findings were examined on a multi-detector CT system: 32 dynamic phases (∇t = 1.5 s) during application of 35 mL iomeprol-350 were acquired at 80 kV/200mAs. Three hemodynamic parameters were calculated for 18 arterial and venous vessel segments: A (maximum of the time-density-curve), T (time-to-peak), and W (full-width-at-half-maximum). Using receiver operator characteristic (ROC) curve analysis and Fisher's linear discriminant analysis (FLDA), the performance of every classifier (A, T, W) and of all linear combinations for the differentiation of arterial and venous vessels was determined. A maximum area under the ROC-curve (AUC) of 0.945 (accuracy = 86.8 %) was obtained using the FLDA combination of A and T or the triplet FLDA of A and T and W for the classification of venous and arterial vessels. The best single parameter was T with an AUC of 0.871 (accuracy = 79.0 %), which performed significantly worse than the combination A and T (p < 0.001). Arteries and veins can be accurately differentiated based on dynamic CT perfusion data using the maximum of the time-density curve, its time-to-peak, its width, and FLDA combinations of these parameters, which yield accuracies up to 87 %. (orig.)

  1. Comparison of CT perfusion summary maps to early diffusion-weighted images in suspected acute middle cerebral artery stroke

    Energy Technology Data Exchange (ETDEWEB)

    Benson, John; Payabvash, Seyedmehdi [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States); Salazar, Pascal [Vital Images, A Division of Toshiba Medical, Minnetonka, MN (United States); Jagadeesan, Bharathi; Palmer, Christopher S.; Truwit, Charles L. [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States); McKinney, Alexander M., E-mail: mckinrad@umn.edu [Hennepin County and University of Minnesota Medical Centers, Department of Radiology, Minneapolis, MN (United States)

    2015-04-15

    Objectives: To assess the accuracy and reliability of one vendor's (Vital Images, Toshiba Medical, Minnetonka, MN) automated CT perfusion (CTP) summary maps in identification and volume estimation of infarcted tissue in patients with acute middle cerebral artery (MCA) distribution infarcts. Subjects and methods: From 1085 CTP examinations over 5.5 years, 43 diffusion-weighted imaging (DWI)-positive patients were included who underwent both CTP and DWI <12 h after symptom onset, with another 43 age-matched patients as controls (DWI-negative). Automated delay-corrected postprocessing software (DC-SVD) generated both infarct “core only” and “core + penumbra” CTP summary maps. Three reviewers independently tabulated Alberta Stroke Program Early CT scores (ASPECTS) of both CTP summary maps and coregistered DWI. Results: Of 86 included patients, 36 had DWI infarct volumes ≤70 ml, 7 had volumes >70 ml, and 43 were negative; the automated CTP “core only” map correctly classified each as >70 ml or ≤70 ml, while the “core + penumbra” map misclassified 4 as >70 ml. There were strong correlations between DWI volume with both summary map-based volumes: “core only” (r = 0.93), and “core + penumbra” (r = 0.77) (both p < 0.0001). Agreement between ASPECTS scores of infarct core on DWI with summary maps was 0.65–0.74 for “core only” map, and 0.61–0.65 for “core + penumbra” (both p < 0.0001). Using DWI-based ASPECTS scores as the standard, the accuracy of the CTP-based maps were 79.1–86.0% for the “core only” map, and 83.7–88.4% for “core + penumbra.” Conclusion: Automated CTP summary maps appear to be relatively accurate in both the detection of acute MCA distribution infarcts, and the discrimination of volumes using a 70 ml threshold.

  2. Development of spontaneous activity in the avian hindbrain

    Directory of Open Access Journals (Sweden)

    Yoko Momose-Sato

    2016-08-01

    Full Text Available Spontaneous activity in the developing central nervous system occurs before the brain responds to external sensory inputs, and appears in the hindbrain and spinal cord as rhythmic electrical discharges of cranial and spinal nerves. This spontaneous activity recruits a large population of neurons and propagates like a wave over a wide region of the central nervous system. Here, we review spontaneous activity in the chick hindbrain by focusing on this large-scale synchronized activity. Asynchronous activity that is expressed earlier than the abovementioned synchronized activity and activity originating in midline serotonergic neurons are also briefly mentioned.

  3. Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque; Medecine nucleaire et maladie coronarienne: evaluation de traceurs de la perfusion myocardique et de la plaque d'atherome vulnerable

    Energy Technology Data Exchange (ETDEWEB)

    Broisat, A

    2005-04-15

    Coronary artery disease is one of the primary cause of mortality worldwide. Nuclear medicine is the major imaging technique for diagnosis and following of this disease. perfusion: nowadays, major radioactive agents used in clinical practice are myocardial perfusion tracers. The reference tracer is thallium-201. However, {sup 201}Tl presents some drawbacks. {sup 99m}Tcn-noet has been proposed for its replacement. This study shows that in contrast with previous studies realized in vitro on cardio myocytes, verapamil, an l-type calcium channel inhibitor, does not inhibit myocardial fixation of {sup 99m}Tcn-noet in vivo in dog. This data is in agreement with the hypothesis of a non specific endothelial fixation of this tracer. Moreover, this study shows that as a pure tracer of myocardial perfusion, {sup 99m}Tcn-noet can also be used to assess myocardial viability on a model of myocardial chronic infarction in rat. atherosclerosis: disruption of vulnerable atherosclerotic plaques is the main event leading to coronary accidents. The second part of this study concerns the evaluation of new potential tracers of the vulnerable atherosclerotic plaque in an experimental model of rabbit with an inheritable hypercholesterolemia. The four tracers evaluated (b2702(r), b2702-I, b2702-Tc and Tc-raft-b2702) are synthetic peptides comprising the residues 75-84 of hla-b2702, a molecule known to link vcam-1, an adhesion molecule expressed in vulnerable atherosclerotic plaque. The autoradiography studies show that all tracers accumulate within atherosclerotic plaque expressing vcam- and that. i-b2702 shows the best plaque/control fixation ratio. (author)

  4. Assessment of myocardial perfusion and viability with technetium-99m methoxyisobutylisonitrile and thallium-201 rest redistribution in chronic coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Rosetti, C. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Landoni, C. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Lucignani, G. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Huang, G. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Bartorelli, A.L. [Institute of Cardiology, University of Milan, CNR, `I. Monzino` Foundation (Italy); Guazzi, M.D. [Institute of Cardiology, University of Milan, CNR, `I. Monzino` Foundation (Italy); Margonato, A. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Chierchia, S. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Galli, L. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Savi, A. [INB-CNR, University of Milan, Institute H San Raffaele (Italy); Fazio, F. [INB-CNR, University of Milan, Institute H San Raffaele (Italy)

    1995-11-01

    We compare thallium-201 rest redistribution and fluorine-18 fluorodeoxyglucose ([{sup 18}F]FDG) for the assessment of myocardial viability within technetium-99m methoxyisobutylisonitrile (MIBI) perfusion defects in 27 patients with chronic stable coronary artery disease. The following studies were performed: (1) stress {sup 99m}Tc-MIBI, (2) rest {sup 99m}Tc-MIBI, (3) {sup 201}Tl rest-redistribution single-photon emission tomography, (4) [{sup 18}F]FDG positron emission tomography. The left ventricle was devided into 11 segments on matched tomographic images. The segment with the highest activity at stress was taken as the reference (activity = 100%). Perfusion defects at {sup 99m}Tc-MIBI rest were classified as severe (activity < 50%), moderate (activity 50%-60%) or mild (activity 60%-85%). Uptakes of [{sup 18}F]FDG and rest-redistributed {sup 201}Tl were recognized as significant if they exceeded 50% of that in the reference segment. Among the 33 segments with severe {sup 99m}Tc-MIBI rest perfusion defects, 21 had significant [{sup 18}F]FDG and 10 significant rest-redistributed {sup 201}Tl uptake. As regards the 37 segments with moderate defects, [{sup 18}F]FDG was present in 29 and {sup 201}Tl in 31, while of the 134 segments with mild defects, 128 showed [{sup 18}F]FDG uptake, and 131, {sup 201}Tl uptake. In conclusion, there is an inverse relationship between the severity of {sup 99m}Tc-MIBI perfusion defects and the uptake of rest-redistributed {sup 201}Tl and [{sup 18}F]FDG. Both tracers are adequate markers of viability in mild and moderate defects; in severe defects {sup 201}Tl might underestimate the presence of viability as assessed by [{sup 18}F]FDG. (orig.)

  5. 原位肾低温灌注腹腔镜下肾部分切除术%Laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ

    Institute of Scientific and Technical Information of China (English)

    李汉忠; 董德鑫; 严维刚; 张玉石

    2010-01-01

    Objective To study a modified method of laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ.Methods Laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ was performed in 5 patients from March 2009 to May 2009.There were 3 males and 2 females,with an average age of 49 years (39 to 63 years).There were 3 tumors in the left kidney and 2 in the right kidney,with an average diameter of 5.6 cm (range,3.8 to 7.0 cm).There were 2 cases of chronic renal insufficiency,1 case of solitary kidney,1 case of contralateral renal atrophy and 1 case of larger benign tumor.The procedure of laparoscopic partial nephrectomy with hypothermic renal artery perfusion in situ was as follows:A catheter with balloon was placed in the renal artery with percutaneous approach through the femoral artery preoperatively.During the operation the balloon of the catheter was inflated with water in order to block the renal artery,and renal artery perfusion of about 200ml saline of 4 ℃ was conducted through the catheter under high pressure in order to achieve low temperature in situ kidney.The water of the balloon was extracted after the accomplishment of the laparoscopic partial nephrectomy.Results Laparoscopic partial nephrectomies with hypothermic renal artery perfusion in situ were carried out successfully in 5 cases.The average operative time was 102 min (80 to 120 min),the average renal artery occlusion time was 35 min (range,29 to 39 min),and the average amount of bleeding was 190 ml(50 to 300 ml).The temperature of skin,kidneys,and tumor after hypothermic perfusion dropped by an average of 0.6℃,10.0 ℃,and 9.8℃,respectively.The endogenous creatinine clearance rate was(84.7±16.9),(48.9±14.5),(52.1±12.4),(54.5±13.8),and(54.6±11.7)ml/min before and 1 day,3 days,5 days and 10 days after operation.There was significant difference among the 5 groups in endogenous creatinine clearance rate(P=0.001).There was significant difference

  6. A head-to-head comparison of the coronary calcium score by computed tomography with myocardial perfusion imaging in predicting coronary artery disease

    Institute of Scientific and Technical Information of China (English)

    Mansour Almoudi; Zhong-Hua Sun

    2012-01-01

    Objectives The coronary artery calcium (CAC) score has been shown to predict future cardiac events. However the extent to which the added value of a CAC score to the diagnostic performance of myocardial perfusion imaging (MPI) by single photon emission computed tomography (SPECT) is unclear. The purpose of this study is to investigate the correlation between CAC score and SPECT in patients with suspected coronary artery disease. Methods A retrospective review of the CAC scores by use of the Agatston calcium scoring method and cardiac SPECT diagnostic reports was conducted in 48 patients, who underwent both coronary computed tomography (CT) and SPECT examinations due to suspected coronary artery disease. A Pearson correlation test was used to determine the relation between CAC scores and MPI-SPECT assessments with regard to the evaluation of the extent of disease. Results Forty-seven percent of the patients had CAC scores more than 100, while 42% of these patients demonstrated abnormal, or probably abnormal, MPI-SPECT. Of the 23% of patients with a zero CAC score, only 7% had normal MPI-SPECT findings. No significant correlation was found between the CAC scores and MPISPECT assessments (r value ranged from 0.012 to 0.080), regardless of the degree of coronary calcification. Conclusions There is a lack of correlation between the CAC scores and the MPI-SPECT findings in the assessment of the extent of coronary artery disease. CAC scores and MPI-SPECT should be considered complementary approaches in the evaluation of patients with suspected coronary artery disease.

  7. Changes of tumor microcirculation after transcatheter arterial chemoembolization:First pass perfusion MR imaging and Chinese ink casting in a rabbit model

    Institute of Scientific and Technical Information of China (English)

    Jun-Gong Zhao; Gan-Sheng Feng; Xiang-Quan Kong; Xin Li; Ming-Hua Li; Ying-Sheng Cheng

    2004-01-01

    AIM: To observe the change of tumor microcirculation after transcatheter arterial chemoembolization (TACE) with bletilla microspheres by using first pass perfusion MR imaging (FP) and Chinese ink casting.METHODS: VX2 carcinoma cells were surgically implanted into the left and right lobes of liver of 30 New Zealand white rabbits, which were divided into 3 groups at random. Emulsion of lipiodol mixed with mitomycin C, and 5-FU bletilla microspheres were injected into the hepatic artery respectively, and saline was used as control agent. MR imaging was performed with turbo-flash sequence 14 d after tumor implantation and 7 d after interventional therapy. The steepest slopes (SS) of the signal intensity versus time curves were created for quantitative analysis, 7.5% Chinese ink gelatin solution was injected through ascending artery (17 cases) or portal vein (2 cases) for lesion microvessel area (MVA) measurement after the last MRI examination.The correlation between perfusion imaging and MVA was studied blindly.RESULTS: The SS values at the rim of tumor in lipiodol group (mean, 49% per second) and bletilla group (mean,35% per second) were significantly decreased (P<0.05) as compared with control group (mean, 124% per second), no difference was found between lipiodol and bletilla groups (P>0.05). In lipiodol group, the MVAs (24 974±11 836 μm2) in the center of the tumor were significantly smaller than those of the control group (35 510±15 675 μm2) (P<0.05),while the MVAs (80 031±22 745 μm2) around the tumor were significantly increased because small and dense plexuses appeared around the tumor which correlated to intense reaction of granulation tissue. None of the vessels was seen in the tumor in bletilla group, the peripheral MVAs of the tumor were significantly smaller than those of the control group (P<0.05) and lipiodol group (P<0.05). There was a good correlation between SS and MVAs in control group (rs, 0.985, P<0.0001) and bletilla group (rs, 0

  8. Measurement of the arterial concentration of Gd-DTPA using MRI: a step toward quantitative perfusion imaging

    DEFF Research Database (Denmark)

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

    1996-01-01

    A noninvasive method using an inversion recovery turbo-FLASH for dynamic measurement of the arterial input function represented by the bolus passage of Gd-DTPA in the descending aorta is presented, and the results are compared with the input function obtained by arterial blood samples. A good...

  9. 慢性大脑中动脉狭窄或闭塞的CT灌注成像%CT perfusion imaging in patients with chronic middle cerebral artery stenosis or occlusion

    Institute of Scientific and Technical Information of China (English)

    苏凯燕; 刘增韬

    2012-01-01

    Objective To evaluate the blood perfusion character of chronic middle cerebral artery stenosis or occlusion with CT perfusion imaging. Methods The clinical and imaging dala of 11 cases with unilateral chronic middle cerebral artery stenosis or occlusion were collected. All cases were examined with CT perfusion and MR (MR1 and MKA). Results The CT perfusion character of chronic middle cerebral artery stenosis or occlusion included CBV elevated, CBF decreased, and MTI prolonged. Conclusion CT perfusion imaging can describe the blood perfusion character of chronic middle cerebral artery stenosis or occlusion, and provide theoretical basis for therapeutic plan.%目的 利用CT灌注成像技术研究慢性大动脉狭窄或闭塞患者的脑血流灌注特征.方法 搜集具有完整临床资料的单侧慢性大脑中动脉重度狭窄或闭寨患者11例,行CT灌注成像及磁共振(MRI及MRA)检查.结果 慢性大脑中动脉狭窄或闭塞患者的脑CT灌注特征是患侧脑血流量(CBF)降低,脑血容量(CBV)升高,平均通过时间(MTT)延长.结论 CT灌注成像能反映慢性大脑中动脉狭窄或闭塞患者的脑血流灌注特征,为临床治疗方案的制订提供理论依据.

  10. Effect of noradrenaline on tail arteries of SHR and WKY under perfusion at constant flow and constant pressure

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Tarasova, Olga S; Timin, Eugeny N;

    1997-01-01

    pressure. Two series of experiments were performed. In the first series, vessels were perfused/superfused with Krebs-Henseleit solution. In the second one a modified salt solution was used, in which NaCl was totally replaced by an equimolar amount of KCI. Under constant flow conditions noradrenaline evoked......, vasoconstriction at constant pressure in SHR became more pronounced than that in WKY. We suggest that there is greater wall thickness:lumen diameter ratio in SHR vessels and thus different contribution of distension-activated myogenic response is of primary importance for the data obtained....... a more prominent resistance increase in SHR compared with WKY independently of the composition of solution (normal or high-K+) used. At constant pressure perfusion with normal solution, the vasoconstrictor response to noradrenaline was more prominent in WKY. Under application of high-K+ solution...

  11. Improvement of myocardial perfusion reserve detected by cardiovascular magnetic resonance after direct endomyocardial implantation of autologous bone marrow cells in patients with severe coronary artery disease

    Directory of Open Access Journals (Sweden)

    Lau Chu-Pak

    2010-01-01

    Full Text Available Abstract Background Recent studies suggested that bone marrow (BM cell implantation in patients with severe chronic coronary artery disease (CAD resulted in modest improvement in symptoms and cardiac function. This study sought to investigate the functional changes that occur within the chronic human ischaemic myocardium after direct endomyocardial BM cells implantation by cardiovascular magnetic resonance (CMR. Methods and Results We compared the interval changes of left ventricular ejection fraction (LVEF, myocardial perfusion reserve and the extent of myocardial scar by using late gadolinium enhancement CMR in 12 patients with severe CAD. CMR was performed at baseline and at 6 months after catheter-based direct endomyocardial autologous BM cell (n = 12 injection to viable ischaemic myocardium as guided by electromechanical mapping. In patients randomized to receive BM cell injection, there was significant decrease in percentage area of peri-infarct regions (-23.6%, P = 0.04 and increase in global LVEF (+9.0%, P = 0.02, the percentage of regional wall thickening (+13.1%, P= 0.04 and MPR (+0.25%, P = 0.03 over the target area at 6-months compared with baseline. Conclusions Direct endomyocardial implantation of autologous BM cells significantly improved global LVEF, regional wall thickening and myocardial perfusion reserve, and reduced percentage area of peri-infarct regions in patients with severe CAD.

  12. Deleterious Effects of Intra-arterial Administration of Particulate Steroids on Microvascular Perfusion in a Mouse Model.

    Science.gov (United States)

    Laemmel, Elisabeth; Segal, Nicolas; Mirshahi, Massoud; Azzazene, Dalel; Le Marchand, Sylvie; Wybier, Marc; Vicaut, Eric; Laredo, Jean-Denis

    2016-06-01

    Purpose To determine the in vivo effects of several particulate steroids on microvascular perfusion by using intravital microscopy in a mice model and to investigate the in vitro interactions between these particulate steroids and red blood cells (RBCs). Materials and Methods The study was conducted in agreement with the guidelines of the National Committee of Ethic Reflection on Animal Experimentation. By using intravital microscopy of mouse cremaster muscle, the in vivo effects of several particulate steroids on microvascular perfusion were assessed. Four to five mice were allocated to each of the following treatment groups: saline solution, dexamethasone sodium phosphate, a nonparticulate steroid, and the particulate steroids cortivazol, methylprednisolone, triamcinolone, and prednisolone. By using in vitro blood microcinematography and electron microscopy, the interactions between these steroids and human RBCs were studied. All results were analyzed by using nonparametric tests. Results With prednisolone, methylprednisolone, or triamcinolone, blood flow was rapidly and completely stopped in all the arterioles and venules (median RBC velocity in first-order arterioles, 5 minutes after administration was zero for these three groups) compared with a limited effect in mice treated with saline, dexamethasone, and cortivazol (20.3, 21.3, and 27.5 mm/sec, respectively; P steroids. Conclusion Several particulate steroids have an immediate and massive effect on microvascular perfusion because of formation of RBC aggregates associated with the transformation of RBCs into spiculated RBCs. (©) RSNA, 2016 Online supplemental material is available for this article.

  13. Effect of minimized perfusion circuit on brain injury markers carnosinase and brain-type fatty binding protein in coronary artery bypass grafting patients.

    Science.gov (United States)

    Pahari, Dipak R; Gu, Y John; van Oeveren, Willem; El-Essawi, Aschraf; Harringer, Wolfgang; Brouwer, René M H

    2013-02-01

    A minimized perfusion circuit (MPC) has proven to be superior to the conventional circulatory perfusion bypass (CCPB) as it reduces the blood-material interaction and hemodilution. Until now not much is known about impact these different perfusion systems have on the brain. The objective of this study is to determine carnosinase and brain-type fatty binding protein (BFABP) activity as novel specific biomarkers for ischemic brain tissue damage and how their activity differs during and after MPC and CCPB as well as to compare the inflammatory response of both perfusion systems. In a prospective pilot study, 28 patients undergoing coronary artery bypass grafting were randomly divided into an MPC group (n = 14) and a CCPB group (n = 14). Blood samples were taken before, during, and after operation until the fifth postoperative day. The brain biomarker carnosinase was determined by measuring the rate of histidine production from the substrate homocarnosine, whereas BFABP and interleukin-6 were determined by enzyme-linked immunosorbent assay (ELISA). C-reactive protein (CRP) and endothelin-1 were determined by enzyme immunoassay. The mean serum carnosinase activity was significantly higher in MPC (0.57 ± 0.34 nM histidine/mL/min) as compared with the CCPB group (0.36 ± 0.13 nM histidine/mL/min) at the end of operation (P = 0.02). The BFABP did not show any difference between the two groups in the immediate postoperative period until the second postoperative day. From that time point onward, it showed a steep increase in the CCPB group (581.3 ± 157.11 pg/mL) as compared with the concentrations in the MPC group (384.6 ± 39 pg/mL) (P = 0.04). The inflammation markers interleukin-6 and CRP showed a similar pattern in both groups without significant difference. In contrast, the leukocyte count on operation day and endothelin-1 on the first postoperative day were significantly higher in the CCPB group (P = 0.01, P = 0

  14. Probing forebrain to hindbrain circuit functions in Xenopus.

    Science.gov (United States)

    Kelley, Darcy B; Elliott, Taffeta M; Evans, Ben J; Hall, Ian C; Leininger, Elizabeth C; Rhodes, Heather J; Yamaguchi, Ayako; Zornik, Erik

    2017-01-01

    The vertebrate hindbrain includes neural circuits that govern essential functions including breathing, blood pressure and heart rate. Hindbrain circuits also participate in generating rhythmic motor patterns for vocalization. In most tetrapods, sound production is powered by expiration and the circuitry underlying vocalization and respiration must be linked. Perception and arousal are also linked; acoustic features of social communication sounds-for example, a baby's cry-can drive autonomic responses. The close links between autonomic functions that are essential for life and vocal expression have been a major in vivo experimental challenge. Xenopus provides an opportunity to address this challenge using an ex vivo preparation: an isolated brain that generates vocal and breathing patterns. The isolated brain allows identification and manipulation of hindbrain vocal circuits as well as their activation by forebrain circuits that receive sensory input, initiate motor patterns and control arousal. Advances in imaging technologies, coupled to the production of Xenopus lines expressing genetically encoded calcium sensors, provide powerful tools for imaging neuronal patterns in the entire fictively behaving brain, a goal of the BRAIN Initiative. Comparisons of neural circuit activity across species (comparative neuromics) with distinctive vocal patterns can identify conserved features, and thereby reveal essential functional components.

  15. Automatic measurement of contrast bolus distribution in carotid arteries using a C-arm angiography system to support interventional perfusion imaging

    Science.gov (United States)

    Fieselmann, Andreas; Ganguly, Arundhuti; Yu, Deuerling-Zheng; Boese, Jan; Hornegger, Joachim; Fahrig, Rebecca

    2011-03-01

    Brain perfusion CT using a C-arm angiography system capable of CT-like imaging could optimize patient treatment during stroke therapy procedures. For this application, an intra-arterial contrast bolus injection at the aortic arch could be used provided that the location of the injection catheter enables uniform distribution of the bolus into the two common carotid arteries (CCA). In this work, we present a novel method to support optimal injection catheter placement by providing additional quantitative information about the distribution of the contrast bolus into the CCAs. Our fully automatic method uses 2-D digital subtraction angiography (DSA) images following a test bolus injection. It segments both CCAs and computes the relative contrast distribution. We have tested the method in DSA data sets from 5 healthy pigs and our method achieved successful segmentation of both CCAs in all data sets. The results showed that the contrast is uniformly distributed (mean relative difference less or equal than 10%) if the injection location is properly chosen.

  16. 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.

  17. Perfusão da artéria pulmonar não melhora os índices de fator natriurético cerebral (BNP em estudo experimental em suínos Pulmonary artery perfusion does not improve brain natriuretic peptide (BNP levels in suine experimental research

    Directory of Open Access Journals (Sweden)

    Edmo Atique Gabriel

    2010-12-01

    Full Text Available OBJETIVO: Avaliar se perfusão controlada do tronco pulmonar durante circulação extracorpórea (CEC modifica os níveis de BNP expressos pelo miocárdio ventricular. MÉTODOS: Estudo experimental com 32 porcos, divididos em dois grupos de acordo com estratégia de CEC - grupo I (cardioplegia e grupo II (coração batendo. Ambos os grupos foram alocados em três subgrupos, de acordo com a estratégia de perfusão pulmonar - subgrupo A (controle: sem perfusão pulmonar, subgrupo B (perfusão pulmonar com sangue arterial e subgrupo C (perfusão com sangue venoso. Nos subgrupos B e C, pulmões foram perfundidos por 30 minutos, utilizando pressão arterial média pulmonar (PAPM préoperatória como pressão de perfusão, a qual foi controlada com manômetro. PAPM e resistência vascular pulmonar (RVP foram medidas após saída de CEC com cateter de Swan-Ganz. No período pré-operatório e após 30 minutos de perfusão pulmonar, fragmentos de miocárdio ventricular direito foram coletados para avaliar expressão de peptídeo natriurético cerebral (BNP e padrão histológico tecidual. Técnicas de imunohistoquímica e hematoxilina-eosina foram utilizadas para determinar, respectivamente, expressão de BNP e lesões inflamatórias miocárdicas. RESULTADOS: Nos animais submetidos à perfusão controlada do tronco pulmonar, houve redução pós-operatória da PAPM (P=0,03 e da RVP (P=0,005. Não houve diferenças entre os subgrupos do grupo I (P=0,228 e subgrupos do grupo II (P=0,325 quanto à expressão pós-operatória de BNP. Não houve diferenças entre subgrupos com e sem perfusão pulmonar quanto à intensidade das lesões inflamatórias miocárdicas identificadas no pós-operatório (P>0,05. CONCLUSÃO: Perfusão controlada do tronco pulmonar por 30 minutos não foi suficiente para promover alterações substanciais na expressão de BNP e no padrão histológico miocárdico do ventrículo direito.OBJECTIVE: Assess if the main pulmonary artery

  18. Effect of vertebral artery hypoplasia on the territory-related perfusion of posterior inferior cerebellar artery%椎动脉发育不全对小脑后下动脉供血区脑灌注的影响

    Institute of Scientific and Technical Information of China (English)

    马乾坤; 张道培; 张杰文; 张淑玲; 鹿桂凤; 尹所

    2016-01-01

    目的:探讨椎动脉发育不全(vertebral artery hypoplasia,VAH )对小脑后下动脉供血区脑灌注的影响。方法选择2014-12—2015-07年龄≥30岁并行头颅磁共振灌注成像和头颈部三维对比增强磁共振血管造影检查的头晕或眩晕患者244例。获脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)和达峰时间(TTP)灌注图,测量一侧小脑后下动脉供血区及对侧镜像区的灌注参数值(CBF、CBV、MTT、TTP),计算椎动脉直径较小侧/对侧镜像区的灌注参数相对比值(rCBF、rCBV、rMTT、rTTP)。定义 VAH 为椎动脉直径≤2 mm,或双侧椎动脉不对称比≥1.7:1,分为 VAH 组和 non-VAH(Non-hypoplasitic vertebral artey)组,对临床资料和小脑、延髓灌参数相对比值进行比较。结果共纳入114例患者,男女各57例;VAH 组31例(27.2%),左侧5例(16%),右侧26例(84%);Non-VAH 组83例。2组间 VA 直径较小侧与对侧的 rTTP和 rCBF≤0.85的例数存在显著统计学差异(P 值分别为0.005,0.031);rCBF 倾向于有统计学差异(P =0.098);rCBV、rMTT 及 rCBV≤0.85例数无显著统计学差异。结论VAH 可以造成小脑后下动脉供血区域低灌注改变,且以 TTP 延长或 CBF 降低为主。%Objective To investigate the effect of vertebral artery hypoplasia on the territory perfusion of posterior inferi-or cerebellar artery (PICA).Methods 244 patients with vertigo or dizziness (age≥30 years old)from December 2014 to July 201 5 were selected as subjects who underwent brain perfusion-weighted imaging (pWI)and three-dimensional dynamic con-trast-enhanced MRA (3D DCE-MRA).The perfusion figures of cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT)and time to peak(TTP)were obtained.The perfusion parameters including CBF,CBV,MTT and TTP val-ues were measured at PICA areas and at the opposite mirror-imaging areas.Relative perfusion parameter values (rCBF,rCBV, rMTT and rTTP)defined as the ratio of the

  19. Disappearance of myocardial perfusion defects on prone SPECT imaging: Comparison with cardiac magnetic resonance imaging in patients without established coronary artery disease

    Directory of Open Access Journals (Sweden)

    Hedén Bo

    2009-08-01

    Full Text Available Abstract Background It is of great clinical importance to exclude myocardial infarction in patients with suspected coronary artery disease who do not have stress-induced ischemia. The diagnostic use of myocardial perfusion single-photon emission computed tomography (SPECT in this situation is sometimes complicated by attenuation artifacts that mimic myocardial infarction. Imaging in the prone position has been suggested as a method to overcome this problem. Methods In this study, 52 patients without known prior infarction and no stress-induced ischemia on SPECT imaging were examined in both supine and prone position. The results were compared with cardiac magnetic resonance imaging (CMR with delayed-enhancement technique to confirm or exclude myocardial infarction. Results There were 63 defects in supine-position images, 37 of which disappeared in the prone position. None of the 37 defects were associated with myocardial infarction by CMR, indicating that all of them represented attenuation artifacts. Of the remaining 26 defects that did not disappear on prone imaging, myocardial infarction was confirmed by CMR in 2; the remaining 24 had no sign of ischemic infarction but 2 had other kinds of myocardial injuries. In 3 patients, SPECT failed to detect small scars identified by CMR. Conclusion Perfusion defects in the supine position that disappeared in the prone position were caused by attenuation, not myocardial infarction. Hence, imaging in the prone position can help to rule out ischemic heart disease for some patients admitted for SPECT with suspected but not documented ischemic heart disease. This would indicate a better prognosis and prevent unnecessary further investigations and treatment.

  20. Thrombus aspiration plus intra-infarct-related artery administration of tirofiban improves myocardial perfusion during primary angioplasty for acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    YAN Hong-bing; ZHANG Xiao-jiang; LI Wen-zheng; LI Shi-ying; SONG Li; WANG Jian; WU Zheng; CHI Yun-peng; ZHENG Bin; ZHAO Han-jun; LI Qing-xiang

    2010-01-01

    Background We developed a new combined strategy of thrombus aspiration plus intra-infarct-related artery (IRA) bolus administration of tirofiban via the aspiration catheter in patients with ST-segment elevation myocardial infarction (STEMI). This strategy can reduce the distal embolism and achieve highly localized concentrations of tirofiban, which can improve myocardial reperfusion without increasing the risk of bleeding. The aim of this study was to investigate whether this combined strategy is superior to thrombus aspiration alone in improving myocardial perfusion in patients with STEMI undergoing primary angioplasty.Results Baseline characteristics of the two groups were well-balanced. The TIMI 3 flow showed a better tendency in the intra-IRA group than in the aspiration alone group (97.22% vs. 87.04%, X~2=7.863, P=0.049). The peak of CK-MB (83.9 (68.9-310.5) U/L vs. 126.1 (74.7-356.7) U/L, P=0.034) and Tnl (42.7 (14.7-113.9) ng/ml vs. 72.5 (59.8-135.3) ng/ml, FMD.029) were lower in the intra-IRA group than in the aspiration alone group. LVEF in the hospital favored the intra-IRA group, (45.7±8.3)% to (42.9±12.1)%, t=1.98, P=0.049. There was a tendency towards a lower MACE at 9-month follow-up in the intra-IRA group although it did not reach statistical difference (Log-rank X~2=2.865, P=0.09). There was no statistical difference in any bleeding events between the two groups.Conclusions Thrombus aspiration plus intra-IRA bolus administration of tirofiban combined with angioplasty may be related with improved myocardium perfusion, saved more myocardium, and resulted in a better clinical prognosis.

  1. Prognostic value of dobutamine stress myocardial perfusion echocardiography in patients with known or suspected coronary artery disease and normal left ventricular function

    Science.gov (United States)

    Mattoso, Angele A. A.; Tsutsui, Jeane M.; Kowatsch, Ingrid; Cruz, Vitória Y. L.; Sbano, João C. N.; Ribeiro, Henrique B.; Kalil Filho, Roberto; Porter, Thomas R.; Mathias, Wilson

    2017-01-01

    Objective We sought to determine the prognostic value of qualitative and quantitative analysis obtained by real-time myocardial perfusion echocardiography (RTMPE) in patients with known or suspected coronary artery disease (CAD). Background Quantification of myocardial blood flow reserve (MBFR) in patients with CAD using RTMPE has been demonstrated to further improve accuracy over the analysis of wall motion (WM) and qualitative analysis of myocardial perfusion (QMP). Methods From March 2003 to December 2008, we prospectively studied 168 patients with normal left ventricular function (LVF) who underwent dobutamine stress RTMPE. The replenishment velocity reserve (β) and MBFR were derived from RTMPE. Acute coronary events were: cardiac death, myocardial infarction and unstable angina with need for urgent coronary revascularization. Results During a median follow-up of 34 months (5 days to 6.9 years), 17 acute coronary events occurred. Abnormal β reserve in ≥2 coronary territories was the only independent predictor of events hazard ratio (HR) = 21, 95% CI = 4.5–99; p<0.001). Both, abnormal β reserve and MBFR added significant incremental value in predicting events over qualitative analysis of WM and MP (χ2 = 6.6 and χ2 = 24.6, respectively; p = 0.001 and χ2 = 6.6 and χ2 = 15.5, respectively; p = 0.012, respectively). When coronary angiographic data was added to the multivariate analysis model, β reserve remained the only predictor of events with HR of 21.0 (95% CI = 4.5–99); p<0.001. Conclusion Quantitative dobutamine stress RTMPE provides incremental prognostic information over clinical variables, qualitative analysis of WM and MP, and coronary angiography in predicting acute coronary events. PMID:28234978

  2. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%双源CT低剂量对比剂肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    谭四平; 沈比先; 陈丽兴; 薛水培; 楚二伟; 刘康; 汪春荣; 贾飞鸽

    2012-01-01

    Objective: To assess the relation between intravascular clots of pulmonaiy artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging. Materials and Methods: Image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEP1) in 15 patients without pulmonary embolism (PE) was analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging. CT pulmonary angiogra-phy (CTPA) and lung perfusion images were analyzed at the same time. Intravascular clots of pulmonary artery were analyzed,including the location,number and morphology by the axial image and three-dimensional reconstruction of CTPA. Lung perfusion defects and its location,extent were evaluated with lung PBV software on the workstation. The relationship between in-trava8Cular clots of pulmonary artery and lung perfusion defects were analyzed statistically. Results: No significant difference was found in the image quality of low-dose and conventional dose DEPI of patients without PE(P>0.05). One hundred and two perfusion defects were found in 13 patients by pulmonary perfusion imaging,including lobular,segmental and BubsegmentaJ perfusion defects. Six perfusion defects in 4 cases had no clear intravascular clots. Images of axial CTPA and three-dimensional reconstruction showed 43 intravascular clots in 11 patients. Two cases with 5 intravascular clots depicted by CTPA showed no perfusion defects. Nine cases showed both intravascular clots and perfusion defects,with 21 perfusion defects unrelated to the blood supply areas of pulmonary artery(8 segmental and 13 subsegmental),and the remaining 75 perfusion defects consistent with the blood supply areas of pulmonary artery. Conclusion: There is unexpected dissociation between the intravascular clots of pulmonary artery and lung perfusion defects. Analysing the perfusion maps and CTPA of dual source CT low-dose contrast perfusion image will improve the accuracy

  3. 选择性肋间动脉灌注在降主动脉手术中的应用%Selective intercostal arterial perfusion during descending aortic surgery

    Institute of Scientific and Technical Information of China (English)

    王东进; 周庆; 李庆国; 武忠

    2009-01-01

    目的 探讨选择性肋间动脉灌注在降主动脉手术中对脊髓的保护作用.方法 2007年8月至2009年3月,5例降主动脉夹层和2例降主动脉瘤病人行降主动脉置换术.术中保留置换降主动脉上所有肋间动脉,进行选择性肋间动脉灌注,以减少脊髓缺血时间及程度以达到脊髓保护的目的 .术后早期观察和中期随访是否有截瘫发生.结果 术中脊髓缺血23~27 min,平均(24.8±1.6) min.7例术后均未发生截瘫,治愈出院.随访1~19个月,全组无截瘫,生活质量良好.结论 选择性肋间动脉灌注可缩短脊髓缺血时间和程度,脊髓保护效果良好,并可大大降低手术操作难度.%Objective This clinical study evaluated the efficacy of selective intercostal arterial perfusion for protection of spinal cord during descending aortic surgery.Methods From August 2007 to March 2009,7 patients received descending aorta replacement for type B dissection (5 patients) or thoracic aortic aneurysm (2 patients).Descending aorta replacement was performed through a posterolateral incision and left femoral vein-artery bypass in 1 case and left atrial-left femoral artery (LA-FA) bypass in 6.The grafts extended from the distal arch at the root of subclavian artery to the descending aorta at the T10-11 vertebra.The posterior wall of the descending aorta with intercostal arteries was sutured to form an 15 mm tube in diameter and an end-to-side anastomosis was made to an 8 mm graft branch.Selective intercostal arterial perfusion was performed from the T1 intercostal artery to the T10-11 intercostal artery through the 8 mm graft branch to protect spinal cord from ischemia.Cerebrospinal fluid pressure was monitored and cerebrospinal fluid drainage was performed necessarily.Results The replaced grafts measured from 19 to 23 cm [mean (20.2±1.4) cm].The CPB duration ranged from73-84 min [mean (24.8 ± 1.6) min].The mean ischemic duration was 23 to 27min [mean(24.8 ± 1.6) min

  4. Impact of Gender on the Prognostic Value of Coronary Artery Calcium in Symptomatic Patients With Normal Single-Photon Emission Computed Tomography Myocardial Perfusion.

    Science.gov (United States)

    Engbers, Elsemiek M; Timmer, Jorik R; Ottervanger, Jan Paul; Mouden, Mohamed; Knollema, Siert; Jager, Pieter L

    2016-12-01

    The coronary artery calcium (CAC) score provides independent prognostic value on top of single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI). We sought to determine whether the prognostic value of the CAC score in patients with normal SPECT MPI is gender specific. We studied 3,705 consecutive symptomatic patients without a history of coronary artery disease with normal SPECT MPI. All patients underwent concomitant CAC scoring, which was categorized as CAC score 0, 1 to 99, 100 to 399, 400 to 999, or ≥1,000. Major adverse cardiac events were defined as revascularization, nonfatal myocardial infarction, or all-cause mortality. The median CAC score was 9 in women (interquartile range 0 to 113) and 47 in men (interquartile range 1 to 307, p CAC score, annual event rates were similar (for women and men, respectively: CAC score 0, 0.6% and 0.5%, p = 0.95; CAC score 1 to 99, 0.9% and 1.2%, p = 0.45; CAC score 100 to 399, 2.7% and 3.8%, p = 0.23; CAC score 400 to 999, 3.8% and 5.3%, p = 0.34; CAC score ≥1,000, 8.4% and 8.7%, p = 0.99). The CAC score was an independent predictor of major adverse cardiac events in both genders (CAC score ≥1,000: hazard ratio for women 8.5, 95% confidence interval 4.0 to 18.1; hazard ratio for men 14.8, 95% confidence interval 5.3 to 41.1). In conclusion, risk for events is similar for both genders when stratified by CAC score, wherein a high CAC score carries a high risk for events despite normal SPECT MPI. Our findings do not reveal a gender-specific prognostic value of the CAC score.

  5. Rationale and design of a proof-of-concept trial investigating the effect of uninterrupted perioperative (parenteral nutrition on amino acid profile, cardiomyocytes structure, and cardiac perfusion and metabolism of patients undergoing coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Cocchieri Riccardo

    2011-03-01

    Full Text Available Abstract Background Malnutrition is very common in patients undergoing cardiac surgery. Malnutrition can change myocardial substrate utilization which can induce adverse effects on myocardial metabolism and function. We aim to investigate the hypothesis that there is a disturbed amino acids profile in the cardiac surgical patient which can be normalized by (parenteral nutrition before, during and after surgery, subsequently improving cardiomyocyte structure, cardiac perfusion and glucose metabolism. Methods/Design This randomized controlled intervention study investigates the effect of uninterrupted perioperative (parenteral nutrition on cardiac function in 48 patients undergoing coronary artery bypass grafting. Patients are given enteral nutrition (n = 16 or parenteral nutrition (n = 16, at least two days before, during, and two days after coronary artery bypass grafting, or are treated according to the standard guidelines (control (n = 16. We will illustrate the effect of (parenteral nutrition on differences in concentrations of amino acids and asymmetric dimethylarginine and in activity of dimethylarginine dimethylaminohydrolase and arginase in cardiac tissue and blood plasma. In addition, cardiomyocyte structure by histological, immuno-histochemical and ultrastructural analysis will be compared between the (parenteral and control group. Furthermore, differences in cardiac perfusion and global left ventricular function and glucose metabolism, and their changes after coronary artery bypass grafting are evaluated by electrocardiography-gated myocardial perfusion scintigraphy and 18F-fluorodeoxy-glucose positron emission tomography respectively. Finally, fat free mass is measured before and after intervention with bioelectrical impedance spectrometry in order to evaluate nutritional status. Trial registration Netherlands Trial Register (NTR: NTR2183

  6. Assessment of myocardial perfusion by positron emission tomography in patients with end-stage coronary artery disease treated with percutaneous myocardial revascularization

    Institute of Scientific and Technical Information of China (English)

    Marcus Wiemer; Johannes Peter Wielepp; Oliver Lindner; Wolfgang Burchert; Christoph Langer; Dieter Horstkotte; Thomas Butz

    2009-01-01

    Background Reportedly, patients with persistent refractory angina due to end-stage coronary artery disease (CAD) not amenable to traditional revascularization techniques have experienced symptomatic relief following laser revascularization, either surgical transmyocardial revascularization (TMR) or percutaneous myocardial revascularization (PMR). In spite of several hypotheses (i.e., channel patency, placebo effect, denervation, neoangiogenesis), the mechanism of action and the benefit remains controversial.Methods A prospective trial utilizing positron emission tomography (PET) was conducted as an attempt to correlate quantified myocardial blood flow (MBF) to clinical improvement following PMR. Thirteen consecutive patients with angina class >Ⅱ in spite of maximal medical treatment underwent PMR with a holmium:yttrium-aluminum-garnet (Ho:YAG) laser.MBF at rest and under hyperemia was assessed by [~(13)N]ammonia PET at baseline, 3 and 6 months following PMR.Results Mean angina class and exercise tolerance time improved at 6 months compared with baseline (P<0.001). The clinical results were accompanied with an improvement in hyperemic MBF (P=0.05) and a reduction in minimal coronary resistance (MCR; P<0.05) in PMR-treated segments. Opposite effects, reduced hyperemic MBF and increased MCR,were observed in nontreated segments. The increase in MCR in nontreated segments revealed the favorable therapeutic impact achieved in PMR-treated segments.Conclusion The results of this trial utilizing a quantitative technique to quantify myocardial perfusion link clinical improvement post-PMR to neoangiogenesis and consistently improved microcirculation.

  7. Assessment of Heart Rate Recovery with GATED-Myocardial Perfusion Scintigraphy Outcome in Patients with Coronary Artery Disease: A Retrospective Study and Institutional Experience

    Directory of Open Access Journals (Sweden)

    Yusuf Ziya Tan

    2016-10-01

    Full Text Available Objective: This study aimed to investigate the effects of assessment with myocardial perfusion scintigraphy (MPS and heart rate recovery (HRrec measurements in combination to evaluate the current status of patients with a diagnosis or suspicion of coronary artery disease (CAD. Methods: A total of 350 patients were included in the study. CAD group consisted of 200 patients with stable angina pectoris and a known history of CAD, while the control group consisted of 150 patients with suspicious stress test who had no history of known CAD. In order to calculate the HRrec index, the treadmill exercise test was performed in all patients according to the Bruce protocol. The MPS results were evaluated for the presence or absence of myocardial ischemia and infarction by visual and quantitative (summed stress score and summed difference score assessments. 
 Results: When the MPS results and HRrec were evaluated together, there was no statistically significant difference in the non-CAD group. But, when GATED-MPS was evaluated alone in the triple-vessel patient group, 27 (36% patients were found to be normal while evaluated with HRrec, four (5.3% patients were found to be normal. Conclusion: HRrec measurements obtained during stress MPS is important in patient evaluation. Therefore, evaluation of MPS results and HRrec measurements together may provide a more accurate estimation of possible presence of CAD in patients.

  8. The predictive value of chronic kidney disease for assessing cardiovascular events under consideration of pretest probability for coronary artery disease in patients who underwent stress myocardial perfusion imaging.

    Science.gov (United States)

    Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru

    2013-02-01

    Pretest probability of coronary artery disease (CAD) facilitates diagnosis and risk stratification of CAD. Stress myocardial perfusion imaging (MPI) and chronic kidney disease (CKD) are established major predictors of cardiovascular events. However, the role of CKD to assess pretest probability of CAD has been unclear. This study evaluates the role of CKD to assess the predictive value of cardiovascular events under consideration of pretest probability in patients who underwent stress MPI. Patients with no history of CAD underwent stress MPI (n = 310; male = 166; age = 70; CKD = 111; low/intermediate/high pretest probability = 17/194/99) and were followed for 24 months. Cardiovascular events included cardiac death and nonfatal acute coronary syndrome. Cardiovascular events occurred in 15 of the 310 patients (4.8 %), but not in those with low pretest probability which included 2 CKD patients. In patients with intermediate to high pretest probability (n = 293), multivariate Cox regression analysis identified only CKD [hazard ratio (HR) = 4.88; P = 0.022) and summed stress score of stress MPI (HR = 1.50; P probability. In patients with intermediate to high pretest probability, CKD and stress MPI are independent predictors of cardiovascular events considering the pretest probability of CAD in patients with no history of CAD. In assessing pretest probability of CAD, CKD might be an important factor for assessing future cardiovascular prognosis.

  9. Prediction of Changes in Left Ventricular Ejection Fraction after Off-Pump Coronary Artery Bypass Grafting Surgery by Myocardial Perfusion Single-Photon Emission Computed Tomography

    Directory of Open Access Journals (Sweden)

    Maryam Mirzaie

    2015-09-01

    Full Text Available Introduction: Left ventricular ejection fraction (LVEF is considered to be the single most important prognostic factor in patients with previous myocardial infarction. LVEF is not improved in all patients after coronary artery bypass grafting (CABG. This study aimed to assess the possibility of prediction of LVEF changes after CABG using myocardial perfusion gated signle photon emission computed tomography (GSPECT. Materials and Methods: Overall, 48 patients with mean LVEF of 30.2% (±4.7 underwent Echocardiography and GSPECT after injection of Tc-99m-MIBI at rest. Myocardial uptake was evaluated in 17 myocardial segments and was compared with age and gender matched normal data pool. The risks and benefits of CABG were explained to the patients and 16 cases (15 male and 1 female with the mean age of 61.1 years (±10.8 accepted to undergo off-pump CABG. All the patients were followed-up for at least six months and echocardiography and GSPECT were repeated at the end of follow up. Results: The mean LVEF was increased from of 31.1% (±3.5 to 34.5% (±3.6 after surgery (P

  10. Coronary artery calcium score and N-terminal pro-B-type natriuretic peptide as potential gatekeepers for myocardial perfusion imaging

    DEFF Research Database (Denmark)

    Haarmark, Christian; Andersen, Kim Francis; Madsen, Claus;

    2017-01-01

    Myocardial perfusion imaging (MPI) holds an important place as non-invasive risk assessment in patients with intermediate risk of coronary heart disease (CHD). However, as much as 60-70% of MPI scans are normal. This study evaluates the role of coronary artery calcium scoring (CAC score) and NT......-proBNP as potential gatekeepers for MPI. Patients with intermediate risk of CHD referred for standard MPI were included. CAC score and NT-proBNP were both assessed at the day of the stress study. Sensitivity, specificity and NPV for prediction of abnormal MPI scans were calculated for CAC, NT......-proBNP and the combination hereof. A total of 190 patients were included (mean age 61 ± 12 years, 55% female) of whom 24% had known CHD. In all 30% of the scans were abnormal. CAC score achieved the highest AUC regardless of whether patients with known CHD were included or not [AUC 0·75 95% CI (0·66-0·84) and AUC 0·79 (0...

