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Sample records for cerebral misery perfusion

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

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    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

  2. Cerebral misery perfusion diagnosed using hypercapnic blood-oxygenation-level-dependent contrast functional magnetic resonance imaging: a case report

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    D'Souza Olympio

    2010-02-01

    Full Text Available Abstract Introduction Cerebral misery perfusion represents a failure of cerebral autoregulation. It is an important differential diagnosis in post-stroke patients presenting with collapses in the presence of haemodynamically significant cerebrovascular stenosis. This is particularly the case when cortical or internal watershed infarcts are present. When this condition occurs, further investigation should be done immediately. Case presentation A 50-year-old Caucasian man presented with a stroke secondary to complete occlusion of his left internal carotid artery. He went on to suffer recurrent seizures. Neuroimaging demonstrated numerous new watershed-territory cerebral infarcts. No source of arterial thromboembolism was demonstrable. Hypercapnic blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging was used to measure his cerebrovascular reserve capacity. The findings were suggestive of cerebral misery perfusion. Conclusions Blood-oxygenation-level-dependent-contrast functional magnetic resonance imaging allows the inference of cerebral misery perfusion. This procedure is cheaper and more readily available than positron emission tomography imaging, which is the current gold standard diagnostic test. The most evaluated treatment for cerebral misery perfusion is extracranial-intracranial bypass. Although previous trials of this have been unfavourable, the results of new studies involving extracranial-intracranial bypass in high-risk patients identified during cerebral perfusion imaging are awaited. Cerebral misery perfusion is an important and under-recognized condition in which emerging imaging and treatment modalities present the possibility of practical and evidence-based management in the near future. Physicians should thus be aware of this disorder and of recent developments in diagnostic tests that allow its detection.

  3. SPECT measurement of cerebral hemodynamics in transient ischemic attack patients; Evaluation of pathogenesis and detection of misery perfusion

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    Toyama, Hiroshi; Takeshita, Gen; Takeuchi, Akira; Ejiri, Kazutaka; Maeda, Hisato; Katada, Kazuhiro; Koga, Sukehiko; Ishiyama, Norio; Kanno, Tetsuo (Fujita-Gakuen Health Univ., Toyoake, Aichi (Japan))

    1989-12-01

    To evaluate the cerebral hemodynamics and the pathogenesis by regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV), 42 transient ischemic attack (TIA) patients and 9 normal volunteers were studied using SPECT. We classified these patients into Group A (n=23: no occlusion or stenosis of the internal carotid or middle cerebral artery; non large vessel disease) and Group B (n=19: chronic occlusion or severe stenosis of the internal carotid or middle cerebral artery; large vessel disease). We obtained rCBF with {sup 133}Xe inhalation and rCBV with {sup 99m}Tc-red blood cells. Of 9 normal volunteers aged 43-70 yr (mean age 59.8{plus minus} 8.3 yr), the mean rCBF was 45.8{plus minus} 5.1 (ml/100 g brain/min), the mean rCBV was 4.0{plus minus} 0.4 (ml/100 g brain). The examination was done by comparing the values of the affected hemispheres of Group A and Group B patients with the mean rCBF and the mean rCBV of normal volunteers. Eleven out of Group A patients and 15 out of Group B patients showed decreased rCBF. But of those patients, no patients of Group A showed increased rCBV and 6 out of 19 Group B patients showed increased rCBV. Thromboembolic mechanism which is of Group A patients and Group B patients without increased rCBV, and hemodynamic mechanism which is of Group B patients with increased rCBV were considered as the main cause of TIA. Decreased rCBF and increased rCBV in Group B patients can be assumed as the misery perfusion as reported in PET studies. We conclude that SPECT measurement of not only rCBF but also rCBV on TIA patients is very significant to evaluate the pathogenesis and to detect the misery perfusion. (author).

  4. Long-term effects of cerebral hypoperfusion on neural density and function using misery perfusion animal model.

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    Nishino, Asuka; Tajima, Yosuke; Takuwa, Hiroyuki; Masamoto, Kazuto; Taniguchi, Junko; Wakizaka, Hidekatsu; Kokuryo, Daisuke; Urushihata, Takuya; Aoki, Ichio; Kanno, Iwao; Tomita, Yutaka; Suzuki, Norihiro; Ikoma, Yoko; Ito, Hiroshi

    2016-04-27

    We investigated the chronic effects of cerebral hypoperfusion on neuronal density and functional hyperemia using our misery perfusion mouse model under unilateral common carotid artery occlusion (UCCAO). Neuronal density evaluated 28 days after UCCAO using [(11)C]flumazenil-PET and histology indicated no neurologic deficit in the hippocampus and neocortex. CBF response to sensory stimulation was assessed using laser-Doppler flowmetry. Percentage changes in CBF response of the ipsilateral hemisphere to UCCAO were 18.4 ± 3.0%, 6.9 ± 2.8%, 6.8 ± 2.3% and 4.9 ± 2.4% before, and 7, 14 and 28 days after UCCAO, respectively. Statistical significance was found at 7, 14 and 28 days after UCCAO (P < 0.01). Contrary to our previous finding (Tajima et al. 2014) showing recovered CBF response to hypercapnia on 28 days after UCCAO using the same model, functional hyperemia was sustained and became worse 28 days after UCCAO.

  5. 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

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    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

  6. Can the detection of misery perfusion in chronic cerebrovascular disease be based on reductions in baseline CBF and vasoreactivity?

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    Okazawa, Hidehiko; Kobayashi, Masato; Pagani, Marco; Yonekura, Yoshiharu [University of Fukui, Biomedical Imaging Research Center, Matcuoka-cho, Fukui (Japan); Tsuchida, Tatsuro [Faculty of Medical Sciences, University of Fukui, Department of Radiology, Fukui (Japan); Arai, Yoshikazu; Isozaki, Makoto [University of Fukui, Department of Neurosurgery, Faculty of Medical Sciences, Fukui (Japan)

    2007-01-15

    The aim of this study was to clarify whether decreases in baseline regional cerebral blood flow (rCBF) and in residual cerebral vasoreactivity (CVR), assessed by the acetazolamide (ACZ) challenge, can detect misery perfusion in patients with chronic cerebrovascular disease (CVD). Oxygen extraction fraction (OEF) and other haemodynamic parameters were measured in 115 patients (64{+-}9 years old) with unilateral cerebrovascular steno-occlusive disease (>70% stenosis) using {sup 15}O-gas and water PET. A significant elevation of OEF, by greater than the mean+2SD compared with healthy controls, was defined as misery perfusion. CBF, CVR determined by percent change in CBF after ACZ administration, OEF and other haemodynamic parameters in the territories of the bilateral middle cerebral arteries were analysed. Diagnostic accuracy for the detection of misery perfusion using the criteria determined by baseline CBF and CVR was evaluated in all patients and in only those patients with occlusive lesions. Ten of 24 patients with misery perfusion showed a significant reduction in CVR. Using criteria determined by significant decreases in CVR and baseline CBF, misery perfusion was detected with a sensitivity of 42% and a specificity of 95% in all patients. In patients with occlusive lesions (n=50), sensitivity was higher but specificity was slightly lower. The diagnostic accuracy of the threshold determined by baseline CBF alone was similar in all patients and in only those patients with occlusive lesions, and was higher than that achieved using the asymmetry index of OEF. Reductions in CVR and baseline CBF in the ACZ challenge for CVD would detect misery perfusion with high specificity. Reduction in baseline rCBF is more accurate than reduction in CVR alone for the detection of misery perfusion. (orig.)

  7. Changes in cortical microvasculature during misery perfusion measured by two-photon laser scanning microscopy.

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    Tajima, Yosuke; Takuwa, Hiroyuki; Kokuryo, Daisuke; Kawaguchi, Hiroshi; Seki, Chie; Masamoto, Kazuto; Ikoma, Yoko; Taniguchi, Junko; Aoki, Ichio; Tomita, Yutaka; Suzuki, Norihiro; Kanno, Iwao; Saeki, Naokatsu; Ito, Hiroshi

    2014-08-01

    This study aimed to examine the cortical microvessel diameter response to hypercapnia in misery perfusion using two-photon laser scanning microscopy (TPLSM). We evaluated whether the vascular response to hypercapnia could represent the cerebrovascular reserve. Cerebral blood flow (CBF) during normocapnia and hypercapnia was measured by laser-Doppler flowmetry through cranial windows in awake C57/BL6 mice before and at 1, 7, 14, and 28 days after unilateral common carotid artery occlusion (UCCAO). Diameters of the cortical microvessels during normocapnia and hypercapnia were also measured by TPLSM. Cerebral blood flow and the vascular response to hypercapnia were decreased after UCCAO. Before UCCAO, vasodilation during hypercapnia was found primarily in arterioles (22.9%±3.5%). At 14 days after UCCAO, arterioles, capillaries, and venules were autoregulatorily dilated by 79.5%±19.7%, 57.2%±32.3%, and 32.0%±10.8%, respectively. At the same time, the diameter response to hypercapnia in arterioles was significantly decreased to 1.9%±1.5%. A significant negative correlation was observed between autoregulatory vasodilation and the diameter response to hypercapnia in arterioles. Our findings indicate that arterioles play main roles in both autoregulatory vasodilation and hypercapnic vasodilation, and that the vascular response to hypercapnia can be used to estimate the cerebrovascular reserve.

  8. A mismatch between the abnormalities in diffusion- and susceptibility-weighted magnetic resonance imaging may represent an acute ischemic penumbra with misery perfusion.

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    Fujioka, Masayuki; Okuchi, Kazuo; Iwamura, Asami; Taoka, Toshiaki; Siesjö, Bo K

    2013-11-01

    Susceptibility-weighted imaging (SWI) has recently attracted attention for its ability to investigate acute stroke pathophysiology. SWI detects an increased ratio of deoxyhemoglobin to oxyhemoglobin in cerebral venous compartments, which can illustrate cerebral misery perfusion with a compensatory increase of oxygen extraction fraction in the hypoperfused brain. In this study we make the first case report of blunt cervical trauma leading to a stroke, demonstrating the disparity between diffusion-weighted imaging (DWI) and SWI changes, or DWI-SWI mismatch, in the acute ischemic brain. The area of mismatch between a smaller DWI cytotoxic edema and a larger SWI misery perfusion in our patient matured into a complete infarction with time. The DWI-SWI mismatch may signify the presence of an ischemic penumbra, and provide information about viability of the brain tissue at risk of potential infarction if without early reperfusion.

  9. PET imaging of cerebral perfusion and oxygen metabolism in stroke

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    Pointon, O.; Yasaka, M.; Berlangieri, S.U.; Newton, M.R.; Thomas, D.L.; Chan, C.G.; Egan, G.F.; Tochon-Danguy, H.J.; O``Keefe, G.; Donnan, G.A.; McKay, W.J. [Austin Hospital, Melbourne, VIC (Australia). Centre for PET and Depts of Nuclear Medicine and Neurology

    1998-03-01

    Full text: Stroke remains a devastating clinical event with few therapeutic options. In patients with acute stroke, we studied the cerebral perfusion and metabolic patterns with {sup 15}O-CO{sub 2} or H{sub 2}O and {sup 15}O-O{sub 2} positron emission tomography and correlated these findings to the clinical background. Forty three patients underwent 45 studies 0-23 days post-stroke (mean 7 days). Fifteen patients showed luxury perfusion (Group A), 10 had matched low perfusion and metabolism (B) and 3 showed mixed pattern including an area of misery perfusion (C). Seventeen showed no relevant abnormality (D) and there were no examples of isolated misery perfusion. Twelve of the 15 in Group A had either haemorrhagic transformation on CT, re-opening on angiography, or a cardioembolic mechanism. In contrast only 5/10 in Group B, 0/3 in Group C and 2/17 in Group D had these features. Although 7/10 in group B had moderate or large size infarcts on CT the incidence of haemorrhagic transformation was low (2/10) and significant carotid stenoses were more common in those studied (5/8) compared with the other groups. Misery perfusion was not seen beyond five days. Thus, luxury perfusion seems to be related to a cardio-embolic mechanism or reperfusion. Matched low perfusion and metabolism was associated with a low rate of haemorrhagic transformation despite a high incidence of moderate to large size infarcts. Misery perfusion is an early phenomenon in the evolution of ischaemic stroke.

  10. Sumatriptan and cerebral perfusion in healthy volunteers.

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    Scott, A K; Grimes, S; Ng, K; Critchley, M; Breckenridge, A M; Thomson, C; Pilgrim, A J

    1992-04-01

    1. The effect of sumatriptan on regional cerebral perfusion was studied in healthy volunteers. 2. Intravenous sumatriptan (2 mg) had no detectable effect on regional cerebral perfusion as measured using a SPECT system with 99technetiumm labelled hexemethylpropyleneamineoxime. 3. Sumatriptan had no effect on pulse, blood pressure or ECG indices. 4. All six volunteers experienced minor adverse effects during the intravenous infusion.

  11. Cerebral perfusion SPECT in transient ischemic attack

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    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.