  11. 双源双能量CT心肌灌注成像在冠状动脉以及心肌灌注联合诊断中的应用价值%The Application Value of Myocardial Perfusion Imaging of Dual energy CT in the Diagnosis of Coronary artery and Myocardial Perfusion in Combination

    Institute of Scientific and Technical Information of China (English)

    孟祥兵

    2015-01-01

    Objective To investigate the myocardial perfusion imaging of dual energy CT in the diagnosis of coronary artery and myocardial perfusion in value.Methods Select 2013 January 2014 to 12 months in our hospital from accept dual energy CT examination of 28 cases of subjects were as the research object,the dual energy CT examination of the coronary artery and myocardial perfusion situation.Results In 28 subjects, 15 patients with 31 coronary artery stenosis or occlusion,including mild stenosis 5,moderate stenosis 19,severe stenosis 5,occlusion 2;476 left ventricular myocardial segment,left ventricular myocardial perfusion score was 2 points,3 (204/476), folowed by 38.4% (183/476).Conclusion Dual energy CT myocardial perfusion imaging as a one-stop examination means,in the coronary artery and myocardial perfusion combined with diagnosis exists obvious advantages,higher clinical value.%目的:探讨双源双能量CT心肌灌注成像在冠状动脉以及心肌灌注联合诊断中的价值。方法选取2013年1月至2014年12月收治的接受双源双能量CT检查的28例冠状动脉疾病患者作为研究对象,采用双源双能量CT检查其冠状动脉以及心肌灌注情况。结果28例冠状动脉疾病患者中,15例患者的31支冠状动脉分支有狭窄或闭塞等表现,其中轻度狭窄19支,中度狭窄5支,重度狭窄5支,闭塞2支;476个左室心肌节段中,左心室心肌灌注评分为2分居多,占42.9%(204/476),其次为3分,占38.4%(183/476)。结论双源双能量CT心肌灌注成像作为一站式检查手段,在冠状动脉以及心肌灌注联合诊断中存在明显优势,临床价值较高。

  12. Relation between intravascular clots of pulmonary artery and lung perfusion defects: assessment with dual source CT low-dose contrast perfusion imaging%低剂量对比剂双能量肺灌注成像评估肺动脉内血栓与灌注缺损间的关系

    Institute of Scientific and Technical Information of China (English)

    沈比先; 谭四平; 彭冬红; 汪春荣; 贾飞鸽; 李元歌; 罗玉娟; 楚二伟

    2012-01-01

    目的:应用双源CT低剂量对比剂双能量肺灌注成像评估急性肺动脉栓塞患者血管内血栓与肺灌注缺损间的关系,以提高对肺动脉栓塞诊断的准确性.方法:随机选择无肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像各15例,对比分析其图像质量;收集20例疑肺动脉栓塞患者行低剂量双能量肺灌注成像;同时获得肺动脉CTA及肺灌注图像.分析肺动脉内有无血栓.以及血栓的部位、数量及形态特征.用双能量肺灌注分析软件判断有无灌注缺损及缺损的部位、形态及范围.对比分析并统计肺动脉内血栓与肺灌注缺损间的关系.结果:肺动脉栓塞患者的低剂量与常规剂量双能量肺灌注成像质量无明显差异(P>0.05).20例疑似病例中,15例诊断为肺动脉栓塞,其中13例患者肺灌注图像中出现102个肺叶、肺段、或亚段灌注缺损,4例共6个灌注缺损CTA无明确血栓;11例肺动脉CTA显示43个血栓,其中9例血栓与灌注缺损同时存在,2例CTA共5个血栓肺内无灌注缺损.75个灌注缺损与栓塞肺动脉供血范围一致,21个灌注缺损(8段、13亚段)与肺动脉供血范围无关.结论:综合分析双源CT低剂量双能量肺灌注图与CTPA,可以提高肺动脉栓塞诊断的准确性.%Objective: To assess the relation between intravascular clots of pulmonary artery and lung perfusion defects with dual source CT low-dose contrast perfusion imaging so as to elevate the accuracy of diagnosis of PE. Methods: The image quality of low-dose and conventional dose dual energy lung perfusion imaging (DEPI) of patients without pulmonary embolism (PE). With 15 cases in each sose, were analyzed. Twenty consecutive patients with suspected PE underwent dual source CT low-dose contrast perfusion imaging and CT pulmonary angiography (CTPA) and lung perfusion images were aquired at the same time. The intravascular clots of pulmonary artery if or not, including the

  13. Perfusion imaging of parotid gland tumours: usefulness of arterial spin labeling for differentiating Warthin's tumours

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Hiroki; Watanabe, Haruo [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Kanematsu, Masayuki [Gifu University School of Medicine, Department of Radiology, Gifu (Japan); Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Kajita, Kimihiro [Gifu University Hospital, High-level Imaging Diagnosis Center, Gifu (Japan); Mizuta, Keisuke; Aoki, Mitsuhiro [Gifu University School of Medicine, Department of Otolaryngology, Gifu (Japan); Okuaki, Tomoyuki [Philips Healthcare, Tokyo (Japan)

    2015-11-15

    To assess prospectively the efficacy of arterial spin labelling (ASL) against conventional and diffusion-weighted (DW) MR imaging for differentiating parotid gland tumours. We included 10 pleomorphic adenomas, 12 Warthin's tumours, and nine malignant tumours of the parotid glands. Only tumours larger than 10 mm were included in this study. All parotid gland tumours underwent T1-weighted, T2-weighted, DW, and ASL imaging. Tumour-to-parotid gland signal intensity ratios (SIRs) and apparent diffusion coefficients (ADCs) of solid components were correlated with these pathologies. SIRs on T2-weighted images and ADCs were higher in pleomorphic adenomas than in Warthin's tumours (p <.01) and malignant tumours (p <.01). SIRs on ASL were higher in Warthin's tumours than in pleomorphic adenomas (p <.01) and malignant tumours (p <.05). Az value of SIRs on ASL for differentiating Warthin's tumours from the other pathologies was 0.982. The sensitivity, specificity, and accuracy of SIRs on ASL for the diagnosis of Warthin's tumours at an optimal SIR threshold of over 8.70 were 91.7 %, 94.7 %, and 93.5 %, respectively. ASL with SIR measurements could non-invasively evaluate tumour blood flow of parotid gland tumours and differentiate Warthin's tumours from pleomorphic adenomas and malignant tumours. (orig.)

  14. 大脑中动脉狭窄程度与脑灌注的相关性研究%Correlation between stenosis of middle cerebral artery and cerebral perfusion

    Institute of Scientific and Technical Information of China (English)

    史文倩; 石进; 杨帆; 时惠平

    2015-01-01

    Objective To investigate the correlation between stenosis of middle cerebral artery (MCA) and cerebral perfusion in patients with unilateral MCA stenosis.Methods Computed tomography perfusion (CTP) was performed in 34 patients with unilateral MCA stenosis,admitted to our hospital trom April 2012 to March 2013.The CTP parameters of mean transit time,cerebral blood flow,cerebral blood volume and time to peak were measured in regions supplied by anterior cerebral artery,MCA and posterior cerebral artery.All patients were divided into severe stenosis group and moderate stenosis group; the correlation between MCA stenosis and cerebral perfusion was analyzed.Results A decreased perfusion was detected in 25 patients (73.5%),and it was more likely found in the severe stenosis group (18/20,90%) than that in the moderate stenosis group (7/14,50%,P=0.017).The degree ofMCA stenosis was positively correlated with the changes of cerebral perfusion (r=0.381,P=0.026).The ratio of patients with transient ischemic attack (TIA) between the normal cerebral perfusion group and decreased cerebral perfusion group had statistical difference (11.11% vs.72.00%,P=0.004).Conclusion Cerebral perfusion is significantly correlated with the severity of MCA stenosis in unilateral MCA stenosis patients; the proportion of TIA in the low cerebral perfusion patients is higher than that in the normal cerebral perfusion ones.%目的 探讨单侧大脑中动脉(MCA)狭窄患者MCA狭窄程度与脑灌注的相关性.方法 对自2012年4月至2013年3月在北京空军总医院神经内科住院的34例单侧MCA狭窄患者行CT灌注成像(CTP)检查:在双侧半球大脑前动脉、MCA及大脑后动脉供血区选择对称的感兴趣区,测量CTP参数如脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)及达峰时间(TTP)等.并将患者按MCA狭窄程度分组(重度、中度),对狭窄程度与MCA供血区的脑灌注进行等级相关性分析. 结果 34例患者中有25

  15. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H

    1983-01-01

    The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD...... in legs with arterial occlusions at two levels or more; (4) In 47 legs with AOD, the SPP on the calf or on the thigh was compared with transcutaneously measured pO2. The two different methods correlated statistically significant, but the scatter was great; (5) During induced variations in systemic blood...... pressure in seven patients (12 legs with AOD), the segmental SPP and the segmental systolic blood pressure were found on average to vary in proportion with intra-arterial mean and systolic pressure respectively; however, this proportional relationship was not valid for the individual leg. It is concluded...

  16. Experimental investigation of the perfusion of the liver with non-diffusible tracers: Differentiation of the arterial and portal-venous components by deconvolution analysis of first-pass time-activity curves

    Energy Technology Data Exchange (ETDEWEB)

    Szabo, Z.; Torsello, G.; Reifenrath, C.; Porschen, R.; Vosberg, H.

    1988-10-01

    The transfer function of the liver perfusion is an idealised time-activity curve that could be registered over the liver if a non-diffusible tracer would be injected directly into the abdominal aorta and no tracer recirculation would occur. The reproducibility of the transfer function was experimentally investigated in foxhounds. Both the routes of tracer application and the modes of data evaluation were varied and the perfusion was investigated under physiological and pathological conditions. The transfer function was calculated by deconvolution analysis of first-pass time-activity curves using the matrix regularisation method. The transfer function showed clearly distinguishable arterial and portal-venous components. Repeated peripheral venous and central aortic applications resulted in reproducible curves. In addition to the arterial and portal-venous components the subcomponents of the portal-venous component could also be identified in the transfer function after ligation of the appropriate vessels. The accuracy of the mathematical procedure was tested by computer simulations. The simulation studies demonstrated also that the matrix regularisation technique is suitable for deconvolution analysis of time-activity curves even when they are significantly contaminated by statistical noise. Calculation of the transfer function of liver perfusion and of its quantitative parameters seems thus to be a reliable method for non-invasive investigation of liver hemodynamics under physiological and pathological conditions.

  17. Astrocytic tumour grading: a comparative study of three-dimensional pseudocontinuous arterial spin labelling, dynamic susceptibility contrast-enhanced perfusion-weighted imaging, and diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Xiao, Hua-Feng [302 Hospital of Chinese People' s Liberation Army, Department of Radiology, Beijing (China); Chen, Zhi-Ye; Wang, Yu-Lin; Wang, Yan; Ma, Lin [People' s Liberation Army General Hospital, Department of Radiology, Beijing (China); Lou, Xin [People' s Liberation Army General Hospital, Department of Radiology, Beijing (China); University of California, Department of Neurology, Los Angeles, CA (United States); Gui, Qiu-Ping [People' s Liberation Army General Hospital, Department of Pathology, Beijing (China); Shi, Kai-Ning; Zhou, Zhen-Yu; Zheng, Dan-Dan [General Electric Healthcare (China) Co., Ltd., Beijing; Wang, Danny J.J. [University of California, Department of Neurology, Los Angeles, CA (United States)

    2015-12-15

    We hypothesized that three-dimensional pseudocontinuous arterial spin labelling (pCASL) may have similar efficacy in astrocytic tumour grading as dynamic susceptibility contrast-enhanced perfusion-weighted imaging (DSC-PWI), and the grading accuracy may be further improved when combined with apparent diffusion coefficient (ADC) values. Forty-three patients with astrocytic tumours were studied using diffusion weighted imaging (DWI), pCASL, and DSC-PWI. Histograms of ADC and normalized tumour cerebral blood flow values (nCBF on pCASL and nrCBF on DSC-PWI) were measured and analyzed. The mean 10 % ADC value was the DWI parameter that provided the best differentiation between low-grade astrocytoma (LGA) and high-grade astrocytoma (HGA). The nCBF and nrCBF (1.810 ± 0.979 and 2.070 ± 1.048) in LGA were significantly lower than those (4.505 ± 2.270 and 5.922 ± 2.630) in HGA. For differentiation between LGA and HGA, the cutoff values of 0.764 x 10{sup -3} mm{sup 2}/s for mean 10 % ADC, 2.374 for nCBF, and 3.464 for nrCBF provided the optimal accuracy (74.4 %, 86.1 %, and 88.6 %, respectively). Combining the ADC values with nCBF or nrCBF could further improve the grading accuracy to 97.7 % or 95.3 %, respectively. pCASL is an alternative to DSC-PWI for astrocytic tumour grading. The combination of DWI and contrast-free pCASL offers a valuable choice in patients with risk factors. (orig.)

  18. Pulsatile compared with nonpulsatile perfusion using a centrifugal pump for cardiopulmonary bypass during coronary artery bypass grafting. Effects on systemic haemodynamics, oxygenation, and inflammatory response parameters.

    Science.gov (United States)

    Driessen, J J; Dhaese, H; Fransen, G; Verrelst, P; Rondelez, L; Gevaert, L; van Becelaere, M; Schelstraete, E

    1995-01-01

    The present study investigated the influence of pulsatile or nonpulsatile flow delivery with a centrifugal pump for cardiopulmonary bypass (CPB) during coronary artery bypass grafting (CABG) in two randomized groups of 19 patients each. All patients received a standard anaesthetic and surgical protocol. Pulsatile perfusion during CPB was created by accelerating the baseline pump speed of the Sarns centrifugal pump at a rate of 50 cycles per minute. Measurements included perioperative systemic haemodynamics and oxygen exchange, total haemolytic complement (CH50), polymorphonuclear (neutrophil) granulocyte (PMN) count and plasma granulocyte elastase bound to alpha 1-proteinase inhibitor (E-alpha 1-PI). Laboratory measurements were corrected for haemodilution. During and after CPB there were only a few significant differences between the groups in systemic haemodynamics and oxygenation, i.e. a lower mean arterial blood pressure after the end of CPB in the nonpulsatile group (65 mmHg, SD = 11 vs 76 mmHg, SD = 11) and a lower SvO2 during rewarming on CPB in the nonpulsatile group (62%, SD = 8 vs 67%, SD = 8). The decrease in percentage of PMNs in the total white blood cell count during CPB was greater in the nonpulsatile group than in the pulsatile group (from 61 to 46% vs 63 to 53% of prebypass value). The steep increase of PMN count at the end of CPB and postoperatively was comparable in both groups. The maximal decrease of CH50 levels, occurring after surgery, was significantly higher in the nonpulsatile group (70% SD = 15 vs 79%, SD = 16, of baseline value), suggesting a greater complement activation. E-alpha 1-PI levels increased significantly in both groups during and after CPB with higher peak levels, obtained at one hour after admission to an intensive care unit, in the nonpulsatile group (316 micrograms/l, SD = 102) than in the pulsatile group (247 micrograms/l, SD = 106). There was a partly inverse correlation between the peak postoperative elastase levels and

  19. CT measurement of changes in cerebral perfusion in patients with asymptomatic carotid artery stenosis undergoing carotid stenting prior to cardiac surgery: "proof of principle"

    NARCIS (Netherlands)

    Heyden, J. Van der; Waaijer, A.; Wouter, E.S. Van; Neerven, D. van; Sonker, U.; Suttorp, M.J.; Bal, E.T.; Prokop, M.

    2011-01-01

    AIMS: To identify asymptomatic patients with impaired cerebral perfusion using CT perfusion (CTP) technique during staged carotid stenting (CAS) and cardiac surgery. METHODS AND RESULTS: This is a prospective, non-randomised study in 16 neurologically asymptomatic patients designed to analyse cerebr

  20. 鼻咽癌多层螺旋CT灌注输入动脉的选择%Selection of reference arteries with multi-slice spiral CT perfusion imaging in diagnosis of nasopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    丁玲; 苏丹柯; 刘丽东; 金观桥; 赵梦鸥

    2011-01-01

    目的 分析不同输入动脉所得鼻咽癌(NPC)多层螺旋CT灌注参数值的差异.方法 对38例经病理确诊的初发NPC患者进行CT灌注扫描,每例患者均分别选择肿瘤同侧的颈内动脉(ICA组)和颈外动脉(ECA组)作为输入动脉、颈内静脉作为输出静脉进行灌注成像后处理,获得两组灌注参数.采用配对t检验分析两组灌注参数值的差异,并对两组数据进行直线相关分析.结果 两组不同血管所得灌注参数值差异均无统计学意义(P>0.05),两组数据血流量、血容量、平均通过时间和表面通透性的相关系数分别为0.879、0.630、0.525、0.695(P均<0.001),两组血管所得数据均成正相关.结论 在对NPC患者进行CT灌注成像后处理时,可根据患者血管的显示情况选择颈内动脉和(或)颈外动脉作为输入动脉.%Objective To observe the difference of multi-slice spiral CT perfusion parameters in different reference arteries in diagnosis of nasopharyngeal carcinoma (NPC). Methods Thirty-eight patients with NPC underwent CT perfusion imaging, internal carotid artery (ICA group) and external carotid artery (ECA group) were selected respectively as reference artery with CT perfusion imaging post-processing in each patient. The differences of perfusion parameters between the two groups were analyzed with paired-samples t test and linear correlation. Results Parameters derived from ICA and ECA as reference artery were not statistically different (all P>0. 05). There were positive correlation of all parameters between both groups, the correlation coefficients was 0. 879 for blood flow, 0. 630 for blood volume, 0. 525 for mean transit time and 0. 695 for permeability surface (all P<0. 001). Conclusion On the post-processing of CT perfusion imaging for NPC,internal carotid artery and external carotid arteries can both be selected as the reference artery according to their displaying.

  1. 256-Slice CT perfusion imaging in transcatheter arterial chemoembolization for hepatocellular carcinoma%256层CT全肝灌注成像在原发性肝癌肝动脉化疗栓塞术中的价值

    Institute of Scientific and Technical Information of China (English)

    黄丽娜; 倪衡建; 姜建威; 殷允娟; 侯海燕

    2015-01-01

    Objective To explore the clinical value of 256-slice CT whole hepatic perfusion imaging in transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods Twenty-three patients with hepatocellular carcinoma underwent whole hepatic perfusion with the JOG technique one week before TACE.The scanning data of cancer and liver tissues were analyzed using the perfusion software.The cancer tissue perfusion was repeated 4 to 6 weeks after treatment and was compared with that before treatment.Results (1) Before TACE,the HCC lesions were shown on the hepatic arterial perfusion (HAP) map as homogeneous hyper-perfusion lesions in 8 patients and as inhomogeneous hyper-perfusion lesions in 15 patients.The HAP and hepatic arterial perfusion index (HAPI) values of the tumor were higher than those of the liver tissues,while the hepatic portal perfusion (HPP) values of the tumor was lower than that of the liver tissues.The differences were all significant (P < 0.05).(2) Mter TACE,the tumors were totally filled with lipiodol in 3 patients,partially filled with lipiodol in 13 patients,and sparsely filled with lipiodol in the remaining 3 patients.There was no blood perfusion in the lipiodol-filled areas and in the cancer necrotic tissues,but in the sparsely or partially lipiodol-filled areas blood perfusion could still be seen.21 patients received another session of TACE 6 to 8 weeks later.The results between the hepatic arterial digital subtraction angiography (DSA) and the CT perfusion were 100% matching.The HAP and HAPI values of the tumor decreased when compared with before treatment,and the difference was significant (both P <0.05).The HPP values decreased slightly with no significant difference (P > 0.05),while higher HAP and HPI and lower HPP were observed in the active cancer tissues when compared with the liver tissues after treatment (P < 0.05).Conclusion 256-slice MSCT whole liver perfusion imaging can quantitatively reflect abnormal

  2. Dynamic CT myocardial perfusion imaging.

    Science.gov (United States)

    Caruso, Damiano; Eid, Marwen; Schoepf, U Joseph; Jin, Kwang Nam; Varga-Szemes, Akos; Tesche, Christian; Mangold, Stefanie; Spandorfer, Adam; Laghi, Andrea; De Cecco, Carlo N

    2016-10-01

    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.

  3. Salicylic acid analogues as chemical exchange saturation transfer MRI contrast agents for the assessment of brain perfusion territory and blood-brain barrier opening after intra-arterial infusion.

    Science.gov (United States)

    Song, Xiaolei; Walczak, Piotr; He, Xiaowei; Yang, Xing; Pearl, Monica; Bulte, Jeff Wm; Pomper, Martin G; McMahon, Michael T; Janowski, Mirosław

    2016-07-01

    The blood-brain barrier (BBB) is a major obstacle for drug delivery to the brain. Predicted, focal opening of the BBB through intra-arterial infusion of hyperosmolar mannitol is feasible, but there is a need to facilitate imaging techniques (e.g. MRI) to guide interventional procedures and assess the outcomes. Here, we show that salicylic acid analogues (SAA) can depict the brain territory supplied by the catheter and detect the BBB opening, through chemical exchange saturation transfer (CEST) MRI. Hyperosmolar SAA solutions themselves are also capable of opening the BBB, and, when multiple SAA agents were co-injected, their locoregional perfusion could be differentiated.

  4. Color doppler blood flow imaging in twin reversed arterial perfusion sequence%彩色多普勒超声诊断双胎反向动脉灌注序列征

    Institute of Scientific and Technical Information of China (English)

    李雪蕾; 李昌安; 穆仲平

    2012-01-01

    目的探讨彩色多普勒超声诊断双胎反向动脉灌注序列征的价值.方法对5例双胎反向动脉灌注序列征的产前彩色多普勒超声检查结果进行回顾性分析,并与产后结果对照,总结声像图表现及诊断要点.结果 5例于产前彩色多普勒超声检查中发现并于产后证实为双胎反向动脉灌注序列征;5例均为单绒毛膜双胎,其中3例为单羊膜囊,2例为双羊膜囊;5例均为无脑、无心畸胎.结论彩色多普勒超声检查可以准确并及早诊断双胎反向动脉灌注序列征,有助于指导临床实现优生优育.%Objective To detect the diagnostic value of color doppler blood flow imaging in twin reversed arterial perfusion sequence. Methods Review and analysis of 5 cases of twin reversed arterial perfusion sequence were examined by color Doppler, and compared with the results of the clinical diagnosis after delivery. The main points of diagnosis were summarized. Results The twin reversed arterial perfusion sequence was observed in prenatal examination and demonstrated in postpartum through prenatal ultrasonic inspection system of 5 inspection objects. All 5 cases were confirmed to monochorionic twin. Among them 3 cases were monoamnionic twin and 2 cases were diamnionic twin. All 5 cases were anencephalia and acardia. Conclusion Color doppler imaging can provide accurate diagnoses with twin reversed arterial perfusion sequence timely, and will offer available instructions on clinical therapy to achieve prenatal and postnatal care.

  5. 动脉留置针在大鼠体脑组织灌注中的应用%In Vivo Perfusion Method of Artery Remaining Needle Applied to Rat Brain Tissue

    Institute of Scientific and Technical Information of China (English)

    韦晓勇; 陆波; 闵红星; 王毅; 李军

    2015-01-01

    目的:拟寻求一种更好的大鼠体脑组织灌注方法以提高灌注固定效果。方法:健康雄性SD大鼠经10%水合氯醛进行麻醉,暴露心脏和主动脉弓,以小动脉夹夹闭胸主动脉,用动脉留置针在大鼠心尖波动最明显处进针,进入约0.5 cm时,边退出针芯,边将套管自左侧心室推送至升主动脉直至套管针尾部,并关闭套管针尾端的开关,防止血液外溢,连接输液管,剪破右心耳,依次从心脏灌注0.9%复方氯化钠注射液和4%多聚甲醛固定脑组织。结果:脑组织灌注所需的灌注液减少,灌注插管时间及总灌注时间均缩短,且灌注后脑组织更硬、色泽更白。结论:采用此种灌注方法后,其灌注固定效果明显提高,且操作过程简单易行,值得推广。%Objective:To seek a better method for in vivo perfusion of rat brain tissues and improve the efficiency of perfusion fixation.Method:The healthy male SD rat was anesthetized by 10% chloral hydrate,exposed the heart and aortic arch,clipping the thoracic aorta with small arteries clip,with artery remaining needle in the tip of the heart of the rat fluctuation most obviously needled into about 0.5 cm,exited the needle core,at the same time pushed the cannula from the left ventricle to the aorta until the trocar tail,and closed the cannula needle end of the switch to prevent blood spills,then connected with the infusion pipe and cuted the right auricle,fixation brain tissue from the heart perfused sequentially with 0.9%compound sodium chloride injection and 4% paraformaldehyde.Result:The required perfusion fluid of Cerebral tissue perfusion was reduced, perfusion intubation time and total perfusion time was shortened,and the brain tissue after the infusion was harder,the color was more white.Conclusion:By this method of perfusion,the perfusion fixation effect is obviously improved and the operation process is simple and easy to operate,which is worthy

  6. The meninges is a source of retinoic acid for the late-developing hindbrain.

    Science.gov (United States)

    Zhang, Jinghua; Smith, Deborah; Yamamoto, Miyuki; Ma, Lanhua; McCaffery, Peter

    2003-08-20

    One general function for retinoic acid (RA) is pattern organization in the CNS. This regulatory factor has an essential role in spinal cord motor neuron and early posterior hindbrain development. In the anterior CNS, however, there is only a limited number of foci of RA synthesis, and less attention has been placed on regions such as the anterior hindbrain where RA synthesizing enzymes are absent. This study shows that a rich source of RA lies around the hindbrain from the RA synthetic enzyme retinaldehyde dehydrogenase-2 (RALDH2) present in the surrounding meninges and mesenchyme by embryonic day 13. RALDH2 is not distributed uniformly throughout the meninges but is restricted to territories over the developing hindbrain, suggesting that RA signaling may be localized to those regions. Further regulation of RA signaling is provided by the presence of a RA sink in the form of the CYP26B1 RA catabolic enzyme expressed in deeper regions of the brain. As a guide to the neural anatomy of hindbrain RA signaling, we used a mouse transgenic for a lacZ reporter gene driven by a RA response element (RAREhsplacZ) to identify regions of RA signaling. This reporter mouse provides evidence that RA signaling in the hindbrain after embryonic day 13 occurs in the regions of the cerebellum and precerebellar system adjacent to sources of RA, including the inferior olive and the pontine nuclei.

  7. Increased perfusion pressure enhances the expression of endothelin (ETB) and angiotensin II (AT1, AT2) receptors in rat mesenteric artery smooth muscle cells

    DEFF Research Database (Denmark)

    Lindstedt, Isak; Xu, Cang-Bao; Zhang, Yaping;

    2009-01-01

    and luminally perfused in a perfusion chamber. After either exposure to no ("organ culture" (0 mmHg)), normal (85/75 mmHg) or high pressure (160/150 mmHg) at constant flow for 1-17 h, the vessel segments were snap frozen and real-time polymerase chain reaction was performed to quantify the ET- and AT-receptor m......RNA content, or immersed in a fixative solution, dehydrated, frozen, cut in a cryostat and immunohistology stained for ET- and AT-receptor protein. The mRNA expressions of ETB and of AT2 were significantly enhanced in vessels exposed to high perfusion pressure, compared with normal and no perfusion pressure...

  8. Update on neuroimaging phenotypes of mid-hindbrain malformations

    Energy Technology Data Exchange (ETDEWEB)

    Jissendi-Tchofo, Patrice [University Hospital of Lille (CHRU), Department of Neuroradiology, MRI 3T Research, Plateforme Imagerie du vivant, IMPRT-IFR 114, Lille-Cedex (France); CHU Saint-Pierre, Radiology Department, Pediatric Neuroradiology Section, Brussels (Belgium); Severino, Mariasavina [Istituto Giannina Gaslini, Neuroradiology Unit, Genoa (Italy); Nguema-Edzang, Beatrice; Toure, Cisse; Soto Ares, Gustavo [University Hospital of Lille (CHRU), Department of Neuroradiology, MRI 3T Research, Plateforme Imagerie du vivant, IMPRT-IFR 114, Lille-Cedex (France); Barkovich, Anthony James [University of California, Neuroradiology Section, Department of Radiology and Biomedical Imaging, San Francisco, CA (United States)

    2014-10-23

    Neuroimaging techniques including structural magnetic resonance imaging (MRI) and functional positron emission tomography (PET) are useful in categorizing various midbrain-hindbrain (MHB) malformations, both in allowing diagnosis and in helping to understand the developmental processes that were disturbed. Brain imaging phenotypes of numerous malformations are characteristic features that help in guiding the genetic testing in case of direct neuroimaging-genotype correlation or, at least, to differentiate among MHB malformations entities. The present review aims to provide the reader with an update of the use of neuroimaging applications in the fine analysis of MHB malformations, using a comprehensive, recently proposed developmental and genetic classification. We have performed an extensive systematic review of the literature, from the embryology main steps of MHB development through the malformations entities, with regard to their molecular and genetic basis, conventional MRI features, and other neuroimaging characteristics. We discuss disorders in which imaging features are distinctive and how these features reflect the structural and functional impairment of the brain. Recognition of specific MRI phenotypes, including advanced imaging features, is useful to recognize the MHB malformation entities, to suggest genetic investigations, and, eventually, to monitor the disease outcome after supportive therapies. (orig.)

  9. Magnetic Resonance Imaging of Malformations of Midbrain-Hindbrain.

    Science.gov (United States)

    Abdel Razek, Ahmed Abdel Khalek; Castillo, Mauricio

    2016-01-01

    We aim to review the magnetic resonance imaging appearance of malformations of midbrain and hindbrain. These can be classified as predominantly cerebellar malformations, combined cerebellar and brain stem malformations, and predominantly brain stem malformations. The diagnostic criteria for the majority of these morphological malformations are based on neuroimaging findings. The predominantly cerebellar malformations include predominantly vermian hypoplasia seen in Dandy-Walker malformation and rhombencephalosynapsis, global cerebellar hypoplasia reported in lissencephaly and microlissencephaly, and unilateral cerebellar hypoplasia seen in PHACES, vanishing cerebellum, and cerebellar cleft. Cerebellar dysplasias are seen in Chudley-McCullough syndrome, associated with LAMA1 mutations and GPR56 mutations; Lhermitte-Duclos disease; and focal cerebellar dysplasias. Cerebellar hyperplasias are seen in megalencephaly-related syndromes and hemimegalencephaly with ipsilateral cerebellomegaly. Cerebellar and brain stem malformations include tubulinopathies, Joubert syndrome, cobblestone malformations, pontocerebellar hypoplasias, and congenital disorders of glycosylation type Ia. Predominantly brain stem malformations include congenital innervation dysgenesis syndrome, pontine tegmental cap dysplasia, diencephalic-mesencephalic junction dysplasia, disconnection syndrome, and pontine clefts.

  10. Labeling and imaging cells in the zebrafish hindbrain.

    Science.gov (United States)

    Jayachandran, Pradeepa; Hong, Elim; Brewster, Rachel

    2010-07-25

    Key to understanding the morphogenetic processes that shape the early vertebrate embryo is the ability to image cells at high resolution. In zebrafish embryos, injection of plasmid DNA results in mosaic expression, allowing for the visualization of single cells or small clusters of cells (1) . We describe how injection of plasmid DNA encoding membrane-targeted Green Fluorescent Protein (mGFP) under the control of a ubiquitous promoter can be used for imaging cells undergoing neurulation. Central to this protocol is the methodology for imaging labeled cells at high resolution in sections and also in real time. This protocol entails the injection of mGFP DNA into young zebrafish embryos. Embryos are then processed for vibratome sectioning, antibody labeling and imaging with a confocal microscope. Alternatively, live embryos expressing mGFP can be imaged using time-lapse confocal microscopy. We have previously used this straightforward approach to analyze the cellular behaviors that drive neural tube formation in the hindbrain region of zebrafish embryos (2). The fixed preparations allowed for unprecedented visualization of cell shapes and organization in the neural tube while live imaging complemented this approach enabling a better understanding of the cellular dynamics that take place during neurulation.

  11. Associação entre fatores de risco para doença arterial coronariana e coronariopatia em pacientes submetidos a cintilografia de perfusão do miocárdio Association between risk factors for coronary artery disease and coronary disease in patients undergoing myocardial perfusion scintigraphy

    Directory of Open Access Journals (Sweden)

    Paulo Schiavom Duarte

    2007-03-01

    Full Text Available OBJETIVOS: Estabelecer o grau de associação entre fatores de risco cardiovascular e a presença de doença arterial coronária (DAC em um grupo de pacientes submetidos a cintilografia de perfusão do miocárdio (CPM. MÉTODOS: Foram estudados 7.183 pacientes submetidos a CPM. Utilizando análise de regressão logística, avaliou-se a razão de chances dos seguintes fatores de risco: idade, sexo, antecedentes familiares, índice de massa corpórea, tabagismo, dislipidemia, diabetes melito (DM e hipertensão arterial sistêmica. Definiram-se como indicativas da presença de DAC as seguintes condições: infarto, revascularização, angioplastia ou alteração na CPM. Analisou-se a amostra global de pacientes bem como os indivíduos masculinos e femininos separadamente. Caracterizou-se também a importância dos fatores de risco por faixas etárias. RESULTADOS: Observou-se associação estatisticamente significativa entre a idade e o sexo dos pacientes e a presença de DAC. Para o sexo feminino, o DM apareceu como o principal fator de risco controlável para DAC. Para o masculino, vários fatores de risco controláveis foram associados à presença de DAC, destacando-se o DM e a dislipidemia. Na análise por faixas etárias alguns fatores de risco passaram a apresentar associação mais expressiva. CONCLUSÃO: Os principais fatores de risco para DAC foram o envelhecimento e o sexo masculino. Dos fatores de risco passíveis de serem controlados, os que apresentaram maior associação com a presença de DAC foram o DM e a dislipidemia no homem e o DM na mulher. Para faixas etárias específicas destacaram-se o tabagismo para homens jovens, o DM e o tabagismo para mulheres entre 40 e 50 anos.OBJECTIVES: To establish the degree of association between cardiovascular risk factors and the presence of coronary artery disease (CAD in a group of patients undergoing myocardial perfusion scintigraphy (MPS. METHODS: The study included 7183 patients who had

  12. Cirurgia do arco aórtico com perfusão cerebral bilateral pelo isolamento do tronco braquiocefálico e da artéria carótida esquerda Aortic arch surgery with bilateral cerebral perfusion by isolation of brachiocephalic trunk and left carotid artery

    Directory of Open Access Journals (Sweden)

    Valdo José Carreira

    2008-03-01

    Full Text Available OBJETIVO: Estudar os resultados da técnica descrita por Carreira et al. com utilização de perfusão cerebral seletiva bilateral (PCSAB pelo isolamento do tronco braquiocefálico e artéria carótida esquerda. MÉTODOS: Quinze pacientes foram operados consecutivamente entre de junho de 2005 e setembro de 2007. Os dados foram analisados por programa informatizado Epi Info e significância estatística com p0,05. CONCLUSÃO: A técnica de PCSAB é reprodutível e apresenta resultados semelhantes aos da literatura mundial. A excelente evolução neurológica e o fácil controle de sangramentos nas linhas de sutura podem ter contribuído com os resultados obtidos.OBJECTIVE: To evaluate the results of a technique described by Carreira et al. using bilateral antegrade selective cerebral perfusion by isolating the brachiocephalic trunk and the left carotid artery. METHODS: Fifteen patients were operated between June 2005 and September 2007. Data analysis were performed using Epi Info and statistical significance was set at p0.05. CONCLUSION: The technique of bilateral selective cerebral perfusion described by Carreira et al. can be performed by others and presents similar results to the international literature. The excellent neurological outcome and easy bleeding control on surgical sutures lines are the major advantages of this new procedure.

  13. Fair灌注成像在一侧大脑中动脉狭窄或闭塞中的应用%Fair for evaluation of middle cerebral artery stenosis or occlusion in brian tissue perfusion imaging

    Institute of Scientific and Technical Information of China (English)

    刘玉涛; 李淑明; 阮骥

    2011-01-01

    目的 探讨Fair灌注成像对大脑中动脉狭窄或闭塞中灌注信息的诊断价值,为指导临床提供依据.方法 20例临床TIA患者或怀疑大脑血管的狭窄或闭塞患者,行常规MRI,DWI,MRA,Fair和DSC检查,确定病变范围,定量评价Fair与DSC的rCBF差异.结果 Fair CBF图显示患侧与健侧灌注程度改变对比t=4.46,P<0.05,有差异;Fair 的rCBF为0.84±0.52,DSC的rCBF为0.79±0.31,二者对比:t=0.705,P >0.05,无统计血差异.结论 Fair为无创性脑灌注成像,操作简单,能定量评估的大脑中动脉狭窄或闭塞引起的缺血性脑血管病的灌注信息.%Objective To disscuss diagnostic value of Fair in cerebral artery stenosis or occlusion reperfusion.Methods 20 patients of middle cerebral artery stenosis or occlusion were studied with rountine MRI,DWI,MRA,Fair and DSC examination, Showing the size of lesions were compared, The perfusion difference between Fair and DSC through the rCBF was compared.Results Fair showed the perfusion of abnomality of unilateral and contralateral changes in perfusion , t=4.46, P<0.05, with statistical significance.rCBF of Fair was 0.84±0.52, rCBF of DSC was 0.79±0.31, Comparison of DSC and Fair perfusionmethod showed no difference (t=0.705,P>0.05).Conclusion Fair, need no contrast injection of invasive operation, is convenient and useful method in assessing cerebral perfusion information of middle cerebral artery stenosis or occlusion.

  14. Quantification of perfusion and risk stratification by myocardial perfusion SPECT; Quantifizierung der Perfusion und Risikostratifizierung durch die Myokardperfusions-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nowak, Bernd [Ueberoertliche Gemeinschaft (GbR) fuer diagnostische und interventionelle Radiologie und Nuklearmedizin (DIRANUK), Bielefeld (Germany); Klinikum Bielefeld-Mitte (Germany). Klinik fuer Nuklearmedizin; Schaefer, W.M. [Kliniken Maria Hilf GmbH, Krankenhaus St. Franziskus, Moenchengladbach (Germany). Klinik fuer Nuklearmedizin

    2010-06-15

    Myocardial perfusion SPECT detects flow-limiting coronary artery disease with high sensitivity and specificity, enables semiquantification of severity and extensiveness of myocardial ischemia, and furthermore enables reliable assessment of future cardiac events independently of other clinical and diagnostic parameters. A normal myocardial perfusion SPECT is associated with a favorable prognosis and warrants restrictive patient management. Cardiac risk increases in relation to the severity of perfusion abnormalities. Differentiated analysis of quantitative parameters derived from myocardial perfusion SPECT provides effective risk stratification of patients with a large variety of risk factors. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    Elhendy, A.; Sozzi, F.B.; Van Domburg, R.T.; Bax, J.J.; Roelandt, J.R.T.C. [Erasmus Universiteit, Rotterdam (Netherlands). Thorax Center; Valkema, R. [Dept. of Nuclear Medicine, University Hospital-Dijkzigt, Rotterdam (Netherlands)

    2000-03-01

    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.)

  16. Withholding or Continuing Beta-Blocker Treatment Before Dipyridamole Myocardial Perfusion Imaging for the Diagnosis of Coronary Artery Disease? a Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Babak Fallahi

    2013-01-01

    Full Text Available Although it has been shown that acute beta-blocker administration may reduce the presence or severity of myocardial perfusion defects with dipyridamole stress, little information is available about the potential effect of chronic beta-blocker treatment on the sensitivity of dipyridamole myocardial perfusion imaging (DMPI.Methods As a randomized clinical trial, one hundred twenty patients (103 male and 17 female with angiographically confirmed CAD who were on long-term beta blocker therapy ([greater than or equal to]3 months enrolled in a randomized clinical trial study. The patients were allocated into two groups: Group A (n=60 in whom the beta-blocker agent was discontinued for 72h before DMPI and Group B (n=60 without discontinuation of beta-blockers prior to DMPI.ResultsNo significant difference was noted between the groups concerning age, sex, type of the injected radiotracer and number of involved coronary vessels. The mean rank of total perfusion scores for whole myocardium (irrespective of reversibility or irreversibility in group B was not significantly different from that of group A, (65.75 vs. 55.25, P=0.096. Regarding the only irreversible perfusion defects, the mean rank of perfusion score in group B was higher than that of group A for whole myocardium (72 vs. 49, P=0.0001; however, no difference was noted between two groups for only reversible perfusion defects (61.0 vs. 60.0, P=0.898. The overall sensitivity of DMPI for the diagnosis of CAD in group A (91.7% was not statistically different from group B (90%.ConclusionBeta-blocker withholding before DMPI did not generally affect the sensitivity of the test for the diagnostic purposes in our study. Thus, beta-blocker withdrawal for just the purpose of diagnostic imaging is not mandatory particularly when medication discontinuation may cause the patients to face increased risk of heart events.

  17. Magnetic resonance perfusion imaging without contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Martirosian, Petros; Graf, Hansjoerg; Schick, Fritz [University Hospital of Tuebingen, Section on Experimental Radiology, Tuebingen (Germany); Boss, Andreas; Schraml, Christina; Schwenzer, Nina F.; Claussen, Claus D. [University Hospital of Tuebingen, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2010-08-15

    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.)

  18. Whole-brain dynamic CT angiography and perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Orrison, W.W. [CHW Nevada Imaging Company, Nevada Imaging Centers, Spring Valley, Las Vegas, NV (United States); College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Department of Medical Education, University of Nevada School of Medicine, Reno, NV (United States); Snyder, K.V.; Hopkins, L.N. [Department of Neurosurgery, Millard Fillmore Gates Circle Hospital, Buffalo, NY (United States); Roach, C.J. [School of Life Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States); Ringdahl, E.N. [Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV (United States); Nazir, R. [Shifa International Hospital, Islamabad (Pakistan); Hanson, E.H., E-mail: eric.hanson@amigenics.co [College of Osteopathic Medicine, Touro University Nevada, Henderson, NV (United States); Department of Health Physics and Diagnostic Sciences, University of Nevada Las Vegas, Las Vegas, NV (United States); Advanced Medical Imaging and Genetics (Amigenics), Las Vegas, NV (United States)

    2011-06-15

    The availability of whole brain computed tomography (CT) perfusion has expanded the opportunities for analysing the haemodynamic parameters associated with varied neurological conditions. Examples demonstrating the clinical utility of whole-brain CT perfusion imaging in selected acute and chronic ischaemic arterial neurovascular conditions are presented. Whole-brain CT perfusion enables the detection and focused haemodynamic analyses of acute and chronic arterial conditions in the central nervous system without the limitation of partial anatomical coverage of the brain.

  19. Intermodel Agreement of Myocardial Blood Flow Estimation From Stress-Rest Myocardial Perfusion Magnetic Resonance Imaging in Patients With Coronary Artery Disease

    NARCIS (Netherlands)

    Handayani, Astri; Triadyaksa, Pandji; Dijkstra, Hildebrand; Pelgrim, Gert Jan; van Ooijen, Peter M. A.; Prakken, Niek H. J.; Schoepf, U. Joseph; Oudkerk, Matthijs; Vliegenthart, Rozemarijn; Sijens, Paul E.

    2015-01-01

    Objectives: The aim of this study was to assess the intermodel agreement of different magnetic resonance myocardial perfusion models and evaluate their correspondence to stenosis diameter. Materials and Methods: In total, 260 myocardial segments were analyzed from rest and adenosine stress first-pas

  20. Combined use of 64-slice computed tomography angiography and gated myocardial perfusion SPECT for the detection of functionally relevant coronary artery stenoses. First results in a clinical setting concerning patients with stable angina

    Energy Technology Data Exchange (ETDEWEB)

    Hacker, M.; Hack, N.; Tiling, R. [Klinikum Grosshadern (Germany). Dept. of Nuclear Medicine; Jakobs, T.; Nikolaou, K.; Becker, C. [Klinikum Grosshadern (Germany). Dept. of Clinical Radiology; Ziegler, F. von; Knez, A. [Klinikum Grosshadern (Germany). Dept. of Cardiology; Koenig, A.; Klauss, V. [Medizinische Poliklinik-Innenstadt, Univ. of Munich (Germany). Dept. of Cardiology

    2007-07-01

    Aim: In patients with stable angina pectoris both morphological and functional information about the coronary artery tree should be present before revascularization therapy is performed. High accuracy was shown for spiral computed tomography (MDCT) angiography acquired with a 64-slice CT scanner compared to invasive coronary angiography (ICA) in detecting ''obstructive'' coronary artery disease (CAD). Gated myocardial SPECT (MPI) is an established method for the noninvasive assessment of functional significance of coronary stenoses. Aim of the study was to evaluate the combination of 64-slice CT angiography plus MPI in comparison to ICA plus MPI in the detection of hemodynamically relevant coronary artery stenoses in a clinical setting. Patients, methods: 30 patients (63 {+-} 10.8 years, 23 men) with stable angina (21 with suspected, 9 with known CAD) were investigated. MPI, 64-slice CT angiography and ICA were performed, reversible and fixed perfusion defects were allocated to determining lesions separately for MDCT angiography and ICA. The combination of MDCT angiography plus MPI was compared to the results of ICA plus MPI. Results: Sensitivity, specificity, negative and positive predictive value for the combination of MDCT angiography plus MPI was 85%, 97%, 98% and 79%, respectively, on a vessel-based and 93%, 87%, 93% and 88%, respectively, on a patient-based level. 19 coronary arteries with stenoses =50% in both ICA and MDCT angiography showed no ischemia in MPI. Conclusion: The combination of 64-slice CT angiography and gated myocardial SPECT enabled a comprehensive non-invasive view of the anatomical and functional status of the coronary artery tree. (orig.)

  1. Measuring myocardial perfusion

    DEFF Research Database (Denmark)

    Qayyum, A A; Kastrup, J

    2015-01-01

    -pass of non-ionic and ionic contrast agents, respectively. Absolute quantification with CMR has yet to be established in routine clinical practice, while CT has yet to prove its diagnostic and prognostic value. The upcoming years may change the way we diagnose and treat patients suspected of having CAD......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...

  2. A Hox regulatory network of hindbrain segmentation is conserved to the base of vertebrates.

    Science.gov (United States)

    Parker, Hugo J; Bronner, Marianne E; Krumlauf, Robb

    2014-10-23

    A defining feature governing head patterning of jawed vertebrates is a highly conserved gene regulatory network that integrates hindbrain segmentation with segmentally restricted domains of Hox gene expression. Although non-vertebrate chordates display nested domains of axial Hox expression, they lack hindbrain segmentation. The sea lamprey, a jawless fish, can provide unique insights into vertebrate origins owing to its phylogenetic position at the base of the vertebrate tree. It has been suggested that lamprey may represent an intermediate state where nested Hox expression has not been coupled to the process of hindbrain segmentation. However, little is known about the regulatory network underlying Hox expression in lamprey or its relationship to hindbrain segmentation. Here, using a novel tool that allows cross-species comparisons of regulatory elements between jawed and jawless vertebrates, we report deep conservation of both upstream regulators and segmental activity of enhancer elements across these distant species. Regulatory regions from diverse gnathostomes drive segmental reporter expression in the lamprey hindbrain and require the same transcriptional inputs (for example, Kreisler (also known as Mafba), Krox20 (also known as Egr2a)) in both lamprey and zebrafish. We find that lamprey hox genes display dynamic segmentally restricted domains of expression; we also isolated a conserved exonic hox2 enhancer from lamprey that drives segmental expression in rhombomeres 2 and 4. Our results show that coupling of Hox gene expression to segmentation of the hindbrain is an ancient trait with origin at the base of vertebrates that probably led to the formation of rhombomeric compartments with an underlying Hox code.

  3. Skin perfusion pressure measured by isotope washout in legs with arterial occlusive disease. Evaluation of different tracers, comparison to segmental systolic pressure, angiography and transcutaneous oxygen tension and variations during changes in systemic blood pressure

    DEFF Research Database (Denmark)

    Holstein, P; Trap-Jensen, J; Bagger, H;

    1983-01-01

    digit (strain gauge technique). The two different methods correlated statistically significant at all four levels, but the systolic blood pressures were higher than the SPP in particular in diabetic legs; (3) Angiograms in 35 legs with AOD showed that the SPP on the ankle was only consistently decreased......The skin perfusion pressure (SPP) measured as the isotope washout cessation external pressure is valuable in selection of major amputation level. Five methodological investigations important to clinical use were carried out: (1) In five normal legs and 10 legs with arterial occlusive disease (AOD......Hg (range 18-98) (P less than 0.02). The average washout constant for the three different tracers were approximately equal and correlated statistically significant with the SPP; (2) In 59 legs with AOD, segmental SPP was compared to segmental systolic blood pressures on the thigh, calf, ankle and first...

  4. Improved visualization of delayed perfusion in lung MRI

    Energy Technology Data Exchange (ETDEWEB)

    Risse, Frank [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Eichinger, Monika [Department of Radiology, German Cancer Research Center, Heidelberg (Germany); Kauczor, Hans-Ulrich [Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg (Germany); Semmler, Wolfhard [Department of Medical Physics in Radiology, German Cancer Research Center, Heidelberg (Germany); Puderbach, Michael, E-mail: m.puderbach@dkfz.de [Department of Radiology, German Cancer Research Center, Heidelberg (Germany)

    2011-01-15

    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{sub 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 {tau} to visualize regions with delayed bolus onset; and (3) ratio R = S{sub n,max}/{tau} 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.

  5. Nuclear stress perfusion imaging versus computed tomography coronary angiography for identifying patients with obstructive coronary artery disease as defined by conventional angiography: insights from the CorE-64 multicenter study

    Directory of Open Access Journals (Sweden)

    Yutaka Tanami

    2014-08-01

    Full Text Available We investigated the diagnostic accuracy of computed tomography angiography (CTA versus myocardial perfusion imaging (MPI for detecting obstructive coronary artery disease (CAD as defined by conventional quantitative coronary angiography (QCA. Sixty-three patients who were enrolled in the CorE-64 multicenter study underwent CTA, MPI, and QCA imaging. All subjects were referred for cardiac catheterization with suspected or known coronary artery disease. The diagnostic accuracy of quantitative CTA and MPI for identifying patients with 50% or greater coronary arterial stenosis by QCA was evaluated using receiver operating characteristic (ROC analysis. Pre-defined subgroups were patients with known CAD and those with a calcium score of 400 or over. Diagnostic accuracy by ROC analysis revealed greater area under the curve (AUC for CTA than MPI for all 63 patients: 0.95 [95% confidence interval (CI: 0.89-0.100] vs 0.65 (95%CI: 0.53-0.77, respectively (P<0.01. Sensitivity, specificity, positive and negative predictive values were 0.93, 0.95, 0.97, 0.88, respectively, for CTA and 0.85, 0.45, 0.74, 0.63, respectively, for MPI. In 48 patients without known CAD, AUC was 0.96 for CTA and to 0.67 for SPECT (P<0.01. There was no significant difference in AUC for CTA in patients with calcium score below 400 versus over 400 (0.93 vs 0.95, but AUC was different for SPECT (0.61 vs 0.95; P<0.01. In a direct comparison, CTA is markedly superior to MPI for detecting obstructive coronary artery disease in patients. Even in subgroups traditionally more challenging for CTA, SPECT does not offer similarly good diagnostic accuracy. CTA may be considered the non-invasive test of choice if diagnosis of obstructive CAD is the purpose of imaging.