  12. Feasibility of {sup 62}Cu-ATSM PET for evaluation of brain ischaemia and misery perfusion in patients with cerebrovascular disease

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    Isozaki, Makoto; Arai, Yoshikazu; Kikuta, Ken-ichiro [Faculty of Medical Sciences, Department of Neurosurgery, Fukui (Japan); Kiyono, Yasushi; Okazawa, Hidehiko [University of Fukui, Biomedical Imaging Research Center, Fukui (Japan); University of Fukui, Research and Education Program for Life Science, Fukui (Japan); Kudo, Takashi; Mori, Tetsuya; Maruyama, Rikiya [University of Fukui, Biomedical Imaging Research Center, Fukui (Japan)

    2011-06-15

    [{sup 62}Cu]Diacetyl-bis(N {sup 4}-methylthiosemicarbazone) ({sup 62}Cu-ATSM) was used to evaluate brain haemodynamic impairment in patients with cerebrovascular disease (CVD) as a simplified evaluation method. The tracer distribution was compared with haemodynamic parameters obtained by {sup 15}O positron emission tomography (PET). Ten patients with major cerebral arterial occlusive disease (aged 66 {+-} 7 years) underwent PET with {sup 62}Cu-ATSM and {sup 15}O tracers ({sup 15}O-water, {sup 15}O{sub 2} and C{sup 15}O). Seven healthy volunteers also underwent {sup 62}Cu-ATSM PET as normal controls. After the injection of {sup 62}Cu-ATSM, 20-min dynamic PET data acquisition was started. Early- and delayed-phase images of {sup 62}Cu-ATSM were obtained by averaging the initial 3-min and the last 10-min frame data, which were used for perfusion and retention images. Cerebral blood flow (CBF), blood volume, metabolic rate of oxygen (CMRO{sub 2}) and oxygen extraction fraction (OEF) were measured by {sup 15}O-gas and water studies and compared with early- and delayed-phase {sup 62}Cu-ATSM images and delayed to early (D/E) ratio. Regional values were compared after all parametric images were coregistered to individual MRI. The asymmetry index (AI) was also calculated for OEF and Cu-ATSM D/E ratio, and diagnostic ability for detecting misery perfusion was compared. In the affected hemisphere of the patients, the mean values of haemodynamic parameters were CBF = 33.8 {+-} 5.9 ml/100 g per min, CMRO{sub 2} = 2.6 {+-} 0.3 ml/100 g per min and OEF = 48 {+-} 7%. Standardized uptake values (SUVs) for {sup 62}Cu-ATSM in early and delayed phases were 2.00 {+-} 0.13 and 1.04 {+-} 0.09 in the ipsilateral hemisphere and 2.13 {+-} 0.14 and 1.04 {+-} 0.08 in the contralateral hemisphere, respectively. The early-phase {sup 62}Cu-ATSM images corresponded well to CBF images, and the D/E ratio images were similar to OEF images. Regional values obtained from D/E ratio images were

  13. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

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    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  14. Personality factors correlate with regional cerebral perfusion.

    Science.gov (United States)

    O'Gorman, R L; Kumari, V; Williams, S C R; Zelaya, F O; Connor, S E J; Alsop, D C; Gray, J A

    2006-06-01

    There is an increasing body of evidence pointing to a neurobiological basis of personality. The purpose of this study was to investigate the biological bases of the major dimensions of Eysenck's and Cloninger's models of personality using a noninvasive magnetic resonance perfusion imaging technique in 30 young, healthy subjects. An unbiased voxel-based analysis was used to identify regions where the regional perfusion demonstrated significant correlation with any of the personality dimensions. Highly significant positive correlations emerged between extraversion and perfusion in the basal ganglia, thalamus, inferior frontal gyrus and cerebellum and between novelty seeking and perfusion in the cerebellum, cuneus and thalamus. Strong negative correlations emerged between psychoticism and perfusion in the basal ganglia and thalamus and between harm avoidance and perfusion in the cerebellar vermis, cuneus and inferior frontal gyrus. These observations suggest that personality traits are strongly associated with resting cerebral perfusion in a variety of cortical and subcortical regions and provide further evidence for the hypothesized neurobiological basis of personality. These results may also have important implications for functional neuroimaging studies, which typically rely on the modulation of cerebral hemodynamics for detection of task-induced activation since personality effects may influence the intersubject variability for both task-related activity and resting cerebral perfusion. This technique also offers a novel approach for the exploration of the neurobiological correlates of human personality.

  15. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...

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

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    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.

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

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    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.

  18. 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...

  19. Enhanced Visualization of Optimal Cerebral Perfusion Pressure Over Time to Support Clinical Decision Making

    NARCIS (Netherlands)

    Aries, Marcel J H; Wesselink, Robin; Elting, Jan Willem J; Donnelly, Joseph; Czosnyka, Marek; Ercole, Ari; Maurits, Natasha M; Smielewski, Peter

    2016-01-01

    OBJECTIVE: Cerebrovascular reactivity can provide a continuously updated individualized target for management of cerebral perfusion pressure, termed optimal cerebral perfusion pressure. The objective of this project was to find a way of improving the optimal cerebral perfusion pressure methodology b

  20. Magnetic resonance perfusion imaging evaluation in perfusion abnormalities of the cerebellum after supratentorial unilateral hyperacute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Pan Liang; Yunjun Yang; Weijian Chen; Yuxia Duan; Hongqing Wang; Xiaotong Wang

    2012-01-01

    Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤ 6 hours) were retrospectively analyzed. Six patients exhibited perfusion defects on negative enhancement integral maps, four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps, and three patients exhibited perfusion differences in pseudo-color on time to minimum maps. Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction. The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.

  1. Volume perfusion CT imaging of cerebral vasospasm: diagnostic performance of different perfusion maps

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    Othman, Ahmed E. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Radiology, Tuebingen (Germany); Afat, Saif; Nikoubashman, Omid; Mueller, Marguerite; Wiesmann, Martin; Brockmann, Carolin [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); Schubert, Gerrit Alexander [RWTH Aachen University, Department of Neurosurgery, Aachen (Germany); Bier, Georg [Eberhard Karls University Tuebingen, University Hospital Tuebingen, Department for Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Brockmann, Marc A. [RWTH Aachen University, Department of Diagnostic and Interventional Neuroradiology, Aachen (Germany); University Hospital Mainz, Department of Neuroradiology, Mainz (Germany)

    2016-08-15

    In this study, we aimed to evaluate the diagnostic performance of different volume perfusion CT (VPCT) maps regarding the detection of cerebral vasospasm compared to angiographic findings. Forty-one datasets of 26 patients (57.5 ± 10.8 years, 18 F) with subarachnoid hemorrhage and suspected cerebral vasospasm, who underwent VPCT and angiography within 6 h, were included. Two neuroradiologists independently evaluated the presence and severity of vasospasm on perfusion maps on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting <50 %, 2 - vasospasm affecting >50 % of vascular territory). A third neuroradiologist independently assessed angiography for the presence and severity of vasospasm on a 3-point Likert scale (0 - no vasospasm, 1 - vasospasm affecting < 50 %, 2 - vasospasm affecting > 50 % of vessel diameter). Perfusion maps of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and time to drain (TTD) were evaluated regarding diagnostic accuracy for cerebral vasospasm with angiography as reference standard. Correlation analysis of vasospasm severity on perfusion maps and angiographic images was performed. Furthermore, inter-reader agreement was assessed regarding findings on perfusion maps. Diagnostic accuracy for TTD and MTT was significantly higher than for all other perfusion maps (TTD, AUC = 0.832; MTT, AUC = 0.791; p < 0.001). TTD revealed higher sensitivity than MTT (p = 0.007). The severity of vasospasm on TTD maps showed significantly higher correlation levels with angiography than all other perfusion maps (p ≤ 0.048). Inter-reader agreement was (almost) perfect for all perfusion maps (kappa ≥ 0.927). The results of this study indicate that TTD maps have the highest sensitivity for the detection of cerebral vasospasm and highest correlation with angiography regarding the severity of vasospasm. (orig.)

  2. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement

    Directory of Open Access Journals (Sweden)

    Andreas Habertheuer

    2015-01-01

    Full Text Available Arch surgery remains undoubtedly among the most technically and strategically challenging endeavors in cardiovascular surgery. Surgical interventions of thoracic aneurysms involving the aortic arch require complete circulatory arrest in deep hypothermia (DHCA or elaborate cerebral perfusion strategies with varying degrees of hypothermia to achieve satisfactory protection of the brain from ischemic insults, that is, unilateral/bilateral antegrade cerebral perfusion (ACP and retrograde cerebral perfusion (RCP. Despite sophisticated and increasingly individualized surgical approaches for complex aortic pathologies, there remains a lack of consensus regarding the optimal method of cerebral protection and circulatory management during the time of arch exclusion. Many recent studies argue in favor of ACP with various degrees of hypothermic arrest during arch reconstruction and its advantages have been widely demonstrated. In fact ACP with more moderate degrees of hypothermia represents a paradigm shift in the cardiac surgery community and is widely adopted as an emergent strategy; however, many centers continue to report good results using other perfusion strategies. Amidst this important discussion we review currently available surgical strategies of cerebral protection management and compare the results of recent European multicenter and single-center data.

  3. How to Perfuse: Concepts of Cerebral Protection during Arch Replacement

    Science.gov (United States)

    Habertheuer, Andreas; Wiedemann, Dominik; Kocher, Alfred; Laufer, Guenther; Vallabhajosyula, Prashanth

    2015-01-01

    Arch surgery remains undoubtedly among the most technically and strategically challenging endeavors in cardiovascular surgery. Surgical interventions of thoracic aneurysms involving the aortic arch require complete circulatory arrest in deep hypothermia (DHCA) or elaborate cerebral perfusion strategies with varying degrees of hypothermia to achieve satisfactory protection of the brain from ischemic insults, that is, unilateral/bilateral antegrade cerebral perfusion (ACP) and retrograde cerebral perfusion (RCP). Despite sophisticated and increasingly individualized surgical approaches for complex aortic pathologies, there remains a lack of consensus regarding the optimal method of cerebral protection and circulatory management during the time of arch exclusion. Many recent studies argue in favor of ACP with various degrees of hypothermic arrest during arch reconstruction and its advantages have been widely demonstrated. In fact ACP with more moderate degrees of hypothermia represents a paradigm shift in the cardiac surgery community and is widely adopted as an emergent strategy; however, many centers continue to report good results using other perfusion strategies. Amidst this important discussion we review currently available surgical strategies of cerebral protection management and compare the results of recent European multicenter and single-center data. PMID:26713319

  4. Diffusion and Perfusion MRI in Acute Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    Tchoyoson CC Lim; Chong-Tin Tan

    2001-01-01

    Reeent advances in magnetic resonance imaging (MRI), in particular diffusion weighted imaging (DWI) and perfusion weighted imaging (PWI), have allowed clinicians to have the ability to differentiate between irreversible cerebral infarction and the potentially reversible ischemic penumbra. This article examines the principles and practice of DWI and PWI. With continued advances in thrombolysis and other therapy for acute cerebral ischemia, neuroimaging is poised to play an increasingly important role in decisionmaking in aeute stroke.

  5. 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

  6. Changes in Cerebral Perfusion around the Time of Delayed Cerebral Ischemia in Subarachnoid Hemorrhage Patients

    NARCIS (Netherlands)

    Dankbaar, J. W.; de Rooij, N. K.; Smit, E. J.; Velthuis, B. K.; Frijns, C. J. M.; Rinkel, G. J. E.; van der Schaaf, I. C.

    2011-01-01

    Background: Because the pathogenesis of delayed cerebral ischemia (DCI) after subarachnoid hemorrhage (SAH) is unclear, we studied cerebral perfusion at different time points around the occurrence of DCI. Methods: We prospectively enrolled 53 patients admitted to the University Medical Center Utrech

  7. Relationship between vasospasm, cerebral perfusion, and delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    Dankbaar, Jan W.; Rijsdijk, Mienke; van der Schaaf, Irene C.; Velthuis, Birgitta K.; Wermer, Marieke J. H.; Rinkel, Gabriel J. E.

    2009-01-01

    Vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is thought to cause ischemia. To evaluate the contribution of vasospasm to delayed cerebral ischemia (DCI), we investigated the effect of vasospasm on cerebral perfusion and the relationship of vasospasm with DCI. We studied 37 consecutive SAH

  8. Cerebral perfusion deficits in divers with neurological decompression illness

    Energy Technology Data Exchange (ETDEWEB)

    Wilmshurst, P.T.; O' Doherty, M.J.; Nunan, T.O. (Saint Thomas' Hospital, London (United Kingdom))

    1993-02-01

    Cerebral perfusion deficits detected by injection of [sup 99]Tc[sup m]-hexamethylpropyleneamine oxime (HMPAO) and single photon emission tomography is said to correlate well with clinical findings in divers with neurological decompression illness. We studied 12 divers. Six had residual cerebral signs (group 1) and six had no residual cerebral symptoms or signs (group 2). Perfusion deficits were as common in group 2 as in group 1. The site of the deficit did not correlate well with either the neurological findings at presentation or the residual clinical signs after treatment. The data suggest that claims that HMPAO scanning correlates with clinical findings and can be used for patient management were incorrect. (author).

  9. Personal computer aided cerebral perfusion imaging with dynamic CT

    Institute of Scientific and Technical Information of China (English)

    林燕; 高培毅

    2004-01-01

    @@Reports on the clinical implementation of dynamic computerised tomography (CT) perfusion imaging and quantitative measurement have increased dramatically of late.1-8 The advantages of dynamic CT perfusion imaging and quantitative measurement for the diagnosis of acute cerebral infarction have been acknowledged. However, most overseas CT vendors set perfusion imaging software package as an option for graphic workstation at a too high price for domestic practitioners. To foster the domestic implementation and development of this new technology, we have extended the earlier work.1,2 Applying the theory of central volume principle to DICOM 3.0 standard forms of prime CT images, we developed dynamic CT perfusion imaging and quantitative measure-ment programmes for PCs using Visual C+ + in Windows 98 system.

  10. Demonstration of cerebral perfusion abnormalities in moyamoya disease using susceptibility perfusion- and diffusion-weighted MRI

    Energy Technology Data Exchange (ETDEWEB)

    Adams, W.M.; Laitt, R.D. [Department of Neuroradiology, Central Manchester Healthcare Trust, Oxford Road, Manchester M13 9WL (United Kingdom); Li, K.L.; Jackson, A. [Department of Diagnostic Radiology, University of Manchester, Manchester M13 9PT (United Kingdom); Sherrington, C.R.; Talbot, P. [Department of Neurology, Central Manchester Healthcare Trust, Oxford Road, Manchester M13 9WL (United Kingdom)

    1999-02-01

    We describe the use of diffusion-weighted imaging and perfusion MRI using a contrast-medium bolus in the preoperative investigation for young man presenting with a cerebral ischaemic episode as a manifestation of moyamoya disease. (orig.) With 6 figs., 21 refs.