  6. Effects of Steroid Hormones on Sex Differences in Cerebral Perfusion.

    Science.gov (United States)

    Ghisleni, Carmen; Bollmann, Steffen; Biason-Lauber, Anna; Poil, Simon-Shlomo; Brandeis, Daniel; Martin, Ernst; Michels, Lars; Hersberger, Martin; Suckling, John; Klaver, Peter; O'Gorman, Ruth L

    2015-01-01

    Sex differences in the brain appear to play an important role in the prevalence and progression of various neuropsychiatric disorders, but to date little is known about the cerebral mechanisms underlying these differences. One widely reported finding is that women demonstrate higher cerebral perfusion than men, but the underlying cause of this difference in perfusion is not known. This study investigated the putative role of steroid hormones such as oestradiol, testosterone, and dehydroepiandrosterone sulphate (DHEAS) as underlying factors influencing cerebral perfusion. We acquired arterial spin labelling perfusion images of 36 healthy adult subjects (16 men, 20 women). Analyses on average whole brain perfusion levels included a multiple regression analysis to test for the relative impact of each hormone on the global perfusion. Additionally, voxel-based analyses were performed to investigate the sex difference in regional perfusion as well as the correlations between local perfusion and serum oestradiol, testosterone, and DHEAS concentrations. Our results replicated the known sex difference in perfusion, with women showing significantly higher global and regional perfusion. For the global perfusion, DHEAS was the only significant predictor amongst the steroid hormones, showing a strong negative correlation with cerebral perfusion. The voxel-based analyses revealed modest sex-dependent correlations between local perfusion and testosterone, in addition to a strong modulatory effect of DHEAS in cortical, subcortical, and cerebellar regions. We conclude that DHEAS in particular may play an important role as an underlying factor driving the difference in cerebral perfusion between men and women.

  7. Effects of Steroid Hormones on Sex Differences in Cerebral Perfusion.

    Directory of Open Access Journals (Sweden)

    Carmen Ghisleni

    Full Text Available Sex differences in the brain appear to play an important role in the prevalence and progression of various neuropsychiatric disorders, but to date little is known about the cerebral mechanisms underlying these differences. One widely reported finding is that women demonstrate higher cerebral perfusion than men, but the underlying cause of this difference in perfusion is not known. This study investigated the putative role of steroid hormones such as oestradiol, testosterone, and dehydroepiandrosterone sulphate (DHEAS as underlying factors influencing cerebral perfusion. We acquired arterial spin labelling perfusion images of 36 healthy adult subjects (16 men, 20 women. Analyses on average whole brain perfusion levels included a multiple regression analysis to test for the relative impact of each hormone on the global perfusion. Additionally, voxel-based analyses were performed to investigate the sex difference in regional perfusion as well as the correlations between local perfusion and serum oestradiol, testosterone, and DHEAS concentrations. Our results replicated the known sex difference in perfusion, with women showing significantly higher global and regional perfusion. For the global perfusion, DHEAS was the only significant predictor amongst the steroid hormones, showing a strong negative correlation with cerebral perfusion. The voxel-based analyses revealed modest sex-dependent correlations between local perfusion and testosterone, in addition to a strong modulatory effect of DHEAS in cortical, subcortical, and cerebellar regions. We conclude that DHEAS in particular may play an important role as an underlying factor driving the difference in cerebral perfusion between men and women.

  8. Retinoic acid is a potential dorsalising signal in the late embryonic chick hindbrain

    Directory of Open Access Journals (Sweden)

    Maden Malcolm

    2007-12-01

    Full Text Available Abstract Background Human retinoic acid teratogenesis results in malformations of dorsally derived hindbrain structures such as the cerebellum, noradrenergic hindbrain neurons and the precerebellar system. These structures originate from the rhombic lip and adjacent dorsal precursor pools that border the fourth ventricle roofplate. While retinoic acid synthesis is known to occur in the meninges that blanket the hindbrain, the particular sensitivity of only dorsal structures to disruptions in retinoid signalling is puzzling. We therefore looked for evidence within the neural tube for more spatiotemporally specific signalling pathways using an in situ hybridisation screen of known retinoic acid pathway transcripts. Results We find that there are highly restricted domains of retinoic acid synthesis and breakdown within specific hindbrain nuclei as well as the ventricular layer and roofplate. Intriguingly, transcripts of cellular retinoic acid binding protein 1 are always found at the interface between dividing and post-mitotic cells. By contrast to earlier stages of development, domains of synthesis and breakdown in post-mitotic neurons are co-localised. At the rhombic lip, expression of the mRNA for retinoic acid synthesising and catabolising enzymes is spatially highly organised with respect to the Cath1-positive precursors of migratory precerebellar neurons. Conclusion The late developing hindbrain shows patterns of retinoic acid synthesis and use that are distinct from the well characterised phase of rostrocaudal patterning. Selected post-mitotic populations, such as the locus coeruleus, appear to both make and break down retinoic acid suggesting that a requirement for an autocrine, or at least a highly localised paracrine signalling network, might explain its acute sensitivity to retinoic acid disruption. At the rhombic lip, retinoic acid is likely to act as a dorsalising factor in parallel with other roofplate signalling pathways. While its

  9. Clinical Observation on the Treatment for Malignant Ascite by Transcatheter Arterial Perfusion Chemotherapy%经动脉灌注化疗治疗癌性腹水的临床观察

    Institute of Scientific and Technical Information of China (English)

    万剑慧; 徐幼龙; 杨大明; 吴敏

    2011-01-01

    Objective: To observe the effects of the treatment for malignant ascite by transcatheter arterial perfusion chemotherapy. Methods: A total of 32 patients suffered intraperitoneal fluid caused by later period stomach and intestines malignant tumor,the routine use of a Seldinger method, select corresponding artery treating chemotherapy medicine. Chemotherapy scheme:oxaliplatin 150mg,5-Fu 500mg. Monthly once, post treatment measure the abdomen encirclement, inspect the amount of intraperitoneal fluid by B scan,assess the cures effect at 2 months post treatment. Results: After the treatment,the intraperitoneal fluid has inordinately fading in most paients [complete response(CR) 6. 25% , partial response(PR) 46. 8% , no change (NO 31.2%, progressive disease(PD) 15.6%, CR+ PR 53.05%)]. Conclusions: The short-term efficacy of the treatment for malignant ascite by transcatheter arterial perfusion chemotherapy is definite and lessside effects,it can improve the sufferer' s living mass obviously,it should be an important treatment of the combined treatment for advanced cancer.%目的:探讨经动脉灌注化疗治疗癌性腹水的疗效.方法:晚期胃肠恶性肿瘤发生转移性癌性腹水的患者32例,用Seldinger方法,选择腹腔动脉、肠系膜上动脉、肠系膜下动脉注入化疗药物奥沙利铂150 mg,5氟尿嘧啶(5-Fu)500 mg.治疗后测量腹围,并行B超检查腹腔积液量,疗程为每月1次,2个疗程后评价疗效.结果:完全缓解(CR)2例(6.25%),部分缓解(PR) 15例(46.8%),无变化(NC)10例(31.2%),病情进展(PD)5例(15.6%),总有效率(CR+ PR)为53.05%.结论:经动脉灌注化疗治疗癌性腹水近期疗效确切,不良反应轻,且能显著改善患者的生活质量,是晚期肿瘤综合治疗中一项重要的治疗方法.

  10. Patient management after noninvasive cardiac imaging results from SPARC (Study of myocardial perfusion and coronary anatomy imaging roles in coronary artery disease).

    NARCIS (Netherlands)

    Hachamovitch, R.; Nutter, B.; Hlatky, M.A.; Shaw, L.J.; Ridner, M.L.; Dorbala, S.; Beanlands, R.S.; Chow, B.J.; Branscomb, E.; Chareonthaitawee, P.; Weigold, W.G.; Voros, S.; Abbara, S.; Yasuda, T.; Jacobs, J.E.; Lesser, J.; Berman, D.S.; Thomson, L.E.; Raman, S.; Heller, G.V.; Schussheim, A.; Brunken, R.; Williams, K.A.; Farkas, S.; Delbeke, D.; Schoepf, U.J.; Reichek, N.; Rabinowitz, S.; Sigman, S.R.; Patterson, R.; Corn, C.R.; White, R.; Kazerooni, E.; Corbett, J.; Bokhari, S.; Machac, J.; Guarneri, E.; Borges-Neto, S.; Millstine, J.W.; Caldwell, J.; Arrighi, J.; Hoffmann, U.; Budoff, M.; Lima, J.; Johnson, J.R.; Johnson, B.; Gaber, M.; Williams, J.A.; Foster, C.; Hainer, J.; Carli, M.F. Di

    2012-01-01

    OBJECTIVES: This study examined short-term cardiac catheterization rates and medication changes after cardiac imaging. BACKGROUND: Noninvasive cardiac imaging is widely used in coronary artery disease, but its effects on subsequent patient management are unclear. METHODS: We assessed the 90-day post

  11. Responses to noradrenaline of tail arteries in hypertensive, hypotensive and normotensive rats under different regimens of perfusion: role of the myogenic response

    DEFF Research Database (Denmark)

    Matchkov, Vladimir; Vlasova, Maria A; Tarasova, Olga S;

    1998-01-01

    The vasoconstrictor effects of noradrenaline were studied in spontaneously hypertensive rats (SHR) compared with Wistar Kyoto rats (WKY), and in Wistar rats with regional hypotension (WH) compared to control Wistar rats (WC). The abdominal aorta was ligated in WH distal to the renal arteries...... thickness causing different degrees of activation of the myogenic response to distension....

  12. Pseudo-asymmetry of cerebral blood flow in arterial spin labeling caused by unilateral fetal-type circle of Willis: Technical limitation or a way to better understanding physiological variations of cerebral perfusion and improving arterial spin labeling acquisition?

    Science.gov (United States)

    Law-Ye, B; Geerts, B; Galanaud, D; Dormont, D; Pyatigorskaya, N

    2016-09-01

    In the recently published article, "Unilateral fetal-type circle of Willis anatomy causes right-left asymmetry in cerebral blood flow with pseudo-continuous arterial spin labeling: A limitation of arterial spin labeling-based cerebral blood flow measurements?", it was shown by the method of arterial spin labeling (ASL) that unilateral fetal-type circle of Willis could induce variation of blood flow in cerebellar and posterior cerebral artery territory. We believe that the reported observation, rather than being a limitation, gives several interesting cues for understanding the ASL sequence. In this commentary, we formulate some suggestions regarding the use of ASL in clinical practice, discuss the potential causes of the above-mentioned pseudo-asymmetry and consider future improvements of the ASL technique.

  13. Comparison between positron emission tomography myocardial perfusion imaging and intracoronary Doppler flow velocity measurements at rest and during cold pressor testing in angiographically normal coronary arteries in patients with one-vessel coronary artery disease

    NARCIS (Netherlands)

    Meeder, JG; Blanksma, PK; Tan, ES; Pruim, J; vanderWall, EE; Vaalburg, W; Lie, KI

    1996-01-01

    With use of invasive methods, coronary endothelial function is generally studied by examining the response of epicardial coronary arteries to intracoronary administered acetylcholine or to cold presser testing. Because invasive methods have substantial inherent limitations, studies should attempt to

  14. 体外循环行肺动脉灌注液对术后肺功能的保护%Protection of Postoperative Lung Function by Cardiopulmonary Bypass Pulmonary Artery Perfusion Fluid

    Institute of Scientific and Technical Information of China (English)

    赵宇; 康忠奎

    2012-01-01

    Objective To study the protective effect of cardiopulmonary bypass (CPB) pulmonary perfusion on postoperative lung function. Methods Thirty patients receiving purely artificial mitral valve replacement surgery with CPB between January 2007 and April 2011 were randomly divided into the lung protection group and the control group with 15 patients in each. For patients in the lung protection group, pulmonary artery perfusion with hypothermic protective solution during the CPB period was performed, while patients in the control group received no protective solution. Then, we monitored respiratory index (RJ), oxygenation index (01), IL-6, and TNF-a after induction of anesthesia, 10 minutes after aortic cross-clamping, and 10 minutes, 2 hours, 12 hours, and 24 hours after aortic opening, and preoperative and postoperative pulmonary artery pressure (PAPm), static lung compliance (CLS), and airway resistance (AR). Furthermore, we compared the ICU caring time, postoperative ventilation time, hospital stay and the presence of postoperative complications between the two groups. Results IL-6, TNF-a, RJ, OI, PAPm, AR, and CLS between the two group of patients had significant differences (P 0.05). Conclusion Pulmonary arterial perfusion during CPB has a protective effect on postoperative pulmonary function.%目的 探讨体外循环(CPB)期间行肺动脉灌注液对术后肺功能的保护作用.方法 2007年1月-2011年4月30例在CPB下行单纯二尖瓣人工机械瓣置换术患者,随机分成肺保护组和对照组各15例,肺保护组患者CPB期间经肺动脉灌注低温肺保护液,对照组患者CPB期间未经肺动脉灌注低温肺保护液.监测两组患者在麻醉诱导后、阻断主动脉10 mm及开放主动脉10 min,2、12、24 h各时间点的呼吸指数(RI)、氧合指数(OI)、白介素6 (IL-6)、肿瘤坏死因子α(TNF-α)及术前、术后肺动脉压力(PAPm)、静态肺顺应性(CLS)、气道阻力(AR)变化,并比较术后ICU监护时间、术

  15. 体外循环中肺动脉灌注和间断肺通气的肺保护作用%Protective effects of pulmonary artery perfusion and intermittent ventilation on lung during cardiopulmonary bypass

    Institute of Scientific and Technical Information of China (English)

    任王胜; 吴延虎; 王晓伟; 刘翔; 梁永年; 朱锦富

    2011-01-01

    Objective:To explore the protective effects of comprehensive measures,including pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation on lung during CPB. Methods:Thirty patients with rheumatic heart disease (RHD) or congenital heart defect (CHD) were divided into two groups with random dumber table: protective group (n =15), given simultaneously intermittent ventilation and pulmonary artery perfusion with 4℃ oxygenated blood on lung during CPB; control group (n =15) , performed using routine approaches. Mechanical ventilation time was recorded, the lung oxygenate index (OI), respiratory index (RI), airway resistance(Raw) and lung static compliance (Cstat) were detected at the beginning, ending, 1 h and 6 h after CPB termination, respectively. Results:The time of mechanical ventilation was significantly shorter in protective group than in the control group. The OI and Cstat of protective group at 1 h and 6 h after CPB termination was significantly better than that of the control group (P<0.05, P<0.01, respectively); the Raw and RI of protective group was significantly lower than that of control group at 1 h and 6 h (P<0.05, P<0.01, respectively). Conclusion Comprehensive measures, pulmonary artery perfusion with 4℃ oxygenated blood and intermittent ventilation, has protective effects on lung injury during CPB.%目的:探讨肺动脉灌注4℃含氧冷血和间断肺通气对体外循环(cardiopulmonary bypass,CPB)肺损伤的保护作用.方法:将30例符合条件的心脏手术患者采用随机数字表法分为两组:肺保护组(n=15):CPB期间经肺动脉间断灌注4℃含氧冷血,并在灌注期间给予间断肺通气;对照组(n=15):常规行心脏手术.记录呼吸机支持时间;分别在CPB前和CPB结束及结束后1、6 h测算氧合指数(0I)、呼吸指数(RI)、肺气道阻力(Raw)和肺静态顺应性(Cstat).结果:术后肺保护组呼吸机支持时间明显短于对照组(P<0.05),

  16. Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yoshiyasu; Ogasawara, Kuniaki; Saito, Hideo; Takahashi, Yoshihiro; Ogasawara, Yasushi; Kobayashi, Masakazu; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Yoshida, Kenji; Beppu, Takaaki; Kubo, Yoshitaka; Fujiwara, Shunrou [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Tsushima, Eiki [Hirosaki University, Graduate School of Health Sciences, Hirosaki (Japan)

    2013-10-15

    In patients with unilateral internal carotid or middle cerebral artery (ICA or MCA) occlusive disease, the degree of crossed cerebellar hypoperfusion that is evident within a few months after the onset of stroke may reflect cerebral metabolic rate of oxygen in the affected cerebral hemisphere relative to that in the contralateral cerebral hemisphere. The aim of the present study was to determine whether the ratio of blood flow asymmetry in the cerebellar hemisphere to blood flow asymmetry in the cerebral hemisphere on positron emission tomography (PET) and single photon emission computed tomography (SPECT) correlates with oxygen extraction fraction (OEF) asymmetry in the cerebral hemisphere on PET in patients with chronic unilateral ICA or MCA occlusive disease and whether this blood flow ratio on SPECT detects misery perfusion in the affected cerebral hemisphere in such patients. Brain blood flow and OEF were assessed using {sup 15}O-PET and N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) SPECT, respectively. All images were anatomically standardized using SPM2. A region of interest (ROI) was automatically placed in the bilateral MCA territories and in the bilateral cerebellar hemispheres using a three-dimensional stereotaxic ROI template, and affected-to-contralateral asymmetry in the MCA territory or contralateral-to-affected asymmetry in the cerebellar hemisphere was calculated. Sixty-three patients with reduced blood flow in the affected cerebral hemisphere on {sup 123}I-IMP SPECT were enrolled in this study. A significant correlation was observed between MCA ROI asymmetry of PET OEF and the ratio of cerebellar hemisphere asymmetry of blood flow to MCA ROI asymmetry of blood flow on PET (r = 0.381, p = 0.0019) or SPECT (r = 0.459, p = 0.0001). The correlation coefficient was higher when reanalyzed in a subgroup of 43 patients undergoing a PET study within 3 months after the last ischemic event (r = 0.541, p = 0.0001 for PET; r = 0.609, p < 0

  17. [Ocular perfusion pressure and its relevance for glaucoma].

    Science.gov (United States)

    Schmidl, D; Werkmeister, R; Garhöfer, G; Schmetterer, L

    2015-02-01

    Ocular perfusion pressure is defined as the difference between arterial and venous pressure in ocular vessels. In practice, mean arterial pressure is used to substitute for arterial pressure in ocular vessels while intraocular pressure gives an estimate for ocular venous pressure. This results in a value that is easy to calculate and which is of importance since several studies have shown that it is correlated to the prevalence, incidence and progression of primary open angle glaucoma. Today, ocular perfusion pressure is used to estimate individual risks. Since no target value for ocular perfusion pressure can be defined, direct therapeutic intervention is difficult. Still, it has to be kept in mind that lowering intraocular pressure automatically leads to an increase in ocular perfusion pressure. The present article also points out problems and limitations in the concept of ocular perfusion pressure and suggests possible solutions for these problems in the future.

  18. Prenatal ultrasound application in diagnosis and treatment of twin reverse arterial perfusion syndrome%产前超声在双胎反向动脉灌注综合征诊疗中的应用

    Institute of Scientific and Technical Information of China (English)

    谭喜平; 王慧芳; 胡芷洋; 林琪; 冯程

    2009-01-01

    目的 探讨产前超声在双胎反向动脉灌注(TRAP)综合征诊疗中的临床价值.方法 回顾性分析我院产前超声诊断的5例TRAP超声图像、临床资料及妊娠结局,总结TRAP声像学特点.结果 5例TRAP初次确诊孕周为13~28周,均于产后得到证实.彩色多普勒超声检查显示无心畸胎血液循环呈现反向动脉灌注的特点.5例中2例引产;1例流产;1例超声引导下接受无心畸胎减胎术,妊娠至37周分娩;1例在超声密切监测下妊娠至32~(+4)周分娩,新生儿结局良好.结论 产前超声检查对TRAP的早期诊断、预后判断、治疗方案和分娩时机的选择有重要应用价值.%Objective To investigate the value of prenatal ultrasound in diagnosis and treatment of twin reverse arterial perfusion (TRAP) syndrome. Methods A retrospective study was performed in 5 TRAP cases, including ultrasound images, clinical data and pregnancy outcomes. The sonographic characteristics were summarized. Results Five TRAP cases were diagnosed during 13 to 28 weeks' gestation and confirmed after birth. Color Doppler unltrasonography revealed retrograde umbilical artery perfusion towards acardiac twin. Two of 5 cases ended up in induced abortion, 1 in spontaneous abortion, 1 was delivered at 37 weeks' gestation after ultrasound-guided feticide of the acardiac twin and 1 was monitored closely with ultrasound and delivered alive at 32~(+4) weeks' gestation. Conclusion Prenatal ultrasonography has great applicative value for TRAP syndrome in early diagnosis, choosing optimal treatment and prognosis assessment.

  19. Management of Liver Cancer Argon-helium Knife Therapy with Functional Computer Tomography Perfusion Imaging.

    Science.gov (United States)

    Wang, Hongbo; Shu, Shengjie; Li, Jinping; Jiang, Huijie

    2016-02-01

    The objective of this study was to observe the change in blood perfusion of liver cancer following argon-helium knife treatment with functional computer tomography perfusion imaging. Twenty-seven patients with primary liver cancer treated with argon-helium knife and were included in this study. Plain computer tomography (CT) and computer tomography perfusion (CTP) imaging were conducted in all patients before and after treatment. Perfusion parameters including blood flows, blood volume, hepatic artery perfusion fraction, hepatic artery perfusion, and hepatic portal venous perfusion were used for evaluating therapeutic effect. All parameters in liver cancer were significantly decreased after argon-helium knife treatment (p liver tissue, but other parameters kept constant. CT perfusion imaging is able to detect decrease in blood perfusion of liver cancer post-argon-helium knife therapy. Therefore, CTP imaging would play an important role for liver cancer management followed argon-helium knife therapy.

  20. The Eya1 phosphatase promotes Shh signaling during hindbrain development and oncogenesis.

    Science.gov (United States)

    Eisner, Adriana; Pazyra-Murphy, Maria F; Durresi, Ershela; Zhou, Pengcheng; Zhao, Xuesong; Chadwick, Emily C; Xu, Pin-Xian; Hillman, R Tyler; Scott, Matthew P; Greenberg, Michael E; Segal, Rosalind A

    2015-04-06

    Sonic hedgehog (Shh) signaling is critical in development and oncogenesis, but the mechanisms regulating this pathway remain unclear. Although protein phosphorylation clearly affects Shh signaling, little is known about phosphatases governing the pathway. Here, we conducted a small hairpin RNA (shRNA) screen of the phosphatome and identified Eya1 as a positive regulator of Shh signaling. We find that the catalytically active phosphatase Eya1 cooperates with the DNA-binding protein Six1 to promote gene induction in response to Shh and that Eya1/Six1 together regulate Gli transcriptional activators. We show that Eya1, which is mutated in a human deafness disorder, branchio-oto-renal syndrome, is critical for Shh-dependent hindbrain growth and development. Moreover, Eya1 drives the growth of medulloblastoma, a Shh-dependent hindbrain tumor. Together, these results identify Eya1 and Six1 as key components of the Shh transcriptional network in normal development and in oncogenesis.

  1. Regionalization of the shark hindbrain: a survey of an ancestral organization

    Directory of Open Access Journals (Sweden)

    Isabel eRodríguez-Moldes

    2011-03-01

    Full Text Available Cartilaginous fishes (chondrichthyans represent an ancient radiation of vertebrates currently considered the sister group of the group of gnathostomes with a bony skeleton that gave rise to land vertebrates. This out-group position makes chondrichthyans essential in assessing the ancestral organization of the brain of jawed vertebrates. To gain knowledge about hindbrain evolution we have studied its development in a shark, the lesser spotted dogfish Scyliorhinus canicula by analyzing the expression of some developmental genes and the origin and distribution of specific neuronal populations, which may help to identify hindbrain subdivisions and boundaries and the topology of specific cell groups. We have characterized three developmental periods that will serve as a framework to compare the development of different neuronal systems and may represent a suitable tool for comparing the absolute chronology of development among vertebrates. The expression patterns of Pax6, Wnt8 and Hoxa2 genes in early embryos of S. canicula showed close correspondence to what has been described in other vertebrates and helped to identify the anterior rhombomeres. Also in these early embryos, the combination of Pax6 with protein markers of migrating neuroblasts (DCX and early differentiating neurons (general: HuC/D; neuron type specific: GAD, the GABA synthesizing enzyme revealed the organization of S. canicula hindbrain in both transverse segmental units corresponding to visible rhombomeres and longitudinal columns. Later in development, when the interrhombomeric boundaries fade away, accurate information about S. canicula hindbrain subdivisions was achieved by comparing the expression patterns of Pax6 and GAD, serotonin (serotoninergic neurons, tyrosine hydroxylase (catecholaminergic neurons, choline acetyltransferase (cholinergic neurons and calretinin (a calcium-binding protein. The patterns observed revealed many topological correspondences with other vertebrates

  2. Indicação de cintilografia de perfusão do miocárdio para a detecção de doença arterial coronariana, baseada em evidências ergométricas e clínico-epidemiológicas Indication of myocardial perfusion scintigraphy for coronary artery disease detection based on clinical-epidemiological and treadmill test evidences

    Directory of Open Access Journals (Sweden)

    Paulo Schiavom Duarte

    2006-10-01

    Full Text Available OBJETIVO: Avaliar quando se devem realizar exames de cintilografia de perfusão do miocárdio (CPM, baseando-se em informações objetivas obtidas do teste ergométrico e da análise dos fatores clínico-epidemiológicos para doença arterial coronária (DAC. MÉTODOS: Foram submetidos a CPM 2.100 pacientes que foram classificados segundo o resultado da cintilografia, do escore de Duke e de escore clínico-epidemiológico, baseado em Framingham. Os pacientes com cintilografia positiva foram acompanhados a fim de definir se os resultados eram verdadeiros positivos. Foram utilizadas receiver operating characteristic (ROC curvas para definir a eficiência e os melhores pontos de corte dos escores de Duke e clínico-epidemiológico, na seleção dos pacientes que deveriam ser submetidos a cintilografia. RESULTADOS: Observou-se que, restringindo a solicitação da cintilografia a pacientes com escore de Duke abaixo de 7,5 e/ou escore clínico-epidemiológico acima de 4, deixaríamos de realizar cerca de 50% dos exames com riscos mínimos de perda de diagnóstico. CONCLUSÃO: A utilização do escore de Duke e de escore clínico-epidemiológico para orientar a solicitação da CPM pode diminuir expressivamente o número de exames desnecessários.OBJECTIVE: To establish when the myocardial perfusion scintigraphy (MPS should be performed based on well-defined information obtained from treadmill test results and clinical-epidemiological parameters for coronary artery disease (CAD. METHODS: 2,100 patients who underwent MPS were classified according to the results of scintigraphy, the Duke score and a clinical-epidemiological score based on Framingham study. The patients with positive results on MPS were followed to define whether the results were true positives. Receiver operating characteristic (ROC curves were used to establish the efficiency and the best Duke and clinical-epidemiological scores to define patients that should be submitted to

  3. Implications of normal exercise electrocardiographic results in patients with angiographically documented coronary artery disease. Correlation with left ventricular function and myocardial perfusion.

    Science.gov (United States)

    Hakki, A H; DePace, N L; Colby, J; Iskandrian, A S

    1983-09-01

    The purpose of this study was to examine the incidence and implications of false-negative exercise electrocardiographic results among 216 consecutive patients with angiographically documented coronary artery disease (50 percent diameter narrowing or greater of one or more vessels). Exercise electrocardiography gave negative (false-negative) results in 23 patients and positive (true-positive) results in 102 patients, and were nondiagnostic in the rest. Exercise thallium-201 imaging was performed in 88 patients. The extent of coronary artery disease was quantitated by a scoring system that takes into consideration the degree and site of narrowing in the major vessels and their branches. The exercise heart rate was higher in patients with false-negative than in patients with true-positive exercise electrocardiographic results (161 +/- 18 versus 133 +/- 24 beats per minute, mean +/- SD; p less than 0.0001). Q-wave infarction was present in two patients (9 percent) with false-negative and 20 patients (20 percent) with true-positive exercise electrocardiographic results (p = NS); left ventricular asynergy at rest was observed in 13 patients (57 percent) with false-negative and in 74 patients (74 percent) with true-positive results (p = NS). Patients with false-negative results had less extensive coronary disease than did patients with true-positive results (score 5.8 +/- 3.6 versus 9.2 +/- 5.0; p = 0.0025). Angina during exercise was less frequent in patients with false-negative results (p less than 0.01). Abnormal exercise thallium-201 images were seen in 15 of 20 patients (75 percent) with false-negative results and in 56 of 68 patients (82 percent) with true-positive results (p = NS). It is concluded that (1) false-negative exercise electrocardiographic results are infrequent (10 percent) among patients with coronary artery disease and are associated with less extensive coronary artery disease; (2) the frequency of Q-wave infarction and left ventricular asynergy is

  4. Hindbrain GLP-1 receptor mediation of cisplatin-induced anorexia and nausea.

    Science.gov (United States)

    De Jonghe, Bart C; Holland, Ruby A; Olivos, Diana R; Rupprecht, Laura E; Kanoski, Scott E; Hayes, Matthew R

    2016-01-01

    While chemotherapy-induced nausea and vomiting are clinically controlled in the acute (anorexia, nausea, fatigue, and other illness-type behaviors during the delayed phase (>24 h) of chemotherapy are largely uncontrolled. As the hindbrain glucagon-like peptide-1 (GLP-1) system contributes to energy balance and mediates aversive and stressful stimuli, here we examine the hypothesis that hindbrain GLP-1 signaling mediates aspects of chemotherapy-induced nausea and reductions in feeding behavior in rats. Specifically, hindbrain GLP-1 receptor (GLP-1R) blockade, via 4th intracerebroventricular (ICV) exendin-(9-39) injections, attenuates the anorexia, body weight reduction, and pica (nausea-induced ingestion of kaolin clay) elicited by cisplatin chemotherapy during the delayed phase (48 h) of chemotherapy-induced nausea. Additionally, the present data provide evidence that the central GLP-1-producing preproglucagon neurons in the nucleus tractus solitarius (NTS) of the caudal brainstem are activated by cisplatin during the delayed phase of chemotherapy-induced nausea, as cisplatin led to a significant increase in c-Fos immunoreactivity in NTS GLP-1-immunoreactive neurons. These data support a growing body of literature suggesting that the central GLP-1 system may be a potential pharmaceutical target for adjunct anti-emetics used to treat the delayed-phase of nausea and emesis, anorexia, and body weight loss that accompany chemotherapy treatments.

  5. Electroporation of the hindbrain to trace axonal trajectories and synaptic targets in the chick embryo.

    Science.gov (United States)

    Kohl, Ayelet; Hadas, Yoav; Klar, Avihu; Sela-Donenfeld, Dalit

    2013-05-29

    Electroporation of the chick embryonic neural tube has many advantages such as being quick and efficient for the expression of foreign genes into neuronal cells. In this manuscript we provide a method that demonstrates uniquely how to electroporate DNA into the avian hindbrain at E2.75 in order to specifically label a subset of neuronal progenitors, and how to follow their axonal projections and synaptic targets at much advanced stages of development, up to E14.5. We have utilized novel genetic tools including specific enhancer elements, Cre/Lox - based plasmids and the PiggyBac-mediated DNA transposition system to drive GFP expression in a subtype of hindbrain cells (the dorsal most subgroup of interneurons, dA1). Axonal trajectories and targets of dA1 axons are followed at early and late embryonic stages at various brainstem regions. This strategy contributes advanced techniques for targeting cells of interest in the embryonic hindbrain and for tracing circuit formation at multiple stages of development.

  6. Hindbrain DPP-IV inhibition improves glycemic control and promotes negative energy balance.

    Science.gov (United States)

    Mietlicki-Baase, Elizabeth G; McGrath, Lauren E; Koch-Laskowski, Kieran; Krawczyk, Joanna; Pham, Tram; Lhamo, Rinzin; Reiner, David J; Hayes, Matthew R

    2017-01-22

    The beneficial glycemic and food intake-suppressive effects of glucagon-like peptide-1 (GLP-1) have made this neuroendocrine system a leading target for pharmacological approaches to the treatment of diabetes and obesity. One strategy to increase the activity of endogenous GLP-1 is to prevent the rapid degradation of the hormone by the enzyme dipeptidyl peptidase-IV (DPP-IV). However, despite the expression of both DPP-IV and GLP-1 in the brain, and the clear importance of central GLP-1 receptor (GLP-1R) signaling for glycemic and energy balance control, the metabolic effects of central inhibition of DPP-IV activity are unclear. To test whether hindbrain DPP-IV inhibition suppresses blood glucose, feeding, and body weight gain, the effects of 4th intracerebroventricular (ICV) administration of the FDA-approved DPP-IV inhibitor sitagliptin were evaluated. Results indicate that hindbrain delivery of sitagliptin improves glycemic control in a GLP-1R-dependent manner, suggesting that this effect is due at least in part to increased endogenous brainstem GLP-1 activity after sitagliptin administration. Furthermore, 4th ICV injection of sitagliptin reduced 24h body weight gain and energy intake, with a selective suppression of high-fat diet, but not chow, intake. These data reveal a novel role for hindbrain GLP-1R activation in glycemic control and also demonstrate that DPP-IV inhibition in the caudal brainstem promotes negative energy balance.

  7. Sensibilidad y especificidad de la prueba de esfuerzo y el estudio de perfusión miocárdica con SESTAMIBI para detección de enfermedad arterial coronaria, en el Hospital San Juan de Dios Sensitivity and Specificity of Treadmill Test and Myocardial Perfusion Imaging with SESTAMIBI in the detection of Coronary Artery Disease at the Hospital San Juan de Dios

    Directory of Open Access Journals (Sweden)

    Juan Pablo Solís-Barquero

    2010-07-01

    reality. The treadmill test, myocardial perfusion imaging with SESTAMIBI, and coronary angiography are methods for detecting this disease. Our country does not have its own data regarding these tests. The aim of this study is to determine the diagnostic performance of each one. Methods: The present is an observational, analytic, cohort study. Patients included were those with cardiovascular risk factors that underwent a treadmill test, myocardial perfusion imaging, and a coronary angiography at the Hospital San Juan de Dios, from 2003 to 2007. Sensitivity and specificity were calculated. Adescriptive statistic analysis of the different risk factors was carried out. Results: Eighty three patients were included in the study; 75% men and 25% women. The most frequently found risk factors were dyslipidemia (84%, and hypertension (70%. The treadmill test had a sensitivity of 40%, and specificity of 57%. Myocardial perfusion imaging with SESTAMIBI had a sensitivity of 66% and specificity of 71%. The majority of the patients had lesions in 1 or 2 coronary arteries, with more than 90% obstruction, mostly in the anterior artery descending. Conclusion: A high prevalence of conventional risk factors was present in this population. The treadmill test showed a low sensitivity and specificity, according with the literature. The myocardial perfusion imaging had a significant (p =0.05 better diagnostic performance than the treadmill test.

  8. Whole brain CT perfusion on a 320-slice CT scanner

    Directory of Open Access Journals (Sweden)

    Jai Jai Shiva Shankar

    2011-01-01

    Full Text Available Computed tomography perfusion (CTP has been criticized for limited brain coverage. This may result in inadequate coverage of the lesion, inadequate arterial input function, or omission of the lesion within the target perfusion volume. The availability of 320-slice CT scanners offers whole brain coverage. This minimizes the chances of misregistration of lesions regardless of location, and makes the selection of the arterial input function easy. We present different clinical scenarios in which whole brain CTP is especially useful.

  9. Assessment of liver circulation by quantitative scintiangiography: Evaluation of the relative contribution of the hepatic arterial and portal venous blood flows to liver perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Molino, G.; Squadrone, E.; Baccegal, M.; Magnani, C.

    1989-04-01

    Quantitative hepatic scintiangiography was previously used for evaluating the relative contribution of hepatic arterial and portal venous blood flows to the hepatic circulation. The present study compares 3 different procedures (automatic and manual integration, and slope fitting methods) for analyzing the hepatic time activity curves obtained after bolus i.v. injection of 370 MBq /sup 99m/Tc-diethylentriaminopentacetic acid. Twenty five subjects were studied: Five controls, ten cirrhotics, and ten portal hypertensive patients previously submitted to side to side portacaval anastomosis. The correspondence between results given by the different methods was satisfactory only in shunted patients, and the reproducibility of computed parameters was quite poor for all procedures. Accordingly, none of the methods can be considered as supporting reliable quantitative pathophysiological evaluations. However, the hepatic arterial/portal venous flow ratio was found to be increased in liver cirrhosis and in shunted patients and therefore, in spite of the limitations underlined before and of the absence of data on the reproducibility of consecutive injections, hepatic scintiangiography may be of some clinical utility.

  10. Initial and delayed stress phase imaging in a single-injection double-acquisition SPECT. The potential value of early {sup 99m}Tc-MIBI redistribution in assessment of myocardial perfusion reversibility in patients with coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Beiki, D. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran); Fallahi, B.; Fard-Esfahani, A.; Eftekhari, M. [Research Inst. for Nuclear Medicine, Tehran Univ. of Medical Sciences, Tehran (Iran); Mohseni, Z.; Khalaj, A. [Dept. of Nuclear Pharmacy, Tehran Univ. of Medical Sciences, Tehran (Iran)

    2010-07-01

    Some studies reported that {sup 99m}Tc-MIBI may redistribute in ischaemic myocardium and this phenomenon may have potential role for better assessment of viability by delayed {sup 99m}Tc-MIBI imaging. Some studies also suggested that infusion of low dose dobutamine during delayed imaging may enhance the value of {sup 99m}Tc-MIBI imaging for evaluation of viability. The aim of this study is to determine whether the observed changes of perfusion defects on delayed images are caused by early radiotracer redistribution or as a result of reversal partial volume effect secondary to inotropic stimulation. Patients, methods: 89 patients with angiographically proven coronary artery disease (CAD) were enrolled in this randomized clinical trial study. In all cases, gated-SPECT images were obtained 60 minutes after stress with dipyridamole injection. Subsequently the patients were randomly allocated in two groups and the second imaging was performed at 120{sup th} minute during low dose dobutamine (dobutamine group; 45 cases) or placebo infusion (placebo group; 44 cases). Difference between summed stress score of the first (SSS{sub 1}) and second (SSS{sub 2}) stress images ({delta}SSS) was considered as a marker of reversibility in single-injection double-acquisition (SIDA) protocol. Also summed difference score (SDS) was recorded as a marker of reversibility in standard stress/rest, double-injection double-acquisition (DIDA) protocol. {delta}SSS of the two studied groups were compared. Also the correlation and agreement between {delta}SSS and SDS were analyzed. Results: A significant difference was found between SSS{sub 1} (median 15, range 0-48) and SSS{sub 2} (median 11, range 0-42) in total patients (p < 0.0001). A significant correlation was noted between {delta}SSS and SDS in dobutamine group (r = 0.58, p = 0.002) as well as in placebo group (r = 0.57, p < 0.0001). Considering DIDA protocol as a standard reference method, the influence of dobutamine infusion was not

  11. The value of multi-slice spiral CT perfusion imaging in evaluating the changes of blood supply of hepatocellular carcinoma before and after transcatheter hepatic arterial chemoembolization%多层螺旋CT灌注成像对肝癌经导管肝动脉栓塞化疗前后血供变化的应用价值

    Institute of Scientific and Technical Information of China (English)

    周霖; 邹文远; 陈玉峰

    2010-01-01

    目的 研究多层螺旋CT灌注成像在评价肝癌经导管肝动脉栓塞化疗(TACE)前后血流动力学改变中的价值.方法 17例肝癌患者TACE术前及术后行CT灌注扫描.计算肝血流量(HBF)、肝血容量(HBV)、平均通过时间(MTT)、毛细血管表面通透性(PS)、肝动脉灌注分数(HAF),并计算肝动脉灌注量(HAP)、门静脉灌注量(PVP).根据各灌注参数值评价肝癌TACE前后血流动力学改变.结果 TACE术后,HBF、HBV和HAP[(167.89±96.06)ml/(100 g·min),(14.95±15.13)ml/100 g,(97.71±68.18)ml/(100g·min)]较TACE术前[(250.59±129.56)ml/(100 g·min),(24.44±20.03)ml/100 g,(184.61±178.83)ml/(100 g·min)]减少(P0.05).结论 肝脏灌注参数可有效评价TACE前后肝癌组织的血流灌注改变,具有重要的临床应用价值.%Objective To study the multi-slice spiral CT (MSCT) perfusion imaging in evaluating the changes of blood supply of hepatocellular carcinoma( HCC ) before and after transcatheter hepatic arterial chemoembolization (TACE). Methods Before and after TACE, MSCT perfusion was performed in 17 patients with HCC. The perfusion indexes such as hepatic blood flow (HBF), hepatic blood volume(HBV),mean transit time (MTT),hepatic arterial fracture (HAF),permeability surface (PS), hepatic artery perfusion (HAP), portal venous perfusion (PVP) were calculated. The hemodynamic changes of HCC after TACE were evaluated according to perfusion parameters. Results After TACE, HBF,HBV and HAP found in MTT and PS before and after TACE (P > 0.05). Conclusion The parameters of MSCT perfusion imaging( HBF, HBV and HAP) can effectively evaluate the hemodynamic changes of HCC after TACE, and has important value in chnical application.

  12. 输入动脉选择对CT Perfusion 3.0软件包肺灌注成像的影响%Effect of Different Input Arteries on Lung Perfusion Imaging by Using CT Perfusion 3.0 Software

    Institute of Scientific and Technical Information of China (English)

    王欣; 于丽娟; 刘瑞宝; 张修石; 尚乃舰

    2008-01-01

    目的:探讨输入动脉的选择对CT Perfusion 3.0软件包肺灌注成像的影响.方法:健康新西兰白兔2只,非离子型对比剂优维显5ml,对比剂的注射流率分别为0.1、0.3、0.5和0.8ml/s.所得数据传输到工作站,经Perfusion 3.0 软件包以三种不同的灌注成像方案处理.结果:以主动脉为输入动脉的体部肿瘤方案组所计算的血容量(BV)、血流量(BF)分别与以肺动脉为输入动脉组和肝脏肿瘤方案组所得数值间差异存在显著性意义(t=4.376、t=2.779);以肺动脉为输入动脉组和肝脏肿瘤方案组所得数值组间差异无显著性意义(t=1.5).结论:应用CT Perfusion 3.0软件包,选择不同的输入动脉会对肺灌注成像结果产生影响,其实际应用有待进一步研究.

  13. Implications of normal exercise electrocardiographic results in patients with angiographically documented coronary artery disease. Correlation with left ventricular function and myocardial perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Hakki, A.H.; DePace, N.L.; Colby, J.; Iskandrian, A.S.

    1983-09-01

    The purpose of this study was to examine the incidence and implications of false-negative exercise electrocardiographic results among 216 consecutive patients with angiographically documented coronary artery disease (50 percent diameter narrowing or greater of one or more vessels). Exercise electrocardiography gave negative (false-negative) results in 23 patients and positive (true-positive) results in 102 patients, and were nondiagnostic in the rest. Exercise thallium-201 imaging was performed in 88 patients. The extent of coronary artery disease was quantitated by a scoring system that takes into consideration the degree and site of narrowing in the major vessels and their branches. The exercise heart rate was higher in patients with false-negative than in patients with true-positive exercise electrocardiographic results (161 +/- 18 versus 133 +/- 24 beats per minute, mean +/- SD; p less than 0.0001). Q-wave infarction was present in two patients (9 percent) with false-negative and 20 patients (20 percent) with true-positive exercise electrocardiographic results (p . NS); left ventricular asynergy at rest was observed in 13 patients (57 percent) with false-negative and in 74 patients (74 percent) with true-positive results (p . NS). Patients with false-negative results had less extensive coronary disease than did patients with true-positive results (score 5.8 +/- 3.6 versus 9.2 +/- 5.0; p . 0.0025). Angina during exercise was less frequent in patients with false-negative results (p less than 0.01). Abnormal exercise thallium-201 images were seen in 15 of 20 patients (75 percent) with false-negative results and in 56 of 68 patients (82 percent) with true-positive results (p . NS).

  14. Cerebral perfusion SPECT in transient ischemic attack

    Energy Technology Data Exchange (ETDEWEB)

    You, D.-L. E-mail: dlyou@mail.kfcc.org.tw; Shieh, F.-Y.; Tzen, K.-Y.; Tsai, M.-F.; Kao, P.-F

    2000-04-01

    Purpose: The purpose of our study is to evaluate the efficacy of cerebral perfusion single photon emission computerized tomography (SPECT) in patients with transient ischemic attack (TIA). Methods: Thirty-seven patients with TIA were collected for study. All patients had transient focal neurological symptoms or signs with complete recovery within 24 h after onset. The patients underwent cerebral perfusion SPECT between 6 h and 11 days after onset, with 10 cases performed within 24 h (group A), nine cases performed between 1 and 3 days (group B), 11 cases performed between 3 and 5 days (group C), and seven cases performed after more than 5 days (group D). A semi-quantitative method was used for analyzing the SPECT data, and the difference ratios between lesion side and contralateral normal side were calculated on each pair of regions of interest. Results: In total, 78.4% (29/37) of patients had reduced perfusion in the cerebral cortical regions or deep nuclei, and the regions with reduced perfusion corresponded with clinical presentations of the patients. The abnormal rate with reduced perfusion was 90.0% in group A, 77.8% in group B, 72.7% in group C and 71.4% in group D. Cross cerebellar diaschisis (CCD) was present in seven patients, and all of the primary cerebral perfusion defects of these patients were located at the territory of left or right middle cerebral artery. Conclusion: Cerebral perfusion SPECT is a potential tool to detect cerebral perfusion defects and CCD in patients with TIA. Although the perfusion defect may persist more than 5 days after onset, we suggest cerebral perfusion SPECT should be performed as soon as possible.

  15. Clinical application of hepatic CT perfusion

    Institute of Scientific and Technical Information of China (English)

    Liang Zhong; Wen-Jing Wang; Jian-Rong Xu

    2009-01-01

    Complicated changes occur in hemodynamics of hepatic artery and vein, and portal vein under various kinds of pathologic status because of distinct double hepatic blood supply. This article reviews the clinical application of hepatic computed tomography perfusion in some liver diseases.

  16. CT myocardial perfusion imaging: current status and future directions.

    Science.gov (United States)

    Williams, M C; Newby, D E

    2016-08-01

    Computed tomography (CT) imaging of the heart has advanced rapidly, and it is now possible to perform a comprehensive assessment at a low radiation dose. CT myocardial perfusion imaging can provide additive information to CT coronary angiography, and is particularly useful in patients with heavily calcified coronary arteries or coronary artery stents. A number of protocols are now available for CT myocardial perfusion including static, dynamic, and dual-energy techniques. This review will discuss the current status of CT myocardial perfusion imaging, its clinical application, and future directions for this technology.

  17. Comparison of cerebral perfusion reserve and collateral circulation in patients with internal carotid artery disease; Die zerebrale Perfusionsreserve in Abhaengigkeit vom Kollateralisierungstyp bei Patienten mit A.-carotis-interna-Stenosen/-Verschluessen

    Energy Technology Data Exchange (ETDEWEB)

    Reiche, W.; Schaefer, R.; Hermes, M. [Abt. fuer Neuroradiologie, Radiologische Klinik der Universitaet des Saarlandes, Homburg/Saar (Germany); Mueller, M. [Neurologische Klinik der Universitaet des Saarlandes, Homburg/Saar (Germany)

    1997-11-01

    The cerebral hemodynamics in patients with carotid disease is influenced by a network of extra- and intracranial collaterals. The purpose of this study was to compare the findings of regional cerebral perfusion reserve (rCPR) with angiographically proven collateral circulation. In 41 patients (28 men, 13 women, age 63{+-}10 years) with angiographically proven carotid stenoses or occlusions (30 stenoses, 11 occlusions) 24 {sup 99m}Tc-HMPAO-SPECT and 25 dynamic Xe-CT investigations were conducted, both before and after acetazolamide stimulation. rCPR was quantified as the ratio (1) of the absolute rCBF values obtained by Xe-CT and (2) of the count density measured by HMPAO-SPECT of the acetazolamide administration. A rCPR of less than 95% in a vascular territory was classified as compromised rCPR. A recent CT examination was available in all cases. According to the angiographic findings the patients could be classified into (1) group A (n=9) with residual carotid perfusion, (2) Group B (n=8) with collateralization via the circle of Willis, and (3) group C (n=24) with leptomeningeal or opthalmic artery collateral circulation. (orig./AJ) [Deutsch] Die zerebrale Haemodynamik bei A.-carotis-interna-(ACI-)Stenosen/-Verschluessen wird von extra- und intrakaniellen Kollateralen beeinflusst. Ziel dieser Studie war es, die Befunde der regionalen zerebralen Perfusionsreserve (rCPR) mit angiographisch nachgewiesenen Kollateralisierungs- und Anastomosierungstypen zu vergleichen. Bei 41 Patienten (28 Maennder, 13 Frauen, Alter 63{+-}10 Jahre) mit angiographisch untersuchten ACl-Stenosen/-Verschluessen (30 Stenosen, 11 Verschluesse) wurden in 24 Faellen eine {sup 99m}Tc-HMPAO-SPECT und in 25 eine dynamische Xe-CT jeweils vor und nach Diamox{sup R}-Stimulation durchgefuehrt. Fuer die rCPR-Quantifizierung wurde in der Xe-CT das Verhaeltnis der absoluten rCBF-Werte und in der HMPAO-SPECT der Zaehlratendichten jeweils nach zu vor Diamox berechnet. Eine rCPR<95% in einem zerebralen

  18. Feasibility of perfusion cardiovascular magnetic resonance in paediatric patients

    Directory of Open Access Journals (Sweden)

    Kellenberger Christian

    2009-01-01

    Full Text Available Abstract Aims As coronary artery disease may also occur during childhood in some specific conditions, we sought to assess the feasibility and accuracy of perfusion cardiovascular magnetic resonance (CMR in paediatric patients. Methods and results First-pass perfusion CMR studies were performed under pharmacological stress with adenosine and by using a hybrid echo-planar pulse sequence with slice-selective saturation recovery preparation. Fifty-six perfusion CMR examinations were performed in 47 patients. The median age was 12 years (1 month-18 years, and weight 42.8 kg (2.6-82 kg. General anaesthesia was required in 18 patients. Mean examination time was 67 ± 19 min. Diagnostic image quality was obtained in 54/56 examinations. In 23 cases the acquisition parameters were adapted to patient's size. Perfusion CMR was abnormal in 16 examinations. The perfusion defects affected the territory of the left anterior descending coronary artery in 11, of the right coronary artery in 3, and of the circumflex coronary artery in 2 cases. Compared to coronary angiography, perfusion CMR showed a sensitivity of 87% (CI 52-97% and a specificity of 95% (CI 79-99%. Conclusion In children, perfusion CMR is feasible and accurate. In very young children (less than 1 year old, diagnostic image quality may be limited.

  19. Human recombinant erythropoietin alters the flow-dependent vasodilatation of in vitro perfused rat mesenteric arteries with unbalanced endothelial endothelin-1 / nitric oxide ratio.

    Science.gov (United States)

    Barhoumi, Tlili; Jallat, Isabelle; Berthelot, Alain; Laurant, Pascal

    2011-06-01

    Chronic use of human recombinant erythropoietin (r-HuEPO) is accompanied by serious vascular side effects related to the rise in blood viscosity and shear stress. We investigated the direct effects of r-HuEPO on endothelium and nitric oxide (NO)-dependent vasodilatation induced by shear stress of cannulated and pressurized rat mesenteric resistance arteries. Intravascular flow was increased in the presence or absence of the NO synthase inhibitor N(G)-nitro-l-arginine methyl ester (L-NAME; 10(-4) mol/L). In the presence of r-HuEPO, the flow-dependent vasodilatation was attenuated, while L-NAME completely inhibited it. The association of r-HuEPO and L-NAME caused a vasoconstriction in response to the rise in intravascular flow. Bosentan (10(-5) mol/L), an inhibitor of endothelin-1 (ET-1) receptors, corrected the attenuated vasodilatation observed with r-HuEPO and inhibited the vasoconstriction induced by flow in the presence of r-HuEPO and L-NAME. r-HuEPO and L-NAME exacerbated ET-1 vasoconstriction. At shear stress values of 2 and 14 dyn/cm(2) (1 dyn = 10(-5) N), cultured EA.hy926 endothelial cells incubated with r-HuEPO, L-NAME, or both released greater ET-1 than untreated cells. In conclusion, r-HuEPO diminishes flow-induced vasodilatation. This inhibitory effect seems to implicate ET-1 release. NO withdrawal exacerbates the vascular effects of ET-1 in the presence of r-HuEPO. These findings support the importance of a balanced endothelial ET-1:NO ratio to avoid the vasopressor effects of r-HuEPO.

  20. Stem cells expanded from the human embryonic hindbrain stably retain regional specification and high neurogenic potency.

    Science.gov (United States)

    Tailor, Jignesh; Kittappa, Raja; Leto, Ketty; Gates, Monte; Borel, Melodie; Paulsen, Ole; Spitzer, Sonia; Karadottir, Ragnhildur Thora; Rossi, Ferdinando; Falk, Anna; Smith, Austin

    2013-07-24

    Stem cell lines that faithfully maintain the regional identity and developmental potency of progenitors in the human brain would create new opportunities in developmental neurobiology and provide a resource for generating specialized human neurons. However, to date, neural progenitor cultures derived from the human brain have either been short-lived or exhibit restricted, predominantly glial, differentiation capacity. Pluripotent stem cells are an alternative source, but to ascertain definitively the identity and fidelity of cell types generated solely in vitro is problematic. Here, we show that hindbrain neuroepithelial stem (hbNES) cells can be derived and massively expanded from early human embryos (week 5-7, Carnegie stage 15-17). These cell lines are propagated in adherent culture in the presence of EGF and FGF2 and retain progenitor characteristics, including SOX1 expression, formation of rosette-like structures, and high neurogenic capacity. They generate GABAergic, glutamatergic and, at lower frequency, serotonergic neurons. Importantly, hbNES cells stably maintain hindbrain specification and generate upper rhombic lip derivatives on exposure to bone morphogenetic protein (BMP). When grafted into neonatal rat brain, they show potential for integration into cerebellar development and produce cerebellar granule-like cells, albeit at low frequency. hbNES cells offer a new system to study human cerebellar specification and development and to model diseases of the hindbrain. They also provide a benchmark for the production of similar long-term neuroepithelial-like stem cells (lt-NES) from pluripotent cell lines. To our knowledge, hbNES cells are the first demonstration of highly expandable neuroepithelial stem cells derived from the human embryo without genetic immortalization.

  1. Pulmonary ventilation/perfusion scan

    Science.gov (United States)

    V/Q scan; Ventilation/perfusion scan; Lung ventilation/perfusion scan ... A pulmonary ventilation/perfusion scan is actually two tests. They may be done separately or together. During the perfusion scan, a health care provider injects ...

  2. 25例双胎反向动脉灌注序列征的产前评估与临床处理%Prenatal evaluation and management of 25 cases of twin reversed arterial perfusion sequence

    Institute of Scientific and Technical Information of China (English)

    何志明; 高羽; 周袆; 罗艳敏; 杨永忠; 陈涌珍; 陈筠虹; 方群

    2012-01-01

    目的 分析双胎反向动脉灌注序列征(twin reversed arterial perfusion sequence,TRAP)的临床特点,探讨其产前评估方法及临床处理.方法 回顾25例TRAP产前诊断及超声检查结果,包括无心胎估重和脐血流、泵血胎心功能及大脑中动脉收缩期峰值流速,分析其临床处理及妊娠结局.采用Fisher精确概率法进行统计学分析.结果 (1)16例泵血胎行羊水染色体核型分析,发现1例嵌合型46,XX[ 36]/46,XY[ 14].(2)根据超声评估,巨大无心胎占87.0%(20/23),86.4%(19/22)的病例两胎脐动脉阻力指数差值≤0.20,提示无心胎血供丰富,66.7%(10/15)的泵血胎出现心功能失代偿,泵血胎大脑中动脉收缩期峰值流速>1.5中位数的倍数者占75.0%(12/16),提示贫血.(3)血供丰富者发生巨大无心胎的比例(94.7%,18/19)高于血供不丰富者(1/3),差异有统计学意义(Fisher精确概率法,P=0.04).巨大无心胎者泵血胎发生心功能失代偿的比例(83.3%,10/12)高于非巨大无心胎发生心功能失代偿的比例(0/3),差异有统计学意义(Fisher精确概率法,P=0.02).(4)11例首诊后选择引产终止妊娠,14例继续妊娠者泵血胎存活率为64.3%(9/14).继续妊娠者中3例首诊时不伴泵血胎心功能异常的非巨大无心胎选择保守观察,2例足月分娩,1例病情进展而引产;11例泵血胎心功能异常或贫血的巨大无心胎中5例选择保守观察,其中1例流产,3例病情进展(1例引产、2例早产),1例病情稳定至分娩;另外6例选择脐带电凝,5例成功,其中4例泵血胎存活.结论 泵血胎的产前诊断结果、心功能状态、贫血、无心胎发育程度及脐血供是TRAP产前评估的重要指标,应根据产前评估结果对TRAP进行及时处理.%Objective To analyze the clinical characteristics of twin reversed arterial perfusion sequence (TRAP),and investigate its prenatal evaluation and clinical management.Methods Karyotype results and

  3. 邻苯三酚与亚甲蓝舒张大鼠肠系膜动脉的不同机制%Mechanisms of relaxation by pyrogallol and methylthioninium chloride in perfused rat mesenteric artery

    Institute of Scientific and Technical Information of China (English)

    李元建; Sue Piper DUCKLES

    1994-01-01

    In perfused rat mesenteric arteries without endothelium, pyrogallol (Pyr) or methylthioninium chloride (methylene blue,Met) produced a concentration-dependent re-laxation. Superoxide dismutase abolished in-hibition by Pyr, but not Met, of vasoconstric-tor responses to transmural nerve stimulation(TNS). Neither catalase nor deferoxamine had any effect on vasodilator responses to Pyr or Met. Vasodilator responses to Pyr were unaltered by Nω-nitro-L-arginine methyl ester(L-NAME), indomethacin, or capsaicin.Similarly, the relaxing effect of Met was unaf-fected by indomethacin or capsaicin. These findings suggest that vasodilator responses to Pyr may be due to endothelial-independent generation of superoxide anion. In contrast the relaxation produced by Met appears to be due to a direct action on vascular smooth muscle independent of superoxide anion generation.%在去内皮肠系膜血管,邻苯三酚与亚甲蓝产生浓度依赖性舒张,SOD可取消邻苯三酚对TNS所致缩血管效应的抑制作用,但不影响亚甲蓝的效应.邻苯三酚与亚甲蓝的舒血管效应不被过氧化氢酶、去铁胺、吲哚美辛和辣椒素所影响.结果提示,邻苯三酚的舒血管效应是其产生超氧阴离子所致,而亚甲蓝的效应为直接作用于血管平滑肌.

  4. Procedure for Decellularization of Rat Livers in an Oscillating-pressure Perfusion Device.

    Science.gov (United States)

    Hillebrandt, Karl; Polenz, Dietrich; Butter, Antje; Tang, Peter; Reutzel-Selke, Anja; Andreou, Andreas; Napierala, Hendrik; Raschzok, Nathanael; Pratschke, Johann; Sauer, Igor M; Struecker, Benjamin

    2015-01-01

    Decellularization and recellularization of parenchymal organs may enable the generation of functional organs in vitro, and several protocols for rodent liver decellularization have already been published. We aimed to improve the decellularization process by construction of a proprietary perfusion device enabling selective perfusion via the portal vein and/or the hepatic artery. Furthermore, we sought to perform perfusion under oscillating surrounding pressure conditions to improve the homogeneity of decellularization. The homogeneity of perfusion decellularization has been an underestimated factor to date. During decellularization, areas within the organ that are poorly perfused may still contain cells, whereas the extracellular matrix (ECM) in well-perfused areas may already be affected by alkaline detergents. Oscillating pressure changes can mimic the intraabdominal pressure changes that occur during respiration to optimize microperfusion inside the liver. In the study presented here, decellularized rat liver matrices were analyzed by histological staining, DNA content analysis and corrosion casting. Perfusion via the hepatic artery showed more homogenous results than portal venous perfusion did. The application of oscillating pressure conditions improved the effectiveness of perfusion decellularization. Livers perfused via the hepatic artery and under oscillating pressure conditions showed the best results. The presented techniques for liver harvesting, cannulation and perfusion using our proprietary device enable sophisticated perfusion set-ups to improve decellularization and recellularization experiments in rat livers.

  5. Effect of arterial perfusion of 3-bromopyruvate on transplanted rectal tumors:an experimental study in rabbits%动脉灌注3-溴丙酮酸对兔移植性直肠肿瘤的作用

    Institute of Scientific and Technical Information of China (English)

    翁文采; 张文俊; 王峰; 梁文波; 高宏波; 李成刚; 艾琦; 宋吉慧

    2015-01-01

    目的:观察动脉灌注3-溴丙酮酸(3-BrPA)对兔移植性直肠肿瘤的作用效果。方法将60只移植有直肠肿瘤的新西兰大白兔随机分为低、中、高剂量治疗组及生理盐水对照组,每组各15只。对低、中、高剂量组实验兔分别经导管于肠系膜后动脉灌注0.5 mmol/L、1.0 mmol/L、2.0 mmol/L浓度的3-BrPA各10 ml;对照组灌注等量生理盐水。4 d后活体解剖取出直肠肿瘤,镜下观察肿瘤细胞坏死程度并计算坏死率,评估各浓度3-BrPA对肿瘤的作用效果。结果60只实验兔完成直肠肿瘤移植、动脉灌注实验,镜下实验兔肿瘤细胞均有不同程度损坏。低剂量组Ⅰ级坏死3只,Ⅱ级坏死11只,Ⅲ级坏死1只,治疗有效率为6.7%;中剂量组Ⅱ级坏死2只,Ⅲ级坏死10只,Ⅳ级坏死3只,治疗有效率为86.6%;高剂量组Ⅲ级坏死2只,Ⅳ级坏死13只,治疗有效率为100%;对照组Ⅰ级坏死15只。中、高剂量组Ⅲ、Ⅳ级肿瘤坏死率、治疗有效率、4级肿瘤坏死水平比较差异有统计学意义(P<0.05),3-BrPA治疗作用明显,而正常肠组织无损伤。结论动脉灌注3-BrPA治疗兔移植性直肠肿瘤有一定疗效,高浓度剂量组肿瘤坏死率和治疗有效率最高,疗效显著。%Objective To investigate the effect of 3-bromopyruvate (3-BrPA) on transplanted rectal tumors in experimental rabbit models. Methods A total of 60 New Zealand white rabbits with transplanted rectal tumor were randomly and equally divided into low-dose (0.5 mmol/L), medium-dose (1.0 mmol/L), high-dose (2.0 mmol/L) treatment groups and saline control group with 15 rabbits in each group. Arterial perfusion of 10 ml 3-BrPA with concentration of 0.5 mmol/L, 1.0 mmol/L and 2.0 mmol/L via caudal mesenteric artery was respectively employed for the rabbits of the corresponding treatment group; the control group was perfused with equal amounts of saline. Four days later, rectal tumors were removed by vivisection. The

  6. A combined study of cerebral artery system through super-selective angiography and real-time-colored latex perfusion in rabbits%超选择造影与实时乳胶灌注在兔脑动脉系统研究应用

    Institute of Scientific and Technical Information of China (English)

    张桂运; 陈左权; 凌锋; 海舰; 李玉健; 顾斌贤; 吴春红; 俞丽敏

    2009-01-01

    Objective To study the character of cerebral artery system in rabbits and to found the base for establishing cerebrovascular disease models of rabbits.Methods Microcatheter-technique was used to perform super-selective cerebral angiography in New Zealand rabbits,after which three dimensional vascular reconstructions were adopted.At the end of angiography,the live rabbits,through microcatheter,were real time perfused with colored latex mixed with contrast medium under fluoroscopy for visualization of their cerebrovascular anatomy.Results The arteries above aortic arch and the arterial system in anterior and posterior circulation were clearly visualized.After latex perfusion,the arterial circle of skull base,anterior cerebral arteries,middle cerebral arteries,posterior cerebral arteries and their subpial branches were clearly displayed as well asthe resistance vessels in posterior watershed.Conclusions Super-selective cerebral angiography was helpful to better display the anterior and posterior circulation in rabbits,and the colored latex perfusion could provide more details about the microcirculation especially in the posterior watershed.The outcome of colored latex perfusion could be used as an authentication to angiography.With the combination of super-selective angiography and colored latex perfusion,it was easy to find the morphological changes of cerebral arterial circulation in rabbits.%目的 研究兔脑动脉系统的特点,为建立兔脑血管疾病模型奠定基础.方法 应用微导管技术对新西兰大白兔进行超选择性脑血管造影并进行血管三维重建,造影完毕后在活体上透视下经微导管进行染色乳胶实时灌注.结果 主动脉弓上血管及颅内前后循环系统显影清楚;乳胶灌注后清晰显示颅底动脉环、大脑前动脉、大脑中动脉、大脑后动脉及其皮层分枝,后分水岭区阻力血管显示清楚.结论 超选择性脑血管造影有利于更好地显示兔脑前后动脉系统,

  7. 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.)

  8. Diagnostic Accuracy of Stress Myocardial Perfusion Imaging Compared to Invasive Coronary Angiography With Fractional Flow Reserve Meta-Analysis

    NARCIS (Netherlands)

    Takx, Richard A. P.; Blomberg, Bjorn A.; El Aidi, Hamza; Habets, Jesse; de Jong, Pim A.; Nagel, Eike; Hoffmann, Udo; Leiner, Tim

    2015-01-01

    Background-Hemodynamically significant coronary artery disease is an important indication for revascularization. Stress myocardial perfusion imaging is a noninvasive alternative to invasive fractional flow reserve for evaluating hemodynamically significant coronary artery disease. The aim was to det

  9. Perfusion computed tomography evaluation of angiogenesis in liver cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Han Feng [Xuanwu Hospital, Capital Medical University, Department of Clinical Pain, Beijing (China); Hospital of North Sichuan Medical College, Department of Radiology, Nanchong City, Sichuan Province (China); Du, Yong; Xu, Xiao Xue; Li, Yang [Hospital of North Sichuan Medical College, Department of Radiology, Nanchong City, Sichuan Province (China); Ni, Jia Xiang [Xuanwu Hospital, Capital Medical University, Department of Clinical Pain, Beijing (China); Zhou, Xiang Ping [West China Hospital, Sichuan University, Department of Radiology, Chengdu City, Sichuan Province (China); Li, Jin Dong [Hospital of North Sichuan Medical College, Department of General Surgery, Nanchong City, Sichuan Province (China); Zhang, Qing [Hospital of North Sichuan Medical College, Department of Ultrasound, Nanchong City, Sichuan Province (China)

    2010-06-15

    To investigate the value of computed tomography (CT) perfusion imaging for assessment of angiogenesis in liver cancer. Twenty-one patients with histologically proven liver cancer underwent CT perfusion examination. We compared the following perfusion parameters in the tumour area versus the non-tumour area: total blood flow (TBF), hepatic arterial perfusion (HAP), hepatic portal perfusion (HPP) and hepatic arterial perfusion index (HAPI). Slices of postoperative specimen were stained with haematoxylin-eosin and anti-CD34 immunohistochemistry. The slices were evaluated with emphasis on the CD34-positive neovasculature in the tumour parenchyma. Tumour microvascular density (MVD) was calculated according to the Weidner method. Pearson correlation was used to detect correlations between tumour MVD and tumour perfusion parameters. TBF and HPP in the tumour area were lower than in the non-tumour area (P < 0.05). HAP and HAPI in the tumour area were higher than those of the non-tumour area (P < 0.05). TBF and HAP in the tumour area correlated with MVD in the tumour (P < 0.05), with correlation coefficients of 0.849 and 0.829, respectively. CT perfusion imaging can quantitatively assess the blood supply and its distribution in liver cancer. TBF or HAP may be a useful parameter in assessing angiogenesis of liver cancer. (orig.)

  10. Perfusion CT in acute stroke; Stellenwert der CT-Perfusion fuer die Therapie des Schlaganfalls

    Energy Technology Data Exchange (ETDEWEB)

    Eckert, Bernd [Asklepios Klinik Altona (Germany). Radiologie und Neuroradiologie; Roether, Joachim [Asklepios Klinik Altona (Germany). Neurologische Abt.; Fiehler, Jens [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neuroradiologische Diagnostik und Intervention; Thomalla, Goetz [Universitaetsklinikum Hamburg-Eppendorf, Hamburg (Germany). Klinik und Poliklinik fuer Neurologie, Kopf- und Neurozentrum

    2015-06-15

    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.

  11. Sema4d is required for the development of the hindbrain boundary and skeletal muscle in zebrafish

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Jie; Zeng, Zhen; Wei, Juncheng; Jiang, Lijun; Ma, Quanfu; Wu, Mingfu; Huang, Xiaoyuan; Ye, Shuangmei; Li, Ye; Ma, Ding [Cancer Biology Research Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China); Gao, Qinglei, E-mail: qlgao@tjh.tjmu.edu.cn [Cancer Biology Research Centre, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030 (China)

    2013-04-05

    Highlights: ► Sema4d was expressed at all developmental stages of zebrafish. ► Knockdown of sema4d in embryos resulted in defects in the hindbrain and the trunk structure. ► Knockdown of sema4d in embryos upregulated the expression of three hindbrain rhombomere markers. ► Knockdown of sema4d in embryos increased the expression of myogenic regulatory factors. ► Knockdown of sema4d in embryos resulted in an obvious increase of cell apoptosis. -- Abstract: Semaphorin4d (SEMA4D), also known as CD100, an oligodendrocyte secreted R-Ras GTPase-activating protein (GAP), affecting axonal growth is involved in a range of processes including cell adhesion, motility, angiogenesis, immune responses and tumour progression. However, its actual physiological mechanisms and its role in development remain unclear. This study has focused on the role of sema4d in the development and expression patterns in zebrafish embryos and the effect of its suppression on development using sema4d-specific antisense morpholino-oligonucleotides. In this study the knockdown of sema4d, expressed at all developmental stages, lead to defects in the hindbrain and trunk structure of zebrafish embryos. In addition, these phenotypes appeared to be associated with the abnormal expression of three hindbrain rhombomere boundary markers, wnt1, epha4a and foxb1.2, and two myogenic regulatory factors, myod and myog. Further, a notable increase of cell apoptosis appeared in the sema4d knockdown embryos, while no obvious reduction in cell proliferation was observed. Collectively, these data suggest that sema4d plays an important role in the development of the hindbrain and skeletal muscle.

  12. 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.

  13. Axonal patterns and targets of dA1 interneurons in the chick hindbrain.

    Science.gov (United States)

    Kohl, Ayelet; Hadas, Yoav; Klar, Avihu; Sela-Donenfeld, Dalit

    2012-04-25

    Hindbrain dorsal interneurons that comprise the rhombic lip relay sensory information and coordinate motor outputs. The progenitor dA1 subgroup of interneurons, which is formed along the dorsal-most region of the caudal rhombic lip, gives rise to the cochlear and precerebellar nuclei. These centers project sensory inputs toward upper-brain regions. The fundamental role of dA1 interneurons in the assembly and function of these brainstem nuclei is well characterized. However, the precise en route axonal patterns and synaptic targets of dA1 interneurons are not clear as of yet. Novel genetic tools were used to label dA1 neurons and trace their axonal trajectories and synaptic connections at various stages of chick embryos. Using dA1-specific enhancers, two contralateral ascending axonal projection patterns were identified; one derived from rhombomeres 6-7 that elongated in the dorsal funiculus, while the other originated from rhombomeres 2-5 and extended in the lateral funiculus. Targets of dA1 axons were followed at later stages using PiggyBac-mediated DNA transposition. dA1 axons were found to project and form synapses in the auditory nuclei and cerebellum. Investigation of mechanisms that regulate the patterns of dA1 axons revealed a fundamental role of Lim-homeodomain (HD) proteins. Switch in the expression of the specific dA1 Lim-HD proteins Lhx2/9 into Lhx1, which is typically expressed in dB1 interneurons, modified dA1 axonal patterns to project along the routes of dB1 subgroup. Together, the results of this research provided new tools and knowledge to the assembly of trajectories and connectivity of hindbrain dA1 interneurons and of molecular mechanisms that control these patterns.

  14. Impedance plethysmography: a new method for continuous muscle perfusion monitoring.

    Science.gov (United States)

    Concannon, M J; Stewart, D H; Welsh, C F; Puckett, C L

    1991-08-01

    Vigilant postoperative monitoring of the buried muscle flap is critical after free transfer because early diagnosis of vascular insufficiency is essential to allow prompt correction. We have identified a monitoring method utilizing needle electrodes and impedance plethysmography that gives a beat-to-beat representation of muscular perfusion. In 25 New Zealand White rabbits the gastrocnemius muscle was isolated on its vascular pedicle, and two intramuscular needle electrodes were placed. The instantaneous impedance changes of the muscle (corresponding to the pulsatile volume changes of perfusion) were measured and recorded. Using this representation of perfusion, an independent judge was able to correctly diagnose muscular ischemia 100 percent of the time (n = 25). Further, the judge was able to correctly distinguish the ischemia as arterial (n = 10) or venous (n = 10) in origin 100 percent of the time. Additionally, we monitored muscle perfusion transcutaneously in five free muscle flaps and demonstrated a reliable impedance signal that correlated with perfusion.

  15. Myocardial perfusion imaging with dual energy CT.

    Science.gov (United States)

    Jin, Kwang Nam; De Cecco, Carlo N; Caruso, Damiano; Tesche, Christian; Spandorfer, Adam; Varga-Szemes, Akos; Schoepf, U Joseph

    2016-10-01

    Dual-energy CT (DECT) enables simultaneous use of two different tube voltages, thus different x-ray absorption characteristics are acquired in the same anatomic location with two different X-ray spectra. The various DECT techniques allow material decomposition and mapping of the iodine distribution within the myocardium. Static dual-energy myocardial perfusion imaging (sCTMPI) using pharmacological stress agents demonstrate myocardial ischemia by single snapshot images of myocardial iodine distribution. sCTMPI gives incremental values to coronary artery stenosis detected on coronary CT angiography (CCTA) by showing consequent reversible or fixed myocardial perfusion defects. The comprehensive acquisition of CCTA and sCTMPI offers extensive morphological and functional evaluation of coronary artery disease. Recent studies have revealed that dual-energy sCTMPI shows promising diagnostic accuracy for the detection of hemodynamically significant coronary artery disease compared to single-photon emission computed tomography, invasive coronary angiography, and cardiac MRI. The aim of this review is to present currently available DECT techniques for static myocardial perfusion imaging and recent clinical applications and ongoing investigations.

  16. CT perfusion: principles, applications, and problems

    Science.gov (United States)

    Lee, Ting-Yim

    2004-10-01

    The fast scanning speed of current slip-ring CT scanners has enabled the development of perfusion imaging techniques with intravenous injection of contrast medium. In a typical CT perfusion study, contrast medium is injected and rapid scanning at a frequency of 1-2 Hz is used to monitor the first circulation of the injected contrast medium through a 1-2 cm thick slab of tissue. From the acquired time-series of CT images, arteries can be identified within the tissue slab to derive the arterial contrast concentration curve, Ca(t) while each individual voxel produces a tissue residue curve, Q(t) for the corresponding tissue region. Deconvolution between the measured Ca(t) and Q(t) leads to the determination of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in brain studies. In this presentation, an important application of CT perfusion in acute stroke studies - the identification of the ischemic penumbra via the CBF/CBV mismatch and factors affecting the quantitative accuracy of deconvolution, including partial volume averaging, arterial delay and dispersion are discussed.

  17. 64层螺旋CT脑灌注成像联合CT血管造影评价颅内外血管搭桥术后疗效%Assessment of cerebral internal and external vascular bypass graft in patients with single middle cerebral artery stenosis or occlusion by combining 64-row CT cerebral perfusion with angiography

    Institute of Scientific and Technical Information of China (English)

    陈天金; 朱栓庄; 温有信; 王耀彬; 韩向东; 白莹; 于旋

    2012-01-01

    Objective To assess the curative effect of cerebral internal and external vascular bypass graft in patients with sin -gle middle cerebral artery (MCA) stenosis or occlusion by combining 64 -row CT cerebral perfusion (CTP) with angiography ( CTA ). Methods Patients with middle cerebral artery stenosis or occlusion were recruited and underwent superficial temporal artery and mid -die cerebral artery(STA -MCA) bypass graft between March 2009 and Mar 2011. CTP and CTA examinations were performed in all patients before and after operation. The cerebral perfusion parameters were analyzed quantitatively and qualitatively . The origin, travel and anastomotic stoma of bypass grafts were evaluated by reconstructed CTA images . Results 46 patients were found with severe MCA stenosis or occlusion. The time to peak (TTP) and relative mean transit time (rMTT) images before therapy displayed the existence of perfusion delay. The relative cerebral blood flow (rCBF) and relative cerebral blood volume (rCRV) images did not change significantly. The decrease of TTP and rMTT after therapy was of statistical significance ( P 0.05). In reconstructed CTA images , 82 bridge vessels were well displayed, including double bridges in 39 patients. The accuracy of CTA examination was 96.5%. All the bypass grafts were well shown and the anastomotic stomas were unobstructed. Conclusions It is feasible to evaluate the curative effects of cerebral internal and ex — ternal vascular bypass graft by combining CTP images of cerebral perfusion after therapy with CTA images of cerebral internal and exter -nal bypass grafts.%目的 探讨64层螺旋CT脑灌注成像(CT perfusion,CTP)联合CT血管造影(CT angiography,CTA)评价单侧大脑中动脉(middle cerebral artery,MCA)重度狭窄(闭塞)颅内外血管搭桥术后疗效的可行性.方法 46例拟行颅内外血管搭桥术患者,术前、后均行CTP及CTA检查.计算脑灌注参数图,对治疗前后脑灌注参数进行定量和定性对

  18. Artery by Neuropeptides

    Directory of Open Access Journals (Sweden)

    Esmeralda Sofia Costa Delgado

    2012-01-01

    Methods. Isolated rabbit eyes (n=12 were perfused in situ with tyrode through the external ophthalmic artery. Effects of intra-arterial injections of NPY 200 μg/ml (Group A; n=6 and VIP 200 μg/ml (Group B; n=6 on the recorded pressure were obtained. For statistical analysis, Student's paired t-test and Fast Fourier Transform were used. Results. Spontaneous oscillations were observed before any drug administration in the 12 rabbit models. NPY produced an increase in total vascular resistance and a higher frequency and amplitude of oscillations, while VIP evoked the opposite effects. Conclusions. This study provides evidence of vasomotion in basal conditions in rabbit external ophthalmic artery. Concerning drug effects, NPY increased arterial resistance and enhanced vasomotion while VIP produced opposite effects which demonstrates their profound influence in arterial vasomotion.

  19. Assessment of the Repeatability and Sensitivity of the Thermoelectric Perfusion Probe

    OpenAIRE

    Ellis, Brent Earl

    2006-01-01

    The Thermoelectric Perfusion Probe is a completely electronic system that cyclically heats and cools tissue to measure blood perfusion. The probe produces the thermal event with a thermoelectric cooler and then measures the resulting heat flux and temperatures: the arterial temperature and the sensor temperature (the temperature between the heat flux gage and the skin). The Thermoelectric Perfusion Probe was validated and calibrated on a phantom tissue test stand, a system that simulates pe...

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

    OpenAIRE

    Sundaram P; Padma S

    2009-01-01

    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 my...

  1. 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

  2. Hepatic perfusion disorders: Etiopathogenesis and related diseases

    Institute of Scientific and Technical Information of China (English)

    Jin-Lin Tian; Jin-Shan Zhang

    2006-01-01

    In this article, we have reviewed the hepatic perfusion disorder (HPD), etiopathogenesis of HPD and corresponding diseases. Review of the literature was based on computer searches (PubMed, Index Medicus)and personal experiences. We considered HPD reflects perfusion differences due to redistribution of arterial blood flow among segments, subsegments and lobes of the liver. The plain CT scan findings of HPD manifests as triangular or wedge-shaped areas of low attenuation.On contrast-enhanced CT scan, HPD manifests multiple (or single) transient wedge-shaped, rotundloid or irregular appearance, homogeneous hyperattenuation (in less cases, hypoattenuation) during the hepatic arterial phase (HAP) and isoattenuated or slightly hyperattenuated areas during the portal arterial phase.Dynamic enhanced magnetic resonance (MR) features are similar to enhanced CT scan. Angiographic findings include non-opacification of portal vein on portograms or wedge-shaped segmental staining in arterial and parenchymal phases on hepatic angiograms. The causes of HPD are arterioportal shunts (APS), intrahepatic vascular compressions and portal vein occlusion,steal phenomenon by hypervascular tumors, vascular variations and any other unknown reasons. It is very important for radiologists to be familiar with the various appearances of HPD to avoid false-positive diagnosis of pseudolesions and not to overestimate the extent of the disease.

  3. The dream of a one-stop-shop : Meta-analysis on myocardial perfusion CT

    NARCIS (Netherlands)

    Pelgrim, Gert Jan; Dorrius, Monique; Xie, Xueqian; den Dekker, Martijn A. M.; Schoepf, U. Joseph; Henzler, Thomas; Oudkerk, Matthijs; Vliegenthart, Rozemarijn

    2015-01-01

    Purpose: To determine the diagnostic performance of computed tomography (CT) perfusion techniques for the detection of functionally relevant coronary artery disease (CAD) in comparison to reference standards, including invasive coronary angiography (ICA), single photon emission computed tomography (

  4. Subendocardial versus transmural ischaemia in myocardial perfusion SPECT--a Monte Carlo study

    DEFF Research Database (Denmark)

    Bartosik, Jolanta; El-Ali, Henrik Hussein; Nilsson, Ulf;

    2006-01-01

    Myocardial perfusion imaging with single-photon emission computed tomography (SPECT) is useful for the evaluation of patients with known or suspected coronary artery disease. Parameters of interest are the reduction in the blood perfusion (severity) and the lesion volume (extent). The aim...

  5. Using Perfusion fMRI to Measure Continuous Changes in Neural Activity with Learning

    Science.gov (United States)

    Olson, Ingrid R.; Rao, Hengyi; Moore, Katherine Sledge; Wang, Jiongjiong; Detre, John A.; Aguirre, Geoffrey K.

    2006-01-01

    In this study, we examine the suitability of a relatively new imaging technique, "arterial spin labeled perfusion imaging," for the study of continuous, gradual changes in neural activity. Unlike BOLD imaging, the perfusion signal is stable over long time-scales, allowing for accurate assessment of continuous performance. In addition, perfusion…

  6. Skin perfusion pressure measured with a photo sensor in an air-filled plastic balloon: validity and reproducibility on the lower leg in normal subjects and patients suspected of obliterative arterial disease

    DEFF Research Database (Denmark)

    Nielsen, Steen Levin; Nielsen, Anne Lerberg; Vind, Susanne Haase

    2011-01-01

    An inflatable small plastic bag including a photo sensor was constructed for measurement of skin perfusion pressure avoiding the rim of the photo sensor over bony and tendineous surfaces of the tibia below the knee, at the ankle, and on the dorsal forefoot. Compression was obtained using a conical...

  7. Perfusion-related stimuli for compensatory lung growth following pneumonectomy.

    Science.gov (United States)

    Dane, D Merrill; Yilmaz, Cuneyt; Gyawali, Dipendra; Iyer, Roshni; Ravikumar, Priya; Estrera, Aaron S; Hsia, Connie C W

    2016-07-01

    Following pneumonectomy (PNX), two separate mechanical forces act on the remaining lung: parenchymal stress caused by lung expansion, and microvascular distension and shear caused by increased perfusion. We previously showed that parenchymal stress and strain explain approximately one-half of overall compensation; the remainder was presumptively attributed to perfusion-related factors. In this study, we directly tested the hypothesis that perturbation of regional pulmonary perfusion modulates post-PNX lung growth. Adult canines underwent banding of the pulmonary artery (PAB) to the left caudal (LCa) lobe, which caused a reduction in basal perfusion to LCa lobe without preventing the subsequent increase in its perfusion following right PNX while simultaneously exaggerating the post-PNX increase in perfusion to the unbanded lobes, thereby creating differential perfusion changes between banded and unbanded lobes. Control animals underwent sham pulmonary artery banding followed by right PNX. Pulmonary function, regional pulmonary perfusion, and high-resolution computed tomography of the chest were analyzed pre-PNX and 3-mo post-PNX. Terminally, the remaining lobes were fixed for detailed morphometric analysis. Results were compared with corresponding lobes in two control (Sham banding and normal unoperated) groups. PAB impaired the indices of post-PNX extravascular alveolar tissue growth by up to 50% in all remaining lobes. PAB enhanced the expected post-PNX increase in alveolar capillary formation, measured by the prevalence of double-capillary profiles, in both unbanded and banded lobes. We conclude that perfusion distribution provides major stimuli for post-PNX compensatory lung growth independent of the stimuli provided by lung expansion and parenchymal stress and strain.

  8. Development of an Ex Vivo, Beating Heart Model for CT Myocardial Perfusion

    Directory of Open Access Journals (Sweden)

    Gert Jan Pelgrim

    2015-01-01

    Full Text Available Objective. To test the feasibility of a CT-compatible, ex vivo, perfused porcine heart model for myocardial perfusion CT imaging. Methods. One porcine heart was perfused according to Langendorff. Dynamic perfusion scanning was performed with a second-generation dual source CT scanner. Circulatory parameters like blood flow, aortic pressure, and heart rate were monitored throughout the experiment. Stenosis was induced in the circumflex artery, controlled by a fractional flow reserve (FFR pressure wire. CT-derived myocardial perfusion parameters were analysed at FFR of 1 to 0.10/0.0. Results. CT images did not show major artefacts due to interference of the model setup. The pacemaker-induced heart rhythm was generally stable at 70 beats per minute. During most of the experiment, blood flow was 0.9–1.0 L/min, and arterial pressure varied between 80 and 95 mm/Hg. Blood flow decreased and arterial pressure increased by approximately 10% after inducing a stenosis with FFR ≤ 0.50. Dynamic perfusion scanning was possible across the range of stenosis grades. Perfusion parameters of circumflex-perfused myocardial segments were affected at increasing stenosis grades. Conclusion. An adapted Langendorff porcine heart model is feasible in a CT environment. This model provides control over physiological parameters and may allow in-depth validation of quantitative CT perfusion techniques.

  9. CTP在颅内动脉狭窄支架成形术中的术前评估价值%Pre-operative evaluation value of CT perfusion imaging in intravascular stenting of intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    袁晖; 赵振伟; 曲友直; 袁阳; 杨震

    2013-01-01

    Objective To analyze the changes of CT brain perfusion imaging parameters before and after stent-assisted angioplasty in severe symptomatic intracranial atherosclerotic, and to investigate the pre-operative evaluation value of computed tomography perfusion (CTP) imaging. Methods A total of 58 cases of intracranial stenosis (the degree of stenosis >70% ) were divided into low perfusion group and normal perfusion group through pre-operative CTP imaging. The patients were performed with CTP again to evaluate the cerebral hemodynamic changes 3 months after intracranial stent-assisted angioplasty. The relative perfusion parameters including regional cerebral blood flow (rCBF).regional cerebral blood volume (rCBV), regional mean transit time (rMTT), and regional time to peak (rTTP) in both groups were compared. The curative effects of both groups were compared. Results rCBF, rMTT, and rTTP were improved significantly (P < 0.05) in the low perfusion group after treatment. The post-treatment follow-up indicated that the incidence of ischemic events in the low perfusion group were significantly lower than the normal perfusion group (P < 0. 05). The number of patients with mRS ≤ 2 was increased and better function improvement was obtained in the low perfusion group than the normal perfusion group (P < 0. 05). Conclusion According to pre-operative CTP parameters, it plays an important guiding role for the pre-operative assessment in treatment of severe symptomatic intracranial atherosclerotic stenosis.%目的 分析CT脑灌注成像(CTP)在重度症状性颅内动脉狭窄支架成形术前后的变化,探讨其对术前评估的价值.方法 根据术前CTP将58例颅内动脉狭窄程度>70%患者分为低灌注组和正常灌注组,术后3个月查CTP,比较相对局部脑血流量(rCBF)、脑血容量(rCBV)、平均通过时间(rMTT)、达峰时间(rTTP)变化及疗效.结果 低灌注组术后rCBF、rMTT、rTTP改善明显(P<0.05).低灌注组术后缺血事件

  10. 外源性HGF基因转染对肺动脉高压兔肺血流灌注及肺动脉压力的影响%Effect of exogenous HGF gene transfection on pulmonary perfusion and pressure in pulmonary artery hypertension in rabbits

    Institute of Scientific and Technical Information of China (English)

    王伟; 张芳; 谢悦; 张宜乾; 吴树明

    2011-01-01

    AIM: To investigate the feasibility of exogenous hepatocyte growth factor (HGF) gene transfection to promote pulmonary collateral angiogenesis, improve pulmonary perfusion and reduce pulmonary artery pressure in the rabbit model of pulmonary artery hypertension (PAH). METHODS: The model rabbits of PAH were randomly divided into control group, empty vector group and HGF gene transfection group. The rabbits in HGF gene transfection group were transfected with Ad - HGF via intratracheal instillation. Pulmonary hemodynamic indicators were monitored in the 4th week after HGF gene transfection. Density of pulmonary vessels was examined with double - labeling immunofluorescence (endo-thelial cells were labeled with anti - FVK and vascular smooth muscle cells were marked with anti - a - SMA). Double - labeling immunofluorescence of FTTC - lectin and anti - a - SMA was also performed to evaluate the pulmonary blood perfusion. RESULTS: Four weeks after transfection, the density of pulmonary arterioles of the rabbits in HGF gene transfection group was higher than that in control group and empty vector group ( P < 0.05 ) , which was confirmed by double - labeling immunofluorescence. Pulmonary blood perfusion in HGF group was significantly increased compared with that in the other two groups, in which pulmonary arterial stenosis and occlusion were observed. The mean pulmonary artery pressure in HGF transfection group was much lower than that in control group and empty vector group (P <0.05). CONCLUSION: Four weeks after intratracheal adenoviral - mediated HGF gene transfection, pulmonary collateral vessels and pulmonary perfusion increase, and the pulmonary artery pressure is effectively reduced.%目的:探讨外源性肝细胞生长因子(HGF)基因转染高动力性肺动脉高压家兔后促进侧支肺血管生成、改善肺血流灌注、降低肺动脉压力的可行性.方法:将肺动脉高压兔随机分为对照组、空病毒组和HGF基因转染组;HGF基因转染

  11. A novel dual ex vivo lung perfusion technique improves immediate outcomes in an experimental model of lung transplantation.

    Science.gov (United States)

    Tanaka, Y; Noda, K; Isse, K; Tobita, K; Maniwa, Y; Bhama, J K; D'Cunha, J; Bermudez, C A; Luketich, J D; Shigemura, N

    2015-05-01

    The lungs are dually perfused by the pulmonary artery and the bronchial arteries. This study aimed to test the feasibility of dual-perfusion techniques with the bronchial artery circulation and pulmonary artery circulation synchronously perfused using ex vivo lung perfusion (EVLP) and evaluate the effects of dual-perfusion on posttransplant lung graft function. Using rat heart-lung blocks, we developed a dual-perfusion EVLP circuit (dual-EVLP), and compared cellular metabolism, expression of inflammatory mediators, and posttransplant graft function in lung allografts maintained with dual-EVLP, standard-EVLP, or cold static preservation. The microvasculature in lung grafts after transplant was objectively evaluated using microcomputed tomography angiography. Lung grafts subjected to dual-EVLP exhibited significantly better lung graft function with reduced proinflammatory profiles and more mitochondrial biogenesis, leading to better posttransplant function and compliance, as compared with standard-EVLP or static cold preservation. Interestingly, lung grafts maintained on dual-EVLP exhibited remarkably increased microvasculature and perfusion as compared with lungs maintained on standard-EVLP. Our results suggest that lung grafts can be perfused and preserved using dual-perfusion EVLP techniques that contribute to better graft function by reducing proinflammatory profiles and activating mitochondrial respiration. Dual-EVLP also yields better posttransplant graft function through increased microvasculature and better perfusion of the lung grafts after transplantation.

  12. Abdominal perfusion computed tomography.

    Science.gov (United States)

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  13. Gbx2 is required for the morphogenesis of the mouse inner ear: a downstream candidate of hindbrain signaling.

    Science.gov (United States)

    Lin, Zhengshi; Cantos, Raquel; Patente, Maria; Wu, Doris K

    2005-05-01

    Gbx2 is a homeobox-containing transcription factor that is related to unplugged in Drosophila. In mice, Gbx2 and Otx2 negatively regulate each other to establish the mid-hindbrain boundary in the neural tube. Here, we show that Gbx2 is required for the development of the mouse inner ear. Absence of the endolymphatic duct and swelling of the membranous labyrinth are common features in Gbx2-/- inner ears. More severe mutant phenotypes include absence of the anterior and posterior semicircular canals, and a malformed saccule and cochlear duct. However, formation of the lateral semicircular canal and its ampulla is usually unaffected. These inner ear phenotypes are remarkably similar to those reported in kreisler mice, which have inner ear defects attributed to defects in the hindbrain. Based on gene expression analyses, we propose that activation of Gbx2 expression within the inner ear is an important pathway whereby signals from the hindbrain regulate inner ear development. In addition, our results suggest that Gbx2 normally promotes dorsal fates such as the endolymphatic duct and semicircular canals by positively regulating genes such as Wnt2b and Dlx5. However, Gbx2 promotes ventral fates such as the saccule and cochlear duct, possibly by restricting Otx2 expression.

  14. Increased pulsatile movement of the hindbrain in syringomyelia associated with the Chiari malformation: cine-MRI with presaturation bolus tracking

    Energy Technology Data Exchange (ETDEWEB)

    Terae, S. [Hokkaido Univ. School of Medicine, Sapporo (Japan). Dept. of Radiology; Miyasaka, K. [Hokkaido Univ. School of Medicine, Sapporo (Japan). Dept. of Radiology; Abe, S. [Hokkaido Univ. School of Medicine, Sapporo (Japan). Dept. of Radiology; Abe, H.; Tashiro, K. [Hokkaido Univ. School of Medicine, Sapporo (Japan). Dept. of Neurology

    1994-02-01

    Cine-MRI with presaturation bolus tracking was used in patients with syringomyelia associated with a Chiari malformation to study pulsatile movement of the hindbrain, cervical spinal cord, cerebrospinal fluid and the fluid within the syrinx. Nine patients had 13 examinations, 6 preoperative, 3 after syringosubarachnoid shunting and 4 after posterior fossa decompression. Five controls were also examined. Dynamic display of the acquired images demonstrated downward displacement of the presaturation bolus on the cerebellar tonsils and medulla oblongata (or upper cervical cord) at the C1 level in all preoperative examinations and in two patients after syringo-subarachnoid shunting but with residual foramen magnum obstruction. Downward displacement of the bolus on the cervical spinal cord was also demonstrated in 7 examinations, but not observed in the controls. Thus, the hindbrain-spinal cord axis showed larger pulsatile movements in patients with foramen magnum obstruction. Based on these observations and a review of the literature, a new theory on the mode of extension of syringomyelia, emphasising the role of increased pulsatile movement of the hindbrain-spinal cord axis is proposed: that the pulsatile movements, together with a one-way valve mechanism in the syrinx cavity act as a ``vacuum-pump`` to enlarge the syrinx. (orig.)

  15. Perfusion Linearity and Its Applications

    CERN Document Server

    Pianykh, Oleg

    2010-01-01

    Perfusion analysis computes blood flow parameters (blood volume, blood flow, mean transit time) from the observed flow of contrast agent, passing through the patient's vascular system. Perfusion deconvolution has been widely accepted as the principal numerical tool for perfusion analysis, and is used routinely in clinical applications. This extensive use of perfusion in clinical decision-making makes numerical stability and robustness of perfusion computations vital for accurate diagnostics and patient safety. The main goal of this paper is to propose a novel approach for validating numerical properties of perfusion algorithms. The approach is based on Perfusion Linearity Property (PLP), which we find in perfusion deconvolution, as well as in many other perfusion techniques. PLP allows one to study perfusion values as weighted averages of the original imaging data. This, in turn, uncovers hidden problems with the existing deconvolution techniques, and may be used to suggest more reliable computational approac...

  16. Possibilities of differentiation of solitary focal liver lesions by computed tomography perfusion

    Directory of Open Access Journals (Sweden)

    Irmina Sefić Pašić

    2015-08-01

    Full Text Available Aim To evaluate possibilities of computed tomography (CT perfusion in differentiation of solitary focal liver lesions based on their characteristic vascularization through perfusion parameters analysis. Methods Prospective study was conducted on 50 patients in the period 2009-2012. Patients were divided in two groups: benign and malignant lesions. The following CT perfusion parameters were analyzed: blood flow (BF, blood volume (BV, mean transit time (MTT, capillary permeability surface area product (PS, hepatic arterial fraction (HAF, and impulse residual function (IRF. During the study another perfusion parameter was analyzed: hepatic perfusion index (HPI. All patients were examined on Multidetector 64-slice CT machine (GE with application of perfusion protocol for liver with i.v. administration of contrast agent. Results In both groups an increase of vascularization and arterial blood flow was noticed, but there was no significant statistical difference between any of 6 analyzed parameters. Hepatic perfusion index values were increased in all lesions in comparison with normal liver parenchyma. Conclusion Computed tomography perfusion in our study did not allow differentiation of benign and malignant liver lesions based on analysis of functional perfusion parameters. Hepatic perfusion index should be investigated in further studies as a parameter for detection of possible presence of micro-metastases in visually homogeneous liver in cases with no lesions found during standard CT protocol

  17. Measuring myocardial perfusion: the role of PET, MRI and CT.

    Science.gov (United States)

    Qayyum, A A; Kastrup, J

    2015-06-01

    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. 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-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-pass of non-ionic and ionic contrast agents, respectively. Absolute quantification with CMR has yet to be established in routine clinical practice, while CT has yet to prove its diagnostic and prognostic value. The upcoming years may change the way we diagnose and treat patients suspected of having CAD with more precise methods for measuring myocardial perfusion. The aim of this comprehensive review is to discuss current and emerging imaging techniques used for myocardial perfusion imaging.

  18. Excitatory Hindbrain-Forebrain Communication Is Required for Cisplatin-Induced Anorexia and Weight Loss.

    Science.gov (United States)

    Alhadeff, Amber L; Holland, Ruby A; Zheng, Huiyuan; Rinaman, Linda; Grill, Harvey J; De Jonghe, Bart C

    2017-01-11

    Cisplatin chemotherapy is commonly used to treat cancer despite severe energy balance side effects. In rats, cisplatin activates nucleus tractus solitarius (NTS) projections to the lateral parabrachial nucleus (lPBN) and calcitonin-gene related peptide (CGRP) projections from the lPBN to the central nucleus of the amygdala (CeA). We demonstrated previously that CeA glutamate receptor signaling mediates cisplatin-induced anorexia and body weight loss. Here, we used neuroanatomical tracing, immunofluorescence, and confocal imaging to demonstrate that virtually all NTS→lPBN and lPBN→CeA CGRP projections coexpress vesicular glutamate transporter 2 (VGLUT2), providing evidence that excitatory projections mediate cisplatin-induced energy balance dysregulation. To test whether lPBN→CeA projection neurons are required for cisplatin-induced anorexia and weight loss, we inhibited these neurons chemogenetically using a retrograde Cre-recombinase-expressing canine adenovirus-2 in combination with Cre-dependent inhibitory Designer Receptors Exclusive Activated by Designer Drugs (DREADDs) before cisplatin treatment. Inhibition of lPBN→CeA neurons attenuated cisplatin-induced anorexia and body weight loss significantly. Using a similar approach, we additionally demonstrated that inhibition of NTS→lPBN neurons attenuated cisplatin-induced anorexia and body weight loss significantly. Together, our data support the view that excitatory hindbrain-forebrain projections are necessary for cisplatin's untoward effects on energy intake, elucidating a key neuroanatomical circuit driving pathological anorexia and weight loss that accompanies chemotherapy treatment.