  11. Method for performing cerebral perfusion-weighted MRI in neonates

    Energy Technology Data Exchange (ETDEWEB)

    Laswad, Tarek; Alamo, Leonor; Meuli, Reto; Gudinchet, Francois [University of Lausanne (CH). Radiology Department, Lausanne (Switzerland)]|[Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (Switzerland); Wintermark, Pia; Moessinger, Adrien [University of Lausanne, Division of Neonatology, Lausanne (Switzerland)]|[Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne (Switzerland)

    2009-03-15

    Cerebral perfusion-weighted imaging (PWI) in neonates is known to be technically difficult and there are very few published studies on its use in preterm infants. In this paper, we describe one convenient method to perform PWI in neonates, a method only recently used in newborns. A device was used to manually inject gadolinium contrast material intravenously in an easy, quick and reproducible way. We studied 28 newborn infants, with various gestational ages and weights, including both normal infants and those suffering from different brain pathologies. A signal intensity-time curve was obtained for each infant, allowing us to build perfusion maps. This technique offered a fast and easy method to manually inject a bolus gadolinium contrast material, which is essential in performing PWI in neonates. Cerebral PWI is technically feasible and reproducible in neonates of various gestational age and with various pathologies. (orig.)

  12. The effects of propofol on cerebral perfusion MRI in children

    Energy Technology Data Exchange (ETDEWEB)

    Harreld, Julie H.; Helton, Kathleen J.; Reddick, Wilburn E.; Glass, John O.; Sansgiri, Rakhee; Ji, Qing; Patay, Zoltan [St. Jude Children' s Research Hospital, Department of Radiological Sciences, Memphis, TN (United States); Kaddoum, Roland N.; Parish, Mary Edna [St. Jude Children' s Research Hospital, Department of Anesthesiology, Memphis, TN (United States); Li, Yimei; Feng, Tianshu [St. Jude Children' s Research Hospital, Department of Biostatistics, Memphis, TN (United States); Gajjar, Amar [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States)

    2013-08-15

    The effects of anesthesia are infrequently considered when interpreting pediatric perfusion magnetic resonance imaging (MRI). The objectives of this study were to test for measurable differences in MR measures of cerebral blood flow (CBF) and cerebral blood volume (CBV) between non-sedated and propofol-sedated children, and to identify influential factors. Supratentorial cortical CBF and CBV measured by dynamic susceptibility contrast perfusion MRI in 37 children (1.8-18 years) treated for infratentorial brain tumors receiving propofol (IV, n = 19) or no sedation (NS, n = 18) were compared between groups and correlated with age, hematocrit (Hct), end-tidal CO{sub 2} (ETCO{sub 2}), dose, weight, and history of radiation therapy (RT). The model most predictive of CBF and CBV was identified by multiple linear regression. Anterior cerebral artery (ACA) and middle cerebral artery (MCA) territory CBF were significantly lower, and MCA territory CBV greater (p = 0.03), in IV than NS patients (p = 0.01, 0.04). The usual trend of decreasing CBF with age was reversed with propofol in ACA and MCA territories (r = 0.53, r = 0.47; p < 0.05). ACA and MCA CBF (r = 0.59, 0.49; p < 0.05) and CBV in ACA, MCA, and posterior cerebral artery territories (r = 0.73, 0.80, 0.52; p < 0.05) increased with weight in propofol-sedated children, with no significant additional influence from age, ETCO{sub 2}, hematocrit, or RT. In propofol-sedated children, usual age-related decreases in CBF were reversed, and increases in CBF and CBV were weight-dependent, not previously described. Weight-dependent increases in propofol clearance may diminish suppression of CBF and CBV. Prospective study is required to establish anesthetic-specific models of CBF and CBV in children. (orig.)

  13. 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....

  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. Prognostic indices for cerebral venous thrombosis on CT perfusion: A prospective study

    Energy Technology Data Exchange (ETDEWEB)

    Gupta, Rakesh Kumar, E-mail: rakrakgupta@gmail.com [Department of Radiodiagnosis and Imaging, MMIMSR, Mullana, Ambala (India); Bapuraj, J.R., E-mail: jrajiv@med.umich.edu [Department of Radiology, Division of Neuroradiology, University Hospital, University of Michigan, 1500 E Medical Center Drive, Ann Arbor, MI 48109 (United States); Khandelwal, N. [Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India); Khurana, Dheeraj [Department of Neurology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh (India)

    2014-01-15

    Purpose: We determined the prognostic significance of CT perfusion characteristics of patients with cerebral venous sinus thrombosis (CVST) and assessed the change in perfusion parameters following anticoagulation therapy. Materials and methods: 20 patients with CVST diagnosed on non-contrast computed tomography (NCCT), magnetic resonance imaging (MRI), and magnetic resonance venography (MRV) were included in this study. The initial CT perfusion study was performed at the time of admission. The following perfusion parameters: relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), and relative mean transit time (rMTT) were calculated in the core and periphery of the affected area of the brain. Follow-up CT perfusion studies were performed at 1 month following anticoagulation therapy and the perfusion parameters thus obtained were compared with pre-treatment results. Receiver operating characteristic (ROC) curve analysis was performed to determine the prognostic significance of perfusion parameters. Results: All patients in this study showed areas of hypoperfusion on CT perfusion. To determine the favorable clinical outcome on basis of perfusion parameters, ROC curve analysis was performed which showed that the optimal threshold for rCBF > 60.5%, rCBV > 75.5%, and rMTT < 148.5% correlated with better clinical outcomes. Post treatment perfusion parameters showed significant correlation in core of the lesion (p < 0.05) than in the periphery. Conclusion: CT perfusion studies in CVST are a good prognostic tool and yield valuable information regarding clinical outcome.

  16. Clinical Neuroimaging of cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji [Nakamura Memorial Hospital, Sapporo (Japan)

    1999-06-01

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  17. Maladaptation of cerebral perfusion in the spinal cord injured individuals

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Ihn Ho; Chun, Kyung A.; Lee, Hyoung Woo; Ahn, Sang Ho; Hayashida, Kohei [National Cardiovascular Center, Osaka (Korea, Republic of)

    2001-07-01

    The aim of this study was to evaluate the tilt-induced alteration of cerebral perfusion of spinal cord injured individuals. Supine and upright sitting brain SPECT was performed using a 1-day protocol with {sup 99m}Tc-ethylcysteinate dimer (ECD) in 11 SCI individuals (mean age, 32.6 y), with lesions between C3 and T4, ad 5 AB individuals (mean age, 31.4 y). The patients rested on a wheelchair in the supine position. Then, they sat up and, at the same time 555MBq of ECD was injected. The upright SPECT was done. Finally, 740MBq of ECD was injected and supine SPECT was performed again. The SPECT data were acquired with dual head gamma camera (E-cam, Siemens). For semiquantitative analysis, 14 ROIs were drawn on the brain. In the SCI individuals, the radiotracer uptake in the frontal, temporal and parietal areas were significantly decreased in the upright SPECT. No postural changes was evident in the occipital lobe, basal ganglia and thalamus in the SCI individuals. In the AB individuals, there were no such changes on the upright SPECT. Postural cerebral hypoperfusion in the frontal, temporal and parietal areas in the SCI individuals might relate to maladaptation of the vascular response during the upright position.

  18. Carbon dioxide induced changes in cerebral blood flow and flow velocity: Role of cerebrovascular resistance and effective cerebral perfusion pressure

    NARCIS (Netherlands)

    F. Grüne (Frank); S. Kazmaier (Stephan); R.J. Stolker (Robert J.); G.H. Visser (Gerhard Henk); A. Weyland (Andreas)

    2015-01-01

    textabstractIn addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2 -induced changes in CBF, CVR,

  19. Clinical and Physiological Events That Contribute to the Success Rate of Finding "Optimal" Cerebral Perfusion Pressure in Severe Brain Trauma Patients

    NARCIS (Netherlands)

    Weersink, Corien S. A.; Aries, Marcel J. H.; Dias, Celeste; Liu, Mary X.; Kolias, Angelos G.; Donnelly, Joseph; Czosnyka, Marek; van Dijk, J. Marc C.; Regtien, Joost; Menon, David K.; Hutchinson, Peter J.; Smielewski, Peter

    2015-01-01

    Objective: Recently, a concept of an individually targeted level of cerebral perfusion pressure that aims to restore impaired cerebral vasoreactivity has been advocated after traumatic brain injury. The relationship between cerebral perfusion pressure and pressure reactivity index normally is suppos

  20. Effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies

    Science.gov (United States)

    Murase, Kenya; Nanjo, Takafumi; Satoshi, Ii; Miyazaki, Shohei; Hirata, Masaaki; Sugawara, Yoshifumi; Kudo, Masayuki; Sasaki, Kousuke; Mochizuki, Teruhito

    2005-11-01

    The purpose of this study was to investigate the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using multi-detector row CT (MDCT). Following the standard CT perfusion study protocol, continuous (cine) scans (1 s/rotation × 60 s) consisting of four 5 mm thick contiguous slices were performed using an MDCT scanner with a tube voltage of 80 kVp and a tube current of 200 mA. We generated the simulated images with tube currents of 50 mA, 100 mA and 150 mA by adding the corresponding noise to the raw scan data of the original image acquired above using a noise simulation tool. From the original and simulated images, we generated the functional images of cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) in seven patients with cerebrovascular disease, and compared the correlation coefficients (CCs) between the perfusion parameter values obtained from the original and simulated images. The coefficients of variation (CVs) in the white matter were also compared. The CC values deteriorated with decreasing tube current. There was a significant difference between 50 mA and 100 mA for all perfusion parameters. The CV values increased with decreasing tube current. There were significant differences between 50 mA and 100 mA and between 100 mA and 150 mA for CBF. For CBV and MTT, there was also a significant difference between 150 mA and 200 mA. This study will be useful for understanding the effect of x-ray tube current on the accuracy of cerebral perfusion parameters obtained by CT perfusion studies using MDCT, and for selecting the tube current.

  1. A study of cerebral perfusion using single photon emission computed tomography in neonates with brain lesions

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, J.; Contantinesco, A.; Brunot, B.; Messer, J. (Hospital Universitaire de Strasbourg (France))

    1994-03-01

    In this study the authors used a single photon emission computed tomography technique (SPECT) with radiolabelled [sup 99m]Tc HMPAO to assess cerebral perfusion in newborn infants with documented cerebral lesions and to determine to what extent brain SPECT might be useful in the neonatal period. A total of 15 newborn infants with the following cerebral pathologies were enrolled: severe parietal bilateral periventricular leucomalacia; moderate parietal bilateral PVL; intraventricular haemorrhage grade II with unilateral parietal parenchymal extension; cerebral infarction in the zone of middle cerebral artery; and post-haemorrhagic hydrocephalus. Follow-up was available in all infants. Alterations in cerebral perfusion were seen in only 12 of 15 infants and at the location of severe PVL, PE and CI. It was noted that the regions of diminished perfusion extended beyond the apparent extent of cerebral pathology delineated by ultrasound or magnetic resonance imaging. Markedly diminished perfusion was seen in one infant with hydrocephalus, which recovered following placement of ventriculo-peritoneal shunt. Regarding outcome, SPECT data failed to provide additional information than that of neuroradiological investigations. It is concluded that the use of SPECT, under these conditions, to assess alteration of cerebral perfusion in the neonatal period will not provide any additional information than that of neuroradiological investigations. 17 refs., 3 figs., 1 tab.

  2. Comparison of Cerebral Oxygen Saturation and Cerebral Perfusion Computed Tomography in Cerebral Blood Flow in Patients with Brain Injury.

    Science.gov (United States)

    Trofimov, Alexey O; Kalentiev, George; Voennov, Oleg; Grigoryeva, Vera

    2016-01-01

    The purpose of this study was to determine the relationship between cerebral tissue oxygen saturation and cerebral blood volume in patients with traumatic brain injury. Perfusion computed tomography of the brain was performed in 25 patients with traumatic brain injury together with simultaneous SctO2 level measurement using cerebral near-infrared oxymetry. The mean age of the injured persons was 34.5±15.6 years (range 15-65); 14 men, 11 women. The Injury Severity Score (ISS) values were 44.4±9.7 (range 25-81). The Glasgow Coma Score (GCS) mean value before the study was 10.6±2.1 (range 5-13). SctO2 ranged from 51 to 89%, mean 62±8.2%. Cerebral blood volume (CBV) values were 2.1±0.67 ml/100 g (min 1.1; max 4.3 ml/100 g). Cerebral blood flow (CBF) was 31.99±13.6 ml/100 g×min. Mean transit time (MTT) values were 5.7±4.5 s (min 2.8; max 34.3 s). The time to peak (TTP) was 22.2±3.1 s. A statistically significant correlation was found between SctO2 level and cerebral blood volume (CBV) level (R=0.9; pperfusion.

  3. Helical CT study of cerebral perfusion and related hemodynamic parameters

    Science.gov (United States)

    Cenic, Aleksa; Lee, Ting-Yim; Craen, Rosemary A.; Gelb, Adrian W.

    1997-05-01

    A convenient method for assessing cerebral perfusion and related functional parameters has been developed using a third generation slip-ring CT scanner. Dynamic contrast- enhanced scanning at the same level was employed to image the cerebral circulation at the rate of 1 image per second. Using data acquired with this non-helical mode of scanning, we have developed a method for the simultaneous in-vivo determination of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT). These measurements are given in the same physiological units as positron emission tomography. In order to obtain accurate measurements of these parameters, methods were also developed to correct for recirculation and partial volume averaging in imaging small blood vessels. We have used 6 New Zealand white rabbits in our studies. For each rabbit, up to 3 CT measurements of CBF, CBV, and MTT were made at normocapnia under isoflurane anesthesia. Coronal sections through the brain were imaged while simultaneously imaging either a brain artery or the ear artery. Images were acquired for 1 minute as Isovue 300 was injected intravenously. In the acquired CT images, regions of interest in brain parenchyma and an artery were drawn. For each region of interest, the mean CT number in pre-contrast images was subtracted from the mean in post-contrast images to calculate the contrast concentration curves for the brain regions Q(t) and the arterial region Ca(t). Using a robust deconvolution method, the MTT was determined. CBV was then determined from the ratio of the areas of Q(t) and Ca(t). Finally, CBF was calculated from the Central Volume Principle. The mean regional CBF, CBV and MTT values were 73.3 +/- 5.1 ml/min/100g, 1.93 +/- 0.12 ml/100g and 1.80 +/- 0.18 s respectively. IN order to validate our CT CBF measurements, we also measured CBF using the well- established technique of microspheres with each CT study. The feasibility of our CT method to measure CBF accurately was

  4. Optimal Cerebral Perfusion Pressure Management at Bedside : A Single-Center Pilot Study

    NARCIS (Netherlands)

    Dias, Celeste; Silva, Maria Joao; Pereira, Eduarda; Monteiro, Elisabete; Maia, Isabel; Barbosa, Silvina; Silva, Sofia; Honrado, Teresa; Cerejo, Antonio; Aries, Marcel J. H.; Smielewski, Peter; Paiva, Jose-Artur; Czosnyka, Marek

    2015-01-01

    Guidelines recommend cerebral perfusion pressure (CPP) values of 50-70 mmHg and intracranial pressure lower than 20 mmHg for the management of acute traumatic brain injury (TBI). However, adequate individual targets are still poorly addressed, since patients have different perfusion thresholds. Beds

  5. Perfusion-CT for early assessment of traumatic cerebral contusions

    Energy Technology Data Exchange (ETDEWEB)

    Soustiel, Jean F.; Mahamid, Eugenia; Goldsher, Dorith; Zaaroor, Menashe [Faculty of Medicine, Technion - Israel Institute of Technology, Department of Neurosurgery, Rambam Medical Center, P.O. Box 9602, Haifa (Israel)

    2008-02-15

    To investigate the value of perfusion-CT (PCT) for assessment of traumatic cerebral contusions (TCC) and to compare the abilities of early noncontrast CT and PCT modalities to evaluate tissue viability. PCT studies performed in 30 patients suffering from TCC during the acute phase of their illness were retrospectively reviewed. Cerebral blood flow (CBF), volume (CBV) and mean transit time (MTT) were measured in three different areas: the hemorrhagic core of the TCC, the surrounding hypodense area and the perilesional normal-appearing parenchyma. TCC area was measured on CBF-, CBV- and MTT-derived maps and compared with the areas measured using the same slice obtained with CT scans performed on admission, at the time of PCT (follow-up CT) and at 1 week. TCC were characterized by low CBF and CBV values (9.2{+-}6.6 ml/100 g per min and 0.9{+-}0.7 ml/100 g, respectively) and a significant prolongation of MTT (11.9{+-}10.7 s) in the hemorrhagic core whereas PCT parameters were more variable in the hypodense area. The TCC whole area showed a noticeable growth of the lesions during the first week of admission. In comparison with early noncontrast CT, CBV and CBF maps proved to be more congruent with the findings of noncontrast CT scans at 1 week. PCT confirmed the results of xenon-CT studies and was shown to allow better evaluation of tissue viability than noncontrast CT. These findings suggest that PCT could be implemented in the future for the early assessment of patients with traumatic brain injury. (orig.)

  6. 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)

  7. 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

  8. Effect of propofol and remifentanil on cerebral perfusion and oxygenation in pigs

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Miles, James Edward;

    2016-01-01

    The objective of this review is to evaluate the existing literature with regard to the influence of propofol and remifentanil total intravenous anaesthesia (TIVA) on cerebral perfusion and oxygenation in healthy pigs. Anaesthesia has influence on cerebral haemodynamics and it is important not onl...

  9. Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion

    NARCIS (Netherlands)

    R.V. Immink; J. Truijen; N.H. Secher; J.J. van Lieshout

    2009-01-01

    Immink RV, Truijen J, Secher NH, Van Lieshout JJ. Transient influence of end-tidal carbon dioxide tension on the postural restraint in cerebral perfusion. J Appl Physiol 107: 816-823, 2009. First published July 2, 2009; doi: 10.1152/japplphysiol.91198.2008.-In the upright position, cerebral blood fl

  10. Cerebral perfusion changes in traumatic diffuse brain injury. IMP SPECT studies

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Hiroshi; Kawashima, Ryuta; Fukuda, Hiroshi [Tohoku Univ., Sendai (Japan). Inst. of Development, Aging and Cancer; Ishii, Kiyoshi; Onuma, Takehide

    1997-05-01

    Diffuse brain injury (DBI) is characterized by axonal degeneration and neuronal damage which cause diffuse brain atrophy. We have investigated the time course of abnormalities in cerebral perfusion distribution in cases of DBI by using Iodine-123-IMP SPECT, and the relationship to the appearance of diffuse brain atrophy. SPECT scans were performed on eight patients with diffuse brain injury due to closed cranial trauma in acute and chronic stages. All patients showed abnormalities in cerebral perfusion with decreases in perfusion, even in non-depicted regions on MRI, and the affected areas varied throughout the period of observation. Diffuse brain atrophy appeared in all patients. In some patients, diffuse brain atrophy was observed at or just after the time when the maximum number of lesions on SPECT were seen. The abnormalities in cerebral perfusion in cases of DBI might therefore be related to axonal degeneration and neuronal damage which causes diffuse brain atrophy. (author)

  11. 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....

  12. Carbon dioxide induced changes in cerebral blood flow and flow velocity: role of cerebrovascular resistance and effective cerebral perfusion pressure.

    Science.gov (United States)

    Grüne, Frank; Kazmaier, Stephan; Stolker, Robert J; Visser, Gerhard H; Weyland, Andreas

    2015-09-01

    In addition to cerebrovascular resistance (CVR) zero flow pressure (ZFP), effective cerebral perfusion pressure (CPPe) and the resistance area product (RAP) are supplemental determinants of cerebral blood flow (CBF). Until now, the interrelationship of PaCO2-induced changes in CBF, CVR, CPPe, ZFP, and RAP is not fully understood. In a controlled crossover trial, we investigated 10 anesthetized patients aiming at PaCO2 levels of 30, 37, 43, and 50 mm Hg. Cerebral blood flow was measured with a modified Kety-Schmidt-technique. Zero flow pressure and RAP was estimated by linear regression analysis of pressure-flow velocity relationships of the middle cerebral artery. Effective cerebral perfusion pressure was calculated as the difference between mean arterial pressure and ZFP, CVR as the ratio CPPe/CBF. Statistical analysis was performed by one-way RM-ANOVA. When comparing hypocapnia with hypercapnia, CBF showed a significant exponential reduction by 55% and mean VMCA by 41%. Effective cerebral perfusion pressure linearly decreased by 17% while ZFP increased from 14 to 29 mm Hg. Cerebrovascular resistance increased by 96% and RAP by 39%; despite these concordant changes in mean CVR and Doppler-derived RAP correlation between these variables was weak (r=0.43). In conclusion, under general anesthesia hypocapnia-induced reduction in CBF is caused by both an increase in CVR and a decrease in CPPe, as a consequence of an increase in ZFP.

  13. 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.

  14. The Misery Index.

    Science.gov (United States)

    Bracey, Gerald W.

    2000-01-01

    U.S. taxpayers score lower on the "Forbes" Misery Index than taxpayers of other industrialized nations. A recent report concludes that public-school students challenge their schools more than private-school counterparts. Low birth weight and demographic factors (gender, poverty, and race) affect Florida's burgeoning special-education placements.…

  15. 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...

  16. Evaluation of multislice computed tomographic perfusion imaging and computed tomographic angiography on traumatic cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    XU Fang-hong; CHEN Wei-jian; YANG Yun-jun; DUAN Yu-xia; FU Feng-li

    2008-01-01

    Objective: To evaluate the application value of multislice computed tomographic perfusion imaging (MSCTPI) and multislice computed tomographic angiography (MSCTA) on traumatic cerebral infarction. Methods: MSCTA was performed on 10 patients who were initiailly diagnosed as traumatic cerebral infarction by normal conventional computed tomography (NCCT), among whom, 3 patients were examined by MSCTPI simultaneously. Reconstructed images of the intracranial artery were made with techniques of maximum intensity projection (MIP) and volume rendering (VR) from MSCTA scanning data. Then the graph of function of four parameters, regional cerebral blood flow (Rcbf), regional cerebral blood volume (Rcbv), mean transit time (MTT), and time to peak (TTP), acquired by the perfusing analysis software was obtained. Results: Among the 10 patients with traumatic cerebral infarction, 6 showed complex type on NCCT, which depicted abnormality on MSCTA, and 4 showed simple type on NCCT, which had negative results on MSCTA. Among the 4 patients with abnormal great vessels, 2 suffered from steno sis or occlusion of the middle cerebral artery, 1 from spasm of the anterior cerebral artery, and 1 from spasm of the vertebral-basal artery. The image of MSCTPI of 1 patient with massive cerebral infarction on the right cerebral hemisphere confirmed by CT was smaller than those of the other patients, which showed occlusion of the ipsilateral middle cerebral artery on MSCTA. Among the 6 patients whose MSCTA showed no abnormality, 4 showed simple infarction and 2 showed complex infarction. The infarction focus of 5 patients occurred in the basal ganglia and 1 in the splenium of corpus callosum. Among the 2 cases of small cerebral infarction volume on NCCT, one was normal, the other showed hypoperfusion on MSCTPI and was normal on MSCTA. Conclusion: The combination of MSCTPI and MSCTA is very useful for evaluating the change of intracranial artery in ischemic regions and assessing the cerebral

  17. 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.

  18. A pattern of cerebral perfusion anomalies between Major Depressive Disorder and Hashimoto Thyroiditis

    Directory of Open Access Journals (Sweden)

    Altoé Gianmarco

    2011-09-01

    Full Text Available Abstract Background This study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD, Hashimoto Thyroiditis (HT and reduction in regional Cerebral Blood Flow (rCBF in order to explore the possibility that patients with HT and MDD have specific pattern(s of cerebral perfusion. Methods Design: Analysis of data derived from two separate data banks. Sample: 54 subjects, 32 with HT (29 women, mean age 38.8 ± 13.9; 22 without HT (19 women, mean age 36.5 ± 12.25. Assessment: Psychiatric diagnosis was carried out by Simplified Composite International Diagnostic Interview (CIDIS using DSM-IV categories; cerebral perfusion was measured by 99 mTc-ECD SPECT. Statistical analysis was done through logistic regression. Results MDD appears to be associated with left frontal hypoperfusion, left temporal hypoperfusion, diffuse hypoperfusion and parietal perfusion asymmetry. A statistically significant association between parietal perfusion asymmetry and MDD was found only in the HT group. Conclusion In HT, MDD is characterized by a parietal flow asymmetry. However, the specificity of rCBF in MDD with HT should be confirmed in a control sample with consideration for other health conditions. Moreover, this should be investigated with a longitudinally designed study in order to determine a possible pathogenic cause. Future studies with a much larger sample size should clarify whether a particular perfusion pattern is associated with a specific course or symptom cluster of MDD.

  19. 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

  20. 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...

  1. Temporal lobe epilepsy subtypes, differential patterns of cerebral perfusion on ictal SPECT

    NARCIS (Netherlands)

    Ho, SS; Berkovic, SF; McKay, WJ; Kalnins, RM; Bladin, PF

    1996-01-01

    Purpose: We studied cerebral perfusion patterns in the various subtypes of TLE, as determined by pathology and good outcome after temporal lobectomy (as confirmation of temporal origin). Methods: We studied clinical features and ictal technetium 99m hexamethyl-propyleneamineoxime (Tc-99m-HMPAO) sing

  2. Cerebral perfusion and metabolism in resuscitated patients with severe post-hypoxic encephalopathy

    NARCIS (Netherlands)

    Schaafsma, A.; de Jong, B M; Bams, J.L.; Haaxma-Reiche, H; Pruim, J; Zijlstra, J G

    2003-01-01

    Positron emission tomography (PET) was used for the study of regional cerebral perfusion and metabolism in eight patients with severe post-hypoxic encephalopathy, caused by cardiac arrest and resulting in a coma lasting for at least 24 h. Using this method, we aimed to identify regional vulnerabilit

  3. Carotid artery disease and low cerebral perfusion pressure

    DEFF Research Database (Denmark)

    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...

  4. 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......(mean) during ergometer cycling (n = 8). Separate, randomized and counterbalanced trials were performed in control (no drug) conditions and following muscarinic cholinergic receptor blockade by glycopyrrolate. Glycopyrrolate increased resting heart rate from approximately 60 to approximately 110 beats min(-1...

  5. 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.

  6. The cerebral imaging using vessel-around method in the perfusion CT of the human brain

    Science.gov (United States)

    Ahn, Choong-Il; Choi, Seung-Wook; Park, Seung-Chul; Shin, Yeong-Gil; Kim, Jae-Hyoung; Chong, Gi-Bong

    2005-04-01

    Perfusion CT has been successfully used as a functional imaging technique for diagnosis of patients with hyperacute stroke. However, the commonly used methods based on curve-fitting are time consuming. Numerous researchers have investigated to what extent Perfusion CT can be used for the quantitative assessment of cerebral ischemia and to rapidly obtain comprehensive information regarding the extent of ischemic damage in acute stroke patients. The aim of this study is to propose an alternative approach to rapidly obtain the brain perfusion mapping and to show the proposed cerebral flow imaging of the vessel and tissue in human brain be reliable and useful. Our main design concern was algorithmic speed, robustness and automation in order to allow its potential use in the emergency situation of acute stroke. To obtain a more effective mapping, we analyzed the signal characteristics of Perfusion CT and defined the vessel-around model which includes the vessel and tissue. We proposed a nonparametric vessel-around approach which automatically discriminates the vessel and tissue around vessel from non-interested brain matter stratifying the level of maximum enhancement of pixel-based TAC. The stratification of pixel-based TAC was executed using the mean and standard deviation of the signal intensity of each pixel and mapped to the cerebral flow imaging. The defined vessel-around model was used to show the cerebral flow imaging and to specify the area of markedly reduced perfusion with loss of function of still viable neurons. Perfusion CT is a fast and practical technique for routine clinical application. It provides substantial and important additional information for the selection of the optimal treatment strategy for patients with hyperacute stroke. The vessel-around approach reduces the computation time significantly when compared with the perfusion imaging using the GVF. The proposed cerebral imaging shows reliable results which are validated by physicians and

  7. Functional MRI of CO2 induced increase in cerebral perfusion

    DEFF Research Database (Denmark)

    Rostrup, Egill; Larsson, H B; Toft, P B;

    1994-01-01

    The sensitivity of MR gradient echo imaging towards CO2 induced changes in cerebral blood flow was investigated in 10 normal subjects. The subjects were inhaling 5% and 7% CO2 and the experiments were carried out at 1.5 T (n = 6) and 2.0 T (n = 5), allowing a comparison of field strengths...