  19. A new oxytocin-saporin cytotoxin for lesioning oxytocin-receptive neurons in the rat hindbrain.

    Science.gov (United States)

    Baskin, Denis G; Kim, Francis; Gelling, Richard W; Russell, Brian J; Schwartz, Michael W; Morton, Gregory J; Simhan, Hyagriv N; Moralejo, Daniel H; Blevins, James E

    2010-09-01

    Evidence suggests that release of oxytocin in the nucleus tractus solitarius (NTS) of the hindbrain from descending projections that originate in the paraventricular nucleus can inhibit food intake by amplifying the satiety response to cholecystokinin (CCK). To further evaluate this mechanism in rats, we used a novel cytotoxin, saporin conjugated to oxytocin (OXY-SAP), a compound designed to destroy cells that express oxytocin receptors (OXYr). OXY-SAP was injected directly into the NTS to lesion neurons that express OXYr and that are implicated in potentiating CCK's satiety effects. The control consisted of injection of saporin conjugated to a nonsense peptide. We found that OXY-SAP was cytotoxic to human uterine smooth muscle cells in vitro, demonstrating that OXY-SAP can lesion cells that express OXYr. Using laser capture microdissection and real-time quantitative PCR, we demonstrated that OXYr mRNA levels were reduced in the NTS after OXY-SAP administration. Moreover, we found that OXY-SAP attenuated the efficacy of CCK-8 to reduce food intake and blocked the actions of an OXYr antagonist to stimulate food intake. The findings suggest that OXY-SAP is an effective neurotoxin for in vivo elimination of cells that express OXYr and is potentially useful for studies to analyze central nervous system mechanisms that involve the action of oxytocin on food intake and other physiological processes.

  20. Pulmonary artery perfusion with cold modified Low- Potassium Dextran solution reduces lung injury in combined aortic and mitral valve replacement%双瓣置换术中肺动脉灌注低温改良LPD液的肺保护作用

    Institute of Scientific and Technical Information of China (English)

    马明星; 刘立明; 张伟; 廖晓波; 易定武; 彭清云

    2009-01-01

    目的 探讨双瓣置换术中,肺动脉灌注低温改良LPD液对肺损伤的保护作用.方法 24例需实施双瓣置换术的风心病患者,对照组14例和灌注组10例,灌注组常规完成手术+肺动脉灌注低温改良LPD液,对照组常规完成手术,未行肺动脉灌注.术前、停CPB时、停CPB后1、2、6、12 h六个时间点监测两组病例的氧合指数,术前、停CPB时、停CPB后6、12 h四个时间点检测血浆IL-6、IL-10的水平.结果 与对照组相比,灌注组术后氧合指数明显改善,IL-6表达降低,IL-10表达增加.结论 CPB中肺动脉灌注低温改良LPD液能减轻双瓣置换术后肺损伤,改善肺功能.%Objective This study was to evaluate the protective effect of pulmonary perfusion with cold modified low- potassium dextran (LPD) solution on lung function after cardiopulmonary bypass in combined aortic and mitral valve replacement. Method Twenty-four consecutive adult patients with combined aortic and mitral valve disease were divided into a control group ( n =14) and a perfused group ( n = 10). Cold modified LPD solution was infused to the main pulmonary artery in the protective group. PaO_2/FiO_2 were monitored at six different time points; preoperation, 0 hour, 1 hours, 2 hours, 6 hours and 12 hours after the termination of CPB. Concentrations of interleukin-6 and interleukin-10 in plasma were measured at four different time points; preoperation, 0 hour, 6 hours, and 12 hours after the termination of CPB. Result PaO_2/FiO_2 in the perfused group were increased more than that in the control group. The IL-6 and IL-10 increased in both groups after operations( P <0. 05). Patients of the perfused group showed significantly reduced IL-6 expression, compared with the control group ( P <0. 001), but the rising extents of IL-10 in the perfused group were higher than that in the control group ( P <0.001). Conclusion Pulmonary artery perfusion with cold modified LPD solution during cardiopulmonary bypass

  1. Zebrafish gbx1 refines the Midbrain-Hindbrain Boundary border and mediates the Wnt8 posteriorization signal

    Directory of Open Access Journals (Sweden)

    Ahrendt Reiner

    2009-04-01

    Full Text Available Abstract Background Studies in mouse, Xenopus and chicken have shown that Otx2 and Gbx2 expression domains are fundamental for positioning the midbrain-hindbrain boundary (MHB organizer. Of the two zebrafish gbx genes, gbx1 is a likely candidate to participate in this event because its early expression is similar to that reported for Gbx2 in other species. Zebrafish gbx2, on the other hand, acts relatively late at the MHB. To investigate the function of zebrafish gbx1 within the early neural plate, we used a combination of gain- and loss-of-function experiments. Results We found that ectopic gbx1 expression in the anterior neural plate reduces forebrain and midbrain, represses otx2 expression and repositions the MHB to a more anterior position at the new gbx1/otx2 border. In the case of gbx1 loss-of-function, the initially robust otx2 domain shifts slightly posterior at a given stage (70% epiboly, as does MHB marker expression. We further found that ectopic juxtaposition of otx2 and gbx1 leads to ectopic activation of MHB markers fgf8, pax2.1 and eng2. This indicates that, in zebrafish, an interaction between otx2 and gbx1 determines the site of MHB development. Our work also highlights a novel requirement for gbx1 in hindbrain development. Using cell-tracing experiments, gbx1 was found to cell-autonomously transform anterior neural tissue into posterior. Previous studies have shown that gbx1 is a target of Wnt8 graded activity in the early neural plate. Consistent with this, we show that gbx1 can partially restore hindbrain patterning in cases of Wnt8 loss-of-function. We propose that in addition to its role at the MHB, gbx1 acts at the transcriptional level to mediate Wnt8 posteriorizing signals that pattern the developing hindbrain. Conclusion Our results provide evidence that zebrafish gbx1 is involved in positioning the MHB in the early neural plate by refining the otx2 expression domain. In addition to its role in MHB formation, we have

  2. Improved perfusion quantification in FAIR imaging by offset correction

    DEFF Research Database (Denmark)

    Sidaros, Karam; Andersen, Irene K.; Gesmar, Henrik

    2001-01-01

    Perfusion quantification using pulsed arterial spin labeling has been shown to be sensitive to the RF pulse slice profiles. Therefore, in Flow-sensitive Alternating-Inversion Recovery (FAIR) imaging the slice selective (ss) inversion slab is usually three to four times thicker than the imaging...

  3. CT 灌注成像联合 CT 血管造影在颈内动脉系统短暂性脑缺血发作中的应用研究%The applied research of CT perfusion imaging combined with CT angiography in transient ischemic attack of internal carotid artery system

    Institute of Scientific and Technical Information of China (English)

    陈跃峰

    2015-01-01

    Objective To investigate the application value of CT perfusion imaging combined with CT angiography in tran‐sient ischemic attack of internal carotid artery system.Methods We recruited 63 cases with transient ischemic attack of internal carotid artery system ,who received examinations of head CT perfusion imaging and CT angiography within 7 days after symp‐tom onset using TOSHIBA 320 row helical CT. Then the CT perfusion parameters on both interest region and image area were comparatively analyzed ,as well as the consistency of two imaging examinations. Results Comparing the CT perfusion parame‐ters on interest and image area ,no significant difference was found (P> 0.05) ;however cerebral blood flow and the mean tran‐sit time of contrast agent on interest region were significantly lower than those on image area (P < 0.05) ;CT angiography found 54 cases with responsible vascular stenosis ,43 patients with the perfusion abnormalities ,9 cases with no responsible vas‐cular stenosis and 3 cases with no perfusion abnormalities. Compared with non‐responsible vascular stenosis patients ,CT per‐fusion abnormalities showed significantly higher positive rate in responsible vascular stenosis patients (P< 0.05).Conclusion CT perfusion can reflect cerebral perfusion condition in transient ischemic attack of internal carotid artery system ,and CT angi‐ography imaging can be used to detect vascular lesions ,additionally ,the combination of CT perfusion and CT angiography can display the etiology and provide imaging evidence for the diagnosis .%目的:探讨 CT 灌注成像联合 CT 血管造影在颈内动脉系统短暂性脑缺血发作中的应用价值。方法颈内动脉系统短暂性脑缺血发作患者63例,于症状发作后7 d 内采用东芝320排螺旋 CT 行头部 CT 灌注成像以及 CT 血管造影,观察并比较感兴趣区以及镜像区 CT 灌注成像各参数,以及两种影像学检查的符合情况。结果比

  4. CT perfusion: ready for prime time.

    Science.gov (United States)

    Ambrose, Marietta S; Valdiviezo, Carolina; Mehra, Vishal; Lardo, Albert C; Lima, Joao A C; George, Richard T

    2011-02-01

    Advancements in computed tomography (CT) technology have revolutionized clinical practice, particularly regarding the noninvasive assessment of coronary artery disease (CAD). The versatility of cardiac CT has rendered multiple applications including assessment of cardiac structure and function, myocardial viability, and coronary anatomy. The merits of cardiac computed tomography angiography (CTA) have been proven for the detection, and particularly the exclusion, of CAD. However, CTA becomes limited in the presence of significant CAD. Its inability to consistently identify lesion-associated ischemia may necessitate additional radionuclide myocardial perfusion imaging. Myocardial computed tomography perfusion imaging (CTP) has emerged as a useful and convenient method to immediately assess myocardial ischemia. In this review, we discuss the current state of CTP including available technology, its performance to date from current literature, and future challenges to this field.

  5. SPECT Myocardial Blood Flow Quantitation Concludes Equivocal Myocardial Perfusion SPECT Studies to Increase Diagnostic Benefits.

    Science.gov (United States)

    Chen, Lung-Ching; Lin, Chih-Yuan; Chen, Ing-Jou; Ku, Chi-Tai; Chen, Yen-Kung; Hsu, Bailing

    2016-01-01

    Recently, myocardial blood flow quantitation with dynamic SPECT/CT has been reported to enhance the detection of coronary artery disease in human. This advance has created important clinical applications to coronary artery disease diagnosis and management for areas where myocardial perfusion PET tracers are not available. We present 2 clinical cases that undergone a combined test of 1-day rest/dipyridamole-stress dynamic SPECT and ECG-gated myocardial perfusion SPECT scans using an integrated imaging protocol and demonstrate that flow parameters are capable to conclude equivocal myocardial perfusion SPECT studies, therefore increasing diagnostic benefits to add value in making clinical decisions.

  6. Study on the ultrasonic imaging characteristics of the twin reversed arterial perfusion sequence-hemiacardius%双胎反向动脉灌注序列征半心畸形的超声影像学研究

    Institute of Scientific and Technical Information of China (English)

    路小军; 杨小红; 陈欣林; 赵胜; 陈佩文; 杨帆; 戢秀勤

    2016-01-01

    Objective To explore the ultrasonic characteristics of the twin reversed arterial perfusion (TRAP) sequence-hemiacardius.Methods A retrospective analysis of the clinical data and ultrasonic characteristics of 9 cases with the TRAP was made,which were compared with the pathlogical result after delivery.Results The prenatal ultrasonic imaging characteristics showed:The vestigial heart's pulsating was seen in all the hemiacardius twin's thoracic cavity,and the Doppler spectrum in it went up and down.It was noted that the heart rate was slower in the better (multicavity) development of the heart and faster in the poor development (pipe type and single cavity) of the heart.Nine hemiacardius twin had hydroderma and cystic hygroma.The head,spine,abdominal organs (both kindenys and intestines) of all the 9 cases were hypogenetic.The diaphragm was present in 7 cases;lower limbs was present in 8 cases,single leg was seen in one case;upper limbs was present in 7 cases.Seven cases of the pump twin suffered from the cardiac insufficiency.Polyhydramnios were seen in 5 cases.Prognosis of the 9 cases of the TRAP pump twin:the cessation of blood flow spontaneous was seen in one case,the pump twin was survived and delivered at term.Eight cases were demise (2 cases with intrauterine demise,5 cases induced labor with cardiac insufficiency,1 case died from polyhydramnios after premature birth).Conclusions The pump twin of the TRAP hemiacardiacs have a poor prognosis with the nautural course,and are easy to suffer from the cardiac insufficiency in utero.The ultrasonography can diagnose the TRAP hemiacardius accurately,which can be used to guide the clinical doctors to choose a reasonable timing to take intrauterine treatment,that will effectively improve the survival rate of the pump twin.%目的 探讨双胎反向动脉灌注序列征(TRAP)半心畸形的超声影像学特征.方法 回顾性分析9例TRAP半心畸形的临床资料,观察双胎及其附属物的超声特点,并与

  7. 保留导管区域灌注在治疗重症脂源性胰腺炎中的应用%Continuous regional intra-artery perfusion in the treatment of severe lipid-induced acute pancreatitis

    Institute of Scientific and Technical Information of China (English)

    郑宇; 李志伟; 金舒; 李琼; 王元喜; 骆明建; 柯绍标; 张清

    2016-01-01

    Objective To investigate the effect of continuous regional artery perfusion (CRAI) on treating acute severe lipid-induced pancreatitis. Methods Forty-three patients with severe lipid-induced pancreatitis patients admitted to our hospital from January 2013 to May 2016 were assigned to two groups, CRAI group (n=23) and control group (n=20). The patients of CRAI group received conventional treatment combined with conventional treatment and controls were performed the conventional treatment protocol alone. The levels of white blood cell count, amylase, blood sugar, blood calcium were collected in two groups and compared between two groups. The abdominal pain relief time, serum amylase recovery time, the hospitalization stay and expenses, peripancreatic infection incidence of pancreatic pseudocyst were compared between two groups. Results In CRAI group, the levels of serum amylase, urinary amylase, blood glucose on the sixth day, the first ten days of recovery were faster back to normal than that in conventional group, so did the blood calcium recovery time. Abdominal pain relief time, hospitalization stay, incidence of infection, pancreatic pseudocyst, pancreatic drainage in CRAI group were decreased than in normal group. Two cases were dead in control group and there were no death in CRAI group. Conclusion In the present study, CRAI was demonstrated a good efficacy in the treatment of severe acute pancreatitis, selected as an alternative treatment plan in combination with treatment protocol.%目的:评价经供胰腺血管留置导管持续灌注疗法(CRAI)治疗重症脂源性胰腺炎的疗效。方法选择2013年1月至2016年5月期间纳入的43例患者重症脂源性胰腺炎患者,包括区域灌注组(23例)和常规治疗组(20例),分析对比白细胞计数﹑血清淀粉酶﹑尿淀粉酶﹑APACHE-Ⅱ、血糖值﹑血钙值变化情况;比较两组患者腹痛缓解时间﹑血清淀粉酶恢复时间﹑总住院天数,总治疗费用

  8. Shifting boundaries of retinoic acid activity control hindbrain segmental gene expression.

    Science.gov (United States)

    Sirbu, Ioan Ovidiu; Gresh, Lionel; Barra, Jacqueline; Duester, Gregg

    2005-06-01

    Retinoic acid (RA) generated by Raldh2 in paraxial mesoderm is required for specification of the posterior hindbrain, including restriction of Hoxb1 expression to presumptive rhombomere 4 (r4). Hoxb1 expression requires 3' and 5' RA response elements for widespread induction up to r4 and for r3/r5 repression, but RA has previously been detected only from r5-r8, and vHnf1 is required for repression of Hoxb1 posterior to r4 in zebrafish. We demonstrate in mouse embryos that an RA signal initially travels from the paraxial mesoderm to r3, forming a boundary next to the r2 expression domain of Cyp26a1 (which encodes an RA-degrading enzyme). After Hoxb1 induction, the RA boundary quickly shifts to r4/r5, coincident with induction of Cyp26c1 in r4. A functional role for Cyp26c1 in RA degradation was established through examination of RA-treated embryos. Analysis of Raldh2-/- and vHnf1-/- embryos supports a direct role for RA in Hoxb1 induction up to r4 and repression in r3/r5, as well as an indirect role for RA in Hoxb1 repression posterior to r4 via RA induction of vHnf1 up to the r4/r5 boundary. Our findings suggest that Raldh2 and Cyp26 generate shifting boundaries of RA activity, such that r3-r4 receives a short pulse of RA and r5-r8 receives a long pulse of RA. These two pulses of RA activity function to establish expression of Hoxb1 and vHnf1 on opposite sides of the r4/r5 boundary.

  9. Hypothenar hammer syndrome: Distal ulnar artery reconstruction with autologous inferior epigastric artery.

    Science.gov (United States)

    Smith, Hadley E; Dirks, Marco; Patterson, Robert B

    2004-12-01

    Digital artery embolization and ulnar artery thrombosis are consequences of repetitive trauma and can lead to digit loss and debility from ischemia and cold intolerance. We postulate that an arterial autograft is a theoretically superior conduit to traditional saphenous vein, and report reconstruction with inferior epigastric artery. Three adult male smokers, ages 39 to 49 years, had severe digital ischemia and cold-induced vasospasm. Arteriograms confirmed occlusion of the distal ulnar artery without direct perfusion of the superficial palmar arch, distal digital artery embolization, and normal proximal vasculature. All reconstructions were performed from the distal most patent ulnar artery at the wrist to the superficial palmar arch (1 patient) or sequentially to the involved common digital arteries (2 patients), with inferior epigastric artery. Handling characteristics and size match between the arterial autografts and bypassed arteries was excellent. Patency has been confirmed with duplex scanning at follow-up of 8 to 24 months, with resolution of cold intolerance and successful digital preservation.

  10. 经颅多普勒超声(TCD)在颈动脉支架成形术后脑过度灌注综合征中的应用%APPLICATION AND EVALUATION OF TCD IN PATIENTS WITH C-EREBRAL HYPER PERFUSION SYNDROME AFTER CAROTID ARTERY ANGIOPLASTY WITH STENTING

    Institute of Scientific and Technical Information of China (English)

    孟凡华; 孙志清; 刘运涌

    2015-01-01

    Objective To explore the mechanism of cerebral hyper perfusion syndrome (CHS) after ca‐rotid artery stenting (CAS) and to study the evaluation of TCD in patients with CHS after CAS .Methods The clinical data of 3 cases with CHS in 43 patients performed CAS were analyzed retrospectively .Results 2 cases of carotid artery stenosis was extremely severe stenosis (> 90% ) ,1 cases was severe stenosis (70% ~90% ) .2 patients had headaches and nausea;1 case had local neurologie impairment and the level of consciousness was drowsiness .Transcranial Doppler (TCD)showed that the peak of cerebral blood flow was increased≥100% in middle cerebral artery .Conclusion The patients with severe and extremely severe of carotid artery stenosis ,inadequate of collateral circulation (not open of anterior communicating artery and/or posterior communicating artery ) and the blood flow of middle cerebral artery increased ≥ 100% after CAS may lead to CHS after CAS .%目的:探讨颈动脉支架术后脑过度灌注综合征(cerebral hyper perfusion syndrome , CHS)的发生因素,并评估经颅多普勒超声(TCD)在颈动脉支架成形术后CHS中的作用。方法回顾分析了43例颈动脉支架成形术(CAS)后3例CHS的临床资料。结果狭窄程度:2例患者颈动脉狭窄为极重度狭窄(>90%),1例患者为重度狭窄(70%~90%)。临床症状:2例患者有头痛并伴有恶心;1例表现为意识反应水平下降呈嗜睡状,出现局造性神经功能障碍。 T CD监测:T CD证实为支架侧大脑中动脉的血流增加≥100%。结论颈动脉狭窄为重度狭窄(70%~90%)或极重度狭窄(>90%);侧枝循环代偿不好(前交通或前、后交通动脉不开放);术后1h T CD监测同侧大脑中动脉M 1段血流速度的变化为Ⅲ级增加(较基础值增加100%~150%)以上患者,术后发生CHS的可能性大。

  11. Value of 64-slice spiral CT perfusion imaging in estimating the efficacy of transcatheter arterial chemoembolization for the treatment of hepatocellular carcinoma%64排螺旋CT灌注成像在肝细胞癌介入治疗前后的评估价值

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    Objective To discuss the clinical value of 64-slice spiral CT perfusion imaging(CTPI) in estimating the efficacy of transcatheter arterial chemoembolization ( TACE ) for hepatocellular carcinoma (HCC).Methods Using 64-slice spiral CT(GE LightSpeed VCT XT),all CT plain scan and perfusion scan were performed in 30 patients with HCC 1-3 days before and 30-40 days after TACE .Using deconvolution through Infusion Software analysis , hepatic blood flow ( BF ) , blood volume ( BV ) , the mean transit time ( MTT) , hepatic arterial fraction ( HAF ) , permeability surface ( PS ) were caculated to evaluate HCC embolization hemodynamic status .Results After TACE,the tumor was totally filled with lipiodol in 12 cases and partially filled with lipiodol in 18 cases.BF,BV,MTT,HAF and PS perfusion maps showed that lack of blood perfusion was found in lipiodol-filling areas, but sparsely or insufficiently lipiodol-filled areas were hyperperfusion.BF,BV,HAF and PS of HCC after TACE were lower than those of HCC before TACE (P0.05 ) .Conclusions 64-slice spiral CT liver perfusion imaging can be used to monitor the blood supply changes in non -iodized oil deposits area non-invasively ,dynamically ,quantitatively ,which was very important in judging the tumor tissue survival and played an important role in response evaluation of HCC interventional therapy and guiding the follow -up treatment.%目的:探讨64排螺旋CT灌注成像(CTPI)在原发性肝细胞癌(HCC)肝动脉插管化疗栓塞( TACE )术前、后疗效的评估价值。方法选取30例HCC 患者,于TACE术前1~3 d、术后30~40 d应用GE LightSpeed VCT XT(64排128层螺旋CT)分别行全肝常规平扫及灌注扫描,运用灌注软件进行分析,计算肝血流量(BF)、血容量(BV)、平均通过时间(MTT)、肝动脉灌注指数(HAF)、毛细血管通透性( PS )等,统计分析相关参数,以评价 HCC 介入治疗前后的血流动力学状态。结果 TACE

  12. Evaluation of stenosis degree of the middle cerebral artery with high-resolution MRI and brian blood supply with MR perfusion weighted imaging%高分辨率MRI评价大脑中动脉狭窄程度与灌注加权成像评估脑供血的研究

    Institute of Scientific and Technical Information of China (English)

    崔恒; 程敬亮; 张勇

    2012-01-01

    Objective To study the value of high-resolution MRI(HRMRI) and MR perfusion weighted imaging(PWI) in evaluating the middle cerebral artery (MCA) stenosis degree and the brian blood supply. Methods PWI was performed in 30 patients with unilateral stenosis of MCA was diagnosed by HRMRI. The cerebral perfusion parameters including regional cerebral blood volume (rCBV) .regional cerebral blood flow(rCBF) .regional mean transit time(rMTT) and regional time to peak(rTTP) of the both cerebral hemispheres were quantitatively analysed. Results Among 30 patients, the MCA stenosis diagnosed by HRMRI as mild in 7, moderate in 9 and severe or acclusion in 14,respectively. Abnormal perfusion presented in all cases. The perfusion parameters (rCBF, rMTT and rTTP) had statistical significance. Between the rate of MCA moderate stenosis, severe stenosis or occlusion and the increase rate of rMTT showed a positive correlation(r=0. 897 and 0. 829 respectively,P<0. 01). Conclusion There is significantly value in evaluation of the MCA stenosis degree by HRMRI, which in combination with PWI to assess brain blood supply is of important value for clinic.%目的 探讨高分辨率MRI(high-resolution MRI,HRMRI)判定大脑中动脉(middle cerebral artery,MCA)狭窄程度与脑MRI灌注加权成像(perfusion weighted imaging,PWI)评价脑供血的价值.方法 对30例短暂性脑缺血(TIA)患者行HRMRI以判定单侧MCA狭窄程度,并行MRI PWI检查,得出患侧和镜像侧灌注参数,包括相对脑血容量(relative cerebral blood volume,rCBV)、相对脑血流量(relative cerebral blood flow,rBCF)、相对平均通过时间(relative mean transit time,rMTT)、相对达峰时间(relative time to peak,rTTP),并对其进行定量分析.结果 30例患者中,HRMRI判定MCA轻度狭窄7例,中度狭窄9例,重度狭窄或闭塞14例;30例灌注均出现异常,rCBF、rMTT、rTTP灌注参数均具有统计学意义,其中MCA中度、重度狭窄或闭塞组狭窄率与r

  13. Adiposity Is Associated with Gender-Specific Reductions in Left Ventricular Myocardial Perfusion during Dobutamine Stress.

    Directory of Open Access Journals (Sweden)

    Michael E Hall

    Full Text Available Obesity and visceral adiposity are increasingly recognized risk factors for cardiovascular disease. Visceral fat may reduce myocardial perfusion by impairing vascular endothelial function. Women experience more anginal symptoms compared to men despite less severe coronary artery stenosis, as assessed by angiography. Women and men have different fat storage patterns which may account for the observed differences in cardiovascular disease. Therefore, our objective was to evaluate the relationship between visceral adipose tissue distributions and myocardial perfusion in men and women.Visceral and subcutaneous fat distributions and myocardial perfusion were measured in 69 men and women without coronary artery disease using magnetic resonance imaging techniques. Myocardial perfusion index was quantified after first-pass perfusion with gadolinium contrast at peak dose dobutamine stress.We observed inverse relationships between female gender (r = -0.35, p = 0.003, pericardial fat (r = -0.36, p = 0.03, intraperitoneal fat (r = -0.37, p = 0.001, and retroperitoneal fat (r = -0.36, p = 0.002 and myocardial perfusion index. Visceral fat depots were not associated with reduced myocardial perfusion at peak dose dobutamine in men. However, in women, BMI (r = -0.33, p = 0.04, pericardial fat (r = -0.53, p = 0.02, subcutaneous fat (r = -0.39, p = 0.01 and intraperitoneal fat (r = -0.30, p = 0.05 were associated with reduced myocardial perfusion during dobutamine stress.Higher visceral fat volumes are associated with reduced left ventricular myocardial perfusion at peak dose dobutamine stress in women but not in men. These findings suggest that visceral fat may contribute to abnormal microcirculatory coronary artery perfusion syndromes, explaining why some women exhibit more anginal symptoms despite typically lower grade epicardial coronary artery stenoses than men.

  14. Magnetic resonance myocardial perfusion imaging-First experience at 3.0 T

    Energy Technology Data Exchange (ETDEWEB)

    Klumpp, B. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: bernhard.klumpp@med.uni-tuebingen.de; Hoevelborn, T. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Cardiology, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany)], E-mail: tobias.hoevelborn@gmx.de; Fenchel, M. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: michael.fenchel@med.uni-tuebingen.de; Stauder, N.I. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: norbert.stauder@stgag.ch; Kramer, U. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: ulrich.kramer@med.uni-tuebingen.de; May, A. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Cardiology, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany)], E-mail: andreas.may@med.uni-tuebingen.de; Gawaz, M.P. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Cardiology, Otfried-Mueller-Str. 10, 72076 Tuebingen (Germany)], E-mail: meinrad.gawaz@med.uni-tuebingen.de; Claussen, C.D. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: claus.claussen@med.uni-tuebingen.de; Miller, S. [Eberhard-Karls-University Tuebingen, University Hospital Tuebingen, Department of Diagnostic Radiology, Hoppe-Seyler-Str. 3, 72076 Tuebingen (Germany)], E-mail: stephan.miller@med.uni-tuebingen.de

    2009-01-15

    Objective: MR myocardial perfusion imaging (MRMPI) is an established technique for the evaluation of the hemodynamical relevance of coronary artery disease. Perfusion imaging at 3.0 T provides certain advantages compared to 1.5 T. Aim of this study was to evaluate myocardial MR perfusion imaging at 3.0 T. Materials and methods: Twelve patients with stable Angina pectoris and known or suspected coronary artery disease were examined at 3.0 T. Myocardial perfusion was assessed using a saturation recovery gradient echo 2D sequence (TR 1.9 ms, TE 1.0 ms, FA 12 deg.) with 0.05 mmol Gd-DTPA per kg body weight at stress during injection of 140 {mu}g adenosine/kg body weight/min and at rest in short axis orientation. Perfusion analysis was based on a least square fit of the signal/time curve (peak signal intensity, slope). Perfusion series were assessed by two independent observers. Reference for the presence of relevant coronary artery stenoses was invasive coronary angiography. Two experienced observers evaluated the coronary angiograms in biplane projections for the presence and grade of stenoses. Results were compared with the MR perfusion analysis. Results: All MR examinations could be safely performed and yielded high image quality. In eight patients stress-induced hypoperfusion was detected (stenosis >70% in coronary angiography). In four patients myocardial hypoperfusion was ruled out (stenosis <70%). The myocardial perfusion reserve index was significantly reduced in hypoperfused myocardium with 1.9 {+-} 1.6 compared to 2.5 {+-} 1.6 in regularly perfused myocardium (p < 0.05). In coronary angiography, eight patients were found to suffer from coronary artery disease, whereas in four patients coronary artery disease was ruled out. Conclusion: Our initial results show that MRMPI at 3.0 T provides reliably high-image quality and diagnostic accuracy.

  15. Precerebellar cell groups in the hindbrain of the mouse defined by retrograde tracing and correlated with cumulative Wnt1-cre genetic labeling.

    Science.gov (United States)

    Fu, Yuhong; Tvrdik, Petr; Makki, Nadja; Paxinos, George; Watson, Charles

    2011-09-01

    The precerebellar nuclei are hindbrain and spinal cord centers that send fibers to the cerebellum. The neurons of the major hindbrain precerebellar nuclei are derived from the rhombic lip. Wnt1, a developmentally important gene involved in intercellular signaling, is expressed in the developing rhombic lip. We sought to investigate the relationship between the cell clusters expressing Wnt1 and the precerebellar nuclei in the hindbrain. We therefore defined the hindbrain precerebellar nuclei by retrograde tracing, following cerebellar injections of HRP, and compared these results with the cell clusters expressing Wnt1 in newborn mice. We found that 39 distinct hindbrain nuclei project to the cerebellum. Of these nuclei, all but three (namely the oral pontine reticular nucleus, the caudal pontine reticular nucleus, and the subcoeruleus nucleus) contain neurons expressing Wnt1. This shows a high degree of overlap between the precerebellar nuclei and the nuclei that express Wnt1. However, it should be noted that neurons expressing Wnt1 are also found in the superior olivary complex, which is a basal plate derivative lacking cerebellar projections.

  16. Perfusion Magnetic Resonance Imaging: A Comprehensive Update on Principles and Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Jahng, Geon Ho [Dept. of Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul (Korea, Republic of); Li, Ka Loh [Wolfson Molecular Imaging Center, The University of Manchester, Manchester (United Kingdom); Ostergaard, Leif [Center for Functionally Integrative Neuroscience, Dept. of Neuroradiology, Aarhus University Hospital, Aarhus (Denmark); Calamante, Femando [Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria (Austria)

    2014-10-15

    Perfusion is a fundamental biological function that refers to the delivery of oxygen and nutrients to tissue by means of blood flow. Perfusion MRI is sensitive to microvasculature and has been applied in a wide variety of clinical applications, including the classification of tumors, identification of stroke regions, and characterization of other diseases. Perfusion MRI techniques are classified with or without using an exogenous contrast agent. Bolus methods, with injections of a contrast agent, provide better sensitivity with higher spatial resolution, and are therefore more widely used in clinical applications. However, arterial spin-labeling methods provide a unique opportunity to measure cerebral blood flow without requiring an exogenous contrast agent and have better accuracy for quantification. Importantly, MRI-based perfusion measurements are minimally invasive overall, and do not use any radiation and radioisotopes. In this review, we describe the principles and techniques of perfusion MRI. This review summarizes comprehensive updated knowledge on the physical principles and techniques of perfusion MRI.

  17. 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

    BACKGROUND AND PURPOSE: Both cerebral hypoperfusion and vascular risk factors have been implicated in early aging of the brain and the development of neurodegenerative disease. However, the current knowledge of the importance of cardiovascular health on resting brain perfusion is limited. The aim...... of the present study was to elucidate the relation between brain perfusion variability and risk factors of endothelial dysfunction and atherosclerosis in healthy aged subjects. METHODS: Thirty-eight healthy subjects aged 50-75 years old were included. Mean global brain perfusion was measured using magnetic...... resonance phase contrast mapping and regional brain perfusion by use of arterial spin labeling. RESULTS: Mean global brain perfusion was inversely correlated with caffeine and hematocrit, and positively with end-tidal PCO2. Furthermore, the mean global brain perfusion was inversely correlated...

  18. Isolated Pelvic Hyperthermochemotherapeutic Perfusion -An Experimental Study on Isolating Efficacy

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Hyperthermochemotherapeutic perfusion model through isolated pelvic vessels was developed to evaluate the leakage of hyperthermia and drugs (such as adriamycin) from the isolated pelvic circulation to systemic circulation and its associated side/toxic effects. The isolated pelvic circulation was perfused through a femoral artery catheter with hyperthermic (48 ℃ to 55 ℃) adriamycin solution (50 μg/ml) for 30 min. The efflux was drained through a femoral vein catheter. And the pelvic temperature was kept at the level of 43±0.5 ℃. The temperature of pelvic circulation was kept at 4 ℃ to 5 ℃ greater than the systemic/core temperature. The adriamycin concentration of pelvic efflux was 12 to 46 folds of that of systemic serum. The difference between them was very significant (P<0.001). As the perfusion pressure was increased, which kept lower than the mean systemic artery pressure, the leakage of the adriamycin from the isolated pelvic circulation to systemic circulation was increased, but there was no significant difference between them (P>0.05). During isolated perfusion, the systemic blood dynamics remained stable and there were no organic injuries on the important organs. It was suggested that the isolating efficacy of the modality of isolated pelvic hyperthermochemotherapeutic perfusion through vessels was rather high. The hyperthermia and drugs could be effectively limited in the isolated pelvic region with minor side effects on the systemic circulation and important organs.

  19. Effect of vibration on muscle perfusion: a systematic review.

    Science.gov (United States)

    Fuller, Joel T; Thomson, Rebecca L; Howe, Peter R C; Buckley, Jonathan D

    2013-01-01

    Vibration has become of increasing interest to health professionals, primarily owing to reports that vibration can increase tissue blood flow. The aim of this review was to investigate the available scientific evidence on the effects of exogenous vibration on skeletal muscle perfusion. The databases searched from inception to December 2010 included Ovid MEDLINE, EMBASE, CINAHL via EbscoHost and CENTRAL. Experimental and observational studies, where exogenous vibration was an intervention, were included in this review. The main outcomes of interest were muscle blood volume, blood flow, blood flow velocity, arterial diameter and muscle temperature. One reviewer selected studies for inclusion, extracted data and assessed the quality of the eligible studies. Percentage change in muscle perfusion outcome was the measure of treatment effect, and regression analysis was used to investigate associations between vibratory load and muscle perfusion. Twenty-two studies with a total of 302 participants were included in this review. Muscle blood volume increased with vibration in five of nine studies and decreased in two studies; muscle blood flow velocity increased with vibration in five of six studies; muscle blood flow increased with vibration in two of three studies; vibration had a positive effect on arterial diameter in three of three studies; vibration had no effect on muscle temperature in two of two studies. The magnitude of increase in muscle perfusion was positively associated with vibratory load (Pvibration increases muscle perfusion with the magnitude of increase positively related to the vibratory load applied.

  20. Whole-brain perfusion imaging and angiography performed with 256-slice CTin evaluation of cerebrovascular reserve capacity in unilateral carotid artery stenosis%256层CT全脑灌注成像联合CTA评估单侧颈动脉狭窄的脑血管储备能力的价值

    Institute of Scientific and Technical Information of China (English)

    唐健; 常军; 侯海燕; 姜旭栋; 堵红群; 姜建威

    2012-01-01

    Objective To assess the value of combination of whole-brain perfusion imaging and CTA in evaluating cerebrovascular reserve capacity in unilateral carotid artery stenosis. Methods Twenty-seven patients with unilateral carotid artery stenosis of ≥50% were divided into 2 groups according to CTA results: carotid moderate stenosis groupfcarotid stenosis of 50%-69%, group A) and carotid severe stenosis or occlusion group(carotid stenosis of ≥70% , group B). The relative cerebral blood volume(rCBV) , the relative cerebral blood folw(rCBF) , the difference in mean transit time(dMTT) and the difference in time to peak(dTTP) in bilateral temporal white matter and gray matter supplied by middle cerebral artery were measured and calculated. CTA was used to assess the configuration of the circle of Willis and if primary collaterals were patent. Differences in perfusion parameters between group A and group B, and between patients with patent primary collaterals or not were determined by using one way ANOVA test. Results There were statistical differences in rCBV, rCBF, dMTT and dTTP between two groups in white matter. Statistical difference of dMTT and dTTP was found between two groups in gray matter. There was significant increase in dTTP in the group B of the patients without patent primary collaterals. Conclusion Combined whole-brain perfusion imaging and CTA is a good way to evaluate cerebrovascular reserve capacity in unilateral carotid artery stenosis, and to provide a reliable method for choice of clinic treatments.%目的 探讨256层CT全脑灌注成像联合CTA评估单侧颈动脉狭窄的脑血管储备能力的价值.方法 单侧颈动脉狭窄≥50%的患者27例,根据CTA结果 按颈动脉狭窄程度划分为第一组中度狭窄组(血管阻塞50%~69%)和第二组重度狭窄或闭塞组(血管阻塞≥70%).测量并计算2组大脑中动脉供血区的白质和灰质的相对脑血容量(relative cerebral blood volume,r

  1. Effect of Coronary Artery Stenosis on the Transmural Extent of the Rest Myocardial Perfusion of Different Segments of Left Ventricular Wall Using 640 Slices CT%静息态下冠状动脉狭窄对左室壁透壁心肌灌注影响的640层CT研究

    Institute of Scientific and Technical Information of China (English)

    陈为军; 李丹; 孙永青; 卢明明; 全冠民; 车东东; 袁涛; 刘亚飞; 门肾力; 杨卓

    2012-01-01

    目的 确定静息态下透壁心肌灌注指数(TPR)的正常值,并探讨静息态下不同分支的冠状动脉狭窄与各冠状动脉分支的不同狭窄程度对左室壁不同节段TPR的影响.方法 274例患者行Toshiba 640层CT检查,包括冠状动脉CTA及左心室室壁CT灌注(CTP)检查.根据冠状动脉狭窄程度及17节段进行分组.计算正常组及不同冠状动脉狭窄程度组之间相应节段内TPR是否存在差异,以及冠状动脉狭窄程度与相应节段TPR的相关性.结果 前降支及左旋支病变对于左室壁心肌灌注影响较为明显,前降支狭窄主要影响中间段前壁(r=-0.288)、心尖段前壁(r=-0.263)及中间段间隔壁(r=-0.196),左旋支主要影响基底部前侧壁(r=-0.241)、基底部后侧壁(r=-0.279)及心尖段侧壁(r=-0.201),而右冠状动脉病变影响较小,主要影响中间段后壁(r=-0.195);冠状动脉中、重度狭窄组对于左室壁心肌灌注影响程度较大(P<0.05),轻度狭窄影响较小;左室前壁心肌灌注最易受到冠状动脉狭窄影响;在静息状态下前降支供血区域组、左旋支供血区域组及右冠状动脉供血区域组正常心肌和重度狭窄心肌平均TPR值分别为1.14±0.09和1.07±0.13、1.13±0.11和1.06±0.14、1.15±0.14和1.10±0.12.结论 不同冠状动脉分支狭窄分别可以影响不同节段的心肌透壁灌注;不同冠状动脉狭窄程度可以不同程度地影响心肌的TPR,二者具有相关性;静息状态下TPR正常值大于负荷状态下TPR.本研究提供了TPR静息态下的正常值.%Objective To evaluate the influence of different branches and degree of the coronary artery stenosis on the myocardial transmural perfusion ratio of different segments of left ventricular wall, and to discuss the normal myocardial transmural perfusion ratio(TPR) of each territory of left ventricular wall in the rest state. Methods CT images of 274 patients who received Toshiba 640 slices CT for CTA and CTP

  2. Patient satisfaction with coronary CT angiography, myocardial CT perfusion, myocardial perfusion MRI, SPECT myocardial perfusion imaging and conventional coronary angiography

    Energy Technology Data Exchange (ETDEWEB)

    Feger, S.; Rief, M.; Zimmermann, E.; Richter, F.; Roehle, R. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Dewey, M. [Freie Universitaet Berlin, Department of Radiology, Charite - Universitaetsmedizin Berlin Campus Mitte, Humboldt-Universitaet zu Berlin, Berlin (Germany); Institut fuer Radiologie, Berlin (Germany); Schoenenberger, E. [Medizinische Hochschule Hannover, Department of Medicine, Hannover (Germany)

    2015-07-15

    To evaluate patient acceptance of noninvasive imaging tests for detection of coronary artery disease (CAD), including single-photon emission computed tomography myocardial perfusion imaging (SPECT-MPI), stress perfusion magnetic resonance imaging (MRI), coronary CT angiography (CTA) in combination with CT myocardial stress perfusion (CTP), and conventional coronary angiography (CCA). Intraindividual comparison of perception of 48 patients from the CORE320 multicentre multinational study who underwent rest and stress SPECT-MPI with a technetium-based tracer, combined CTA and CTP (both with contrast agent, CTP with adenosine), MRI, and CCA. The analysis was performed by using a validated questionnaire. Patients had significantly more concern prior to CCA than before CTA/CTP (p < 0.001). CTA/CTP was also rated as more comfortable than SPECT-MPI (p = 0.001). Overall satisfaction with CT was superior to that of MRI (p = 0.007). More patients preferred CT (46 %; p < 0.001) as a future diagnostic test. Regarding combined CTA/CTP, CTP was characterised by higher pain levels and an increased frequency of angina pectoris during the examination (p < 0.001). Subgroup analysis showed a higher degree of pain during SPECT-MPI with adenosine stress compared to physical exercise (p = 0.016). All noninvasive cardiac imaging tests are well accepted by patients, with CT being the preferred examination. (orig.)

  3. Clinical investigation of large perfusion defect cases with {sup 201}Tl exercise myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Morota, Motoi; Kobayashi, Yasuhiko [Tokyo Medical Coll. (Japan)

    1999-02-01

    We investigated retrospectively the clinical significance of large perfusion defect on {sup 201}Thallium myocardial scintigraphy from the records of 833 patients during the past 3 years from 1991 to 1994. The patients were divided into 3 groups according to the extent of perfusion defect; cases with normal perfusion (n=561), with small perfusion defect (n=211) and with large perfusion defect (n=61). We found that the proportions of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in myocardial disease (MD; hypertrophic cardiomyopathy, dilated cardiomyopathy, and post myocarditis combined) (P<0.001). Analyzing patients with ischemic heart disease (IHD; angina pectoris and myocardial infarction) according to the severity of coronary artery lesion, the proportion of cases with large perfusion defect was significantly larger than that of cases with small perfusion defect in 3 vessel disease (P<0.001). Incidence of diabetes mellitus was significantly higher in patients with IHD than in those with MD in large perfusion defect group (P<0.01). As for symptoms in large perfusion defect group, the incidences of chest pain, chest oppression, and chest discomfort were significantly higher in patients with IHD than in those with MD (P<0.001), whereas the incidences of palpitation and shortness of breath were significantly higher in patients with MD (P<0.001). These results suggest that IHD with multiple artery lesions and MD underlie large perfusion defect on {sup 201}Thallium myocardial scintigraphy and that complication of diabetes mellitus and clinical symptoms may be useful in differentiating IHD from MD. (author)

  4. One-step Examination of Myocardial Perfusion Imaging Combined with Coronary Artery Calcium Score in Diagnosis of Coronary Artery Disease%心肌灌注显像联合冠状动脉钙化积分一站式检查对冠心病的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王建锋; 袁建伟; 王跃涛; 周瑞珏; 杨玲; 邵晓梁; 陆培奇

    2016-01-01

    Purpose The one-step examination of myocardial perfusion imaging (MPI) combined with coronary artery calcium score (CACS) can obtain both coronary functional information and anatomical information simultaneously, this paper aims to evaluate the value of the one-step examination of MPI combined with CACS for detecting coronary artery disease (CAD). Materials and Methods 188 cases who underwent one-step examination of MPI combined with CACS and invasive coronary angiography (ICA) because of chest tightness, chest pain with suspected coronary artery disease were analyzed retrospectively, with the results of ICA used as"gold standard", the diagnostic efficacy of MPI, CACS and one-step examination with combination of the two techniques for CAD was investigated. Results ①Pre-test probability of CAD was intermediate in 79.8%(150/188), and high in 20.2%(38/188) cases. Seventy-three cases were confirmed as CAD and 115 of 188 patients were negative according to ICA.②The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) for the diagnosis of CAD by MPI were 65.8%, 75.7%, 71.8%, 63.1%and 77.7%, respectively. ③ The CACS of CAD group was significantly higher than the non-CAD group (494.96±99.60 vs. 38.15±16.03, P0.05) and accuracy (75.0% vs. 71.8%, P>0.05) showed no statistically significant difference; the sensitivity of MPI combined with CACS were significantly higher than CACS (80.8%vs. 60.3%, P0.05). Conclusion The one-step examination of MPI combined with CACS can reduce coronary heart disease misdiagnosis, improve the diagnostic sensitivity of CAD compared with the MPI or CACS, with high application value for the diagnosis of CAD, especially in moderate risk groups.%目的:心肌灌注显像(MPI)联合冠状动脉钙化积分(CACS)一站式检查可同时获得冠状动脉功能信息和解剖信息,本研究探讨MPI联合CACS一站式检查对冠心病(CAD)的诊断价值。资料与方法回

  5. 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 ext

  6. Reactivity of the isolated perfused rat tail vascular bed

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    A.S. França

    1997-07-01

    Full Text Available Isolated segments of the perfused rat tail artery display a high basal tone when compared to other isolated arteries such as the mesenteric and are suitable for the assay of vasopressor agents. However, the perfusion of this artery in the entire tail has not yet been used for functional studies. The main purpose of the present study was to identify some aspects of the vascular reactivity of the rat tail vascular bed and validate this method to measure vascular reactivity. The tail severed from the body was perfused with Krebs solution containing different Ca2+ concentrations at different flow rates. Rats were anesthetized with sodium pentobarbital (65 mg/kg and heparinized (500 U. The tail artery was dissected near the tail insertion, cannulated and perfused with Krebs solution plus 30 µM EDTA at 36oC and 2.5 ml/min and the procedures were started after equilibration of the perfusion pressure. In the first group a dose-response curve to phenylephrine (PE (0.5, 1, 2 and 5 µg, bolus injection was obtained at different flow rates (1.5, 2.5 and 3.5 ml/min. The mean perfusion pressure increased with flow as well as PE vasopressor responses. In a second group the flow was changed (1.5, 2, 2.5, 3 and 3.5 ml/min at different Ca2+ concentrations (0.62, 1.25, 2.5 and 3.75 mM in the Krebs solution. Increasing Ca2+ concentrations did not alter the flow-pressure relationship. In the third group a similar protocol was performed but the rat tail vascular bed was perfused with Krebs solution containing PE (0.1 µg/ml. There was an enhancement of the effect of PE with increasing external Ca2+ and flow. PE vasopressor responses increased after endothelial damage with air and CHAPS, suggesting an endothelial modulation of the tone of the rat tail vascular bed. These experiments validate the perfusion of the rat tail vascular bed as a method to investigate vascular reactivity

  7. Clinical observation of femoral artery pressure perfusion of Shuxuetong injection on the treatment of phase Ⅱlower limb arteriosclerosis obliterans%疏血通注射液股动脉加压灌注治疗Ⅱ期下肢动脉硬化闭塞症60例临床观察

    Institute of Scientific and Technical Information of China (English)

    姜淑凤; 艾发元; 苗志勃; 王丽娟; 贾岩

    2012-01-01

    目的 观察疏血通注射液股动脉加压灌注对Ⅱ期下肢动脉硬化闭塞症的影响.方法 将120例Ⅱ期下肢动脉硬化闭塞症患者随机分为2组,治疗组60例采用疏血通注射液股动脉加压灌注治疗,对照组60例采用疏血通注射液静脉滴注治疗.2组均20d为1个疗程,共治疗1个疗程.观察2组治疗前后血液流变学指标及纤维蛋白原定量变化情况,检测患肢治疗前后血流束宽度及血流频谱峰值,统计临床疗效,评价安全性.结果 治疗组总有效率95.0%,对照组总有效率83.3%,2组总有效率比较差异有统计学意义(P<0.05),治疗组疗效优于对照组.2组治疗后血液流变学指标、纤维蛋白原定量、血流束宽度及血流频谱峰值与本组治疗前比较均明显改善(P<0.05,P<0.01),且治疗组全血黏度(低切)及血浆黏度,股浅动脉、足背动脉、胫后动脉的血流束宽度及股浅动脉、腘动脉、胫前动脉的血流频谱峰值改善均优于对照组(P<0.05).2组均无明显不良反应.结论 采用股动脉加压灌注疏血通注射液治疗Ⅱ期下肢动脉硬化闭塞症安全、有效,值得临床推广应用.%Objective To the effect of femoral artery pressure perfusion of Shuxuetong injection on the treatment of phase II lower limb arteriosclerosis obliterans. Methods 120 patients with phase II lower limb arteriosclerosis obliterate were randomly divided into two groups. 60 cases in treatment group were treated by femoral artery pressure perfusion of Shuxuetong injection. 60 cases in control group were treated by intravenous infusion of Shuxuetong injection. The therapeutic course was 20 days in two groups. The changes of hemorheology index and fibrinogen before and after treatment were observed in the two groups. Flow beam width and peak flow spectrum before and after treatment were detected. Results The total effective rate in treatment group (95.0% ) was superior to that in control group (83.3% , P<0

  8. 计算机断层扫描灌注成像对颈内动脉重度狭窄支架成形术的术前指导及术后评价%Preoperative Guidance and Postoperative Evaluation in Patients with Severe Stenosis of Internal Carotid Artery before and after Stent Placement using Computer Tomography Perfusion Imaging

    Institute of Scientific and Technical Information of China (English)

    温宏峰; 陈宇; 王培福; 李继来; 杜继臣; 任艳

    2011-01-01

    目的 探讨计算机断层扫描灌注成像(computer tomography perfusion,CTP)结合数字减影血管造影(digital subtraction angiography,DSA)对颈内动脉重度狭窄支架成形术的术前适应证选择及术后血流变化评价的作用.方法:40例经DSA检查提示单侧颈内动脉重度狭窄患者,按照DSA检查结果对缺血部位代偿良好的20例患者行保宁治疗,代偿不良的20例患者行狭窄部位支架成形术,行CTP检查,比较非手术组及手术组基线和术后1年的CT相对灌注参数,并比较手术组基线、术后7d、术后1年的手术侧和健侧的绝对灌注参数.结果:手术组基线相对脑血流量 (relative cerebral blood flow,PCBF)明显较非手术组降低,相对脑血容量(relative cerebral blood volume,rCBV)升高(P分别为0.018和0.015),两组相对平均通过时间(relative mean transit time,rMTT)无差异,1年后手术组rMTT较非手术组低(P=0,012),rCBF,rCB差异无统计学意义;与健侧相比,手术组术前患侧基线平均通过时间(mean transit time,MTT)延迟、脑血流量(cerebral blood flow,CBF)减低、脑血容量(cerebral blood volume,CBV)增高,术后7d患侧MTT缩短、CBF明显增加、CBV回落,术后1年MTT,、CBF、CBV患侧与健侧相比更加接近,两组比较尽管有统计学意义(P=0.015、0.012、0.037),但三个变量总体趋势逐渐接近;手术组术前、术后7d、术后1年,不同时间点患侧与健侧绝对灌注参数变化有统计学意义(P=0.001,0.009,0.028);支架成形与时间之间有交互作用(P=0.006,0.002,0.032).结论:CTP结合DSA对颈动脉狭窄的患者合理选择手术适应证有一定指导作用.颈动脉支架成形术(carotid artery scenting,CAS)可以改善患者的脑血流状况.%Objective To evaluate the computed tomography perfusion (CTP) imaging with digital subtraction angiography (DSA) in severe carotid artery stenosis before and after stenting and clinical evaluation of hemodynamic changes.Methods Forty cases

  9. CT Perfusion Characteristics Identify Metastatic Sites in Liver.

    Science.gov (United States)

    Wang, Yuan; Hobbs, Brian P; Ng, Chaan S

    2015-01-01

    Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT) perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF), blood volume (BV), mean transit time (MTT), permeability (PS), and hepatic arterial fraction (HAF), for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  10. CT Perfusion Characteristics Identify Metastatic Sites in Liver

    Directory of Open Access Journals (Sweden)

    Yuan Wang

    2015-01-01

    Full Text Available Tissue perfusion plays a critical role in oncology because growth and migration of cancerous cells require proliferation of new blood vessels through the process of tumor angiogenesis. Computed tomography (CT perfusion is an emerging functional imaging modality that measures tissue perfusion through dynamic CT scanning following intravenous administration of contrast medium. This noninvasive technique provides a quantitative basis for assessing tumor angiogenesis. CT perfusion has been utilized on a variety of organs including lung, prostate, liver, and brain, with promising results in cancer diagnosis, disease prognostication, prediction, and treatment monitoring. In this paper, we focus on assessing the extent to which CT perfusion characteristics can be used to discriminate liver metastases from neuroendocrine tumors from normal liver tissues. The neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow (BF, blood volume (BV, mean transit time (MTT, permeability (PS, and hepatic arterial fraction (HAF, for tumor and normal liver. The result reveals the potential of CT perfusion as a tool for constructing biomarkers from features of the hepatic vasculature for guiding cancer detection, prognostication, and treatment selection.