  8. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    Energy Technology Data Exchange (ETDEWEB)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A. [Austin and Repatriation Medical Centre, Heidelberg, VIC (Australia). Departments of Nuclear Medicine and Centre for PET Neurology and Clinical Neuropsychology

    1998-06-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual`s T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

  11. Dynamic Changes of the CT Perfusion Parameters in the Embolic Model of Cerebral Ischemia

    Institute of Scientific and Technical Information of China (English)

    陈唯唯; 漆剑频; 张进华; 黄文华; 宋金梅

    2004-01-01

    To study the dynamic changes of CT perfusion parameters during the first 12 h in the embolic cerebral ischemia models. Local cerebral ischemia model were established in 7 New Zealand white rabbits. All CT scans were performed with a GE Lightspeed 16 multislice CT. Following the baseline scan, further CT perfusion scans were performed at the same locations 20 min, 1-6 h and8, 10 and 12 h after the embolus delivery. Maps of all parameters were obtained by CT perfusion software at each time point. The brains, taken 12 h after the scan, were sliced corresponding to the positions of the CT slices and stained by 2,3,5-triphenyltetrazolium chloride (TTC). On the basis of the TTC results, the ischemicsides were divided into 3 regions: core, penumbra and the relatively normal region. The changes of all parameters were then divided into 3 stages. In the first two hours (the first stage), the CBV dropped more remarkably in the core than in the penumbra but rose slightly in the relatively normal region while the CBF decreased and MTT, TTP extended in all regions to varying degrees. In the 2nd-5th h (the second stage), all the parameters fluctuated slightly around a certain level. In the 5th-12th h (the third stage), the CBV and CBF dropped,and MTT and TTP were prolonged or shortened slightly in the core and penumbra though much notably in the former while the CBV, CBF roseand MTT, TTP were shortened remarkably in the relatively normal region. We experimentally demonstrated that the location and extent of cerebral ischemia could be accurately assessed by CT perfusion imaging. The pathophysiology of the ischemia could be reflected by the CT perfusion to varying degrees.

  12. Cerebral hemodynamics in aging : the interplay between blood pressure, cerebral perfusion, and dementia

    NARCIS (Netherlands)

    Claassen, J.A.H.R.

    2008-01-01

    Advances in measurement techniques have made it possible to study dynamic changes in brain blood flow. Transcranial Doppler ultrasonography measures changes in cerebral blood flow-velocity in the larger cerebral arteries (e.g. the middle cerebral artery). Near infrared spectroscopy records changes i

  13. Retrograde cerebral perfusion (RCP) in aortic arch surgery: efficacy and possible mechanisms of brain protection.

    Science.gov (United States)

    Bavaria, J E; Pochettino, A

    1997-07-01

    Retrograde cerebral perfusion (RCP) was first introduced to treat air embolism during cardiopulmonary bypass (CPB). Its use was reintroduced to extend the safety of hypothermic circulatory arrest (HCA) during operations involving an open aortic arch. RCP seems to prevent cerebral rewarming during HCA. Both clinical and animal data suggest that RCP provides between 10% and 30% of baseline cerebral blood flow when administered through the superior vena cava (SVC) at jugular pressures of 20 to 25 mm Hg. RCP flows producing jugular venous pressures higher than 30 mm Hg may cause cerebral edema. Cerebral blood flow generated by RCP is able to sustain some cerebral metabolic activity, yet is not able to fully meet cerebral energy demands even at temperatures of 12 degrees to 18 degrees C. RCP may further prevent embolic events during aortic arch surgery when administered at moderate jugular vein pressures (RCP, when applied during aortic arch reconstruction, may extend the safe HCA period and improve morbidity and mortality, especially when HCA times are more than 60 minutes. RCP applied in patients and severe carotid and brachiocephalic occlusive disease may be ineffective, and caution is in order when RCP times are greater than 90 minutes.

  14. 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

  15. Effect of propofol and remifentanil on cerebral perfusion and oxygenation in pigs

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Miles, James Edward

    2016-01-01

    in human but also in veterinary anaesthesia to preserve optimal regulation of cerebral haemodynamics. Propofol and remifentanil are widely used in neuroanaesthesia and are increasingly used in experimental animal studies. In translational models, the pig has advantages compared to small laboratory animals......The objective of this review is to evaluate the existing literature with regard to the influence of propofol and remifentanil total intravenous anaesthesia (TIVA) on cerebral perfusion and oxygenation in healthy pigs. Anaesthesia has influence on cerebral haemodynamics and it is important not only...... and oxygenation (CPO). The evidence evaluated in this systematic review is limited, not focused on propofol and remifentanil and possibly influenced by factors of potential importance for CPO assessment. In one study of healthy pigs, CPO measures were within normal ranges following propofol...

  16. Single photon emission CT perfusion imaging of cerebral blood flow of early syphilis patients

    Institute of Scientific and Technical Information of China (English)

    施辛; 吴锦昌; 刘增礼; 唐军; 苏玉华

    2003-01-01

    Objective To injvestigate the cerebral blood flow of patients with early syphilis. Methods 99Tcm-ECD as brain perfusion imaging agent was used in single photon emission computed tomography (SPECT) for 32 patients with early syphilis and 15 controls. Visual analyses were made on every BSPECT image. Results The 32 patients with early syphilis had general, patchy hypoperfusion of cerebral blood flow. Fourteen of the 32 patients had 48 episodes of marked patchy hypoperfusion of rCBF. The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe (6 episodes), right frontal lobe (3), left parietal lobe (7), right parietal lobe (6), left temporal lobe (11), right temporal lobe (5), left occipital lobe (3), left basal ganglia (3), cerebellum (1), and nerve nuceus (1). No abnormality was found in the control group.Conclusions Cerebral blood flow abnormalities exist in patients with early syphilis. General patchy hypoperfusion on SPECT imaging is common.

  17. Vasopressin content in the cerebrospinal fluid and fluid perfusing cerebral ventricles in rats after the afferent vagus nerve fibres stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Orlowska-Majdak, M.; Traczyk, W.Z. [Akademia Medyczna, Lodz (Poland). Katedra Fizjologii

    1996-12-31

    Experiments were carried out on male rats in urethane anaesthesia. Cerebroventricular system was perfused with McIlwain-Rodniht`s solution from lateral ventricles to cerebellomedullary cistern. Both vagus nerves were cut and the central ends of the nerves were electrically stimulated during the collection of the third 30-min portion of perfusing fluid. Vasopressin (AVP) was determined by radioimmunoassay in samples of the cerebrospinal fluid (CSF) (the first portion) and in five successive samples of the perfusing fluid. AVP concentration in the CSF was several times greater than in the fluid perfusing cerebral ventricles. Alternate electrical stimulation of both vagus nerves did not change considerably the release of AVP into the fluid perfusing the cerebral ventricles in rat, although a certain upward tendency could be observed. It seems that only AVP raised in circulating blood and not in CSF, after vagus nerves stimulation may act on the central nervous structures. (author). 37 refs, 3 figs, 1 tab.

  18. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinnatamby, R. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Antoun, N.A. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Freer, C.E.L. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Miles, K.A. [Dept. of Nuclear Medicine, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Hodges, J.R. [Dept. of Neurology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom)

    1996-04-01

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using {sup 99m}Tc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  19. Evaluation of cerebral perfusion imaging with N-isopropyl-p-[{sup 123}I]iodoamphetamine (IMP) in the cases of antiphospholipid syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru [Nagoya City Univ. (Japan). Faculty of Medicine

    1995-01-01

    Five cases of antiphospholipid syndrome with mild headache, but without any neurological deficits and abnormal findings by CT and MRI, were examined by cerebral blood perfusion SPECT using N-isopropyl-p-[{sup 123}I] iodoamphetamine (IMP). Although three cases were performed quantification of cerebral blood flow with a microsphere method simultaneously, their values were within normal limits. Two of them showed focal low perfusion areas. One case had relatively low perfusion areas in the bilateral occipital lobes and the right temporal lobe, which improved after treatment. One of two had low perfusion in the bilateral occipital lobes. Other three cases only showed ununiformity of radioisotope uptake on the cerebral blood perfusion SPECT. Low perfusion areas in antiphospholipid syndrome might be caused by microarterial thrombosis, microvenous thrombosis or spasms, although they could be reversible. As early irreversible progress of cerebral blood flow, cerebral blood flow SPECT should be performed in cases of antiphospholipid syndrome with neurological complainments. (author).

  20. Intrathoracic Pressure Regulation Improves Cerebral Perfusion and Cerebral Blood Flow in a Porcine Model of Brain Injury.

    Science.gov (United States)

    Metzger, Anja; Rees, Jennifer; Kwon, Young; Matsuura, Timothy; McKnite, Scott; Lurie, Keith G

    2015-08-01

    Brain injury is a leading cause of death and disability in children and adults in their most productive years. Use of intrathoracic pressure regulation (IPR) to generate negative intrathoracic pressure during the expiratory phase of positive pressure ventilation improves mean arterial pressure and 24-h survival in porcine models of hemorrhagic shock and cardiac arrest and has been demonstrated to decrease intracranial pressure (ICP) and cerebral perfusion pressure (CPP) in these models. Application of IPR for 240 min in a porcine model of intracranial hypertension (ICH) will increase CPP when compared with controls. Twenty-three female pigs were subjected to focal brain injury by insertion of an epidural Foley catheter inflated with 3 mL of saline. Animals were randomized to treatment for 240 min with IPR set to a negative expiratory phase pressure of -12 cmH2O or no IPR therapy. Intracranial pressure, mean arterial pressure, CPP, and cerebral blood flow (CBF) were evaluated. Intrathoracic pressure regulation significantly improved mean CPP and CBF. Specifically, mean CPP after 90, 120, 180, and 240 min of IPR use was 43.7 ± 2.8 mmHg, 44.0 ± 2.7 mmHg, 44.5 ± 2.8 mmHg, and 43.1 ± 1.9 mmHg, respectively; a significant increase from ICH study baseline (39.5 ± 1.7 mmHg) compared with control animals in which mean CPP was 36.7 ± 1.4 mmHg (ICH study baseline) and then 35.9 ± 2.1 mmHg, 33.7 ± 2.8 mmHg, 33.9 ± 3.0 mmHg, and 36.0 ± 2.7 mmHg at 90, 120, 180, and 240 min, respectively (P blood flow, as measured by an invasive CBF probe, increased in the IPR group (34 ± 4 mL/100 g-min to 49 ± 7 mL/100 g-min at 90 min) but not in controls (27 ± 1 mL/100 g-min to 25 ± 5 mL/100 g-min at 90 min) (P = 0.01). Arterial pH remained unchanged during the entire period of IPR compared with baseline values and control values. In this anesthetized pig model of ICH, treatment with IPR significantly improved CPP and CBF. This therapy may be of clinical value by noninvasively

  1. Cerebral Perfusion Enhancing Interventions: A New Strategy for the Prevention of Alzheimer Dementia.

    Science.gov (United States)

    de la Torre, Jack C

    2016-09-01

    Cardiovascular and cerebrovascular diseases are major risk factors in the development of cognitive impairment and Alzheimer's disease (AD). These cardio-cerebral disorders promote a variety of vascular risk factors which in the presence of advancing age are prone to markedly reduce cerebral perfusion and create a neuronal energy crisis. Long-term hypoperfusion of the brain evolves mainly from cardiac structural pathology and brain vascular insufficiency. Brain hypoperfusion in the elderly is strongly associated with the development of mild cognitive impairment (MCI) and both conditions are presumed to be precursors of Alzheimer dementia. A therapeutic target to prevent or treat MCI and consequently reduce the incidence of AD aims to elevate cerebral perfusion using novel pharmacological agents. As reviewed here, the experimental pharmaca include the use of Rho kinase inhibitors, neurometabolic energy boosters, sirtuins and vascular growth factors. In addition, a compelling new technique in laser medicine called photobiomodulation is reviewed. Photobiomodulation is based on the use of low level laser therapy to stimulate mitochondrial energy production non-invasively in nerve cells. The use of novel pharmaca and photobiomodulation may become important tools in the treatment or prevention of cognitive decline that can lead to dementia.

  2. 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.)

  3. Effect of cerebral ventricles perfusion with naloxone on trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Janecka, A

    2001-02-02

    The goal of this study was to determine whether opioid receptor antagonist naloxone abolishes the influence of periaqueductal central gray (PAG) on nociceptive evoked tongue jerks (ETJ) -- a trigemino-hypoglossal reflex induced by tooth pulp stimulation. In rats under chloralose anesthesia three series of experiments were performed. In the first two groups perfusions of lateral ventricles-cerebellomedullary cistern with McIlwain-Rodnight's solution and naloxone were carried out. In group 3 naloxone was infused through a catheter through the jugular vein. The amplitudes of tongue jerks induced by tooth pulp stimulation were recorded during subsequent 10 min perfusions. Mean amplitude of tongue movements induced by tooth pulp stimulation was regarded as the indicator of the magnitude of trigemino-hypoglossal reflex. We observed that perfusion of the cerebral ventricles with naloxone (100 nmol/ml) increased the trigemino-hypoglossal reflex up to 143%. The amplitude of ETJ was significantly reduced during PAG stimulation with a train of electrical impulses. After obtaining a significant -- 93% -- inhibition of ETJ (7% of the control), naloxone (100 nmol/ml) was added to the perfusion fluid. This led to a significant increase of the reflex up to 68%. Infusion of naloxone through the jugular vein did not affect the reflex. The above results suggest that the inhibition of ETJ due to PAG stimulation is partially reversed by naloxone and mediated via interactions with endogenous opioid systems involved in modulation of nociception.

  4. Intraoperative imaging of cortical cerebral perfusion by time-resolved thermography and multivariate data analysis

    Science.gov (United States)

    Steiner, Gerald; Sobottka, Stephan B.; Koch, Edmund; Schackert, Gabriele; Kirsch, Matthias

    2011-01-01

    A new approach to cortical perfusion imaging is demonstrated using high-sensitivity thermography in conjunction with multivariate statistical data analysis. Local temperature changes caused by a cold bolus are imaged and transferred to a false color image. A cold bolus of 10 ml saline at ice temperature is injected systemically via a central venous access. During the injection, a sequence of 735 thermographic images are recorded within 2 min. The recorded data cube is subjected to a principal component analysis (PCA) to select slight changes of the cortical temperature caused by the cold bolus. PCA reveals that 11 s after injection the temperature of blood vessels is shortly decreased followed by an increase to the temperature before the cold bolus is injected. We demonstrate the potential of intraoperative thermography in combination with multivariate data analysis to image cortical cerebral perfusion without any markers. We provide the first in vivo application of multivariate thermographic imaging.

  5. Postural influence on intracranial and cerebral perfusion pressure in ambulatory neurosurgical patients

    DEFF Research Database (Denmark)

    Petersen, Lonnie Grove; Petersen, Johan Casper Grove; Andresen, Morten;

    2016-01-01

    We evaluated postural effects on intracranial pressure (ICP) and cerebral perfusion pressure (CPP: mean arterial pressure (MAP) - ICP) in neurosurgical patients undergoing 24-hour ICP monitoring as part of their diagnostic workup. We identified 9 patients (5 women, age 44±20 yrs.; mean±SD) who were...... "as normal as possible" i.e. without indication for neurosurgical intervention (e.g. focal lesions, global edema, abnormalities in ICP-profile or cerebrospinal fluid dynamics). ICP (tip-transducer probe, Raumedic) in the brain parenchyma (N=7) or in the lateral ventricles (N=2) and cardiovascular...

  6. Misery, Corruption, and Presidential Approval

    DEFF Research Database (Denmark)

    Rosas, Guillermo; Manzetti, Luigi

    2016-01-01

    This is a guest post by Guillermo Rosas and Luigi Manzetti. It summarizes their recent paper, ‘Reassessing the trade-off hypothesis: How misery drives the corruption effect on presidential approval’ that was published in Electoral Studies, Volume 39, September 2015, pp. 26–38.......This is a guest post by Guillermo Rosas and Luigi Manzetti. It summarizes their recent paper, ‘Reassessing the trade-off hypothesis: How misery drives the corruption effect on presidential approval’ that was published in Electoral Studies, Volume 39, September 2015, pp. 26–38....

  7. Xueshuantong improves cerebral blood perfusion in elderly patients with lacunar infarction

    Institute of Scientific and Technical Information of China (English)

    Qifeng Gui; Yunmei Yang; Shihong Ying; Minming Zhang

    2013-01-01

    A total of 64 patients with acute lacunar infarction were enrolled within 24 hours of onset. The patients received conventional therapy (antiplatelet drugs and hypolipidemic drugs) alone or conventional therapy plus 450 mg Xueshuantong once a day. The main ingredient of the Xueshuantong lyophilized powder used for injection was Panax notoginseng saponins. Assessments were made at admission and at discharge using the National Institutes of Health Stroke Scale, the Activity of Daily Living and the Mini-Mental State Examination. Additionally, the relative cerebral blood flow, relative cerebral blood volume and relative mean transit time in the region of interest were calculated within 24 hours after the onset of lacunar infarction, using dynamic susceptibility contrast magnetic resonance perfusion imaging technology. Patients underwent a follow-up MRI scan after 4 weeks of treatment. There was an improvement in the Activity of Daily Living scores and a greater reduction in the scores on the National Institutes of Health Stroke Scale in the treatment group than in the control group. However, the Mini-Mental State Examination scores showed no significant differences after 4 weeks of treatment. Compared with the control group, the relative cerebral blood flow at discharge had increased and showed a greater improvement in the treatment group. Furthermore, there was a reduction in the relative mean transit time at discharge and the value was lower in the treatment group than in the control group. The experimental findings indicate that Xueshuantong treatment improves neurological deficits in elderly patients with lacunar infarction, and the mechanism may be related to increased cerebral perfusion.

  8. 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

  9. Misery Is Fun: Using Langston Hughes's "Black Misery."

    Science.gov (United States)

    Benun, Ilise

    1998-01-01

    Uses "Black Misery," a picture book that shines a spotlight on 27 humiliating moments of childhood. Begins by reading the text and discussing the pictures and captions; then asks students to write a minimum of five captions in a manageable amount of time. Concludes by having students read their captions aloud and engage in more discussion. (PA)

  10. 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...

  11. Aortic outflow cannula tip design and orientation impacts cerebral perfusion during pediatric cardiopulmonary bypass procedures.

    Science.gov (United States)

    Menon, Prahlad G; Antaki, James F; Undar, Akif; Pekkan, Kerem

    2013-12-01

    Poor perfusion of the aortic arch is a suspected cause for peri- and post-operative neurological complications associated with cardiopulmonary bypass (CPB). High-speed jets from 8 to 10FR pediatric/neonatal cannulae delivering ~1 L/min of blood can accrue sub-lethal hemolytic damage while also subjecting the aorta to non-physiologic flow conditions that compromise cerebral perfusion. Therefore, we emphasize the importance of cannulation strategy and hypothesize engineering better CPB perfusion through a redesigned aortic cannula tip. This study employs computational fluid dynamics to investigate novel diffuser-tipped aortic cannulae for shape sensitivity to cerebral perfusion, in an in silico cross-clamped aortic arch model modeled with fixed outflow resistances. 17 parametrically altered configurations of an 8FR end-hole and several diffuser cone angled tips in combination with jet incidence angles toward or away from the head-neck vessels were studied. Experimental pressure-flow characterizations were also conducted on these cannula tip designs. An 8FR end-hole aortic cannula delivering 1 L/min along the transverse aortic arch was found to give rise to backflow from the brachicephalic artery (BCA), irrespective of angular orientation, for the chosen ascending aortic insertion location. Parametric alteration of the cannula tip to include a diffuser cone angle (tested up to 7°) eliminated BCA backflow for any tested angle of jet incidence. Experiments revealed that a 1 cm long 10° diffuser cone tip demonstrated the best pressure-flow performance improvement in contrast with either an end-hole tip or diffuser cone angles greater than 10°. Performance further improved when the diffuser was preceded by an expanded four-lobe swirl inducer attachment-a novel component. In conclusion, aortic cannula orientation is crucial in determining net head-neck perfusion but precise angulations and insertion-depths are difficult to achieve practically. Altering the cannula tip

  12. Effect of Acupuncture Signal after Brachial Plexus Blockade on Cerebral Blood Perfusion and Brain Cell Function

    Institute of Scientific and Technical Information of China (English)

    任永功; 郭长春; 贾少微

    2003-01-01

    Objective: Using single photon emission computed tomography (SPECT) to observe the influence of the up-transmitting of acupuncture signal into the brain in health volunteers whose nerve trunk was blocked by anesthetics. Methods: Thirty-one healthy volunteers were divided into two groups, the control group of 20 cases, and the brachial plexus blockade (BPB) group of 11 cases, with supraclavicular BPB route adopted. With the control group 2 acupoints were randomly selected (Hegu and Quchi of both sides), while with the BPB group Hegu and Quchi of anesthetic arm side were selected. Siemens ECAM/ICON SPECT system was used to conduct brain imaging using double imaging assay before acupuncture and 99mTc-ECD imaging agent during acupuncture for cerebral perfusion. The data were quantitatively analyzed by blood functional changing rate (BFCR%) mathematics model. Results: Before acupuncture, the control and BPB groups showed insignificant change by SPECT, but after electro-acupuncture (EA), the control group displayed improved motor and sensory cortex excitability in basal nuclei, contra-lateral thalamus, parietal and frontal lobe; while BPB group was characterized with reduction of the blood perfusion and cell function of contra-lateral thalamus of anesthetized arm. The difference between the two groups was significant (P<0.01). Conclusion: (1) After BPB, the up-transmitting of the acupuncture signal via upper limb into the brain, and its strength was impaired or blocked; (2) After BPB, the effect of acupuncture on cerebral perfusion and brain cell function of contra-lateral thalamus was impaired or blocked.

  13. The role of perfusion computed tomography in the prediction of cerebral hyperperfusion syndrome.

    Directory of Open Access Journals (Sweden)

    Chien Hung Chang

    Full Text Available BACKGROUND: Hyperperfusion syndrome (HPS following carotid angioplasty with stenting (CAS is associated with significant morbidity and mortality. At present, there are no reliable parameters to predict HPS. The aim of this study was to clarify whether perfusion computed tomography (CT is a feasible and reliable tool in predicting HPS after CAS. METHODOLOGY/PRINCIPAL FINDINGS: We performed a retrospective case-control study of 54 patients (11 HPS patients and 43 non-HPS with unilateral severe stenosis of the carotid artery who underwent CAS. We compared the prevalence of vascular risk factors and perfusion CT parameters including regional cerebral blood volume (rCBV, regional cerebral blood flow (rCBF, and time to peak (TTP within seven days prior to CAS. Demographic information, risk factors for atherosclerosis, and perfusion CT parameters were evaluated by multivariable logistic regression analysis. The rCBV index was calculated as [(ipsilateral rCBV - contralateral rCBV/contralateral rCBV], and indices of rCBF and TTP were similarly calculated. We found that eleven patients had HPS, including five with intracranial hemorrhages (ICHs of whom three died. After a comparison with non-HPS control subjects, independent predictors of HPS included the severity of ipsilateral carotid artery stenosis, 3-hour mean systolic blood pressure (3 h SBP after CAS, pre-stenting rCBV index >0.15 and TTP index >0.22. CONCLUSIONS/SIGNIFICANCE: The combination of severe ipsilateral carotid stenosis, 3 h SBP after CAS, rCBV index and TTP index provides a potential screening tool for predicting HPS in patients with unilateral carotid stenosis receiving CAS. In addition, adequate management of post-stenting blood pressure is the most important treatable factor in preventing HPS in these high risk patients.

  14. Application value of CT perfusion imaging with acetazolamide challenge test in the diagnosis of chronic cerebral insufficiency

    Institute of Scientific and Technical Information of China (English)

    高轩

    2014-01-01

    Objective To explore the CT perfusion imaging with acetazolamide(ACZ)challenge test in the diagnosis of chronic cerebral insufficiency.Methods 100 patients undergoing health examination in our hospital from Aug2009 to Feb 2011 were chosen,52 patients diagnosed as chronic cerebral insufficiency were defined as the case group,and the remaining 48 cases of healthy elderly people were defined as the control group.The brain CT

  15. CT perfusion during delayed cerebral ischemia after subarachnoid hemorrhage: distinction between reversible ischemia and ischemia progressing to infarction

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands); Schaaf, Irene C. van der; Velthuis, Birgitta K.; Dankbaar, Jan Willem [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, PO Box 85500, Utrecht, Utrecht (Netherlands)

    2015-09-15

    Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH) can be reversible or progress to cerebral infarction. In patients with a deterioration clinically diagnosed as DCI, we investigated whether CT perfusion (CTP) can distinguish between reversible ischemia and ischemia progressing to cerebral infarction. From a prospectively collected series of aSAH patients, we included those with DCI, CTP on the day of clinical deterioration, and follow-up imaging. In qualitative CTP analyses (visual assessment), we calculated positive and negative predictive value (PPV and NPV) with 95 % confidence intervals (95%CI) of a perfusion deficit for infarction on follow-up imaging. In quantitative analyses, we compared perfusion values of the least perfused brain tissue between patients with and without infarction by using receiver-operator characteristic curves and calculated a threshold value with PPV and NPV for the perfusion parameter with the highest area under the curve. In qualitative analyses of 33 included patients, 15 of 17 patients (88 %) with and 6 of 16 patients (38 %) without infarction on follow-up imaging had a perfusion deficit during clinical deterioration (p = 0.002). Presence of a perfusion deficit had a PPV of 71 % (95%CI: 48-89 %) and NPV of 83 % (95%CI: 52-98 %) for infarction on follow-up. Quantitative analyses showed that an absolute minimal cerebral blood flow (CBF) threshold of 17.7 mL/100 g/min had a PPV of 63 % (95%CI: 41-81 %) and a NPV of 78 % (95%CI: 40-97 %) for infarction. CTP may differ between patients with DCI who develop infarction and those who do not. For this purpose, qualitative evaluation may perform marginally better than quantitative evaluation. (orig.)

  16. 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).

  17. Cerebral perfusion reserve in carotid stenosis: Prognostic role in surgical and rheological therapy

    Energy Technology Data Exchange (ETDEWEB)

    Ussov, W.; Shipulin, V.; Shvera, I. [and others

    1994-05-01

    The study was aimed to evaluate the usefulness of the quantitative cerebral perfusion reserve SPECT for the prognosis in patients with critical stenoses of the internal carotid arteries treated surgically or rheotherapeutically. 23 patients with angiographically verified mono (n=12) or bilateral (n=11) stenosis of the internal carotid artery for more than 75% and with recent (>30 days) minor stroke or TIA events in anamnesis were referred for the study. 6 age-matched healthy persons served as controls. In everybody the cerebral perfusion reserve was studied by using of the local cerebral blood volume to cerebral blood flow (rCBV/rCBF, sec) index using a double isotope technique which combined Tl-199 diethyidithiocarbamate (Tl-199-DDC) SPECT with Tc-99m red blood cells (Tc-99m-RBC) SPECT. 12 patients underwent carotid endartherectomy and 11 were treated rheotherapeutically by nonselective plasma substitution (5 times x 400 ml, >1800 nil in total). Patients were studied twicely: before and 10 days after the treatment, and then followed-up neurologically in the course of 1 year. Patients who had regional rCBV/rCBF index increased in the stenosed a.carotis int. - dependent region before treatment (normal value 5.2, sd 0.2 sec) have got it significantly decreased after intervention both in surgical group (from 7.1, sd 0.4 sec, down to 5.3, sd 0.3 sec, p<0.01 n=7) and in rheotherapeutical one (from 7.3, sd 0.5 sec, to 5.9, sd 0.4 sec, p<0.02 n=8). In everybody who expressed the rCBV/rCBF decreased below 5.6 sec after intervention there were no cerebrovascular ischemic events observed in the course of 12 months after carotid surgery and during 5 months in patients treated by plasmapheresis. We conclude that rCBV/rCBF SPECT index gives an independent prognostic information useful for both rheologic and surgical treatment of cerebrovascular disease; and that plasmapheresis suppress the short-term rise of cerebral ischemic events, which effect is predictable by SPECT.