  11. An investigation of an autonomic innervation of the vertebral artery using monoamine histofluorescence

    Directory of Open Access Journals (Sweden)

    JA Mitchell

    2009-06-01

    Full Text Available Blood flow to the hindbrain, via the paired vertebral arteries, must be uncompromised for adequate neurological functioning of its vital centres. Therefore, it would seem unlikely that the intracranial vertebral artery would need to vasoconstrict, thus reducing its blood flow. In order to investigate the existence and location of a noradrenaline-mediated constrictor mechanism in the wall of the intracranial vertebral artery, transverse sections of ten baboon and ten monkey vessels were stained with sucrose-potassium phosphate-glyoxylic acid (counterstained with malachite-green. This method allows the visualisation of catecholaminergic nerves when the sections are exposed to ultraviolet light. In this study of primate vascular tissue, however, none of the monkey or baboon vertebral artery sections showed the presence of noradrenergic nerves in the tunica media – tunica adventitia junction or penetrating the tunica media of the arteries. These findings indicate that the intracranial vertebral artery does not have a neurogenic vasomotor function in primates.

  12. Evidence for the Presence of Glucosensor Mechanisms Not Dependent on Glucokinase in Hypothalamus and Hindbrain of Rainbow Trout (Oncorhynchus mykiss.

    Directory of Open Access Journals (Sweden)

    Cristina Otero-Rodiño

    Full Text Available We hypothesize that glucosensor mechanisms other than that mediated by glucokinase (GK operate in hypothalamus and hindbrain of the carnivorous fish species rainbow trout and stress affected them. Therefore, we evaluated in these areas changes in parameters which could be related to putative glucosensor mechanisms based on liver X receptor (LXR, mitochondrial activity, sweet taste receptor, and sodium/glucose co-transporter 1 (SGLT-1 6 h after intraperitoneal injection of 5 mL x Kg(-1 of saline solution alone (normoglycaemic treatment or containing insulin (hypoglycaemic treatment, 4 mg bovine insulin x Kg(-1 body mass, or D-glucose (hyperglycaemic treatment, 500 mg x Kg(-1 body mass. Half of tanks were kept at a 10 Kg fish mass x m(-3 and denoted as fish under normal stocking density (NSD whereas the remaining tanks were kept at a stressful high stocking density (70 kg fish mass x m(-3 denoted as HSD. The results obtained in non-stressed rainbow trout provide evidence, for the first time in fish, that manipulation of glucose levels induce changes in parameters which could be related to putative glucosensor systems based on LXR, mitochondrial activity and sweet taste receptor in hypothalamus, and a system based on SGLT-1 in hindbrain. Stress altered the response of parameters related to these systems to changes in glycaemia.

  13. Novel oxytocin gene expression in the hindbrain is induced by alcohol exposure: transgenic zebrafish enable visualization of sensitive neurons.

    Directory of Open Access Journals (Sweden)

    Caitrín M Coffey

    Full Text Available BACKGROUND: Fetal Alcohol Spectrum Disorders (FASD are a collection of disorders resulting from fetal ethanol exposure, which causes a wide range of physical, neurological and behavioral deficits including heightened susceptibility for alcoholism and addictive disorders. While a number of mechanisms have been proposed for how ethanol exposure disrupts brain development, with selective groups of neurons undergoing reduced proliferation, dysfunction and death, the induction of a new neurotransmitter phenotype by ethanol exposure has not yet been reported. PRINCIPAL FINDINGS: The effects of embryonic and larval ethanol exposure on brain development were visually monitored using transgenic zebrafish expressing cell-specific green fluorescent protein (GFP marker genes. Specific subsets of GFP-expressing neurons were highly sensitive to ethanol exposure, but only during defined developmental windows. In the med12 mutant, which affects the Mediator co-activator complex component Med12, exposure to lower concentrations of ethanol was sufficient to reduce GFP expression in transgenic embryos. In transgenic embryos and larva containing GFP driven by an oxytocin-like (oxtl promoter, ethanol exposure dramatically up-regulated GFP expression in a small group of hindbrain neurons, while having no effect on expression in the neuroendocrine preoptic area. CONCLUSIONS: Alcohol exposure during limited embryonic periods impedes the development of specific, identifiable groups of neurons, and the med12 mutation sensitizes these neurons to the deleterious effects of ethanol. In contrast, ethanol exposure induces oxtl expression in the hindbrain, a finding with profound implications for understanding alcoholism and other addictive disorders.

  14. The Order and Place of Neuronal Differentiation Establish the Topography of Sensory Projections and the Entry Points within the Hindbrain.

    Science.gov (United States)

    Zecca, Andrea; Dyballa, Sylvia; Voltes, Adria; Bradley, Roger; Pujades, Cristina

    2015-05-13

    Establishing topographical maps of the external world is an important but still poorly understood feature of the vertebrate sensory system. To study the selective innervation of hindbrain regions by sensory afferents in the zebrafish embryo, we mapped the fine-grained topographical representation of sensory projections at the central level by specific photoconversion of sensory neurons. Sensory ganglia located anteriorly project more medially than do ganglia located posteriorly, and this relates to the order of sensory ganglion differentiation. By single-plane illumination microscopy (SPIM) in vivo imaging, we show that (1) the sequence of arrival of cranial ganglion inputs predicts the topography of central projections, and (2) delaminated neuroblasts differentiate in close contact with the neural tube, and they never loose contact with the neural ectoderm. Afferent entrance points are established by plasma membrane interactions between primary differentiated peripheral sensory neurons and neural tube border cells with the cooperation of neural crest cells. These first contacts remain during ensuing morphological growth to establish pioneer axons. Neural crest cells and repulsive slit1/robo2 signals then guide axons from later-differentiating neurons toward the neural tube. Thus, this study proposes a new model by which the topographical representation of cranial sensory ganglia is established by entrance order, with the entry points determined by cell contact between the sensory ganglion cell bodies and the hindbrain.

  15. Selective cerebro-myocardial perfusion in complex congenital aortic arch pathology: a novel technique.

    Science.gov (United States)

    De Rita, Fabrizio; Lucchese, Gianluca; Barozzi, Luca; Menon, Tiziano; Faggian, Giuseppe; Mazzucco, Alessandro; Luciani, Giovanni Battista

    2011-11-01

    Simultaneous cerebro-myocardial perfusion has been described in neonatal and infant arch surgery, suggesting a reduction in cardiac morbidity. Here reported is a novel technique for selective cerebral perfusion combined with controlled and independent myocardial perfusion during surgery for complex or recurrent aortic arch lesions. From April 2008 to April 2011, 10 patients with arch pathology underwent surgery (two hypoplastic left heart syndrome [HLHS], four recurrent arch obstruction, two aortic arch hypoplasia + ventricular septal defect [VSD], one single ventricle + transposition of the great arteries + arch hypoplasia, one interrupted aortic arch type B + VSD). Median age was 63 days (6 days-36 years) and median weight 4.0 kg (1.6-52). Via midline sternotomy, an arterial cannula (6 or 8 Fr for infants) was directly inserted into the innominate artery or through a polytetrafluoroethylene (PTFE) graft (for neonates cerebro-myocardial perfusion was 39 ± 18 min (17-69). Weaning from cardiopulmonary bypass was achieved without inotropic support in three and with low dose in seven patients. One patient required veno-arterial extracorporeal membrane oxygenation. Four patients, body weight cerebro-myocardial perfusion is feasible in patients with complex or recurrent aortic arch disease, starting from premature newborn less than 2.0 kg of body weight to adults. The technique is as safe as previously reported methods of cerebro-myocardial perfusion and possibly more versatile.

  16. Clinical study on the effect of continuous pulmonary artery perfusion with wxygenated warm blood containing L-arginine on lung injury during cardiopulmonary bypass%含L-精氨酸氧合温血肺动脉持续灌注对肺组织的保护作用

    Institute of Scientific and Technical Information of China (English)

    兰智新; 木拉提·瓦克力; 宋爱玲; 谷冰; 于鹏; 马革萍; 李培

    2010-01-01

    Objective To evaluate the protective effect on lung by using continuous pulmonary artery perfusion with oxygenated blood and L-arginine during cardiopulmonary bypass(CPB).Methods Forty five cases received mitral valve replacement were randomly divided into 3 groups and each group involved 15 cases. Group I(control group), patients received routine procedure of CPB. Proup Ⅱ, patients received rcontinuous pulmonary artery perfusion with oxygenated blood. Group Ⅲ,continuous pulmonary artery perfusion with oxygenated blood containing L-arginine (200 mg/kg) (n=15). All cases received routine procedure of CPB and continuously infused from the root of pulmonary artery until releasing aortaoaic clamp. Blood samples were collected from the radial artery respectively at the following time points:after the induction of anaesthesia, 1 hour after opening of aorta, 0, 6, 12, 24 hours after patients being taken back to ICU. ELISA test was used to detected the expression of tmmor necrosis factor-α(TNF-α), interleukin-6 (IL-6) and interleukin-10 (IL-10). Lung tissue samples (1.0 cm ×1.0 cm×1.0 cm) were obtained from right lower lobe. The pathologicl changes of lung tissues were observed under light mi-croscope by using HE staining. Results at each time points, the expression of TNF-α, IL-6 in group Ⅱ and group Ⅲ weresignificantly lower than that in group Ⅰ (P<0.05). The level of TNF-α, IL-6 in group Ⅲ were lower than in group Ⅱ(P<0.05). However, the expression of IL-10 in group Ⅱ and group Ⅲ were higher than in group Ⅰ, and the level of IL-10 in group Ⅲ were higher than that in group Ⅱ(P<0.05). In the group Ⅰ: HE staining showed marked pulmonary interstitial edema, intra-alveolus neutrophilic granulocyte exudation with karyorrhexis. In the group Ⅱ, light capillary vessel hyperaemia and pulmonary interstitial lymphocyte exudation were detected. Nearly normal lung tissue were observed in group Ⅲ. Conclusion Continuous pulmonary artery perfusion

  17. Intraoperative blood oxygenation continuous pulmonary artery perfusion lung protection of ventricular septal defect combined children with pulmonary hypertension%术中氧合血持续肺动脉灌注对室间隔缺损合并肺动脉高压患儿的肺保护作用

    Institute of Scientific and Technical Information of China (English)

    章晔; 李春玲; 胡建明; 林庆; 陈艰

    2014-01-01

    目的:研究在体外循环手术中使用氧合血进行持续肺动脉灌注对合并肺动脉高压的室间隔缺损患儿的肺保护作用。方法30例室间隔缺损合并肺动脉高压的患儿,随机均分为试验组和对照组。均在体外循环下进行室间隔缺损修补手术。试验组在体外循环中采用氧合血持续肺动脉灌注,对照组未行肺动脉灌注。两组患儿在体外循环前,主动脉开放后6、12、24h时抽取动脉血3ml.采用酶联免疫吸附法(ELISA法)检测丙二醛(MDA)的水平。并抽取动脉血进行血气分析,计算体外循环前,主动脉开放后6、12、24h时的氧合指数(QI),并记录气道峰压和呼吸机辅助时间,进行统计分析。结果试验组术后12、24h的 QI高于对照组(P<0.05),试验组术后6、12h的气道峰压明显低于对照组(P<0.05)。试验组术后呼吸机辅助时间明显低于对照组(P<0.05)。试验组术后6、12、24h时MDA水平均低于对照组(P<0.05)。结论氧合血持续肺动脉灌注能减轻室间隔缺损合并肺动脉高压患儿在体外循环中的肺损伤。%Objective To study the effects of blood oxygenation in extracorporeal circulation operation on continuous pul-monary artery perfusion of merger pulmonary hypertension of ventricular septal defect with pulmonary protection. Methods 30 cases of ventricular septal defect combined pulmonary hypertension were randomly divided into experimental group and control group,15 cases in each group. Both ventricular septal defect repair surgery under extracorporeal circulation. Patients with blood oxygenation in extracorporeal circulation continuous pulmonary artery perfusion, the control group no pulmonary artery perfusion. Two groups of children in front of the extracorporeal circulation, aorta open after 6,12 and 24 h when extracting arterial blood 3 ml. By using enzyme-linked immunosorbent (ELISA) to detect malondialdehyde (MDA

  18. Role of Perfusion CT Differentiating Hemangiomas from Malignant Hepatic Lesions

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    Jagjeet Singh

    2014-01-01

    Full Text Available Objective: The purpose of the study was to determine the role of computed tomography (CT perfusion in differentiating hemangiomas from malignant hepatic lesions. Materials and Methods: This study was approved by the institutional review board. All the patients provided informed consent. CT perfusion was performed with 64 multidetector CT (MDCT scanner on 45 patients including 27 cases of metastasis, 9 cases of hepatocellular carcinoma (HCC, and 9 cases of hemangiomas. A 14 cm span of the liver was covered during the perfusion study. Data was analyzed to calculate blood flow (BF, blood volume (BV, permeability surface area product (PS, mean transit time (MTT, hepatic arterial fraction (HAF, and induced residue fraction time of onset (IRFTO. CT perfusion parameters at the periphery of lesions and background liver parenchyma were compared. Results: Significant changes were observed in the perfusion parameters at the periphery of different lesions. Of all the perfusion parameters BF, HAF, and IRFTO showed most significant changes. In our study we found: BF of more than 400 ml/100 g/min at the periphery of the hemangiomas showed sensitivity of 88.9%, specificity of 83.3%, positive predictive value (PPV of 57.1%, and negative predictive value (NPV of 96.7% in differentiating hemangiomas from hepatic malignancy; HAF of more than 60% at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3% and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy; IRFTO of more than 3 s at the periphery of hemangiomas showed sensitivity of 77.8%, specificity of 86.1%, PPV of 58.3%, and NPV of 93.9% in differentiating hemangiomas from hepatic malignancy. Conclusion: Perfusion CT is a helpful tool in differentiating hemangiomas from hepatic malignancy by its ability to determine changes in perfusion parameters of the lesions.

  19. Quantitative assessment of harmonic power doppler myocardial perfusion imaging with intravenous levovist™ in patients with myocardial infarction: comparison with myocardial viability evaluated by coronary flow reserve and coronary flow pattern of infarct-related artery

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    Nagai Kunihiko

    2005-08-01

    Full Text Available Abstract Background Myocardial contrast echocardiography and coronary flow velocity pattern with a rapid diastolic deceleration time after percutaneous coronary intervention has been reported to be useful in assessing microvascular damage in patients with acute myocardial infarction. Aim To evaluate myocardial contrast echocardiography with harmonic power Doppler imaging, coronary flow velocity reserve and coronary artery flow pattern in predicting functional recovery by using transthoracic echocardiography. Methods Thirty patients with anterior acute myocardial infarction underwent myocardial contrast echocardiography at rest and during hyperemia and were quantitatively analyzed by the peak color pixel intensity ratio of the risk area to the control area (PIR. Coronary flow pattern was measured using transthoracic echocardiography in the distal portion of left anterior descending artery within 24 hours after recanalization and we assessed deceleration time of diastolic flow velocity. Coronary flow velocity reserve was calculated two weeks after acute myocardial infarction. Left ventricular end-diastolic volumes and ejection fraction by angiography were computed. Results Pts were divided into 2 groups according to the deceleration time of coronary artery flow pattern (Group A; 20 pts with deceleration time ≧ 600 msec, Group B; 10 pts with deceleration time Conclusion The preserved microvasculature detecting by myocardial contrast echocardiography and coronary flow velocity reserve is related to functional recovery after acute myocardial infarction.

  20. Isolated Left Pulmonary Artery Agenesis: A Case Report

    Directory of Open Access Journals (Sweden)

    Tansel Ansal Balcı

    2012-08-01

    Full Text Available Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung with normal ventilation was visualized on scintigraphy. MDCT angiography of pulmonary arteries showed absent left main pulmonary artery with systemic collaterals around left hemithorax. Pulmonary artery agenesis can be asymptomatic and isolated until adulthood. Both scintigraphy and CT angiography images of pulmonary artery agenesis of a patient are rare in the literature. Pulmonary ventilation- perfusion scintigraphy can be used not only for pulmonary embolism but also pathologies involving pulmonary artery and its branches. (MIRT 2012;21:80-83

  1. Aneurysm of the posterior meningeal artery embedded within a dorsal exophytic medullary hemangioblastoma: surgical management and review of literature.

    Science.gov (United States)

    Raygor, Kunal P; Rowland, Nathan C; Cooke, Daniel L; Solomon, David A; Huang, Michael C

    2014-09-01

    Hemangioblastomas are World Health Organization (WHO) Grade I neoplasms of the hindbrain and spinal cord, whose management can be complicated by preoperative hemorrhage. We report on a case of a young female in extremis with posterior fossa hemorrhage following rupture of a fusiform posterior meningeal artery aneurysm embedded within a medullary hemangioblastoma. We discuss management options, including operative staging and embolization, and review similar cases of hemangioblastoma associated with aneurysm.

  2. Cintilografia do miocárdio com tecnécio 99m-MIBI e administração de adenosina em portadores de doença arterial coronária: correlação dos resultados com a angiografia coronária e o ultra-som intracoronário Adenosine myocardial perfusion SPECT with Tc-99m-MIBI in patients with obstructive coronary artery disease: correlation between quantitative coronary angiography and intravascular ultrasound measurements

    Directory of Open Access Journals (Sweden)

    Luiz Eduardo Mastrocolla

    2006-01-01

    Full Text Available OBJETIVO: Estabelecer a correlação da cintilografia de perfusão do miocárdio (CPM com Tecnécio 99m-MIBI (MIBI e injeção de adenosina, empregando a angiografia coronária quantitativa (ACQ e o ultra-som intracoronário (UIC como comparação. MÉTODOS: Estudo de 70 pacientes com doença arterial coronária (DAC, encaminhados à CPM com MIBI e adenosina. As manifestações clínicas, do eletrocardiograma (ECG e os resultados das imagens foram correlacionadas às variáveis da análise visual e quantitativa da angiografia, bem como ao UIC. RESULTADOS: A média de idades foi de 60,6 anos, com 39 pacientes do sexo masculino. A angiografia coronária evidenciou estenose do diâmetro da luz (E% de 49,94% em 105 artérias, com reavaliação à ACQ em 83 artérias (79% e média de 44,20%, pOBJECTIVE: To correlate myocardial perfusion scintigraphy (MPS with Tc-99m-MIBI and adenosine infusion using quantitative coronary angiography (QCA and intravascular ultrasound (IVUS. METHODS: Seventy patients with coronary artery disease (CAD referred for myocardial perfusion scintigraphy (MPS with MIBI and adenosine were studied. Clinical, electrocardiographic (ECG, and scintigraphic findings were correlated with variables of visual and quantitative angiographic analysis, as well as to those of IVUS. RESULTS: The mean age of patients was 60.6 years, and 39 were male. Coronary angiography showed percentage of diameter stenosis (% DS of 49.94% in 105 arteries, 83 of which were re-evaluated by QCA (79%, mean of 44.20%, p<0.05. ST-segment depression during adenosine infusion was associated with higher degrees of % DS (55.0% vs. 47.8%, p<0.05. Scintigraphic ischemia was correlated with greater cross-sectional area of lumen obstruction by IVUS (% CSA. Clinical, ECG, and IVUS findings were considered together and expressed as global ischemic versus non-ischemic responses. Ischemia was associated with lower values of minimal lumen diameter (MLD and minimal lumen area

  3. Quantitative and qualitative analysis and interpretation of CT perfusion imaging.

    Science.gov (United States)

    Valdiviezo, Carolina; Ambrose, Marietta; Mehra, Vishal; Lardo, Albert C; Lima, Joao A C; George, Richard T

    2010-12-01

    Coronary artery disease (CAD) remains the leading cause of death in the United States. Rest and stress myocardial perfusion imaging has an important role in the non-invasive risk stratification of patients with CAD. However, diagnostic accuracies have been limited, which has led to the development of several myocardial perfusion imaging techniques. Among them, myocardial computed tomography perfusion imaging (CTP) is especially interesting as it has the unique capability of providing anatomic- as well as coronary stenosis-related functional data when combined with computed tomography angiography (CTA). The primary aim of this article is to review the qualitative, semi-quantitative, and quantitative analysis approaches to CTP imaging. In doing so, we will describe the image data required for each analysis and discuss the advantages and disadvantages of each approach.

  4. Influence of Thin Slice Reconstruction on CT Brain Perfusion Analysis.

    Directory of Open Access Journals (Sweden)

    Edwin Bennink

    Full Text Available Although CT scanners generally allow dynamic acquisition of thin slices (1 mm, thick slice (≥5 mm reconstruction is commonly used for stroke imaging to reduce data, processing time, and noise level. Thin slice CT perfusion (CTP reconstruction may suffer less from partial volume effects, and thus yield more accurate quantitative results with increased resolution. Before thin slice protocols are to be introduced clinically, it needs to be ensured that this does not affect overall CTP constancy. We studied the influence of thin slice reconstruction on average perfusion values by comparing it with standard thick slice reconstruction.From 50 patient studies, absolute and relative hemisphere averaged estimates of cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT, and permeability-surface area product (PS were analyzed using 0.8, 2.4, 4.8, and 9.6 mm slice reconstructions. Specifically, the influence of Gaussian and bilateral filtering, the arterial input function (AIF, and motion correction on the perfusion values was investigated.Bilateral filtering gave noise levels comparable to isotropic Gaussian filtering, with less partial volume effects. Absolute CBF, CBV and PS were 22%, 14% and 46% lower with 0.8 mm than with 4.8 mm slices. If the AIF and motion correction were based on thin slices prior to reconstruction of thicker slices, these differences reduced to 3%, 4% and 3%. The effect of slice thickness on relative values was very small.This study shows that thin slice reconstruction for CTP with unaltered acquisition protocol gives relative perfusion values without clinically relevant bias. It does however affect absolute perfusion values, of which CBF and CBV are most sensitive. Partial volume effects in large arteries and veins lead to overestimation of these values. The effects of reconstruction slice thickness should be taken into account when absolute perfusion values are used for clinical decision making.

  5. CT hepatic perfusion measurement: Comparison of three analytic methods

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Yoshikawa, Takeshi, E-mail: yoshikawa0816@aol.com [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan); Ohno, Yoshiharu; Kanata, Naoki; Koyama, Hisanobu; Takenaka, Daisuke; Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017 (Japan)

    2012-09-15

    Objectives: To compare the efficacy of three analytic methods, maximum slope (MS), dual-input single-compartment model (CM) and deconvolution (DC), for CT measurements of hepatic perfusion and assess the effects of extra-hepatic systemic factors. Materials and methods: Eighty-eight patients who were suspected of having metastatic liver tumors underwent hepatic CT perfusion. The scans were performed at the hepatic hilum 7–77 s after administration of contrast material. Hepatic arterial and portal perfusions (HAP and HPP, ml/min/100 ml) and arterial perfusion fraction (APF, %) were calculated with the three methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors such as age, sex, risk of cardiovascular diseases, arrival time of contrast material at abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction. Results: Mean HAP of MS was significantly higher than DC. HPP of CM was significantly higher than MS and CM, and HPP of MS was significantly higher than DC. There was no significant difference in APF. HAP and APF showed significant and moderate correlations among the methods. HPP showed significant and moderate correlations between CM and DC, and poor correlation between MS and CM or DC. All methods showed weak correlations between HAP or APF and age or sex. Finally, MS showed weak correlations between HAP or HPP and arrival time or cardiovascular risks. Conclusions: Hepatic perfusion values arrived at with the three methods are not interchangeable. CM and DC are less susceptible to extra-hepatic systemic factors.

  6. Nkx2.2 and Nkx2.9 are the key regulators to determine cell fate of branchial and visceral motor neurons in caudal hindbrain.

    Science.gov (United States)

    Jarrar, Wassan; Dias, Jose M; Ericson, Johan; Arnold, Hans-Henning; Holz, Andreas

    2015-01-01

    Cranial motor nerves in vertebrates are comprised of the three principal subtypes of branchial, visceral, and somatic motor neurons, which develop in typical patterns along the anteroposterior and dorsoventral axes of hindbrain. Here we demonstrate that the formation of branchial and visceral motor neurons critically depends on the transcription factors Nkx2.2 and Nkx2.9, which together determine the cell fate of neuronal progenitor cells. Disruption of both genes in mouse embryos results in complete loss of the vagal and spinal accessory motor nerves, and partial loss of the facial and glossopharyngeal motor nerves, while the purely somatic hypoglossal and abducens motor nerves are not diminished. Cell lineage analysis in a genetically marked mouse line reveals that alterations of cranial nerves in Nkx2.2; Nkx2.9 double-deficient mouse embryos result from changes of cell fate in neuronal progenitor cells. As a consequence progenitors of branchiovisceral motor neurons in the ventral p3 domain of hindbrain are transformed to somatic motor neurons, which use ventral exit points to send axon trajectories to their targets. Cell fate transformation is limited to the caudal hindbrain, as the trigeminal nerve is not affected in double-mutant embryos suggesting that Nkx2.2 and Nkx2.9 proteins play no role in the development of branchiovisceral motor neurons in hindbrain rostral to rhombomere 4.

  7. 三维动脉自旋标记脑血流灌注加权成像在交叉性小脑神经机能联系不能的应用价值%Application of three-dimensional arterial spin labeling cerebral blood flow perfusion imaging in crossed cerebellar diaschisis

    Institute of Scientific and Technical Information of China (English)

    黄泽春; 汪文胜; 成丽娜; 谢甜甜; 李松涛; 欧阳兵; 颜刘清; 陈楷哲

    2015-01-01

    Objective To evaluate the use of three-dimensional arterial spin labeling perfusion weighted imaging (3D ASL) in the diagnosis of crossed cerebellar diaschisis (CCD) role by observing the whole brain perfusion of cerebral blood flow,. and to investigate the relationship between the primary brain lesions with CCD. Methods Tha data of 58 cases with supratentorial lesions associated with unilateral middle cerebral artery blood supply combined with contralateral cerebellar hemisphere hypoperfusion were collected..The cerebral blood flow of bilateral cerebellar hemisphere cerebellar was measured using 3D ASL and the asymmetry index (AI) was calculated. CCD was diagnosed if the AI was greater than 10%..The correlations between supratentorial lesion and CCD was analyzed..Results In 58 cases with unilateral supratentorial lesions supplied by middle cerebral artery resulted in contralateral hypoperfusion in infratentorial cerebellar hemisphere, especially in the lower part of cerebellar hemisphere. 55 of the unilateral supratentorial lesions were cerebral infarction, 3 were brain injury. All the supratentorial lesions involved the white matter along the cortex-pons-cerebellar tract..The lower CBF valued in the supratentorial brain tissue and the lower CBF valued in the contralateral cerebellar hemisphere,.which showed a positive correlation..There was no correlation between the occurrence of CCD and the size of low perfusion in supratentorial brain tissue..ASL was done twice in 4 patients and 3 times in 2 patients,.and there was no obvious changes of the CBF in the cerebellum CCD lesion hemisphere..CCD occurred during 1 day and 1 years 2 months after the disease..The occurrence of CCD was related to the location of supratentorial cerebral lesions and not related to the time of onset and duration..Conclusion As a new perfusion method,.3D ASL,.is capable of noninvasive evaluating the occurrence of CCD,.which has a good diagnostic value and can quantitatively assess the degree

  8. Modelling Brain Temperature and Perfusion for Cerebral Cooling

    Science.gov (United States)

    Blowers, Stephen; Valluri, Prashant; Marshall, Ian; Andrews, Peter; Harris, Bridget; Thrippleton, Michael

    2015-11-01

    Brain temperature relies heavily on two aspects: i) blood perfusion and porous heat transport through tissue and ii) blood flow and heat transfer through embedded arterial and venous vasculature. Moreover brain temperature cannot be measured directly unless highly invasive surgical procedures are used. A 3D two-phase fluid-porous model for mapping flow and temperature in brain is presented with arterial and venous vessels extracted from MRI scans. Heat generation through metabolism is also included. The model is robust and reveals flow and temperature maps in unprecedented 3D detail. However, the Karmen-Kozeny parameters of the porous (tissue) phase need to be optimised for expected perfusion profiles. In order to optimise the K-K parameters a reduced order two-phase model is developed where 1D vessels are created with a tree generation algorithm embedded inside a 3D porous domain. Results reveal that blood perfusion is a strong function of the porosity distribution in the tissue. We present a qualitative comparison between the simulated perfusion maps and those obtained clinically. We also present results studying the effect of scalp cooling on core brain temperature and preliminary results agree with those observed clinically.

  9. Dynamic CT head phantom for perfusion and angiography studies

    Science.gov (United States)

    Russell, K.; Blazeski, A.; Dannecker, K.; Lee, Q. Y.; Holscher, C.; Donahue, C.; van Kampen, W.

    2010-03-01

    Contrast imaging is a compelling enhancement for the portable, flat panel-based brain CT scanner currently under development at Xoran. Due to the relative low temporal resolution of flat panel detectors, enabling tomographic imaging on such platform requires optimizing the imaging and injection protocols. A dynamic CT head phantom was designed to facilitate this task. The Dynamic Perfusion and Angiography Model (PAM), mimics tissue attenuation in CT images, provides physiological timing for angiography and perfusion studies, and moves fluid with properties similar to those of blood. The design consists of an arterial system, which contains bifurcating vessels that feed into perfusion chambers, mimicking blood flow through capillaries and smaller vessels, and a venous system, which is symmetrical to the arterial side and drains the perfusion chambers. The variation of geometry and flow rate in the phantom provides the physiological total time that fluid spends in the head, and the difference in material densities correlates to CT numbers for biological tissues. This paper discusses the design of Dynamic PAM and shows experimental results demonstrating its ability to realistically simulate blood flow. Results of dynamic imaging studies of the phantom are also presented.

  10. 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....

  11. A panel data set on harvest and perfusion decellularization of porcine rectus abdominis

    Directory of Open Access Journals (Sweden)

    Jian Zhang

    2016-06-01

    Full Text Available In this dataset, we particularly depicted the harvest and perfusion decellularization of porcine rectus abdominis (RA, accompanied with displaying of the retained vascular trees within the perfusion-decellularized skeletal muscle matrix (pM-ECM using vascular corrosion casting. In addition, several important tips for successful pM-ECM preparation were emphasized, which including using anatomically isolated skeletal muscle as tissue source with all main feeding and draining vessels perfused, preserving the internal microcirculation availability, aseptic technique and pyrogen free in all steps, sequential perfusion via artery or vein, and longtime washing after decellularization. The data are supplemental to our original research article describing detailed associations of pM-ECM as a clinically relevant scale, three-dimensional scaffold with a vascular network template for tissue-specific regeneration, “Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template” Zhang et al. (2016 [1].

  12. Novel Dynamics Observed in a Spiking Neural Network Model of the NTS in the Rat Hind-brain

    Science.gov (United States)

    Zhou, Jingyi; Schaffer, J. David; Dilorenzo, Patricia; Laramee, Craig

    2012-02-01

    The Nucleus of the Solitary Tract (NTS) is a hind-brain structure in the rat that is the first way-station in taste processing. Its structure and function are poorly understood. Recently our group produced a model, implemented as a spiking neural network (SNN), that successfully replicated experimental data. The model's topology was manually devised and the parameters were set by a genetic algorithm. In order to better understand its information processing capabilities, we probed the model with a variety of input spike patterns and observed a striking winner-take-all decision-making dynamic. We show how the topology and tuned parameters enable this decision to depend on precise spike timing events. It is curious that the experimental data upon which the model was originally evolved did not include winner-take-all examples; this was an emergent capability. It remains for additional experiments on rats to confirm or reject this model prediction.

  13. Ultrasound perfusion analysis combining bolus-tracking and burst-replenishment.

    Science.gov (United States)

    Jirik, Radovan; Nylund, Kim; Gilja, Odd H; Mezl, Martin; Harabis, Vratislav; Kolar, Radim; Standara, Michal; Taxt, Torfinn

    2013-02-01

    A new signal model and processing method for quantitative ultrasound perfusion analysis is presented, called bolus-and-burst. The method has the potential to provide absolute values of blood flow, blood volume, and mean transit time. Furthermore, it provides an estimate of the local arterial input function which characterizes the arterial tree, allowing accurate estimation of the bolus arrival time. The method combines two approaches to ultrasound perfusion analysis: bolus-tracking and burst-replenishment. A pharmacokinetic model based on the concept of arterial input functions and tissue residue functions is used to model both the bolus and replenishment parts of the recording. The pharmacokinetic model is fitted to the data using blind deconvolution. A preliminary assessment of the new perfusion-analysis method is presented on clinical recordings.

  14. Volumetric analysis of syringomyelia following hindbrain decompression for Chiari malformation Type I: syringomyelia resolution follows exponential kinetics

    Science.gov (United States)

    Coumans, Jean-Valery; Walcott, Brian P.; Butler, William E.; Nahed, Brian V.; Kahle, Kristopher T.

    2013-01-01

    Object Resolution of syringomyelia is common following hindbrain decompression for Chiari malformation, yet little is known about the kinetics governing this process. The authors sought to establish the volumetric rate of syringomyelia resolution. Methods A retrospective cohort of patients undergoing hindbrain decompression for a Chiari malformation Type I with preoperative cervical or thoracic syringomyelia was identified. Patients were included in the study if they had at least 3 neuroimaging studies that detailed the entirety of their preoperative syringomyelia over a minimum of 6 months postoperatively. The authors reconstructed the MR images in 3 dimensions and calculated the volume of the syringomyelia. They plotted the syringomyelia volume over time and constructed regression models using the method of least squares. The Akaike information criterion and Bayesian information criterion were used to calculate the relative goodness of fit. The coefficients of determination R2 (unadjusted and adjusted) were calculated to describe the proportion of variability in each individual data set accounted for by the statistical model. Results Two patients were identified as meeting inclusion criteria. Plots of the least-squares best fit were identified as 4.01459e−0.0180804x and 13.2556e−0.00615859x. Decay of the syringomyelia followed an exponential model in both patients (R2 = 0.989582 and 0.948864). Conclusions Three-dimensional analysis of syringomyelia resolution over time enables the kinetics to be estimated. This technique is yet to be validated in a large cohort. Because syringomyelia is the final common pathway for a number of different pathological processes, it is possible that this exponential only applies to syringomyelia related to treatment of Chiari malformation Type I. PMID:21882909

  15. Establishment of a Swine Model for Validation of Perfusion Measurement by Dynamic Contrast-Enhanced Magnetic Resonance Imaging

    Directory of Open Access Journals (Sweden)

    Anika Sauerbrey

    2014-01-01

    Full Text Available The aim of the study was to develop a suitable animal model for validating dynamic contrast-enhanced magnetic resonance imaging perfusion measurements. A total of 8 pigs were investigated by DCE-MRI. Perfusion was determined on the hind leg musculature. An ultrasound flow probe placed around the femoral artery provided flow measurements independent of MRI and served as the standard of reference. Images were acquired on a 1.5 T MRI scanner using a 3D T1-weighted gradient-echo sequence. An arterial catheter for local injection was implanted in the femoral artery. Continuous injection of adenosine for vasodilation resulted in steady blood flow levels up to four times the baseline level. In this way, three different stable perfusion levels were induced and measured. A central venous catheter was used for injection of two different types of contrast media. A low-molecular weight contrast medium and a blood pool contrast medium were used. A total of 6 perfusion measurements were performed with a time interval of about 20–25 min without significant differences in the arterial input functions. In conclusion the accuracy of DCE-MRI-based perfusion measurement can be validated by comparison of the integrated perfusion signal of the hind leg musculature with the blood flow values measured with the ultrasound flow probe around the femoral artery.

  16. Evaluating acellular versus cellular perfusate composition during prolonged ex vivo lung perfusion after initial cold ischaemia for 24 hours.

    Science.gov (United States)

    Becker, Simon; Steinmeyer, Jasmin; Avsar, Murat; Höffler, Klaus; Salman, Jawad; Haverich, Axel; Warnecke, Gregor; Ochs, Matthias; Schnapper, Anke

    2016-01-01

    Normothermic ex vivo lung perfusion (EVLP) has developed as a powerful technique to evaluate particularly marginal donor lungs prior to transplantation. In this study, acellular and cellular perfusate compositions were compared in an identical experimental setting as no consensus has been reached on a preferred technique yet. Porcine lungs underwent EVLP for 12 h on the basis of an acellular or a cellular perfusate composition after 24 h of cold ischaemia as defined organ stress. During perfusion, haemodynamic and respiratory parameters were monitored. After EVLP, the lung condition was assessed by light and transmission electron microscopy. Aerodynamic parameters did not show significant differences between groups and remained within the in vivo range during EVLP. Mean oxygenation indices were 491 ± 39 in the acellular group and 513 ± 53 in the cellular group. Groups only differed significantly in terms of higher pulmonary artery pressure and vascular resistance in the cellular group. Lung histology and ultrastructure were largely well preserved after prolonged EVLP and showed only minor structural alterations which were similarly present in both groups. Prolonged acellular and cellular EVLP for 12 h are both feasible with lungs prechallenged by ischaemic organ stress. Physiological and ultrastructural analysis showed no superiority of either acellular or cellular perfusate composition.

  17. 直肠上动脉亚甲蓝灌注法增加直肠癌淋巴结获检数%Perfusion with methylene blue via superior rectal artery can increase detected number of lymph node in rectal cancer specimen

    Institute of Scientific and Technical Information of China (English)

    毛方术; 顾晓辉; 字灿忠; 曹加兴

    2013-01-01

    目的 探讨经直肠上动脉灌注亚甲蓝对直肠癌行全直肠系膜切除术(TME)后标本淋巴结获检数的临床意义.方法 将按照TME原则进行直肠癌根治术的40例直肠癌患者的切除标本,按随机数字表法分为对照组和亚甲蓝组,每组20例.术后立即于标本肠系膜上动脉灌注亚甲蓝,获取标本淋巴结数目,并进一步探讨所获检淋巴结的阳性率.结果 常规组经传统触摸法获检淋巴结为(13.9±3.4)枚/例,亚甲蓝组获检淋巴结为(22.5±4.0)枚/例,两组淋巴结获检数差异显著(P<0.05);亚甲蓝组检出阳性淋巴结获检(2.9±1.8)枚/例,常规组获检(1.3±1.2)枚/例,两组淋巴结获检数差异显著(P<0.05).结论 经直肠上动脉灌注亚甲蓝是一种简单、安全、经济的方法,能够提高直肠癌患者术后标本淋巴结的获检数目,提供更准确的临床分期.%Objective To evaluate the clinical significance of methylene blue perfusion through the superior rectal artery to the improvement of lymph node harvest in rectal cancer specimen after total mesorectal excision( TME ). Methods Forty patients with rectal carcinoma received the radical resection according to the TME principle. Their excision specimens were randomly divided into control group (n=20)and methylene blue group( n = 20 ). After the operation, methylene blue was injected into the superior mesenteric artery of the specimen immediately. The numbers of the lymph node in the specimens were obtained,and the positive lymph nodes were counted. Results The number of lymph node obtained by the conventional touching method was 13.9 ±3.4 per case in the control group and was 22.5 ±4.0 per case in the methylene blue group( P <0.05 ). The positive lymph node number was 2.9 ±1.8 per case in the methylene blue group and was 1.3 ±1.2 per case in the control group( P < 0. 05 ). Conclusion Methylene blue perfusion via superior rectal artery is a simple, safe, and economical method,which is

  18. 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...

  19. Glycopyrrolate abolishes the exercise-induced increase in cerebral perfusion in humans

    DEFF Research Database (Denmark)

    Seifert, Thomas; Fisher, James P; Young, Colin N;

    2010-01-01

    Brain blood vessels contain muscarinic receptors that are important for cerebral blood flow (CBF) regulation, but whether a cholinergic receptor mechanism is involved in the exercise-induced increase in cerebral perfusion or affects cerebral metabolism remains unknown. We evaluated CBF and cerebral...... metabolism (from arterial and internal jugular venous O(2), glucose and lactate differences), as well as the middle cerebral artery mean blood velocity (MCA V(mean); transcranial Doppler ultrasound) during a sustained static handgrip contraction at 40% of maximal voluntary contraction (n = 9) and the MCA V...... abolished by glycopyrrolate (P perfusion without affecting the cerebral metabolic rate for oxygen....

  20. Hepatic blood perfusion estimated by dynamic contrast-enhanced computed tomography in pigs

    DEFF Research Database (Denmark)

    Winterdahl, Michael; Sørensen, Michael; Keiding, Inger Susanne;

    2012-01-01

    The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates.......The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates....

  1. Flicker stimulated retinal perfusion changes assessed with high-speed Doppler tomography

    Science.gov (United States)

    Schmoll, Tilman; Singh, Amardeep S. G.; Frily, Karine; Blatter, Cedric; Villiger, Martin; Pache, Christoph; Lasser, Theo; Leitgeb, R. A.

    2010-02-01

    We developed a high speed Doppler tomography system together with flow extraction algorithms that provide a flexible tool to assess retinal perfusion. The aim of the present study is to stimulate perfusion by flickering with light of adjustable color and to measure changes depending on light frequency and flicker location. We observed relative changes in arterial flow velocity during flicker stimulation up to 50%. We found in arteries close to the optic nerve head the highest flicker response at a frequency of 8Hz. We believe that a multimodal functional imaging concept is of high value for an accurate and early diagnosis and understanding of retinal pathologies and pathogenesis.

  2. Noninvasive Measurement of Perfusion in Rabbit VX2 Tumors Using Flow sensitive Alternting Inversing Recovery with an Extra Radiofrequency Pulse

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ Introduction:MR arterial spin-labeling technique is useful to measure tissue perfusion. The purpose of this study was to evaluate the feasibility of using a novel arterial spin-labeling technique to characterize regions of hyper and hypovascularity in experimental tumors in rabbits.

  3. Perfusion Pressure Cerebral Infarct (PPCI) trial

    DEFF Research Database (Denmark)

    Vedel, Anne G.; Holmgaard, Frederik; Rasmussen, Lars Simon

    2016-01-01

    to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During cardiopulmonary bypass, blood pressure can be below the lower limit of cerebral autoregulation. Although much debated, the constant blood flow provided...... by the cardiopulmonary bypass system is still considered by many as appropriate to avoid cerebral ischaemia despite the low blood pressure. Methods/design: The Perfusion Pressure Cerebral Infarct trial is a single-centre superiority trial with a blinded outcome assessment. The trial is randomising 210 patients...... with coronary vessel and/or valve disease and who are undergoing cardiac surgery with the use of cardiopulmonary bypass. Patients are stratified by age and surgical procedure and are randomised 1:1 to either an increased mean arterial pressure (70–80 mmHg) or ‘usual practice’ (40–50 mmHg) during cardiopulmonary...

  4. Accuracy and precision of pseudo-continuous arterial spin labeling perfusion during baseline and hypercapnia: a head-to-head comparison with ¹⁵O H₂O positron emission tomography.

    Science.gov (United States)

    Heijtel, D F R; Mutsaerts, H J M M; Bakker, E; Schober, P; Stevens, M F; Petersen, E T; van Berckel, B N M; Majoie, C B L M; Booij, J; van Osch, M J P; Vanbavel, E; Boellaard, R; Lammertsma, A A; Nederveen, A J

    2014-05-15

    Measurements of the cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) provide useful information about cerebrovascular condition and regional metabolism. Pseudo-continuous arterial spin labeling (pCASL) is a promising non-invasive MRI technique to quantitatively measure the CBF, whereas additional hypercapnic pCASL measurements are currently showing great promise to quantitatively assess the CVR. However, the introduction of pCASL at a larger scale awaits further evaluation of the exact accuracy and precision compared to the gold standard. (15)O H₂O positron emission tomography (PET) is currently regarded as the most accurate and precise method to quantitatively measure both CBF and CVR, though it is one of the more invasive methods as well. In this study we therefore assessed the accuracy and precision of quantitative pCASL-based CBF and CVR measurements by performing a head-to-head comparison with (15)O H₂O PET, based on quantitative CBF measurements during baseline and hypercapnia. We demonstrate that pCASL CBF imaging is accurate during both baseline and hypercapnia with respect to (15)O H₂O PET with a comparable precision. These results pave the way for quantitative usage of pCASL MRI in both clinical and research settings.

  5. Evaluation of 99m Tc-MIBI myocardial perfusion imaging with intravenous infusion of adenosine triphosphate in diagnosis of coronary artery disease%静脉注射三磷酸腺苷99mTc-MIBI心肌灌注显像诊断冠心病的评价

    Institute of Scientific and Technical Information of China (English)

    何青; 姚稚明; 于雪; 屈婉莹; 孙福成; 季福绥; 许锋; 钱贻简

    2002-01-01

    目的评价三磷酸腺苷(ATP)药物负荷99mTc-MIBI 心肌灌注断层显像在诊断冠心病中的可行性、安全性和特异性.方法共263例临床诊断为冠心病的病人.所有病人都行ATP负荷的99mTc-MIBI心肌灌注显像(0.16 mg/kg/min, 5 min)检查. 在静脉注射ATP 3分钟时静脉注射20 mCi的99mTc-MIBI, 60分钟后行心肌断层显像.再于48小时后静脉注射99mTc-MIBI 20 mCi, 行静息心肌灌注断层显像.51例病人在2周内行冠状动脉造影以评价ATP介入心肌灌注断层显像诊断冠心病的准确性.在静脉注射ATP的过程中仔细地观察心脏的和非心脏的反应.结果所有病人都完成整个ATP负荷试验.尽管有58.9% 的病人有不同类型的副作用发生,但其程度都不严重.无任何病人需要氨茶碱.最为严重的副作用是II度II型房室传导阻滞(4/263 ),但其持续时间均短暂.ATP介入心肌灌注断层显像诊断冠心病的敏感性和特异性分别为97.1%和82.4%.结论对于不能完成运动试验的病人,ATP负荷心肌灌注断层显像是安全、可行的诊断冠心病的影像学技术.%Objective To evaluate the feasibility, safety and diagnostic accuracy of pharmacologic stress of 99m Technetium-MIBI single-photon emission computed tomography (SPECT) with intravenous adenosine triphosphate (ATP) in patients with suspected coronary artery disease.Methods The study group included 263 patients who were suspected of having coronary artery disease. All patients underwent 99m Tc-MIBI myocardial perfusion imaging with ATP infusion (0.16 mg/kg body weight per min for 5 min). 20 mCi of 99m Tc-MIBI were injected 3 minutes after the start of ATP infusion. Myocardial SPECT images were obtained 60 minutes later. Then, two days later, 20 mCi of 99m Tc-MIBI were administered at rest and myocardial SPECT was repeated. 51 patients also underwent coronary angiography within two weeks for evaluation of sensitivity and specificity of ATP-myocardial perfusion

  6. A new surgical technique for perfusion of the epididymal fat pad in situ in rats.

    Science.gov (United States)

    Dauchy, Robert T; Blask, David E; Sauer, Leonard A

    2003-05-01

    We developed a new surgical technique for preparing the epididymal fat pad in rats for perfusion that maintains continuous blood flow. Epididymal fat pads can be perfused in situ using donor blood from either fed or fasted (24 h) animals. During the course of all perfusions, arterial and venous blood pH and gases were monitored and recorded. Total fatty acid (TFA) uptake and release by the epididymal fat depot was measured for the control and treatment perfusions; glycerol release was measured in all control perfusions. After addition of 14C-glucose to the donor-blood perfusate, all radioactivity appeared in the fat pad effluent blood; none appeared in the host systemic blood, and this finding indicated that the epididymal fat pad was separated from the host vasculature during perfusion in situ. The results presented here demonstrate excellent tissue function and metabolism, as a result of the perfusion technique. Our new surgical method for in vivo investigation of the epididymal fat pad, an important white adipose tissue, likely will have many applications in the study of lipid transport and metabolism, hyperlipidemia, obesity, and cancer cachexia.

  7. Transient hyperperfusion after extracranial-intracranial bypass surgery on brain perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yu Kyeong; Oh, Chang Wan; Cho, Sang Soo; Lee, Eun Ju; Eo, Jae Seon; Lee, Won Woo; Kim, Sang Eun [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2005-07-01

    We designed this study to investigate the transient relative hyperperfusion and its clinical implication after STA (superficial temporal artery) to MCA (middle cerebral artery) bypass surgery in patients with ischemic cerebral stroke. In 25 patients, comprising of 11 moyamoya disease (MMD) and 14 atherosclerotic disease (ASD), STA-MCA anastomosis was performed to distal cortical branches of middle cerebral artery for revascularization. 99mTc-ECD brain perfusion SPECT was performed before, 3 days and then 10 days after bypass surgery. Each image was spatially normalized into the standard space and changes of brain perfusion in the entire internal carotid artery (ICA) territory were evaluated using standardized ROIs. In the overall analysis including all patients, the surgery effectively increased ICA territory perfusion on the 3rd and 10th day after bypass surgery in comparison with the preoperative one (p<0.01 and p=0.03). The 3rd day perfusion was significantly higher than the 10th day one (p<0.01), demonstrating transient relative hyperperfusion on the 3rd day compared with the 10th day. In MMD group, such transient increase of perfusion was most severe in the vicinity of the anastomosis site, and more definite than the ASD group. Three patients, 2 ASD and one MMD, showed temporary neurological deterioration (dysphasia or dysarthria) beginning within 3 days after surgery and resolving completely within 2 weeks after onset, without hemorrhage, infarction or other serious defects on CT scan. Their neurological changes correlated well with the focal perfusion changes confirmed by SPECT images on the 3rd and 10th postoperative day. Transient relative hyperperfusion was observed on postoperative 3rd day compared with the 10th day following STA-MCA bypass surgery. In some patients, such transient increase of focal perfusion seems to provoke temporary neurological deterioration.

  8. 基于CT灌注成像的颅内外动脉旁路移植术在治疗缺血性脑血管病中的应用%Extracranial-intracranial Arterial Bypass based on Cerebral CT Perfusion Imaging for Ischemic Cerebrovascular Disease

    Institute of Scientific and Technical Information of China (English)

    段鸿洲; 李良; 邱建星; 张扬; 伊志强; 张家湧; 鲍圣德

    2013-01-01

    Objective To evaluate cerebral CT perfusion imaging in guiding and assessing extracranial-intracranial (EC-IC) arterial bypass ( STA-MCA bypass) for ischemic cerebrovascular diseases. Methods Forty-three patients with atherosclerotic carotid artery occlusion, middle cerebral artery occlusion or severe stenosis were enrolled into this study. DSA and cerebral CT perfusion scan were carried out preoperatively, and regions of interest ( ROI) were selected to measure and assess relative cerebral blood flow (rCBF) , relative cerebral blood volume (rCBV) , relative mean transient time (rMTT) , and relative time to peak (rTTP). Based on the parameters and clinical features, patients with indications received STA-MCA bypass accordingly. DSA and cerebral CT perfusion scan were repeated after the procedure to determine postoperative rCBF, rCBV, rMTT, and rTTP. All the patients were followed up and their neurological deficit before and after the operation were evaluated with the National Institute of Health Stroke Scale (NIHSS). Results STA-MCA bypass was completed successfully in all the patients, postoperative angiography showed that the anastomotie orifice in 42 of the patients (97. 7% ) were patent, and their NIHSS scale decreased after the operation ( 1 week, 3 months and 12 months vs. preoperation: 3. 30 ±0. 89 , 2. 88 ±0. 96 and 2. 34 ± 1. 02 vs. 3.67 ± 1.02; t =2.634, P= 0.012,t =5.373, P= 0.000, and t = 7. 342, P = 0. 000, respectively). No relative ipsilateral stroke occurred during follow-up. Preoperative CT perfusion showed that the symptomatic hemisphere had significantly lower rCBF than the normal hemisphere [(31. 37 ± 9. 29) ml·100 g-1·min-1 vs. (45.41 ±6.91) ml·100 g-1·min-1, t= -7.921, P =0.000], but higher rMTT and rTTP [ ( 11. 32 ± 3. 19) s vs. (8. 43 ± 1.95) s, (=5.754, P = 0.000 and (3.71 ± 1.22) s vs. (2.03 ±0.87) s, t=9.889, P =0.000, respectively]. No significant difference was detected in rCBV between the two hemispheres (P >0. 05

  9. Computed tomography perfusion in evaluating the therapeutic effect of transarterial chemoembolization for hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Guang Chen; Da-Qing Ma; Wen He; Bao-Feng Zhang; Li-Qin Zhao

    2008-01-01

    AIM: To prospectively assess the changes in parameters of computed tomography (CT) perfusion pre- and post-transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) in different treatment response groups,and to correlate the changes with various responses of HCC to TACE.METHODS: Thirty-nine HCC patients underwent CT perfusion examinations pre-(1 d before TACE) and post-treatment (4 wk after TACE).The response evaluation criteria for solid tumors (RECIST) were referred to when treatment responses were distributed.Wilcoxon-signed ranks test was used to compare the differences in CT perfusion parameters pre- and post-TACE for different response groups.RESULTS: Only one case had treatment response to CR and the CT perfusion maps of post-treatment lesion displayed complete absence of signals.In the PR treatment response group,hepatic artery perfusion (HAP),hepatic arterial fracture (HAF) and hepatic blood volume (HBV) of viable tumors POst-TACE were reduced compared with pre-TACE (P = 0.001,0.030and 0.001,respectively).In the SD group,all CT perfusion parameters were not significantly different pre- and post-TACE.In the PD group,HAP,HAF,portal vein perfusion (PVP) and hepatic blood flow (HBF) of viable tumors post-TACE were significantly increased compared with pre-TACE (P = 0.005,0.012,0.035 and 0.005,respectively).CONCLUSION: Changes in CT perfusion parameters of viable tumors are correlated with different responses of HCC to TACE.Therefore,CT perfusion imaging is a feasible technique for monitoring response of HCC to TACE.

  10. Integrity evaluation of resected mesentery specimen after total mesorectal excision by methylene blue perfusion via superior rectal artery%直肠上动脉亚甲蓝灌注法判断全直肠系膜切除术后标本系膜的完整性

    Institute of Scientific and Technical Information of China (English)

    楼征; 张卫; 梅祖兵; 王莉莉; 季秋芳; 孟荣贵; 傅传刚

    2010-01-01

    Objective To evaluate the integrity of the resected mesentery specimen after total mesorectal excision (TME)for low rectal cancer using methylene blue peffusion via the superior rectal artery. Methods Twenty patients with low rectal cancer were randomly divided into the methylene blue group (n=10) and the control group (n=10). All the patients received TME and macroscopic examination of the mesorectal surface was performed to evaluate the quality of the surgical specimen. The methylene blue was injected into the specimen postoperatively via superior rectal artery. Results The mesorectal surface of all the specimens was intact on macroscopic examination.However, after methylene blue perfusion, 2 specimens were found to be incomplete. The number of lymph nodes in the methylene blue group were significantly larger (17.3±2.4 vs. 12.4±5.4,P=0.016).Conclusions Integrity evaluation of TME specimen is necessary. Methylene blue perfusion is a convenient and effective method to identify subtle incompleteness of specimen and can improve the detection of lymph node.%目的 探讨经直肠上动脉灌注亚甲蓝对低位直肠癌行全直肠系膜切除术(TME)后标本系膜完整性判断的临床意义.方法 将按照TME原则进行根治性手术的20例低位直肠癌患者的切除标本,按随机数字表法分为亚甲蓝组和常规检测组,每组10例.常规检测组术后肉眼观察直肠系膜完整性情况,亚甲蓝组经直肠上动脉灌注肝素和亚甲蓝,观察有无亚甲蓝从系膜表面溢出,并进一步对亚甲蓝溢出处系膜及系膜淋巴结情况进行镜检.结果 所有病例标本肉眼下观察直肠系膜均完整,亚甲蓝组经直肠上动脉灌注亚甲蓝后,直肠系膜染色明显,8例直肠系膜面无亚甲蓝溢出,提示直肠系膜完整,2例出现亚甲蓝溢出,提示系膜存在肉眼观察无法辨别的缺损,并在镜下得到证实.此外,亚甲蓝组淋巴结平均检出数目(17.3±2.4)枚,而常规检测组为(12

  11. 三维彩色多普勒超声在双胎反向动脉灌注序列征诊断中的应用研究%Application Study of Three-Dimensional Color Doppler Ultrasound in the Diagnosis of Twin Reversed Arterial Perfusion Sequence

    Institute of Scientific and Technical Information of China (English)

    喻勇; 杨华

    2015-01-01

    Objective To evaluate the value of three-dimensional ultrasonography in the diagnosis of twin reversed arterial perfusion sequence (TRCPS).Methods Fetal sonographic images of 2-dimensional,3-dimensional ultrasonography and color Doppler were retrospectively reviewed in 3 pregnancies complicated by TRAPS.Al about the pump twin,acardiac twin,umbilical cord,placenta and amniotic fluid were reviewed.Results We detected three cases of TRAP-sequence.Both of them are monoamniotic twin.And cord entanglement was observed in two cases.Conclusion The figure of acardiac twins can be obtained vividly by three-dimensional ultrasonography.And it would help us get more information about cord entanglement in monoamniotic twin.%目的:探讨三维彩色多普勒超声在双胎之一无心畸形诊断中的应用价值。方法对3例双胎之一无心畸形的二维、彩色多普勒及三维超声检查结果进行回顾性分析。结果超声诊断3例双胎之一无心畸形,均为单羊膜囊双胎,其中两例伴有不同程度的脐带缠绕。结论三维彩色多普勒超声的应用能更清楚观察无心畸形的形态及血流方向,了解尤其是单羊膜囊之一无心畸形的脐带缠绕情况,为临床提供更多有用信息。

  12. A method to quantify and visualize femoral head intraosseous arteries by micro-CT.

    Science.gov (United States)

    Qiu, Xing; Shi, Xiaotian; Ouyang, Jun; Xu, Dachuan; Zhao, Dewei

    2016-08-01

    We describe a technique for perfusing a barium sulphate suspension into the intraosseous artery. Following the perfusion of abarium sulphate suspension into 14 fresh lower limbs of Chinese cadavers, micro-CT scanning was applied to digitize, quantify and visualize the intraosseous arteries in the human femoral heads. Then, the femoral heads were removed and subjected to micro-CT scanning. The data were imported into the amira and mimics programs to reconstruct and quantify the intraosseous arteries. The femoral head intraosseous artery lengths, areas, volumes, and femoral head bone volumes were quantified. The artery densities and artery ratios were calculated and analysed with independent-samples t-tests. The intraosseous vasculature volume renderings were displayed as screenshots and videos made with amira. Many intraosseous artery study technologies were compared. The barium sulphate suspension was milky white in colour. The perfusion of the barium sulphate suspension followed by micro-CT scanning provided a good representation of the intraosseous artery. The femoral head intraosseous artery lengths, areas and volumes, and the femoral head bone volumes were displayed as the X¯±S . No differences were observed between the left and right femoral head intraosseous arteries in terms of the artery densities or artery ratios. The volume renderings and 3-D orthogonal projections displayed the overall distributions of the intraosseous arteries. The videos clearly demonstrated the entry sites of the nutrition-carrying arteries, their courses and branches, and the intraosseous arterial anastomoses. Our technique is the simplest and least time-consuming method of producing accurate vascular three-dimensional reconstructions. The perfusion of a barium sulphate suspension into intraosseous arteries combined with micro-CT scanning can deliver high-resolution 3-D digitized data and images of intraosseous arteries. This technique does not require bone decalcification or bone

  13. The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery%经右侧腋动脉插管选择性单侧脑灌注在主动脉瘤手术中的应用

    Institute of Scientific and Technical Information of China (English)

    姚昊; 王强; 骆璇; 王喆妍; 陈杨

    2011-01-01

    Objective To summarize the experiences of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery. Methods Methods Retrospectively analyzed 105 cases ( from May 2009 to May 2011 ) of aortic aneurysm surgery with deep hypothermic circulatory arrest ( DHCA ). 78 cases were male and 27 cases were female. The operation procedure included Bentall procedure and semi arch replacement in 6 cases, ascending aorta replacement and semi arch replacement in 5 cases, Bentall procedure and elephant trunk technique in 61 cases, ascending aorta replacement and elephant trunk technique in 33 cases. Combined operations included coronery artery bypass grafting ( 10 cases ), mitral valve replacement or mitral valve repair ( 24 cases ) and tricuspid valve repair ( 11 cases ). Results Average cardiopulmonary bypass time was 81 -374 ( 178. 6 ±41. 5 ) min, average DHCA time was 8 - 36 ( 23.2 ± 10. 1 ) min, average selective cerebral perfusion time was 8 - 46 ( 30. 4 ± 12. 4 ) min, nasopharynx temperature during DHCA was 15. 5 -23. 5 ( 19. 5 ± 1. 7 )℃ , rectal temperature during DHCA was 18.0-25.6 ( 20.6 ± 1. 6 )℃. 89 patients'hearts automaticly reheated and 16 reheated after defibrillation. 5 cases died postoperatively. The complications included mul-tiorgan failure for 3 cases, malignant arrhythmia for 1 case and sudden bleeding for 1 case. Conclusion The use of selective cerebral perfusion through right axillary artery cannulation in aortic aneurysm surgery can get effective brain protection and reduce the postoperative nervous system complications with acceptable results.%目的 总结经右侧腋动脉插管选择性脑灌注(SCP)在主动脉瘤手术中应用的经验.方法 回顾性分析我院2009年5月至2011年5月期间采用深低温停循环(DHCA)SCP的手术方式治疗的105例主动脉瘤患者.男78例,女27例.行Bentall+次全弓置换6例,行升主动脉置换+次全弓置换5例,行Bentall+全弓置换+降主

  14. Intracoronary adenosine improves myocardial perfusion in late reperfused myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Background Myocardial perfusion associates with clinical syndromes and prognosis.Adenosine could improve myocardial perfusion of acute myocardial infarction within 6 hours,but few data are available on late perfusion of myocardial infarction (MI).This study aimed at quantitatively evaluating the value of intracoronary adenosine improving myocardial perfusion in late reperfused MI with myocardial contrast echocardiography(MCE).Methods Twenty-six patients with anterior wall infarcts were divided randomly into 2 groups:adenosine group(n=12) and normal saline group(n=14).Their history of myocardial infarction was about 3-12 weeks.Adenosine or normalsaline was given when the guiding wire crossed the lesion through percutaneous coronary intervention(PCI),then the balloon was dilated and stent(Cypher/Cypher select)was implanted at the lesion.Contrast pulse sequencing MCE with Sonovue contrast via the coronary route was done before PCI and 30 minutes after PCI.Video densitometry and contrast filled-blank area were calculated with the CUSQ off-line software.Heart function and cardiac events were followed up within 30 days.Results Perfusion in the segments of the criminal occlusive coronary artery in the adenosine group was better than that in the saline group(5.71±0.29 vs 4.95±1.22,P<0.05).Ischemic myocardial segment was deminished significantly afterPCI,but the meliorated area was bigger in the adenosine group than in the saline group((1.56±0.60)cm2 vs(1.02±0.56) cm2,P<0.05).The video densitometry in critical segments was also improved significantly in the adenosine group (5.53±0.36 vs 5.26±0.35,P<0.05).Left ventricular ejection fraction(LVEF)was improved in all patients after PCI,but EF was not significant between the two groups((67±6)% vs(62±7)%,P>0.05).There was no in-hospital or 30-day major adverse cardiac event(MACE)in the adenosine group but 3 MACE in the saline group in 30 days after PCI.Conclusions Adenosine could improve myocardial microvascular

  15. Fatal dissection of the pulmonary artery in pulmonary arterial hypertension

    Directory of Open Access Journals (Sweden)

    B. Degano

    2009-09-01

    Full Text Available A 41-yr-old patient with chronic stable idiopathic pulmonary arterial hypertension (PAH presented with sudden chest pain and unusual dyspnoea during physical exertion. The patient had been diagnosed with PAH at the age of 12 yrs and was in New York Heart Association functional class I/II. The patient was being treated with an anticoagulant regimen, low-dose diuretics and continuous intravenous epoprostenol therapy. A computed tomography scan showed ancient massive thrombi in dilated central pulmonary arteries, which were not haemodynamically significant (perfusion lung scans did not demonstrate segmental or larger defects, and extensive dissection of the right pulmonary artery starting from the intermediate branch. Due to the extensiveness of the dissection, the patient was immediately considered for heart–lung transplantation, but died 72 h after the onset of symptoms. Permission for post mortem examination was denied. Pulmonary artery dissection should be suspected in PAH patients presenting with chest pain and worsening dyspnoea. In the current case, the factors possibly associated with increased risk for dissection may include dilatation of the pulmonary artery, local inflammation favoured by in situ thrombosis, and acute increase of pulmonary pressure secondary to physical exertion. Extensive pulmonary artery dissection is a life-threatening complication of PAH, and urgent heart/lung transplantation might be the treatment of choice in eligible patients. In addition, better identification of the risk factors for pulmonary artery dissection may help in considering transplantation for selected patients at risk.

  16. Anomalous Origin of the Left Coronary Artery From the Pulmonary Artery

    Directory of Open Access Journals (Sweden)

    Venkat Gangadharan MD

    2017-01-01

    Full Text Available A 36-year-old woman was seen with complaints of exertional chest pain and shortness of breath. Her medical history included atrial fibrillation and diabetes. Physical examination was unremarkable except for an irregular cardiac rhythm. Myocardial perfusion imaging revealed the presence of a large area of infarction involving the entire anterior and apical walls and part of the anteroseptal wall with minimal periinfarct ischemia. Computed tomography coronary angiogram revealed an anomalous left main coronary artery arising from the main pulmonary artery. Right and left heart catheterizations demonstrated moderate pulmonary hypertension with a slight step-up in oxygen saturation between the right ventricle and main pulmonary artery. Coronary angiography showed a large tortuous right coronary artery with collaterals to the left anterior descending artery that drained into the main pulmonary artery. She was referred for surgery. This case demonstrates a rare coronary artery anomaly in an adult where survival is dependent on collateral circulation.

  17. Quantiifcation of angiogenesis by CT perfusion imaging in liver tumor of rabbit

    Institute of Scientific and Technical Information of China (English)

    Hui-Jie Jiang; Zai-Ren Zhang; Bao-Zhong Shen; Yong Wan; Hong Guo; Jin-Ping Li

    2009-01-01

    BACKGROUND: Tumor angiogenesis is essential for primary and metastatic tumor growth. Computed tomography perfusion (CTP) is a new imaging method, made possible by the recent development of fast CT scanners and improved data analysis techniques, which allows measurement of the physiologic and hemodynamic properties of tissue vasculature. This study aimed to evaluate CTP in the quantiifcation of angiogenesis and to assess the relationship between tissue perfusion parameters and microvascular density (MVD) and vascular endothelial growth factor (VEGF), attempting to detect the physiologic properties of angiogenesis. METHODS: Sixteen rabbits with VX2 liver tumors underwent multi-slice CT perfusion (MSCTP) on day 14 after tumor inoculation. CTP parameters included hepatic blood lfow (HBF), hepatic blood volume (HBV), mean transit time (MTT), permeability of capillary vessel surface (PS), hepatic artery index (HAI), hepatic artery perfusion (HAP), and hepatic portal perfusion (HPP). The border of the tumor was stained with CD34 and VEGF immunohistochemical stains, and MVD was measured by anti-CD34. Then, CTP parameters were determined whether they were correlated with MVD and VEGF using Pearson’s correlation coefifcient. RESULTS: The positive expression of MVD was different in the center and border of the tumor (P0.05). CONCLUSIONS: Signiifcant correlations were found between perfusion parameters and MVD and VEGF. Therefore, MSCTP can be used to evaluate tumor angiogenesisin vivo.

  18. Suppression of pulmonary vasculature in lung perfusion MRI using correlation analysis

    Energy Technology Data Exchange (ETDEWEB)

    Risse, Frank; Semmler, Wolfhard [Deutsches Krebsforschungszentrum, Department of Medical Physics in Radiology, Heidelberg (Germany); Kuder, Tristan A. [Deutsches Krebsforschungszentrum, Department of Medical Physics in Radiology, Heidelberg (Germany); Deutsches Krebsforschungszentrum, Department of Radiology, Heidelberg (Germany); Kauczor, Hans-Ulrich [University of Heidelberg, Department of Diagnostic Radiology, Heidelberg (Germany); Fink, Christian [University Medical Center Mannheim, Medical Faculty Mannheim - University of Heidelberg, Department of Clinical Radiology and Nuclear Medicine, Mannheim (Germany); Universitaetsmedizin Mannheim, Institut fuer Klinische Radiologie und Nuklearmedizin, Mannheim (Germany)

    2009-11-15

    The purpose of the study was to evaluate the feasibility of suppressing the pulmonary vasculature in lung perfusion MRI using cross-correlation analysis (CCA). Perfusion magnetic resonance imaging (MRI) (3D FLASH, TR/TE/flip angle: 0.8 ms/2.1 ms/40 ) of the lungs was performed in seven healthy volunteers at 1.5 Tesla after injection of Gd-DTPA. CCA was performed pixel-wise in lung segmentations using the signal time-course of the main pulmonary artery and left atrium as references. Pixels with high correlation coefficients were considered as arterial or venous and excluded from further analysis. Quantitative perfusion parameters [pulmonary blood flow (PBF) and volume (PBV)] were calculated for manual lung segmentations separately, with the entire left and right lung with all intrapulmonary vessels (IPV) included, excluded manually or excluded using CCA. The application of CCA allowed reliable suppression of hilar and large IPVs. Using vascular suppression by CCA, perfusion parameters were significantly reduced (p {<=} 0.001). The reduction was 8% for PBF and 13% for PBV compared with manual exclusion and 15% for PBF and 25% for PBV when all vessel structures were included. The application of CCA improves the visualisation and quantification of lung perfusion in MRI. Overestimation of perfusion parameters caused by pulmonary vessels is significantly reduced. (orig.)

  19. Comparison of Myocardial Perfusion Scintigraphy and Coronary Angiography Results

    Directory of Open Access Journals (Sweden)

    Umut Elboga

    2017-05-01

    Full Text Available Aim: Coronary artery disease (CAD is one of the most frequent causes of mortality and morbidity worldwide. Coronary angiography is the gold standard for the anatomical diagnosis of coronary artery stenosis. Myocardial Perfusion Scintigraphy (MPS is a non-invasive imaging modality used for the diagnosis of CAD. In this study, we aimed to compare the findings of MPS and coronary angiogram. Material and Method: Eighty-one patients (37 males, 44 females; mean age 55 ± 10.95 years with angina and detected perfusion defects on MPS were included in this study. All of the patients underwent coronary angiogram. A narrowing %u2265 50% was considered pathological on the coronary angiography. Results: Findings of the coronary angiogram and MPS were compared and found consistent in 51 (63% patients. A coronary narrowing < 50% was detected by coronary angiogram in 4 (5% of the remaining patients. Coronary angiogram was found to be normal in the remaining 26 patients (32% and these patients were evaluated as cardiac syndrome X (CSX known as microvascular angina (MA. Discussion: The findings showed that MPS is superior to coronary angiogram in the early diagnosis of myocardial perfusion disorders at the microvascular level. Therefore, we concluded that MPS should be the primary diagnostic tool to begin treatment before an anatomically large narrowing occurs in the coronaries.

  20. Quantitative evaluation of muscle perfusion with CEUS and with MR

    Energy Technology Data Exchange (ETDEWEB)

    Weber, Marc-Andre; Delorme, Stefan [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Krix, Martin [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Bracco ALTANA Pharma GmbH, Konstanz (Germany)

    2007-10-15

    Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases. (orig.)

  1. Isolated Left Pulmonary Artery Agenesis: A Case Report

    OpenAIRE

    Tansel Ansal Balcı; Zehra Pınar Koç; Gamze Kırkıl; Ahmet Kürşad Poyraz

    2012-01-01

    Unilateral pulmonary artery agenesis without any cardiovascular malformation is a rare anomaly. We present the imaging findings of a patient who was diagnosed as isolated left pulmonary artery agenesis. A 27-year-old female patient was admitted to our hospital due to dyspnea during exercise for five years. Chest X-ray revealed minimally small left pulmonary hilum and left lung. She was admitted to our clinic with the suspicion of pulmonary artery pathology. Absent perfusion of the left lung w...

  2. Ocular perfusion pressure in glaucoma.

    Science.gov (United States)

    Costa, Vital P; Harris, Alon; Anderson, Douglas; Stodtmeister, Richard; Cremasco, Fernanda; Kergoat, Helene; Lovasik, John; Stalmans, Ingborg; Zeitz, Oliver; Lanzl, Ines; Gugleta, Konstantin; Schmetterer, Leopold

    2014-06-01

    This review article discusses the relationship between ocular perfusion pressure and glaucoma, including its definition, factors that influence its calculation and epidemiological studies investigating the influence of ocular perfusion pressure on the prevalence, incidence and progression of glaucoma. We also list the possible mechanisms behind this association, and discuss whether it is secondary to changes in intraocular pressure, blood pressure or both. Finally, we describe the circadian variation of ocular perfusion pressure and the effects of systemic and topical medications on it. We believe that the balance between IOP and BP, influenced by the autoregulatory capacity of the eye, is part of what determines whether an individual will develop optic nerve damage. However, prospective, longitudinal studies are needed to better define the role of ocular perfusion pressure in the development and progression of glaucoma.

  3. Parallel imaging for first-pass myocardial perfusion.

    Science.gov (United States)

    Irwan, Roy; Lubbers, Daniël D; van der Vleuten, Pieter A; Kappert, Peter; Götte, Marco J W; Sijens, Paul E

    2007-06-01

    Two parallel imaging methods used for first-pass myocardial perfusion imaging were compared in terms of signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR) and image artifacts. One used adaptive Time-adaptive SENSitivity Encoding (TSENSE) and the other used GeneRalized Autocalibrating Partially Parallel Acquisition (GRAPPA), which are both applied to a gradient-echo sequence. Both methods were tested on 12 patients with coronary artery disease. The order of perfusion sequences was inverted in every other patient. Image acquisition was started during the administration of a contrast bolus followed by a 20-ml saline flush (3 ml/s), and the next perfusion was started at least 15 min thereafter using an identical bolus. An acceleration rate of 2 was used in both methods, and acquisition was performed during breath-holding. Significantly higher SNR, CNR and image quality were obtained with GRAPPA images than with TSENSE images. GRAPPA, however, did not yield a higher CNR when applied after the second bolus. GRAPPA perfusion imaging produced larger differences between subjects than did TSENSE. Compared to TSENSE, GRAPPA produced significantly better CNR on the first bolus. More consistent SNR and CNR were obtained from TSENSE images than from GRAPPA images, indicating that the diagnostic value of TSENSE may be better.

  4. Modeling of nanotherapeutics delivery based on tumor perfusion

    Science.gov (United States)

    van de Ven, Anne L.; Abdollahi, Behnaz; Martinez, Carlos J.; Burey, Lacey A.; Landis, Melissa D.; Chang, Jenny C.; Ferrari, Mauro; Frieboes, Hermann B.

    2013-05-01

    Heterogeneities in the perfusion of solid tumors prevent optimal delivery of nanotherapeutics. Clinical imaging protocols for obtaining patient-specific data have proven difficult to implement. It is challenging to determine which perfusion features hold greater prognostic value and to relate measurements to vessel structure and function. With the advent of systemically administered nanotherapeutics whose delivery is dependent on overcoming diffusive and convective barriers to transport, such knowledge is increasingly important. We describe a framework for the automated evaluation of vascular perfusion curves measured at the single vessel level. Primary tumor fragments, collected from triple-negative breast cancer patients and grown as xenografts in mice, were injected with fluorescence contrast and monitored using intravital microscopy. The time to arterial peak and venous delay, two features whose probability distributions were measured directly from time-series curves, were analyzed using a fuzzy c-mean supervised classifier in order to rank individual tumors according to their perfusion characteristics. The resulting rankings correlated inversely with experimental nanoparticle accumulation measurements, enabling the modeling of nanotherapeutics delivery without requiring any underlying assumptions about tissue structure or function, or heterogeneities contained therein. With additional calibration, these methodologies may enable the investigation of nanotherapeutics delivery strategies in a variety of tumor models.

  5. Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Bair, H.J.; Platsch, G.; Wolf, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Nuclear Medicine; Guenter, E.; Becker, D. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 1; Rupprecht, H.; Neumayer, H.H. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 4

    1997-08-01

    Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [Deutsch] Ziel der Studie war es, das

  6. The primary brain vesicles revisited: are the three primary vesicles (forebrain/midbrain/hindbrain) universal in vertebrates?

    Science.gov (United States)

    Ishikawa, Yuji; Yamamoto, Naoyuki; Yoshimoto, Masami; Ito, Hironobu

    2012-01-01

    It is widely held that three primary brain vesicles (forebrain, midbrain, and hindbrain vesicles) develop into five secondary brain vesicles in all vertebrates (von Baer's scheme). We reviewed previous studies in various vertebrates to see if this currently accepted scheme of brain morphogenesis is a rule applicable to vertebrates in general. Classical morphological studies on lamprey, shark, zebrafish, frog, chick, Chinese hamster, and human embryos provide only partial evidence to support the existence of von Baer's primary vesicles at early stages. Rather, they suggest that early brain morphogenesis is diverse among vertebrates. Gene expression and fate map studies on medaka, chick, and mouse embryos show that the fates of initial brain vesicles do not accord with von Baer's scheme, at least in medaka and chick brains. The currently accepted von Baer's scheme of brain morphogenesis, therefore, is not a universal rule throughout vertebrates. We propose here a developmental hourglass model as an alternative general rule: Brain morphogenesis is highly conserved at the five-brain vesicle stage but diverges more extensively at earlier and later stages. This hypothesis does not preclude the existence of deep similarities in molecular prepatterns at early stages.

  7. Correlation between Dual-Energy and Perfusion CT in Patients with Hepatocellular Carcinoma.

    Science.gov (United States)

    Gordic, Sonja; Puippe, Gilbert D; Krauss, Bernhard; Klotz, Ernst; Desbiolles, Lotus; Lesurtel, Mickaël; Müllhaupt, Beat; Pfammatter, Thomas; Alkadhi, Hatem

    2016-07-01

    Purpose To develop a dual-energy contrast media-enhanced computed tomographic (CT) protocol by using time-attenuation curves from previously acquired perfusion CT data and to evaluate prospectively the relationship between iodine enhancement metrics at dual-energy CT and perfusion CT parameters in patients with hepatocellular carcinoma (HCC). Materials and Methods Institutional review board and local ethics committee approval and written informed consent were obtained. The retrospective part of this study included the development of a dual-energy CT contrast-enhanced protocol to evaluate peak arterial enhancement of HCC in the liver on the basis of time-attenuation curves from previously acquired perfusion CT data in 20 patients. The prospective part of the study consisted of an intraindividual comparison of dual-energy CT and perfusion CT data in another 20 consecutive patients with HCC. Iodine density and iodine ratio (iodine attenuation of the lesion divided by iodine attenuation in the aorta) from dual-energy CT and arterial perfusion (AP), portal venous perfusion, and total perfusion (TP) from perfusion CT were compared. Pearson R and linear correlation coefficients were calculated for AP and iodine density, AP and iodine ratio, TP and iodine density, and TP and iodine ratio. Results The dual-energy CT protocol consisted of bolus tracking in the abdominal aorta (threshold, 150 HU; scan delay, 9 seconds). The strongest intraindividual correlations in HCCs were found between iodine density and AP (r = 0.75, P = .0001). Moderate correlations were found between iodine ratio and AP (r = 0.50, P = .023) and between iodine density and TP (r = 0.56, P = .011). No further significant correlations were found. The volume CT dose index (11.4 mGy) and dose-length product (228.0 mGy · cm) of dual-energy CT was lower than those of the arterial phase of perfusion CT (36.1 mGy and 682.3 mGy · cm, respectively). Conclusion A contrast-enhanced dual-energy CT protocol developed

  8. Radius Intermedius Stenosis Induced Myocardial Perfusion Defect : Provened by the Fusion Images of Myocardial Perfusion SPECT and 64 Channel CTA

    Energy Technology Data Exchange (ETDEWEB)

    Kong, Eun Jung; Cho, Ihn Ho; Chun, Kyung Ah; Won, Kyu Chang; Lee, Hyung Woo; Park, Jong Seon [College of Medicine, Yeungnam University, Daegu (Korea, Republic of)

    2008-02-15

    A 71-year-old woman was assigned to our department for Tc-99m myocardial perfusion SPECT(MPS) and coronary CT angiography. She admitted for substernal pain, via the ER, 2 days ago. The heart was scanned after intravenous injection of 925 MBq of {sup 99m}Tc-sestamibi adenosine-induced stress SPECT using dual head gamma camera (Hawkeye, GE healthcare. USA). The MPS shows decreased tracer uptake in the apical and mid area of anterior and lateral wall and mid and basal inferior wall. Coronary CT angiography was obtained using Discovery VCT (GE healthcare). 3D angiography portrayed significant stenosis of ramus intermedius(RI) and posterolateral branch of right coronary artery(PLB) with fibrocalcified plaque. Two images were fused using Cardiac IQ fusion software package (Advantage workstation 4.4, GE healthcare) The fusion images explain the perfusion defect of anterior, lateral and inferior wall is due to stenosis of the RI and PLB. And 3 days later, coronary angiography was done and revealed the marked stenosis of RI and PLB. Then balloon angioplasty and stent was instituted in RI. Cardiac SPECT/CT fusion imaging provides additional information about hemodynamic relevance and facilitates lesion interpretation by allowing exact allocation of perfusion defects to its subtending coronary artery.

  9. A study on cerebral hemodynamic analysis of moyamoya disease by using perfusion MRI

    Science.gov (United States)

    Dong, Kyung-Rae; Goo, Eun-Hoe; Lee, Jae-Seung; Chung, Woon-Kwan

    2013-10-01

    This study examined the clinical applications of perfusion magnetic resonance imaging (MRI) in patients with moyamoya disease (MMD). Twenty-two patients with moyamoya disease (9 men and 13 women) with a mean age of 9.3 years (range: 4-22 years) were enrolled in this study. Perfusion MRI was performed by scanning the patients7.5 cm upward from the base of the cerebellum before their being process for post-treatment. The scan led to the acquisition of the following four map images: the cerebral blood volume (CBV), the cerebral blood flow (CBF), the mean transit time (MTT) for the contrast medium, and the time to peak (TTP) for the contrast medium. The lesions were assessed using the CBV, the CBF, the MTT and the TTP maps of perfusion MRI; the MTT and the TTP were measured in the lesion areas, as well as in the normal and the symmetric areas. Perfusion defects were recognizable in all four perfusion MRI maps, and the MTT and the TTP showed a conspicuous delay in the parts where perfusion defects were recognized. The MTT and the TTP images of perfusion MRI reflected a significant correlation between the degrees of stenosis and occlusion in the posterior cerebral artery (PCA), as well as the development of collateral vessels. The four perfusion MRI maps could be used to predict the degrees of stenosis and occlusion in the posterior circulation, as well as the development of the collateral vessels, which enabled a hemodynamic evaluation of the parts with perfusion defects. Overall, perfusion MRI is useful for the diagnosis and the treatment of moyamoya disease and can be applied to clinical practice.

  10. A simple physiologic pulsatile perfusion system for the study of intact vascular tissue.

    Science.gov (United States)

    Conklin, B S; Surowiec, S M; Lin, P H; Chen, C

    2000-07-01

    Perfusion vascular culture models may provide a useful link between cell culture models and animal culture models by allowing a high level of control over important parameters while maintaining physiologic structure. The purpose of this study was to develop and test a new vascular culture system for pulsatile perfusion culture of intact vascular tissue. The system generates a pulsatile component of flow by means of a cam-driven syringe and a peristaltic pump and compliance chamber. Cams were designed, constructed and tested to simulate canine femoral and common carotid artery flows. The mean pressure was adjusted between 60 and 200 mmHg without significantly affecting flow rate, flow waveform, or the pressure waveform. Porcine common carotid artery segments were cultured in this pulsatile perfusion system. The viability of vascular segments was tested after various culture times with a functional assay that demonstrated both smooth muscle cell and endothelial cell response to vasomotor challenge.

  11. Predicting hemorrhagic transformation by microvascular permeability using perfusion CT acute cerebral infarction in elderly patients

    Institute of Scientific and Technical Information of China (English)

    田超

    2014-01-01

    Objective To study the possibility of microvascular permeability(PS)value derived from perfusion CT(PCT)in predicting hemorrhagic transformation(HT)in acute cerebral infarction in elderly patients.Methods 52consecutive patients with middle cerebral artery acute ischemic stroke who received thrombolytic therapy were divided into HT group and control group,and patients in

  12. Estimation of x-ray parameters in digital coronary angiography for compensation of myocardial perfusion measurements

    NARCIS (Netherlands)

    Storm, C.J.; Slump, C.H.; Hsieh, J.; Samei, E.

    2008-01-01

    Coronary angiography is the primary technique for diagnosing coronary abnormalities as it is able to locate precisely the coronary artery lesions. However, the clinical relevance of an appearing stenosis is not that easy to assess. In previous work we have analyzed the myocardial perfusion by compar

  13. Alternative technique using dual source CT imaging for assessment of myocardial perfusion

    Directory of Open Access Journals (Sweden)

    Amgad S. Abdel-Rahman

    2015-06-01

    Conclusion: We propose that comprehensive evaluation of coronary artery morphology and myocardial perfusion in patients with CAD could be achieved by single reproducible non-invasive contrast enhanced CT acquisition using DSCT scanners while operated in single energy mode with high sensitivity, specificity and diagnostic accuracy, it also has the potential to be the first, independent and stand out imaging choice in such field.

  14. Computed Tomographic Perfusion Improves Diagnostic Power of Coronary Computed Tomographic Angiography in Women

    DEFF Research Database (Denmark)

    Penagaluri, Ashritha; Higgins, Angela Y; Vavere, Andrea L

    2016-01-01

    BACKGROUND: Coronary computed tomographic angiography (CTA) and myocardial perfusion imaging (CTP) is a validated approach for detection and exclusion of flow-limiting coronary artery disease (CAD), but little data are available on gender-specific performance of these modalities. In this study, w...... REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00934037....

  15. 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)

  16. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

    Science.gov (United States)

    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment.

  17. Impact of severe extracranial ICA stenosis on MRI perfusion and diffusion parameters in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Philipp eKaesemann

    2014-12-01

    Full Text Available Purpose:The aim of this study was to investigate the impact of a coexisting internal carotid artery (ICA stenosis on lesion volumes as well as diffusion and perfusion parameters in acute ischemic stroke resulting from middle cerebral artery (MCA occlusion.Material and Methods:MRI data of 32 patients with MCA occlusion with or without additional ICA stenosis imaged within 4.5 hours of symptom onset were analyzed. Both groups consisted of 16 patients. Acute diffusion lesions were semi-automatically segmented in apparent diffusion coefficient (ADC MRI datasets. Perfusion maps of cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT and Tmax were calculated using perfusion-weighted MRI datasets. Tissue-at-risk (TAR volumes were generated by subtracting the ADC lesion from the hypoperfusion lesion defined by Tmax >6s. Median ADC and perfusion parameter values were extracted separately for the diffusion lesion and tissue-at-risk and used for statistical analysis.Results:No significant differences were found between the groups regarding the diffusion lesion and tissue-at-risk volumes. Statistical analysis of diffusion and perfusion parameters revealed CBV as the only parameter with a significant difference (p=0.009 contributing a small effect (ɛ²=0.11 to the group comparison with higher CBV values for the patient group with a coexisting ICA stenosis, while no significant effects were found for the other diffusion and perfusion parameters analyzed.Conclusion:The results of this study suggest that a coexisting ICA stenosis does not have a strong effect on tissue status or perfusion parameters in acute stroke patients except for a moderate elevation of CBV. This may reflect improved collateral circulation or ischemic preconditioning in patients with a pre-existing proximal stenosis balancing impaired perfusion from the stenosis.

  18. Sildenafil citrate and uteroplacental perfusion in fetal growth restriction

    Directory of Open Access Journals (Sweden)

    Marzieh Vahid Dastjerdi

    2012-01-01

    Full Text Available Background: To determine whether the phosphodiesterase type 5 inhibitor, Sildenafil citrate, affects uteroplacental perfusion. Materials and Methods: Based on a randomized double-blinded and placebo-controlled trial, forty one pregnant women with documented intrauterine growth retardation at 24-37 weeks of gestation were evaluated for the effect of a single dose of Sildenafil citrate on uteroplacental circulation as determined by Doppler ultrasound study of the umbilical and middle cerebral arteries. Statistical analysis included χ2 -test to compare proportions, and independent-samples t-test and paired student′s t-test to compare continuous variables. Results: Sildenafil group fetuses demonstrated a significant decrease in systolic/diastolic ratios (0.60 [SD 0.40] [95% Cl 0.37-0.84], P=0.000, and pulsatility index (0.12 [SD 0.15] [95% Cl 0.02-0.22], P=0.019 for the umbilical artery and a significant increase in middle cerebral artery pulsatility index (MCA PI (0.51 [SD 0.60] [95% Cl 0.16-0.85], P=0.008. Conclusion: Doppler velocimetry index values reflect decreased placental bed vascular resistance after Sildenafil. Sildenafil citrate can improve fetoplacental perfusion in pregnancies complicated by intrauterine growth restriction. It could be a potential therapeutic strategy to improve uteroplacental blood flow in pregnancies with fetal growth restriction (FGR.

  19. Resting state functional connectivity in perfusion imaging: correlation maps with BOLD connectivity and resting state perfusion.

    Directory of Open Access Journals (Sweden)

    Roberto Viviani

    Full Text Available Functional connectivity is a property of the resting state that may provide biomarkers of brain function and individual differences. Classically, connectivity is estimated as the temporal correlation of spontaneous fluctuations of BOLD signal. We investigated differences in connectivity estimated from the BOLD and CBF signal present in volumes acquired with arterial spin labeling technique in a large sample (N = 265 of healthy individuals. Positive connectivity was observable in both BOLD and CBF signal, and was present in the CBF signal also at frequencies lower than 0.009 Hz, here investigated for the first time. Negative connectivity was more variable. The validity of positive connectivity was confirmed by the existence of correlation across individuals in its intensity estimated from the BOLD and CBF signal. In contrast, there was little or no correlation across individuals between intensity of connectivity and mean perfusion levels, suggesting that these two biomarkers correspond to distinct sources of individual differences.

  20. Multi-organ perfusion CT in the abdomen using a 320-detector row CT scanner: Preliminary results of perfusion changes in the liver, spleen, and pancreas of cirrhotic patients

    Energy Technology Data Exchange (ETDEWEB)

    Motosugi, Utaroh, E-mail: utaroh-motosugi@nifty.com [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan); Ichikawa, Tomoaki, E-mail: ichikawa@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan); Sou, Hironobu, E-mail: fffun0300@yahoo.ac.jp [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan); Morisaka, Hiroyuki, E-mail: morisakahiroyuki@hotmail.co.jp [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan); Sano, Katsuhiro, E-mail: snkthr@yahoo.co.jp [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan); Araki, Tsutomu, E-mail: arakit@yamanashi.ac.jp [Department of Radiology, University of Yamanashi, 1110 Shimokato, Chuo-shi, Yamanashi (Japan)

    2012-10-15

    Purpose: To utilize 320-detector row CT in perfusion CT of multiple abdominal organs and to compare the tissue perfusion between patients with and without liver cirrhosis. Materials and methods: This study included 21 patients with cirrhosis and 20 without cirrhosis. The 320-detector row CT scanner enabled multi-organ perfusion CT without requiring the scanner table to be moved. Perfusion was calculated using the maximum slope model for the aorta, the portal vein, the right and left lobes of the liver, the head and body of the pancreas, the spleen, and the corpus and antrum of the stomach. Perfusion in each organ of patients with and without cirrhosis was compared. Results: Portal venous perfusion of the right and left lobes of the liver in patients with cirrhosis (117 and 100 mL min{sup −1} 100 mL{sup −1}, respectively) was significantly less than that in patients without cirrhosis (213 and 174 mL min{sup −1} 100 mL{sup −1}, respectively; p = 0.0081 and 0.0294, respectively). Arterial perfusion of the spleen (111 mL min{sup −1} 100 mL{sup −1}) and the body of the pancreas (112 mL min{sup −1} 100 mL{sup −1}) in patients with cirrhosis was also significantly decreased compared with that in patients without cirrhosis (spleen, 162 mL min{sup −1} 100 mL{sup −1}, p = 0.0020; body of pancreas, 133 mL min{sup −1} 100 mL{sup −1}, p = 0.0405). Conclusion: The results of the perfusion CT suggest that arterial perfusion of the spleen and the body of the pancreas, as well as portal perfusion of the liver, in cirrhotic patients was decreased compared with that in non-cirrhotic patients.

  1. Intra-procedural Transcatheter Intraarterial Perfusion MRI as a Predictor of Tumor Response to Chemoembolization for Hepatocellular Carcinoma

    Science.gov (United States)

    Wang, Dingxin; Gaba, Ron C.; Jin, Brian; Riaz, Ahsun; Lewandowski, Robert J.; Ryu, Robert K.; Sato, Kent T.; Ragin, Ann B.; Kulik, Laura M.; Mulcahy, Mary F.; Salem, Riad; Larson, Andrew C.; Omary, Reed A.

    2011-01-01

    Rationale and Objectives To prospectively test the hypothesis that transcatheter intraarterial perfusion magnetic resonance imaging (TRIP-MRI) measured semi-quantitative perfusion reductions during transcatheter arterial chemoembolization of hepatocellular carcinoma (HCC) are associated with tumor response. Materials and Methods Twenty eight patients (mean age 63 years; range 47–87 years) with 29 tumors underwent chemoembolization in a combined MR-interventional radiology suite. Intra-procedural tumor perfusion reductions during chemoembolization were monitored using TRIP-MRI. Pre- and post-–chemoembolization semi-quantitative area under the time-signal enhancement curve (AUC) tumor perfusion was measured. Mean tumor perfusion pre- and post-chemoembolization were compared using a paired t-test. Imaging follow-up was performed one to three months after chemoembolization. We studied the relationship between short-term tumor imaging response and intra-procedural perfusion reductions using univariate and multivariate analysis. Results Intra-procedural AUC perfusion value decreased significantly after chemoembolization (342.1 versus 158.6 arbitrary unit, P < 0.001). Twenty six patients with 27 HCCs (n = 27) had follow-up imaging at mean 39 days post-chemoembolization. Favorable response was present in 67% of these treated tumors according to necrosis criteria. 15 of 16 (94%) tumors with 25–75% perfusion reductions showed necrosis treatment response compared to only 3 of 11 (27%) tumors with perfusion reductions outside the above range (P = 0.001). Multivariate logistic regression indicated that intra-procedural tumor perfusion reduction and Child-Pugh class were independent factors associated significantly with tumor response (P = 0.012 and 0.047, respectively). Conclusion TRIP-MRI can successfully measure semi-quantitative changes in HCC perfusion during chemoembolization. Intra-procedural tumor perfusion reductions are associated with future tumor response. PMID

  2. Dynamic MR imaging of osteoid osteomas: correlation of semiquantitative and quantitative perfusion parameters with patient symptoms and treatment outcome

    Energy Technology Data Exchange (ETDEWEB)

    Teixeira, Pedro A.G. [Service D' imagerie Guilloz, CHU, Nancy (France); Universite de Lorraine, IADI, UMR S 947, Nancy (France); Pedro Augusto Gondim Teixeira, Jarville-la-Malgrange (France); Chanson, Anne; Lecocq, Sophie; Louis, Matthias [Service D' imagerie Guilloz, CHU, Nancy (France); Beaumont, Marine [Universite de Lorraine, IADI, UMR S 947, Nancy (France); Marie, Beatrice [Service d' anatomo-pathologie, CHU, Nancy (France); Sirveaux, Francois [Service de Chirurgie Traumatologique et Orthopedique, Centre Chirurgical Emile Galle, Nancy (France); Blum, Alain [Service D' imagerie Guilloz, CHU, Nancy (France); Universite de Lorraine, IADI, UMR S 947, Nancy (France)

    2013-09-15

    To evaluate the relationship between multiple MR perfusion parameters and symptoms of patients with osteoid osteomas after percutaneous laser therapy. MR perfusion studies of 20 patients diagnosed with an osteoid osteoma, treated with CT-guided percutaneous laser therapy, were retrospectively evaluated. Multiple perfusion parameters correlated with the treatment outcome and the presence of osteoid osteoma-related symptoms. There were 16 successful treatments, 6 recurrences and a significant difference in the perfusion parameters of these groups (P < 0.0001). Patients with successful treatment demonstrated delayed progressive enhancement or no enhancement (mean time to peak = 182 s, mean delay to the arterial peak = 119.3 s). Patients with treatment failure demonstrated an early and steep enhancement (mean time to peak = 78 s and mean delay to the arterial peak = 24 s). Plasmatic volume and transfer constant values significantly changed after successful treatment (P < 0.008). MR perfusion has a sensitivity and a specificity higher than 90 % in the detection of recurrent osteoid osteomas. The identification of an early and steep enhancement with short time to peak and a short delay between the arterial and nidus peaks on MR perfusion in the postoperative setting is highly indicative of an osteoid osteoma recurrence. (orig.)

  3. Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion

    DEFF Research Database (Denmark)

    Immink, R.V.; Truijen, J.; Secher, Niels H.

    2009-01-01

    In the upright position, cerebral blood flow is reduced, maybe because arterial carbon dioxide partial pressure (Pa(CO(2))) decreases. We evaluated the time-dependent influence of a reduction in Pa(CO(2)), as indicated by the end-tidal Pco(2) tension (Pet(CO(2))), on cerebral perfusion during head......-up tilt. Mean arterial pressure, cardiac output, middle cerebral artery mean flow velocity (MCA V(mean)), and dynamic cerebral autoregulation at supine rest and 70 degrees head-up tilt were determined during free breathing and with Pet(CO(2)) clamped to the supine level. The postural changes in central...