  18. CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Uwano, Ikuko; Kudo, Kohsuke; Sasaki, Makoto [Iwate Medical University, Advanced Medical Research Center, Morioka (Japan); Christensen, Soren [University of Melbourne, Royal Melbourne Hospital, Departments of Neurology and Radiology, Victoria (Australia); Oestergaard, Leif [Aarhus University Hospital, Department of Neuroradiology, Center for Functionally Integrative Neuroscience, DK, Aarhus C (Denmark); Ogasawara, Kuniaki; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan)

    2012-05-15

    Computed tomography perfusion (CTP) and magnetic resonance perfusion (MRP) are expected to be usable for ancillary tests of brain death by detection of complete absence of cerebral perfusion; however, the detection limit of hypoperfusion has not been determined. Hence, we examined whether commercial software can visualize very low cerebral blood flow (CBF) and cerebral blood volume (CBV) by creating and using digital phantoms. Digital phantoms simulating 0-4% of normal CBF (60 mL/100 g/min) and CBV (4 mL/100 g/min) were analyzed by ten software packages of CT and MRI manufacturers. Region-of-interest measurements were performed to determine whether there was a significant difference between areas of 0% and areas of 1-4% of normal flow. The CTP software detected hypoperfusion down to 2-3% in CBF and 2% in CBV, while the MRP software detected that of 1-3% in CBF and 1-4% in CBV, although the lower limits varied among software packages. CTP and MRP can detect the difference between profound hypoperfusion of <5% from that of 0% in digital phantoms, suggesting their potential efficacy for assessing brain death. (orig.)

  19. Methodological NMR imaging developments to measure cerebral perfusion; Developpements methodologiques en IRM pour la mesure de perfusion cerebrale

    Energy Technology Data Exchange (ETDEWEB)

    Pannetier, N.

    2010-12-15

    This work focuses on acquisition techniques and physiological models that allow characterization of cerebral perfusion by MRI. The arterial input function (AIF), on which many models are based, is measured by a technique of optical imaging at the carotid artery in rats. The reproducibility and repeatability of the AIF are discussed and a model function is proposed. Then we compare two techniques for measuring the vessel size index (VSI) in rats bearing a glioma. The reference technique, using a USPIO contrast agent (CA), faces the dynamic approach that estimates this parameter during the passage of a bolus of Gd. This last technique has the advantage of being used clinically. The results obtained at 4.7 T by both approaches are similar and use of VSI in clinical protocols is strongly encouraged at high field. The mechanisms involved (R1 and R2* relaxivities) were then studied using a multi gradient -echoes approach. A multi-echoes spiral sequence is developed and a method that allows the refocusing between each echo is presented. This sequence is used to characterize the impact of R1 effects during the passage of two successive injections of Gd. Finally, we developed a tool for simulating the NMR signal on a 2D geometry taking into account the permeability of the BBB and the CA diffusion in the interstitial space. At short TE, the effect of diffusion on the signal is negligible. In contrast, the effects of diffusion and permeability may be separated at long echo time. Finally we show that during the extravasation of the CA, the local magnetic field homogenization due to the decrease of the magnetic susceptibility difference at vascular interfaces is quickly balanced by the perturbations induced by the increase of the magnetic susceptibility difference at the cellular interfaces in the extravascular compartment. (author)

  20. Brain volume perfusion CT performed with 128-detector row CT system in patients with cerebral gliomas: A feasibility study

    Energy Technology Data Exchange (ETDEWEB)

    Xyda, Argyro [University Hospital of Goettingen, Department of Neuroradiology, Georg-August University, Goettingen (Germany); University Hospital of Heraklion, Department of Radiology, Crete (Greece); Haberland, Ulrike; Klotz, Ernst [Computed Tomography, Siemens AG Healthcare Sector, Forchheim (Germany); Bock, Hans Christoph [University Hospital of Goettingen, Department of Neurosurgery, Georg-August University, Goettingen (Germany); Jung, Klaus [University Hospital of Goettingen, Department of Medical Statistics, Georg-August University, Goettingen (Germany); Knauth, Michael; Schramm, Ramona; Psychogios, Marios Nikos; Schramm, Peter [University Hospital of Goettingen, Department of Neuroradiology, Georg-August University, Goettingen (Germany); Erb, Gunter [Bracco Imaging Deutschland GmbH, Konstanz (Germany)

    2011-09-15

    Validation of the feasibility and efficacy of volume perfusion computed tomography (VPCT) in the preoperative assessment of cerebral gliomas by applying a 128-slice CT covering the entire tumour. Forty-six patients (25 men, 21 women; mean age 52.8 years) with cerebral gliomas were evaluated with VPCT. Two readers independently evaluated VPCT data, drawing volumes of interest (VOIs) around the tumour according to maximum intensity projection volumes, which were mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability (Ktrans) perfusion datasets. As control, a second VOI was placed in the contralateral healthy cortex. Correlation among perfusion parameters, tumour grade, hemisphere and VOIs was assessed. The diagnostic power of perfusion parameters was analysed by receiver operating characteristics curve analyses. VPCT was feasible in the assessment of the entire tumour extent. Mean values of Ktrans, CBV, CBF in high-grade gliomas were significantly higher compared with low-grade (p < 0.01). Ktrans demonstrated the highest diagnostic (97% sensitivity), positive (100%) and negative (94%) prognostic values. VPCT was feasible in all subjects. All areas of different perfusion characteristics are depicted and quantified in colour-coded 3D maps. The derived parameters correlate well with tumour histopathology, differentiating low- from high-grade gliomas. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-09-01

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

  2. 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.

  3. Higher cerebral oxygen saturation may provide higher urinary output during continuous regional cerebral perfusion

    Directory of Open Access Journals (Sweden)

    Tomoyasu Takahiro

    2008-10-01

    Full Text Available Abstract Objective We examined the hypothesis that higher cerebral oxygen saturation (rSO2 during RCP is correlated with urinary output. Methods Between December 2002 and August 2006, 12 patients aged 3 to 61 days and weighing 2.6 to 3.4 kg underwent aortic arch repair with RCP. Urinary output and rSO2 were analyzed retrospectively. Data were assigned to either of 2 groups according to their corresponding rSO2: Group A (rSO2 ≦ 75% and Group B (rSO2 Results Seven and 5 patients were assigned to Group A and Group B, respectively. Group A was characterized by mean radial arterial pressure (37.9 ± 9.6 vs 45.8 ± 7.8 mmHg; P = 0.14 and femoral arterial pressure (6.7 ± 6.1 vs 20.8 ± 14.6 mmHg; P = 0.09 compared to Group B. However, higher urinary output during CPB (1.03 ± 1.18 vs 0.10 ± 0.15 ml·kg-1·h-1; P = 0.03. Furthermore our results indicate that a higher dose of Chlorpromazine was used in Group A (2.9 ± 1.4 vs 1.7 ± 1.0 mg/kg; P = 0.03. Conclusion Higher cerebral oxygenation may provide higher urinary output due to higher renal blood flow through collateral circulation.

  4. Different CT perfusion algorithms in the detection of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Cremers, Charlotte H.P. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Room G03.232, Brain Center Rudolf Magnus Department of Neurology and Neurosurgery, PO Box 85500, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Dankbaar, Jan Willem; Bennink, Edwin; Velthuis, Birgitta K.; Schaaf, Irene C. van der [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Vergouwen, Mervyn D.I.; Rinkel, Gabriel J.E. [University Medical Center Utrecht, Department of Neurology and Neurosurgery, Room G03.232, Brain Center Rudolf Magnus Department of Neurology and Neurosurgery, PO Box 85500, Utrecht (Netherlands); Vos, Pieter C. [University Medical Center Utrecht, Image Sciences Institute, Utrecht (Netherlands)

    2015-05-01

    Tracer delay-sensitive perfusion algorithms in CT perfusion (CTP) result in an overestimation of the extent of ischemia in thromboembolic stroke. In diagnosing delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (aSAH), delayed arrival of contrast due to vasospasm may also overestimate the extent of ischemia. We investigated the diagnostic accuracy of tracer delay-sensitive and tracer delay-insensitive algorithms for detecting DCI. From a prospectively collected series of aSAH patients admitted between 2007-2011, we included patients with any clinical deterioration other than rebleeding within 21 days after SAH who underwent NCCT/CTP/CTA imaging. Causes of clinical deterioration were categorized into DCI and no DCI. CTP maps were calculated with tracer delay-sensitive and tracer delay-insensitive algorithms and were visually assessed for the presence of perfusion deficits by two independent observers with different levels of experience. The diagnostic value of both algorithms was calculated for both observers. Seventy-one patients were included. For the experienced observer, the positive predictive values (PPVs) were 0.67 for the delay-sensitive and 0.66 for the delay-insensitive algorithm, and the negative predictive values (NPVs) were 0.73 and 0.74. For the less experienced observer, PPVs were 0.60 for both algorithms, and NPVs were 0.66 for the delay-sensitive and 0.63 for the delay-insensitive algorithm. Test characteristics are comparable for tracer delay-sensitive and tracer delay-insensitive algorithms for the visual assessment of CTP in diagnosing DCI. This indicates that both algorithms can be used for this purpose. (orig.)

  5. 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

  6. Toward fully automated processing of dynamic susceptibility contrast perfusion MRI for acute ischemic cerebral stroke.

    Science.gov (United States)

    Kim, Jinsuh; Leira, Enrique C; Callison, Richard C; Ludwig, Bryan; Moritani, Toshio; Magnotta, Vincent A; Madsen, Mark T

    2010-05-01

    We developed fully automated software for dynamic susceptibility contrast (DSC) MR perfusion-weighted imaging (PWI) to efficiently and reliably derive critical hemodynamic information for acute stroke treatment decisions. Brain MR PWI was performed in 80 consecutive patients with acute nonlacunar ischemic stroke within 24h after onset of symptom from January 2008 to August 2009. These studies were automatically processed to generate hemodynamic parameters that included cerebral blood flow and cerebral blood volume, and the mean transit time (MTT). To develop reliable software for PWI analysis, we used computationally robust algorithms including the piecewise continuous regression method to determine bolus arrival time (BAT), log-linear curve fitting, arrival time independent deconvolution method and sophisticated motion correction methods. An optimal arterial input function (AIF) search algorithm using a new artery-likelihood metric was also developed. Anatomical locations of the automatically determined AIF were reviewed and validated. The automatically computed BAT values were statistically compared with estimated BAT by a single observer. In addition, gamma-variate curve-fitting errors of AIF and inter-subject variability of AIFs were analyzed. Lastly, two observes independently assessed the quality and area of hypoperfusion mismatched with restricted diffusion area from motion corrected MTT maps and compared that with time-to-peak (TTP) maps using the standard approach. The AIF was identified within an arterial branch and enhanced areas of perfusion deficit were visualized in all evaluated cases. Total processing time was 10.9+/-2.5s (mean+/-s.d.) without motion correction and 267+/-80s (mean+/-s.d.) with motion correction on a standard personal computer. The MTT map produced with our software adequately estimated brain areas with perfusion deficit and was significantly less affected by random noise of the PWI when compared with the TTP map. Results of image

  7. Correspondence of CT perfusion imaging to pathological manifestations in rabbit models of hyperacute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    Mingwu Lou; Yi Fan; Lizhong Jia; Weidong Hu; Yan Teng; Guangfu Yang

    2007-01-01

    BACKGROUND: Could the infarction be diagnosed quickly and accurately at the acute stage by CT perfusion imaging (CTPI) technology? Whether the images of CTPI will correspond with the pathological changes or not? All the questions need to be solved by experimental and clinical studies.OBJECTIVE: To reveal the rules of perfusion map changes and guide the early diagnosis of hyperacute cerebral infarction by analyzing the correlation of CTPI with pathological manifestations for hyperacute cerebral infarction.DESIGN: A randomized controlled animal experiment.SETTING: Experimental Center of Medical Radiology, Longgang Central Hospital of Shenzhen City.MATERIALS: Forty-two adult New Zealand rabbits of (2.6±0.5) kg, either male or female, were randomly divided into experimental group (n =36) and control group (n =6). Six rabbits in the experimental group were observed after ischemia for 0.5, 1, 2, 3, 4 and 6 hours respectively, and 1 rabbit in the control group was observed at each corresponding time point.METHODS: The experiments were carded out in the Experimental Center of Medical Radiology,Longgang Central Hospital of Shenzhen City from March 2003 to July 2004, Rabbit models of cerebral scanned at 0.5, 1, 2, 3, 4 and 6 hours after ischemia respectively. The dynamic CT scan slice was 13 mm from the anterior edge of the frontal cortex, and six fake color functional images were obtained, including cerebral blood flow map (CBF map), cerebral blood volume map (CBV map), peak to enhancement map (PE map),flow without vessels map, time to peak map (TP map), time to start map (TS map). The manifestations and (ROI) were drawn separately on the CBF map, CBV map, TP map and TS map. The blood flow parameters of focal and contralateral cerebral tissues could be obtained to calculate relative cerebral blood flow (rCBF,rCBF=focal CBF/contralateral CBF), relative cerebral blood volume (rCBV, rCBV= focal CBV/contralateral CBV), a relative time to peak (rTP, rTP= focal TP

  8. Iofetamine hydrochloride I 123: a new radiopharmaceutical for cerebral perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Druckenbrod, R.W.; Williams, C.C.; Gelfand, M.J.

    1989-01-01

    Iofetamine hydrochloride I-123 permits cerebral blood perfusion imaging with single photon emission computed tomography (SPECT). SPECT is more widely available than positron emission tomography, and complements anatomic visualization with X-ray computed tomography (CT) or magnetic resonance imaging. Iofetamine is an amphetamine analog that is rapidly taken up by the lungs, then redistributed principally to the liver and brain. The precise mechanism of localization has not been determined, but is believed to result from nonspecific receptor binding. Brain uptake peaks at 30 minutes postinjection and remains relatively constant through 60 minutes. The drug is metabolized and excreted in the urine, with negligible activity remaining at 48 hours. When compared with CT in stroke patients, visualization may be performed sooner after symptom onset and a larger zone of involvement may be evident with iofetamine. Localization of seizure foci and diagnosis of Alzheimer's disease may also be possible. As CT has revolutionized noninvasive imaging of brain anatomy, SPECT with iofetamine permits routine cerebral blood flow imaging. 36 references.