  4. Comprehensive cardiac assessment with multislice computed tomography: evaluation of left ventricular function and perfusion in addition to coronary anatomy in patients with previous myocardial infarction

    Science.gov (United States)

    Henneman, M M; Schuijf, J D; Jukema, J W; Lamb, H J; de Roos, A; Dibbets, P; Stokkel, M P; van der Wall, E E; Bax, J J

    2006-01-01

    Objective To evaluate a comprehensive multislice computed tomography (MSCT) protocol in patients with previous infarction, including assessment of coronary artery stenoses, left ventricular (LV) function and perfusion. Patients and methods 16‐slice MSCT was performed in 21 patients with previous infarction; from the MSCT data, coronary artery stenoses, (regional and global) LV function and perfusion were assessed. Invasive coronary angiography and gated single‐photon emission computed tomography (SPECT) served as the reference standards for coronary artery stenoses and LV function/perfusion, respectively. Results 236 of 241 (98%) coronary artery segments were interpretable on MSCT. The sensitivity and specificity for detection of stenoses were 91% and 97%. Pearson's correlation showed excellent agreement for assessment of LV ejection fraction between MSCT and SPECT (49 (13)% v 53 (12)%, respectively, r  =  0.85). Agreement for assessment of regional wall motion was excellent (92%, κ  =  0.77). In 68 of 73 (93%) segments, MSCT correctly identified a perfusion defect as compared with SPECT, whereas the absence of perfusion defects was correctly detected in 277 of 284 (98%) segments. Conclusions MSCT permits accurate, non‐invasive assessment of coronary artery stenoses, LV function and perfusion in patients with previous infarction. All parameters can be assessed from a single dataset. PMID:16740917

  5. A Short Period of Ventilation without Perfusion Seems to Reduce Atelectasis without Harming the Lungs during Ex Vivo Lung Perfusion

    Directory of Open Access Journals (Sweden)

    Sandra Lindstedt

    2013-01-01

    Full Text Available To evaluate the lung function of donors after circulatory deaths (DCDs, ex vivo lung perfusion (EVLP has been shown to be a valuable method. We present modified EVLP where lung atelectasis is removed, while the lung perfusion is temporarily shut down. Twelve pigs were randomized into two groups: modified EVLP and conventional EVLP. When the lungs had reached 37°C in the EVLP circuit, lung perfusion was temporarily shut down in the modified EVLP group, and positive end-expiratory pressure (PEEP was increased to 10 cm H2O for 10 minutes. In the conventional EVLP group, PEEP was increased to 10 cm H2O for 10 minutes with unchanged lung perfusion. In the modified EVLP group, the arterial oxygen partial pressure (PaO2 was 18.5 ± 7.0 kPa before and 64.5 ± 6.0 kPa after the maneuver (P<0.001. In the conventional EVLP group, the PaO2 was 16.8 ± 3.1 kPa and 46.8 ± 2.7 kPa after the maneuver (P<0.01; P<0.01. In the modified EVLP group, the pulmonary graft weight was unchanged, while in the conventional EVLP group, the pulmonary graft weight was significantly increased. Modified EVLP with normoventilation of the lungs without ongoing lung perfusion for 10 minutes may eliminate atelectasis almost completely without harming the lungs.

  6. Improved perfusion quantification in FAIR imaging by offset correction

    DEFF Research Database (Denmark)

    Sidaros, K; Andersen, I K; Gesmar, H;

    2001-01-01

    Perfusion quantification using pulsed arterial spin labeling has been shown to be sensitive to the RF pulse slice profiles. Therefore, in Flow-sensitive Alternating-Inversion Recovery (FAIR) imaging the slice selective (ss) inversion slab is usually three to four times thicker than the imaging sl...... model is presented that allows the use of thinner ss inversion slabs by taking into account the offset of RF slice profiles between ss and nonselective inversion slabs. This model was tested in both phantom and human studies. Magn Reson Med 46:193-197, 2001....

  7. Study on 64-layer Spiral Computed Tomography Perfusion Imaging in Patients with Fatty Liver

    Institute of Scientific and Technical Information of China (English)

    RAO Xiao-hui; SU Qi; CAI Lei; QIN Jia-sheng; CAI Li-quan; HONG He; WANG Kang-hua; AI Zhi-guo; ZHANG Sheng

    2014-01-01

    Objective:To analyze the changes of hemodynamics of patients with fatty liver by detecting their blood perfusion parameter changes with Philips Brilliance 64-layer spiral computed tomography (CT) perfusion technique. Methods: A total of 74 patients undergoing 64-layer spiral CT perfusion imaging were selected as study objects, in which 39 were with fatty liver and the other 35 were healthy people. The parameters of liver blood perfusion were observed. Results: Hepatic arterial perfusion (Art.Perf), portal perfusion (Port.Perf) and total perfusion (Total.Perf) values as well as hepatic perfusion index (HPI) were (18.4±4.1), (71.5±14.2) and (93.2±6.7) mL/100 g·min as well as (25.15±5.22)% in control group, in which the Art.Perf, Port.Perf and Total.Perf were in close association with the severity of fatty liver and of great significance. Art.Perf of patients with mild, moderate and severe fatty liver was (15.4±4.0), (7.3±9.6) and (4.1±1.3) mL/100 g·min, Port.Perf was (56.5±10.7), (48.6±6.8) and (37.0±4.1) mL/100 g·min and Total.Perf was (71.3±5.7), (55.7±5.8) and (40.2±5.0) mL/100 g·min, respectively. However, HPI could not be considered as the evaluation index for the severity of fatty liver. Conclusion:CT perfusion imaging of liver can relfect blood changes of patients with fatty liver, which can be used to evaluate their blood-supply condition, thus providing more diagnostic evidences for the clinic.

  8. Study on 64-layer Spiral Computed Tomography Perfusion Imaging in Patients with Fatty Liver

    Directory of Open Access Journals (Sweden)

    RAO Xiao-hui

    2014-12-01

    Full Text Available Objective: To analyze the changes of hemodynamics of patients with fatty liver by detecting their blood perfusion parameter changes with Philips Brilliance 64-layer spiral computed tomography (CT perfusion technique. Methods: A total of 74 patients undergoing 64-layer spiral CT perfusion imaging were selected as study objects, in which 39 were with fatty liver and the other 35 were healthy people. The parameters of liver blood perfusion were observed. Results: Hepatic arterial perfusion (Art.Perf, portal perfusion (Port.Perf and total perfusion (Total.Perf values as well as hepatic perfusion index (HPI were (18.4±4.1, (71.5±14.2 and (93.2±6.7 mL/100 g·min as well as (25.15±5.22% in control group, in which the Art.Perf, Port.Perf and Total.Perf were in close association with the severity of fatty liver and of great significance. Art.Perf of patients with mild, moderate and severe fatty liver was (15.4±4.0, (7.3±9.6 and (4.1±1.3 mL/100 g·min, Port.Perf was (56.5±10.7, (48.6±6.8 and (37.0±4.1 mL/100 g·min and Total.Perf was (71.3±5.7, (55.7±5.8 and (40.2±5.0 mL/100 g·min, respectively. However, HPI could not be considered as the evaluation index for the severity of fatty liver. Conclusion: CT perfusion imaging of liver can reflect blood changes of patients with fatty liver, which can be used to evaluate their blood-supply condition, thus providing more diagnostic evidences for the clinic.

  9. Noninvasive methods of measuring bone blood perfusion

    OpenAIRE

    Dyke, J. P.; Aaron, R.K.

    2010-01-01

    Measurement of bone blood flow and perfusion characteristics in a noninvasive and serial manner would be advantageous in assessing revascularization after trauma and the possible risk of avascular necrosis. Many disease states, including osteoporosis, osteoarthritis, and bone neoplasms, result in disturbed bone perfusion. A causal link between bone perfusion and remodeling has shown its importance in sustained healing and regrowth following injury. Measurement of perfusion and permeability wi...

  10. Polydimethylsiloxane embedded mouse aorta ex vivo perfusion model: proof-of-concept study focusing on atherosclerosis.

    Science.gov (United States)

    Wang, Xueya; Wolf, Marc P; Keel, Rahel Bänziger; Lehner, Roman; Hunziker, Patrick R

    2012-07-01

    Existing mouse artery ex vivo perfusion models have utilized arteries such as carotid, uterine, and mesenteric arteries, but not the aorta. However, the aorta is the principal vessel analyzed for atherosclerosis studies in vivo. We have devised a mouse aorta ex vivo perfusion model that can bridge this gap. Aortas from apoE((-/-)) mice are embedded in a transparent, gas-permeable, and elastic polymer matrix [polydimethylsiloxane (PDMS)] and artificially perfused with cell culture medium under cell culture conditions. After 24 h of artificial ex vivo perfusion, no evidence of cellular apoptosis is detected. Utilizing a standard confocal microscope, it is possible to image specific receptor targeting of cells in atherosclerotic plaques during 24 h. Imaging motion artifacts are minimal due to the polymer matrix embedding. Re-embedding of the aorta enables tissue sectioning and immuno-histochemical analysis. The ex vivo data are validated by comparison with in vivo experiments. This model can save animal lives via production of multiple endpoints in a single experiment, is easy to apply, and enables straightforward comparability with pre-existing atherosclerosis in vivo data. It is suited to investigate atherosclerotic disease in particular and vascular biology in general.

  11. 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...

  12. 应用单光子发射断层显像评价合并大脑后动脉病变的烟雾病患者脑血流灌注%Evaluation of cerebral perfusion in moyamoya diseased patients with posterior cerebral artery lesions by single photon emission tomography examination

    Institute of Scientific and Technical Information of China (English)

    王莉; 段炼; 杨伟中; 龙亚红; 暴向阳; 赵峰; 咸鹏

    2013-01-01

    目的 分析合并大脑后动脉(PCA)病变的烟雾病患者脑血流异常灌注情况.方法 共纳入27例合并PCA病变的烟雾病患者,根据DSA检查结果,判定27例患者54侧的半球的铃木分期,及54支PCA的病变程度.27例患者均接受单光子发射断层显像术(SPECT)检查,记录额叶、顶叶、颞叶、枕叶、基底核区3~4个感兴趣区的平均局部脑血流量(rCBF),用各个脑区rCBF与小脑的rCBF的比值作为各个脑区rCBF的相对值.判定PCA病变程度、不同铃木分期对各脑叶rCBF相对值的影响. 结果 ①随着PCA病变程度的加重,额叶、顶叶、颞叶、枕叶、基底核区的rCBF相对值均逐渐下降,差异具有统计学意义,均P<0.05;其中顶叶轻度PCA病变的rCBF相对值(74±6)高于中度(63±9)、重度病变(60±17) PCA的rCBF相对值,差异有统计学意义;枕叶轻度PCA病变的rCBF相对值(72±7)高于中度(65±9)、重度病变(60±15) PCA的rCBF相对值,差异有统计学意义.②不同铃木分期的额叶、顶叶、颞叶、枕叶、基底核区rCBF相对值比较,差异均无统计学意义,P>0.05. 结论 各脑叶的rCBF相对值随着PCA病变程度加重而下降,但与铃木分期的病变程度无关.脑血管后循环病变可能是影响烟雾病患者脑血流灌注水平的重要因素.%Objective To analyze the abnormal cerebral blood flow perfusion in moyamoya diseased patients with posterior cerebral artery ( PCA) lesions. Methods A total of 27 moyamoya diseased patients with posterior cerebral artery lesions were enrolled in the study. According to the digital subtract an-giography (DSA) results, the Suzuki s stages of 27 patients ( 54 hemispheres) were determined and the PCA grading in all the 27 patients were identified. All the patients accepted single photon emission tomography ( SPECT) examination, and the mean value of three or four regions of interest was calculated in five regions ( frontal, parietal, temporal, and occipital

  13. Regional Chemotherapy of the Lung: Investigations of Isolated Lung Perfusion and Selective Pulmonary Artery Perfusion

    NARCIS (Netherlands)

    Grootenboers, M.J.J.H.

    2008-01-01

    The aim of this thesis was two-fold. First, - part I of the dissertation -, to explore ILuP with melphalan and hyperthermia followed by pulmonary metastasectomy in patients with resectable pulmonary metastases. Second, - part II -, to investigate the feasibility and pharmacokinetics of SPAP with gem

  14. Acute arterial occlusion - kidney

    Science.gov (United States)

    Acute renal arterial thrombosis; Renal artery embolism; Acute renal artery occlusion; Embolism - renal artery ... kidney can often result in permanent kidney failure. Acute arterial occlusion of the renal artery can occur after injury or trauma to ...

  15. Percutaneous isolated limb perfusion with thrombolytics for severe limb ischemia.

    Science.gov (United States)

    Ali, Ahsan T; Kalapatapu, Venkat R; Bledsoe, Shelly; Moursi, Mohammed M; Eidt, John F

    2005-01-01

    Patients with severe tibioperoneal disease are poor candidates for a distal bypass. Absence of a distal target, lack of conduit, or multiple medical problems can make these patients a prohibitive risk for revascularization. Acute on chronic ischemia in this group poses a greater challenge. Thrombolytic therapy for acute ischemia can be prolonged and carries a significant risk of bleeding if continued beyond 24 hours. However, if the ischemic limbs can be isolated from the systemic circulation, a higher dose of the lytic agent can be given with lower risk. These are the initial results of a series of 10 patients who underwent percutaneous isolated limb perfusion with a high dose of thrombolytics for severe ischemia. Ten patients (lower extremity 8 and upper extremity 2) presented with severe limb-threatening ischemia. Mean ankle/brachial index (ABI) was 0.15 for the lower extremity, and there were no recordable digital pressures in patients with upper extremity ischemia. No distal target was visible on the initial arteriogram. These patients were then taken to the operating room, and under anesthesia, catheters were placed in an antegrade fashion via femoral approach in the popliteal artery and vein percutaneously. For upper extremity, the catheters were placed in the brachial artery and vein. A proximal tourniquet was then applied. This isolated the limb from the systemic circulation. Heparinized saline was infused through the arterial catheter while the venous catheter was left open. A closed loop or an isolated limb perfusion was confirmed when effluent became clear coming out of the venous port. A high dose of thrombolytic agent (urokinase 500,000 to 1,000,000 U) was infused into the isolated limb via the arterial catheter and drained out of the venous catheter. After 45 minutes, arterial flow was reestablished. In 4 patients, Reopro((R)) was used in addition to thrombolytics. Postprocedure angiograms showed minimal changes, but patients exhibited marked

  16. Quantitative dual energy CT measurements in rabbit VX2 liver tumors: Comparison to perfusion CT measurements and histopathological findings

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Long Jiang, E-mail: kevinzhanglongjiang@yahoo.com.cn [Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 210002 (China); Wu, Shengyong, E-mail: cjr.wushengyong@vip.163.com [Institute of Tianjin Medical Imaging, Tianjin 300192 (China); Wang, Mei, E-mail: 281406196@qq.com [Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 210002 (China); Lu, Li, E-mail: xuzhoululi@163.com [Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 210002 (China); Chen, Bo, E-mail: chenbo1985@yahoo.com.cn [Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 210002 (China); Jin, Lixin, E-mail: lixin.jin@siemens.com [Siemens Healthcare, MR Collaboration NE Asia, Shanghai (China); Wang, Jiandong, E-mail: jdwang1216@163.com [Department of Pathology, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 200012 (China); Larson, Andrew C., E-mail: a-larson@northwestern.edu [Department of Radiology, Northwestern University, Chicago, IL (United States); Lu, Guang Ming, E-mail: cjr.luguangming@vip.163.com [Department of Medical Imaging, Jinling Hospital, Clinical School of Medical College, Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nangjing, Jiangsu Province 210002 (China)

    2012-08-15

    Purpose: To evaluate the correlation between quantitative dual energy CT and perfusion CT measurements in rabbit VX2 liver tumors. Materials and methods: This study was approved by the institutional animal care and use committee at our institution. Nine rabbits with VX2 liver tumors underwent contrast-enhanced dual energy CT and perfusion CT. CT attenuation for the tumors and normal liver parenchyma and tumor-to-liver ratio were obtained at the 140 kVp, 80 kVp, average weighted images and dual energy CT iodine maps. Quantitative parameters for the viable tumor and adjacent liver were measured with perfusion CT. The correlation between the enhancement values of the tumor in iodine maps and perfusion CT parameters of each tumor was analyzed. Radiation dose from dual energy CT and perfusion CT was measured. Results: Enhancement values for the tumor were higher than that for normal liver parenchyma at the hepatic arterial phase (P < 0.05). The highest tumor-to-liver ratio was obtained in hepatic arterial phase iodine map. Hepatic blood flow of the tumor was higher than that for adjacent liver (P < 0.05). Enhancement values of hepatic tumors in the iodine maps positively correlated with permeability of capillary vessel surface (r = 0.913, P < 0.001), hepatic blood flow (r = 0.512, P = 0.010), and hepatic blood volume (r = 0.464, P = 0.022) at the hepatic arterial phases. The effective radiation dose from perfusion CT was higher than that from DECT (P < 0.001). Conclusions: The enhancement values for viable tumor tissues measured in iodine maps were well correlated to perfusion CT measurements in rabbit VX2 liver tumors. Compared with perfusion CT, dual energy CT of the liver required a lower radiation dose.

  17. Abolished ventilation and perfusion of lung caused by blood clot in the left main bronchus

    DEFF Research Database (Denmark)

    Afzelius, P; Bergmann, A; Henriksen, J H

    2015-01-01

    /Q) scintigraphy with single-photon emission CT (SPECT)/CT. V/Q SPECT/CT demonstrated abolished ventilation due to obstruction of the left main bronchus and markedly reduced perfusion of the entire left lung, a condition that was completely reversed after removal of a blood clot. We present the first pictorially......It is generally assumed that the lungs possess arterial autoregulation associated with bronchial obstruction. A patient with pneumonia and congestive heart failure unexpectedly developed frequent haemoptysis. High-resolution CT and diagnostic CT were performed as well as ventilation/perfusion (V...

  18. Perfusion Angiography of the Foot in Patients with Critical Limb Ischemia: Description of the Technique

    Energy Technology Data Exchange (ETDEWEB)

    Jens, Sjoerd, E-mail: s.jens@amc.uva.nl; Marquering, Henk A., E-mail: h.a.marquering@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands); Koelemay, Mark J. W., E-mail: m.j.koelemaij@amc.uva.nl [Academic Medical Center, Department of Surgery (Netherlands); Reekers, Jim A., E-mail: j.a.reekers@amc.uva.nl [Academic Medical Center, Department of Radiology (Netherlands)

    2015-02-15

    ObjectiveTo study the feasibility of 2D perfusion imaging in critical limb ischemia (CLI).Methods/ResultsPerfusion angiography is a new technology which was tested in 18 patients with CLI of the foot. A standardized protocol was used with a catheter placed at the mid-part of the popliteal artery, and a total of 9 cc of non-ionic iodinated contrast material was injected at a rate of 3 cc/sec. The technology is based on early cardiology research where iodinated contrast agents were used for imaging of cardiac perfusion. During the first pass of the contrast, there is a significant diffusion of the contrast agents into the interstitial space, particularly for non-ionic and low-molecular-weight compounds.DiscussionThe original angiography data can be used to make a time–density curve, which represents the actual perfusion of the foot in time. Angiographic perfusion imaging is a post-processing modality for which no extra contrast or radiation is needed. With this technique, it is possible to get more information about the perfusion status and microcirculation of the foot. This is a step toward functional imaging in CLI patients.

  19. γ-Aminobutyric acid (GABA) concentration inversely correlates with basal perfusion in human occipital lobe.

    Science.gov (United States)

    Donahue, Manus J; Rane, Swati; Hussey, Erin; Mason, Emily; Pradhan, Subechhya; Waddell, Kevin W; Ally, Brandon A

    2014-03-01

    Commonly used neuroimaging approaches in humans exploit hemodynamic or metabolic indicators of brain function. However, fundamental gaps remain in our ability to relate such hemo-metabolic reactivity to neurotransmission, with recent reports providing paradoxical information regarding the relationship among basal perfusion, functional imaging contrast, and neurotransmission in awake humans. Here, sequential magnetic resonance spectroscopy (MRS) measurements of the primary inhibitory neurotransmitter, γ-aminobutyric acid (GABA+macromolecules normalized by the complex N-acetyl aspartate-N-acetyl aspartyl glutamic acid: [GABA(+)]/[NAA-NAAG]), and magnetic resonance imaging (MRI) measurements of perfusion, fractional gray-matter volume, and arterial arrival time (AAT) are recorded in human visual cortex from a controlled cohort of young adult male volunteers with neurocognitive battery-confirmed comparable cognitive capacity (3 T; n=16; age=23±3 years). Regression analyses reveal an inverse correlation between [GABA(+)]/[NAA-NAAG] and perfusion (R=-0.46; P=0.037), yet no relationship between AAT and [GABA(+)]/[NAA-NAAG] (R=-0.12; P=0.33). Perfusion measurements that do not control for AAT variations reveal reduced correlations between [GABA(+)]/[NAA-NAAG] and perfusion (R=-0.13; P=0.32). These findings largely reconcile contradictory reports between perfusion and inhibitory tone, and underscore the physiologic origins of the growing literature relating functional imaging signals, hemodynamics, and neurotransmission.

  20. A low-cost, small volume circuit for autologous blood normothermic perfusion of rabbit organs.

    Science.gov (United States)

    Worner, Murray; Poore, Samuel; Tilkorn, Daniel; Lokmic, Zerina; Penington, Anthony J

    2014-04-01

    We have designed a laboratory extracorporeal normothermic blood perfusion system for whole organs (e.g., kidney) that achieves pulsatile flow, low levels of hemolysis, and a blood priming volume of 60 mL or less. Using this uniquely designed extracorporeal circuit, we have achieved perfusion of two isolated ex vivo constructs. In the first experiment, we successfully perfused a rabbit epigastric flap based on the femoral vessels. In the second experiment, we were able to perfuse the isolated rabbit kidney for 48 h (range for all kidneys was 12-48 h) with excellent urine output, normal arterial blood gasses at 24 h, and normal ex vivo kidney histology at the conclusion of the experiments. These parameters have not been achieved before with any known or previously published laboratory extracorporeal circuits. The study has implications for prolonged organ perfusion prior to transplantation and for tissue engineering of vascularized tissues, such as by the perfusion of decellularized organs.

  1. Lung cancer perfusion: can we measure pulmonary and bronchial circulation simultaneously?

    Energy Technology Data Exchange (ETDEWEB)

    Yuan, Xiaodong; Ao, Guokun; Quan, Changbin; Tian, Yuan; Li, Hong [Hospital of Chinese People' s Liberation Army, Department of Radiology, Beijing (China); Zhang, Jing [Tongji Hospital of Tongji University, Department of Radiology, Shanghai (China)

    2012-08-15

    To describe a new CT perfusion technique for assessing the dual blood supply in lung cancer and present the initial results. This study was approved by the institutional review board. A CT protocol was developed, and a dual-input CT perfusion (DI-CTP) analysis model was applied and evaluated regarding the blood flow fractions in lung tumours. The pulmonary trunk and the descending aorta were selected as the input arteries for the pulmonary circulation and the bronchial circulation respectively. Pulmonary flow (PF), bronchial flow (BF), and a perfusion index (PI, = PF/ (PF + BF)) were calculated using the maximum slope method. After written informed consent was obtained, 13 consecutive subjects with primary lung cancer underwent DI-CTP. Perfusion results are as follows: PF, 13.45 {+-} 10.97 ml/min/100 ml; BF, 48.67 {+-} 28.87 ml/min/100 ml; PI, 21 % {+-} 11 %. BF is significantly larger than PF, P < 0.001. There is a negative correlation between the tumour volume and perfusion index (r = 0.671, P = 0.012). The dual-input CT perfusion analysis method can be applied successfully to lung tumours. Initial results demonstrate a dual blood supply in primary lung cancer, in which the systemic circulation is dominant, and that the proportion of the two circulation systems is moderately dependent on tumour size. (orig.)

  2. Application of time sampling in brain CT perfusion imaging for dose reduction

    Science.gov (United States)

    Lee, S. H.; Kim, J. H.; Kim, K. G.; Park, S. J.; Im, Jung Gi

    2007-03-01

    The purpose of this study is to determine a stable sampling rate not to be affected by sampling shift for reducing radiation exposure with time sampling and interpolation in cerebral perfusion CT examination. Original images were obtained every 1 second for 40 time series from 3 patients, respectively. Time sampling was performed with sampling intervals (SI) from 2 to 10 seconds. Sampling shift was applied from +1 to SI-1 for each sampling rate. For each patient, 30 tissue concentration time-course data were collected, and arterial input curves were fitted by gamma-variate function. The sinc function was introduced for interpolation. Deconvolution analysis based on SVD was performed for quantifying perfusion parameters. The perfusion values through time-varying sampling and interpolation were statistically compared with the original perfusion values. The mean CBF values with increase of sampling interval and shift magnitude from the collected data had a wider fluctuation pattern centering around the original mean CBF. The mean CBV values had a similar tendency to the mean CBF values, but a relatively narrower deviation. The mean MTT values were fluctuated reversely to the trend of the mean CBF values. The stable sampling interval for quantifying perfusion parameters with lower radiation exposure was statistically acceptable up to 4 seconds. These results indicate that sampling shift limits sampling rate for acquiring acceptable perfusion values. This study will help in selecting more reasonable sampling rate for low-radiation-dose CT examination.

  3. The clinical value of myocardial perfusion imaging and coronary artery calcification with fusion imaging by acquisition by SPECT/CT in detection of coronary artery disease in elderly patients%单光子发射断层与透射断层图像融合探查心肌灌注和冠状动脉钙化在老年患者中的临床价值

    Institute of Scientific and Technical Information of China (English)

    薛倩倩; 姚稚明; 于治国; 刘秀芹; 陈聪霞; 郭悦; 李文婵; 李旭; 许斌

    2015-01-01

    Objective To investigate the clinical value of myocardial perfusion imaging (MPI) and coronary artery calcification (CAC) with one-stop-shop acquisition by SPECT/CT in detection of coronary artery disease (CAD) in elderly patients.Methods The 133 patients with suspected or diagnosed CAD who underwent gated MPI and CAC scan by SPECT/CT during October 2012 to December 2012 were prospectively studied.All patients were divided into elderly group (aged ≥60 years) and non-elderly group (aged<60 years),normal MPI group and abnormal MPI group,and 0,1-9,10-99,100-399,≥400 subgroups according to CAC scores (CACS).Mann-Whitney U test,Kruskal-Wallis one-way AVOVA test,x2 test,Fisher's exact test were performed for statistical analysis.Results CAC positive rate and CACS were higher in normal MPI group than in abnormal MPI group [72.6% (69/95) vs.52.6% (20/38),(386.8±815.0)scores vs.(56.5±109.0)scores,P<0.05 or 0.01].The abnormal MPI rate was higher in CACS ≥400 group than in the other four CACS groups (P<0.05 或 P<0.01),there was no significant difference between the other four CACS groups (P>0.05).The sensitivity,specificity and accuracy of CAC in detection of myocardial ischemia or infarction were 72.6% (69/95),47.4% (18/38),65.4% (87/133),respectively.The CACS was higher in elderly group than in non-elderly group[(356.7 ± 790.0)scores vs.(89.7± 233.0)scores,P<0.01].The sensitivity of CAC in detection of myocardial ischemia was higher in elderly group than in non-elderly group [79.7% (59/74) vs.47.6% (10/21),P<0.01],while the specificity in elderly group had a decreased tendency as compared with non-elderly group [72.7% (10/27) vs.37.0% (8/11),P>0.05].Conclusions One-stop-shop acquisition of MPI and CAC by SPECT/CT is convenient.MPI-CAC SPECT/CT may offer comprehensive information on both myocardial perfusion and CAC and provide a better information platform for the accurate exploration of myocardial ischemia and infarction in

  4. Characterization of hepatocellular carcinoma (HCC) lesions using a novel CT-based volume perfusion (VPCT) technique

    Energy Technology Data Exchange (ETDEWEB)

    Kaufmann, S., E-mail: sascha.kaufmann@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, T., E-mail: horger@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Oelker, A., E-mail: oelker@ma.tum.de [Technische Universität München, Boltzmannstraße 3, 85748 Garching (Germany); Kloth, C., E-mail: christopher.kloth@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Nikolaou, K., E-mail: Konstantin.Nikolaou@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Schulze, M., E-mail: maximilian.schulze@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany); Horger, M., E-mail: marius.horger@med.uni-tuebingen.de [Department of Diagnostic and Interventional Radiology, Eberhard-Karls-University, Hoppe-Seyler-Strasse 3, 72076 Tübingen (Germany)

    2015-06-15

    Highlights: • Quantification of perfusion with VPCT has great potential for functional imaging. • We present our preliminary results of perfusion parameters (Blood Flow, Blood Volume and kk-trans) of hepatocellular carcinoma (HCC) in terms of using VPCT and two different calculation methods, compare their results and look for correlation between tumor arterialization and lesion size. • VPCT can measure tumor volume perfusion non-invasively and enables quantification of the degree of HCC arterialization. Results are dependent on the technique used with best inter-method correlation for Blood Flow. • Tumor arterialization did not proved size-dependent. - Abstract: Objective: To characterize hepatocellular carcinoma (HCC) in terms of perfusion parameters using volume perfusion CT (VPCT) and two different calculation methods, compare their results, look for interobserver agreement of measurements and correlation between tumor arterialization and lesion size. Material and methods: This study was part of a prospective monitoring study in patients with HCC undergoing TACE, which was approved by the local Institutional Review Board. 79 HCC-patients (mean age, 64.7) with liver cirrhosis were enrolled. VPCT was performed for 40 s covering the involved liver (80 kV, 100/120 mAs) using 64 mm × 0.6 mm collimation, 26 consecutive volume measurements, 50 mL iodinated contrast IV and 5 mL/s flow rate. Mean/maximum blood flow (BF; ml/100 mL/min), blood volume (BV) and k-trans were determined both with the maximum slope + Patlak vs. deconvolution method. Additionally, the portal venous liver perfusion (PVP), the arterial liver perfusion (ALP) and the hepatic perfusion index (HPI) were determined for each tumor including size measurements. Interobserver agreement for all perfusion parameters was calculated using intraclass correlation coefficients (ICC). Results: The max. slope + Patlak method yielded: BFmean/max = 37.8/57 mL/100 g-tissue/′, BVmean/max = 9.8/11.1 mL/100 g

  5. Does machine perfusion decrease ischemia reperfusion injury?

    Science.gov (United States)

    Bon, D; Delpech, P-O; Chatauret, N; Hauet, T; Badet, L; Barrou, B

    2014-06-01

    In 1990's, use of machine perfusion for organ preservation has been abandoned because of improvement of preservation solutions, efficient without perfusion, easy to use and cheaper. Since the last 15 years, a renewed interest for machine perfusion emerged based on studies performed on preclinical model and seems to make consensus in case of expanded criteria donors or deceased after cardiac death donations. We present relevant studies highlighted the efficiency of preservation with hypothermic machine perfusion compared to static cold storage. Machines for organ preservation being in constant evolution, we also summarized recent developments included direct oxygenation of the perfusat. Machine perfusion technology also enables organ reconditioning during the last hours of preservation through a short period of perfusion on hypothermia, subnormothermia or normothermia. We present significant or low advantages for machine perfusion against ischemia reperfusion injuries regarding at least one primary parameter: risk of DFG, organ function or graft survival.

  6. Assessment of perfusion pattern and extent of perfusion defect on dual-energy CT angiography: Correlation between the causes of pulmonary hypertension and vascular parameters

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eun Young [Dept. of Radiology, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine, Jeonju (Korea, Republic of); Seo, Joon Beom; Oh, Sang Young; Lee, Choong Wook; Lee, Sang Min [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Hwang, Hye Jeon [Dept. of Radiology, Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Anyang (Korea, Republic of); Lee, Young Kyung [Dept. of Radiology, Seoul Medical Center, Seoul (Korea, Republic of)

    2014-04-15

    To assess perfusion patterns on a dual-energy pulmonary CT angiography (DECTA) of pulmonary hypertension (PHT) with variable causes and to assess whether the extent of perfusion defect can be used in the severity assessment of PHT. Between March 2007 and February 2011, DECTA scans of 62 consecutive patients (24 men, 38 women; mean age, 58.5 ± 17.3 [standard deviation] years; range, 19-87 years) with PHT were retrospectively included with following inclusion criteria; 1) absence of acute pulmonary thromboembolism, 2) maximal velocity of tricuspid regurgitation jet (TR Vmax) above 3 m/s on echocardiography performed within one week of the DECTA study. Perfusion patterns of iodine map were divided into normal (NL), diffuse heterogeneously decreased (DH), multifocal geographic and multiple peripheral wedging patterns. The extent of perfusion defects (PD), the diameter of main pulmonary artery (MPA) and the ratio of ascending aorta diameter/MPA (aortopulmonary ratio, APR) were measured. Pearson correlation analysis was performed between TR Vmax on echocardiography and CT imaging parameters. Common perfusion patterns of primary PHT were DH (n = 15) and NL (n = 12). The perfusion patterns of secondary PHT were variable. On the correlation analysis, in primary PHT, TR Vmax significantly correlated with PD, MPA and APR (r = 0.52, r = 0.40, r = -0.50, respectively, all p < 0.05). In secondary PHT, TR Vmax significantly correlated with PD and MPA (r = 0.38, r = 0.53, respectively, all p < 0.05). Different perfusion patterns are observed on DECTA of PHT according to the causes. PD and MPA are significantly correlated with the TR Vmax.

  7. Fate-mapping the mammalian hindbrain: segmental origins of vestibular projection neurons assessed using rhombomere-specific Hoxa2 enhancer elements in the mouse embryo.

    Science.gov (United States)

    Pasqualetti, Massimo; Díaz, Carmen; Renaud, Jean-Sébastien; Rijli, Filippo M; Glover, Joel C

    2007-09-05

    As a step toward generating a fate map of identified neuron populations in the mammalian hindbrain, we assessed the contributions of individual rhombomeres to the vestibular nuclear complex, a major sensorimotor area that spans the entire rhombencephalon. Transgenic mice harboring either the lacZ or the enhanced green fluorescent protein reporter genes under the transcriptional control of rhombomere-specific Hoxa2 enhancer elements were used to visualize rhombomere-derived domains. We labeled functionally identifiable vestibular projection neuron groups retrogradely with conjugated dextran-amines at successive embryonic stages and obtained developmental fate maps through direct comparison with the rhombomere-derived domains in the same embryos. The fate maps show that each vestibular neuron group derives from a unique rostrocaudal domain that is relatively stable developmentally, suggesting that anteroposterior migration is not a major contributor to the rostrocaudal patterning of the vestibular system. Most of the groups are multisegmental in origin, and each rhombomere is fated to give rise to two or more vestibular projection neuron types, in a complex pattern that is not segmentally iterated. Comparison with studies in the chicken embryo shows that the rostrocaudal patterning of identified vestibular projection neuron groups is generally well conserved between avians and mammalians but that significant species-specific differences exist in the rostrocaudal limits of particular groups. This mammalian hindbrain fate map can be used as the basis for targeting genetic manipulation to specific subpopulations of vestibular projection neurons.

  8. Criteria for viability assessment of discarded human donor livers during ex vivo normothermic machine perfusion.

    Directory of Open Access Journals (Sweden)

    Michael E Sutton

    Full Text Available Although normothermic machine perfusion of donor livers may allow assessment of graft viability prior to transplantation, there are currently no data on what would be a good parameter of graft viability. To determine whether bile production is a suitable biomarker that can be used to discriminate viable from non-viable livers we have studied functional performance as well as biochemical and histological evidence of hepatobiliary injury during ex vivo normothermic machine perfusion of human donor livers. After a median duration of cold storage of 6.5 h, twelve extended criteria human donor livers that were declined for transplantation were ex vivo perfused for 6 h at 37 °C with an oxygenated solution based on red blood cells and plasma, using pressure controlled pulsatile perfusion of the hepatic artery and continuous portal perfusion. During perfusion, two patterns of bile flow were identified: (1 steadily increasing bile production, resulting in a cumulative output of ≥ 30 g after 6 h (high bile output group, and (2 a cumulative bile production <20 g in 6 h (low bile output group. Concentrations of transaminases and potassium in the perfusion fluid were significantly higher in the low bile output group, compared to the high bile output group. Biliary concentrations of bilirubin and bicarbonate were respectively 4 times and 2 times higher in the high bile output group. Livers in the low bile output group displayed more signs of hepatic necrosis and venous congestion, compared to the high bile output group. In conclusion, bile production could be an easily assessable biomarker of hepatic viability during ex vivo machine perfusion of human donor livers. It could potentially be used to identify extended criteria livers that are suitable for transplantation. These ex vivo findings need to be confirmed in a transplant experiment or a clinical trial.

  9. Pressure and oxygen debt on bypass - potential quality markers of perfusion?

    Science.gov (United States)

    Poullis, Mike; Palmer, K; Al-Rawi, O; Johnson, I; Ridgeway, T

    2012-05-01

    No markers of quality of perfusion pressure and oxygen delivery during cardiopulmonary bypass (CPB), to complement rewarming rate, maximum temperature on rewarming, lowest haematocrit, and blood glucose, exist. Using the electronic acquisition of blood pressure on bypass (JOCAP system), the percentage of time perfusion pressure was below 30, 40, 50, 60 and 70 mmHg, average deviance, confidence interval, median, mode, standard deviation, variance, and average, maximum and cumulative oxygen debt were calculated. Numerous different readouts of achievement of maintenance of constant pressure on bypass and oxygen debt are now easily achievable with perfusion electronic data management systems. Mean, median, and mode offer poor discrimination of pressure control during CPB. Percentage of time perfusion pressure was below 30, 40, 50, 60 and 70 mmHg, average deviance, confidence interval, and standard deviation all have discriminatory power, but need clinical correlation for their significance. A composite score involving non-pressure readouts (e.g. oxygen delivery, arterial and venous saturations, and flow rates) may need to be integrated into any perfusion quality marker. Assessment of adequacy of constant perfusion pressure and oxygen delivery may allow the scientific evaluation of pressure and oxygen delivery on bypass for patients to be compared accurately. Currently, in studies involving CPB, blood pressure targets are stated with no quantitative assessment of adequacy of achievement of these targets. Electronic data monitoring during cardiopulmonary bypass, when correlated with clinical outcome, may help to provide a marker of quality of perfusion pressure during CPB and may, indeed, allow patient-specific perfusion pressure strategies to be developed.

  10. Retinal arterial occlusion in Takayasu′s arteritis

    Directory of Open Access Journals (Sweden)

    Kaushik Sushmita

    2005-01-01

    Full Text Available Takayasu′s arteritis is an auto-immune disorder of the large and medium-sized arteries, commonly involving the heart and its main vessels. It is now recognised that the inflammatory process of the large arteries affects regions of the walls supplied by the vasa vasorum, suggesting that primary small vessel involvement may contribute to the development of the clinico-pathological features of Takayasu aorto-arteritis. Classical ophthalmic features of the disease result from reduced ocular perfusion, which manifests as hypoxic retinal changes such as microaneurysms, arterio-venous anastomosis and non-perfused areas. Branch retinal artery occlusion has not been previously described in this condition. This case illustrates retinal arterial occlusion as the presenting feature of Takayasu′s arteritis.

  11. Is correction necessary when clinically determining quantitative cerebral perfusion parameters from multi-slice dynamic susceptibility contrast MR studies?

    Science.gov (United States)

    Salluzzi, M; Frayne, R; Smith, M R

    2006-01-21

    Several groups have modified the standard singular value decomposition (SVD) algorithm to produce delay-insensitive cerebral blood flow (CBF) estimates from dynamic susceptibility contrast (DSC) perfusion studies. However, new dependences of CBF estimates on bolus arrival times and slice position in multi-slice studies have been recently recognized. These conflicting findings can be reconciled by accounting for several experimental and algorithmic factors. Using simulation and clinical studies, the non-simultaneous measurement of arterial and tissue concentration curves (relative slice position) in a multi-slice study is shown to affect time-related perfusion parameters, e.g. arterial-tissue-delay measurements. However, the current clinical impact of relative slice position on amplitude-related perfusion parameters, e.g. CBF, can be expected to be small unless any of the following conditions are present individually or in combination: (a) high concentration curve signal-to-noise ratios, (b) small tissue mean transit times, (c) narrow arterial input functions or (d) low temporal resolution of the DSC image sequence. Recent improvements in magnetic resonance (MR) technology can easily be expected to lead to scenarios where these effects become increasingly important sources of inaccuracy for all perfusion parameter estimates. We show that using Fourier interpolated (high temporal resolution) residue functions reduces the systematic error of the perfusion parameters obtained from multi-slice studies.

  12. Is correction necessary when clinically determining quantitative cerebral perfusion parameters from multi-slice dynamic susceptibility contrast MR studies?

    Science.gov (United States)

    Salluzzi, M.; Frayne, R.; Smith, M. R.

    2006-01-01

    Several groups have modified the standard singular value decomposition (SVD) algorithm to produce delay-insensitive cerebral blood flow (CBF) estimates from dynamic susceptibility contrast (DSC) perfusion studies. However, new dependences of CBF estimates on bolus arrival times and slice position in multi-slice studies have been recently recognized. These conflicting findings can be reconciled by accounting for several experimental and algorithmic factors. Using simulation and clinical studies, the non-simultaneous measurement of arterial and tissue concentration curves (relative slice position) in a multi-slice study is shown to affect time-related perfusion parameters, e.g. arterial-tissue-delay measurements. However, the current clinical impact of relative slice position on amplitude-related perfusion parameters, e.g. CBF, can be expected to be small unless any of the following conditions are present individually or in combination: (a) high concentration curve signal-to-noise ratios, (b) small tissue mean transit times, (c) narrow arterial input functions or (d) low temporal resolution of the DSC image sequence. Recent improvements in magnetic resonance (MR) technology can easily be expected to lead to scenarios where these effects become increasingly important sources of inaccuracy for all perfusion parameter estimates. We show that using Fourier interpolated (high temporal resolution) residue functions reduces the systematic error of the perfusion parameters obtained from multi-slice studies. Preliminary results associated with this paper were presented at ISMRM 12th Scientific Meeting and Exhibition, Kyoto, Japan, 2004.

  13. Pseudoaneurysm of the superior gluteal artery following polytrauma.

    Science.gov (United States)

    Lee, Dennis; Legiehn, Gerald M; Munk, Peter L

    2007-09-01

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis.

  14. Pseudoaneurysm of the superior gluteal artery following polytrauma

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Dennis [Vancouver General Hospital, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Legiehn, Gerald M. [Vancouver General Hospital, Interventional Radiology, University of British Columbia and Department of Radiology, Vancouver, BC (Canada); Munk, Peter L. [Vancouver General Hospital, MSK Section, University of British Columbia and Department of Radiology, Vancouver, BC (Canada)

    2007-09-15

    Gluteal artery aneurysms are rare and often secondary to pelvic fractures, blunt or penetrating trauma. We describe a case of a superior gluteal artery pseudoaneurysm that presented as back pain with numbness and weakness of the lower extremities. Diagnosis was confirmed by color Doppler sonography and angiography. A proximal and distal control was obtained over the aneurysm neck via coil embolization with excellent hemostasis within the pseudoaneurysm and maintenance of perfusion to the left pelvis. (orig.)

  15. Pressure Myography to Study the Function and Structure of isolated small arteries

    DEFF Research Database (Denmark)

    Schjørring, Olav; Carlsson, Rune; Simonsen, Ulf

    2015-01-01

    Small arteries play an important role in regulation of peripheral resistance and organ perfusion. Here we describe a series of the methods allowing measurements in pressurized segments of small arteries from the systemic and coronary circulation of mice as well as other species. The pressure myog...

  16. 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

  17. Prenatal MRI diagnosis of twin reverse arterial perfusion syndrome:a report of 4 cases and review of literature%双胎反向动脉灌注序列征的 MRI 产前诊断(附4例报告及文献复习)

    Institute of Scientific and Technical Information of China (English)

    庞颖; 夏黎明; 杨小红

    2014-01-01

    Objective:To investigate the characteristics and diagnostic value of MRI for twin reverse arterial perfusion (TRAP)syndrome.Methods:A retrospective study was performed in 83 pregnant women with various fetal malformations. Single-shot fast spin-echo T2-weighted sequences (SSFSE),thick-slab heavy T2 WI with SSFSE and three-dimensional fast imaging employing steady state acquisition were performed.Among the 83 cases,TRAP were confirmed in 4 cases by autop-sy after induced abortion and follow-up records.The MRI images,clinical data and pregnancy outcomes were all analyzed, and MRI characteristics of the TRAP were summarized.Results:4 cases with TRAP were initially diagnosed during 12~31 weeks'gestation.Each acardiac recipient twin of the 4 cases had none or abnormal heart,with various severe malformations. One of 4 cases was born prematurely at 28 weeks and 5 days'gestation and the twins both died.Induced labor was performed in 2 cases.The acardiac recipient twin in one case was detected as stillbirth by ultrasound examination at 24 week'gestation and this case was delivered at 37 weeks'gestation with the pump twin delivered alive.Conclusion:MRI as a complementary method of ultrasound has great applicative value for TRAP syndrome in early diagnosis,prognosis assessment,decisions of optimal treatment and selection of deliver time.%目的:探讨双胎反向动脉灌注序列征(TRAP)的 MRI表现及其诊断价值。方法:回顾性分析本院83例不同的胎儿畸形的 MRI资料,MRI扫描均采集单次激发快速自旋回波序列(SSFSE)、厚层重T2加权成像 SSFSE 序列、三维稳态进动快速成像(3D-FIESTA)序列,其中胎儿引产尸检及随访证实其中的TRAP有4例。分析其 MRI图像、临床资料及妊娠结局,总结TRAP的 MRI影像学特征。结果:4例TRAP 初次确诊的孕周为12~31周。4例TRAP 中每例无心胎儿均缺乏或无正常的心脏,且伴发各种不同的严重畸形。4例TRAP中1

  18. Anomalous origin of the right coronary artery from the pulmonary artery: an autopsied sudden death case with severe atherosclerotic disease of the left coronary artery.

    Science.gov (United States)

    Nagai, T; Mukai, T; Takahashi, S; Takada, A; Saito, K; Harada, K; Mori, S; Abe, N

    2014-03-01

    Anomalous origin of the right coronary artery from the pulmonary artery (ARCAPA) is a rare anomaly. It may contribute to myocardial ischemia or sudden death, although the lesion is usually asymptomatic. We report a sudden death case of a 58-year-old man with ARCAPA coexisting with severe atherosclerotic coronary artery disease. He had been healthy until he complained of chest pain, several days before death, despite the discovery of heart murmur in childhood and suspicion of valvular heart disease. The autopsy revealed not only typical findings of the right coronary anomaly with well-developed collateral circulations but also severe atherosclerotic lesions of the left coronary artery, and ischemic change of the myocardium in the left and right coronary arterial perfusion territory. In addition to the "coronary steal" phenomenon primarily caused by ARCAPA, the reduced flow of both coronary arteries and further increase of "coronary steal" due to atherosclerotic obstructive coronary disease might have contributed to the patient's death.

  19. Correlation of angina pectoris and perfusion decrease by collateral circulation in single-vessel coronary chronic total occlusion using myocardial perfusion single-photon emssion computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Geon; Park, Ki Seong; Kang, Sae Ryung [Chonnam National University Hospital, Gwangju (Korea, Republic of); and others

    2016-03-15

    To evaluate the perfusion decrease in donor myocardium by collateral circulation and its correlation with angina pectoris in patients with chronic total occlusion (CTO) using myocardial perfusion single-photon emission computed tomography (MPS). Thirty-six patients with single-vessel CTO without any other stenosis were included. All patients underwent MPS and coronary angiography (CAG) within 2 months. Total 72 donor arteries were evaluated for the grades of collaterals to the CTO artery using the Rentrop grading system on CAG. Perfusion defects and perfusion scores in donor and CTO territories were analyzed on MPS. Myocardial perfusion of donor and CTO territories were evaluated according to the presence of angina pectoris and the grades of collateral circulation. When the CTO territory was ischemic, symptomatic patients showed higher summed difference scores in the CTO territory compared to asymptomatic patients (3.5 ± 2.4 vs. 1.5 ± 0.8 for symptomatic and asymptomatic groups respectively; p = 0.034). However, when the CTO territory was nonischemic, symptomatic patients showed higher summed stress scores (SSS, 4.3 ± 2.9 vs. 1.6 ± 1.2; p = 0.032) and summed rest scores (SRS, 4.2 ± 2.5 vs. 1.5 ± 1.1; p = 0.003) in the donor territories. On the per-vessel analysis, perfusion defects in donor territories were more frequent (0 % vs. 53 % vs. 86 % for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p < 0.001) and showed higher SSS (0.0 ± 0.0, 1.3 ± 1.6 and 2.1 ± 1.1 for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p = 0.001) and SRS (0.0 ± 0.0, 1.0 ± 1.4 and 1.7 ± 1.2; p = 0.003) at higher Rentrop grades, but their patterns were variable. Angina pectoris was related to either ischemia of the myocardium beyond CTO or a perfusion decrease in the donor myocardium. The perfusion decrease in donor myocardium positively correlated with the collateral grades.

  20. Mean transit time image - a new method of analyzing brain perfusion studies

    Energy Technology Data Exchange (ETDEWEB)

    Szabo, Z.; Ritzl, F.

    1983-05-01

    Point-by-point calculation of the mean transit time based on gamma fit was used to analyze brain perfusion studies in a vertex view. The algorithm and preliminary results in normal brain and in different stages of cerebral perfusion abnormality (ischemia, stroke, migraine, tumor, abscess) are demonstrated. In contrast to the traditional methods using fixed, a priori defined regions of interest this type of mapping of the relative regions cerebral perfusion shows more clearly the irregular outlines of the disturbance. Right to left activity ratios in the arterial part of the time-activity curves showed significant correlation with the mean transit time ratios (Q/sub 1/=1.185-0.192 Qsub(a), n=38, r=0.716, P<0.001).

  1. Blood perfusion in osteomyelitis studied with [(15)O]water PET in a juvenile porcine model

    DEFF Research Database (Denmark)

    Jødal, Lars; Nielsen, Ole L; Afzelius, Pia;

    2017-01-01

    BACKGROUND: Osteomyelitis is a serious disease which can be difficult to treat despite properly instituted antibiotic therapy. This appears to be related at least partly to degraded vascularisation in the osteomyelitic (OM) lesions. Studies of perfusion in OM bones are, however, few and not quant......BACKGROUND: Osteomyelitis is a serious disease which can be difficult to treat despite properly instituted antibiotic therapy. This appears to be related at least partly to degraded vascularisation in the osteomyelitic (OM) lesions. Studies of perfusion in OM bones are, however, few...... that perfusion will be less elevated in OM lesions than in soft tissue (ST) infection. The study comprised 11 juvenile pigs with haematogenous osteomyelitis induced by injection of Staphylococcus aureus into the right femoral artery 1 week before scanning (in one pig, 2 weeks). The pigs were dynamically PET...

  2. 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 sig