  9. Quantitative Measurement of Cerebral Perfusion with Intravoxel Incoherent Motion in Acute Ischemia Stroke: Initial Clinical Experience

    Institute of Scientific and Technical Information of China (English)

    Li-Bao Hu; Nan Hong; Wen-Zhen Zhu

    2015-01-01

    Background:Intravoxel incoherent motion (IVIM) has the potential to provide both diffusion and perfusion information without an exogenous contrast agent,its application for the brain is promising,however,feasibility studies on this are relatively scarce.The aim of this study is to assess the feasibility of IVIM perfusion in patients with acute ischemic stroke (AIS).Methods:Patients with suspected AIS were examined by magnetic resonance imaging within 24 h of symptom onset.Fifteen patients (mean age was 68.7 ± 8.0 years) who underwent arterial spin labeling (ASL) and diffusion-weighted imaging (DWI) were identified as having AIS with ischemic penumbra were enrolled,where ischemic penumbra referred to the mismatch areas of ASL and DWI.Eleven different b-values were applied in the biexponential model.Regions of interest were selected in ischemic penumbras and contralateral normal brain regions.Fast apparent diffusion coefficients (ADCs) and ASL cerebral blood flow (CBF) were measured.The paired t-test was applied to compare ASL CBF,fast ADC,and slow ADC measurements between ischemic penumbras and contralateral normal brain regions.Linear regression and Pearson's correlation were used to evaluate the correlations among quantitative results.Results:The fast ADCs and ASL CBFs of ischemic penumbras were significantly lower than those of the contralateral normal brain regions (1.93 ± 0.78 μm2/ms vs.3.97 ± 2.49 μm2/ms,P =0.007;13.5 ± 4.5 ml· 100 g-1 ·min-1 vs.29.1 ± 12.7 ml·100 g-1 ·min-1,P < 0.001,respectively).No significant difference was observed in slow ADCs between ischemic penumbras and contralateral normal brain regions (0.203 ± 0.090 μm2/ms vs.0.198 ± 0.100 μm2/ms,P =0.451).Compared with contralateral normal brain regions,both CBFs and fast ADCs decreased in ischemic penumbras while slow ADCs remained the same.A significant correlation was detected between fast ADCs and ASL CBFs (r =0.416,P < 0.05).No statistically significant correlation was

  10. 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.)

  11. Similar cerebral protective effectiveness of antegrade and retrograde cerebral perfusion during deep hypothermic circulatory arrest in aortic surgery: a meta-analysis of 7023 patients.

    Science.gov (United States)

    Guo, Shasha; Sun, Yanhua; Ji, Bingyang; Liu, Jinping; Wang, Guyan; Zheng, Zhe

    2015-04-01

    In aortic arch surgery, deep hypothermic circulatory arrest (DHCA) combined with cerebral perfusion is employed worldwide as a routine practice. Even though antegrade cerebral perfusion (ACP) is more widely used than retrograde cerebral perfusion (RCP), the difference in benefit and risk between ACP and RCP during DHCA is uncertain. The purpose of this meta-analysis is to compare neurologic outcomes and early mortality between ACP and RCP in patients who underwent aortic surgery during DHCA. PubMed, EMBASE, and the Cochrane Library were searched using the key words "antegrade," "retrograde," "cerebral perfusion," "cardiopulmonary bypass," "extracorporeal circulation," and "cardiac surgery" for studies reporting on clinical endpoints including early mortality, stroke, temporary neurologic dysfunction (TND), and permanent neurologic dysfunction (PND) in aortic surgery requiring DHCA with ACP or RCP. Heterogeneity was analyzed with the Cochrane Q statistic and I(2) statistic. Publication bias was tested with Begg's funnel plot and Egger's test. Thirty-four studies were included in this meta-analysis, with 4262 patients undergoing DHCA + ACP and 2761 undergoing DHCA + RCP. The overall pooled relative risk for TND was 0.722 (95% CI = [0.579, 0.900]), and the z-score for overall effect was 2.9 (P = 0.004). There was low heterogeneity (I(2) = 18.7%). The analysis showed that patients undergoing DHCA + ACP had better outcomes than those undergoing DHCA + RCP in terms of TND, while there were no significant differences between groups in terms of PND, stroke, and early mortality. This meta-analysis indicates that DHCA + ACP has an advantage over DHCA + RCP in terms of TND, while the two methods show similar results in terms of PND, early mortality, and stroke.

  12. Effect of combined VEGF165/ SDF-1 gene therapy on vascular remodeling and blood perfusion in cerebral ischemia.

    Science.gov (United States)

    Hu, Guo-Jie; Feng, Yu-Gong; Lu, Wen-Peng; Li, Huan-Ting; Xie, Hong-Wei; Li, Shi-Fang

    2016-12-16

    OBJECTIVE Therapeutic neovascularization is a promising strategy for treating patients after an ischemic stroke; however, single-factor therapy has limitations. Stromal cell-derived factor 1 (SDF-1) and vascular endothelial growth factor (VEGF) proteins synergistically promote angiogenesis. In this study, the authors assessed the effect of combined gene therapy with VEGF165 and SDF-1 in a rat model of cerebral infarction. METHODS An adenoviral vector expressing VEGF165 and SDF-1 connected via an internal ribosome entry site was constructed (Ad- VEGF165-SDF-1). A rat model of middle cerebral artery occlusion (MCAO) was established; either Ad- VEGF165-SDF-1 or control adenovirus Ad- LacZ was stereotactically microinjected into the lateral ventricle of 80 rats 24 hours after MCAO. Coexpression and distribution of VEGF165 and SDF-1 were examined by reverse-transcription polymerase chain reaction, Western blotting, and immunofluorescence. The neurological severity score of each rat was measured on Days 3, 7, 14, 21, and 28 after MCAO. Angiogenesis and vascular remodeling were evaluated via bromodeoxyuridine and CD34 immunofluorescence labeling. Relative cerebral infarction volumes were determined by T2-weighted MRI and triphenyltetrazolium chloride staining. Cerebral blood flow, relative cerebral blood volume, and relative mean transmit time were assessed using perfusion-weighted MRI. RESULTS The Ad- VEGF165-SDF-1 vector mediated coexpression of VEGF165 and SDF-1 in multiple sites around the ischemic core, including the cortex, corpus striatum, and hippocampal granular layer. Coexpression of VEGF165 and SDF-1 improved neural function, reduced cerebral infarction volume, increased microvascular density and promoted angiogenesis in the ischemic penumbra, and improved cerebral blood flow and perfusion. CONCLUSIONS Combined VEGF165 and SDF-1 gene therapy represents a potential strategy for improving vascular remodeling and recovery of neural function after cerebral

  13. Books average previous decade of economic misery.

    Science.gov (United States)

    Bentley, R Alexander; Acerbi, Alberto; Ormerod, Paul; Lampos, Vasileios

    2014-01-01

    For the 20(th) century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

  14. Books average previous decade of economic misery.

    Directory of Open Access Journals (Sweden)

    R Alexander Bentley

    Full Text Available For the 20(th century since the Depression, we find a strong correlation between a 'literary misery index' derived from English language books and a moving average of the previous decade of the annual U.S. economic misery index, which is the sum of inflation and unemployment rates. We find a peak in the goodness of fit at 11 years for the moving average. The fit between the two misery indices holds when using different techniques to measure the literary misery index, and this fit is significantly better than other possible correlations with different emotion indices. To check the robustness of the results, we also analysed books written in German language and obtained very similar correlations with the German economic misery index. The results suggest that millions of books published every year average the authors' shared economic experiences over the past decade.

  15. Substance P content in the cerebrospinal fluid and fluid perfusing cerebral ventricles during elicitation and inhibition of trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, Maria; Janecka, Anna

    2002-06-21

    The aim of this study was to establish whether tooth pulp and periaqueductal central gray (PAG) stimulation affects the release of substance P (SP) into the fluid perfusing the cerebral ventricles in rats. The content of substance P in the cerebrospinal fluid and fluid perfusing cerebral ventricles was determined during incisor pulp stimulation with electrical impulses inducing nociceptive trigemino-hypoglossal reflex and then during inhibition of the reflex by stimulation of PAG. Perfusion of the cerebral ventricles was carried out using artificial cerebrospinal fluid (aCSF). SP-like immunoreactivity (SP-LI) was determined in the samples by radioimmunoassay. Samples were collected in four groups: first group-cerebrospinal fluid (CSF); second group-aCSF perfusates without stimulation; third group-aCSF perfusates during incisor pulp stimulation; fourth group-aCSF perfusates during incisor pulp stimulation and simultaneous inhibition of trigemino-hypoglossal reflex by PAG stimulation. It was shown that incisor pulp stimulation led to the increased release of SP-LI into the fluid perfusing cerebral ventricles. Stimulation of PAG reduced the release of SP-LI into the cerebro-ventricular system to the values obtained before the tooth pulp stimulation. The results indicate that PAG significantly inhibits the release of SP-LI into the rat cerebral ventricular system and may be involved in the inhibition of trigemino-hypoglossal reflex.

  16. Differential Features of Cerebral Perfusion in Dementia with Lewy Bodies Compared to Alzheimer's Dementia using SPM Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [College of Medicine, Univ. of Donga, Busan (Korea, Republic of)

    2003-07-01

    Alzheimer's dementia (AD) and dementia with Lewy bodies (DLB) are most common cause of dementia in elderly people. Clinical distinction in some cases of DLB from AD may be difficult as symptom profiles overlap. Some neuropathologic overlap is also seen as beta-amyloidosis and senile plaques can be found in both disease. Both disease also share severe acetylcholine depletion. We evaluated the differences of brain perfusion between DLB and AD using statistical parametric mapping analysis. Twelve DLB (mean age ; 68.8{+-}8.3 years, K-MMSE ; 17.3{+-}6.1) and 51 AD patients (mean age ; 71.4{+-}7.2 years, K-MMSE ; 16.7{+-}4.5), which were matched for age and severity of dementia, participated in this study. Tc-99m HMPAO SPECT was performed for measuring regional cerebral blood flow. Statistical parametric mapping (SPM99) software was used for automatic and objective approach to analyze SPECT image data. The SPECT data of the patients with DLB were compared to patients with AD. Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both occipital (both middle occipital gyrus, Rt B no. 18 and Lt cuneus), both parietal (Lt parietal precuneus, Lt B no. 39, Lt inferior parietal lobule and Rt supramarginal gyrus) lobes in DLB compared with AD. Significant hyperperfusion was noted in Rt frontal (sup. frontal gyrus, B no.10, middle frontal gyrus, B no. 9, B no. 11, inf. frontal gyrus), Rt putamen, Lt ant. cingulate gyrus (B no. 24), both cerebellar post. lobe (Lt tuber, Lt declive, Lt tonsil, Rt declive) in DLB compared with AD. We found a significant differences in the cerebral perfusion pattern between DLB and AD. Differential feature of cerebral perfusion in DLB was both occipital hypoperfusion and preserved Rt frontal perfusion compared to AD. Therefore in difficult case of clinical an neuro pathologic diagnosis, brain perfusion SPECT with SPM analysis may be helpful to differentiate DLB from AD.

  17. Accuracy of CT cerebral perfusion in predicting infarct in the emergency department: lesion characterization on CT perfusion based on commercially available software.

    Science.gov (United States)

    Ho, Chang Y; Hussain, Sajjad; Alam, Tariq; Ahmad, Iftikhar; Wu, Isaac C; O'Neill, Darren P

    2013-06-01

    This study aims to assess the diagnostic accuracy of a single vendor commercially available CT perfusion (CTP) software in predicting stroke. A retrospective analysis on patients presenting with stroke-like symptoms within 6 h with CTP and diffusion-weighted imaging (DWI) was performed. Lesion maps, which overlays areas of computer-detected abnormally elevated mean transit time (MTT) and decreased cerebral blood volume (CBV), were assessed from a commercially available software package and compared to qualitative interpretation of color maps. Using DWI as the gold standard, parameters of diagnostic accuracy were calculated. Point biserial correlation was performed to assess for relationship of lesion size to a true positive result. Sixty-five patients (41 females and 24 males, age range 22-92 years, mean 57) were included in the study. Twenty-two (34 %) had infarcts on DWI. Sensitivity (83 vs. 70 %), specificity (21 vs. 69 %), negative predictive value (77 vs. 84 %), and positive predictive value (29 vs. 50 %) for lesion maps were contrasted to qualitative interpretation of perfusion color maps, respectively. By using the lesion maps to exclude lesions detected qualitatively on color maps, specificity improved (80 %). Point biserial correlation for computer-generated lesions (R pb = 0.46, p perfusion color map assessment, the lesion maps can help improve specificity.

  18. 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

  19. Intracranial pressure and cerebral perfusion pressure monitoring in non-TBI patients: special considerations.

    Science.gov (United States)

    Helbok, Raimund; Olson, DaiWai M; Le Roux, Peter D; Vespa, Paul

    2014-12-01

    The effect of intracranial pressure (ICP) and the role of ICP monitoring are best studied in traumatic brain injury (TBI). However, a variety of acute neurologic illnesses e.g., subarachnoid hemorrhage, intracerebral hemorrhage, ischemic stroke, meningitis/encephalitis, and select metabolic disorders, e.g., liver failure and malignant, brain tumors can affect ICP. The purpose of this paper is to review the literature about ICP monitoring in conditions other than TBI and to provide recommendations how the technique may be used in patient management. A PubMed search between 1980 and September 2013 identified 989 articles; 225 of which were reviewed in detail. The technique used to monitor ICP in non-TBI conditions is similar to that used in TBI; however, indications for ICP monitoring often are intertwined with the presence of obstructive hydrocephalus and hence the use of ventricular catheters is more frequent. Increased ICP can adversely affect outcome, particularly when it fails to respond to treatment. However, patients with elevated ICP can still have favorable outcomes. Although the influence of ICP-based care on outcome in non-TBI conditions appears less robust than in TBI, monitoring ICP and cerebral perfusion pressure can play a role in guiding therapy in select patients.

  20. Quantitative Susceptibility Mapping and Dynamic Contrast Enhanced Quantitative Perfusion in Cerebral Cavernous Angiomas

    Science.gov (United States)

    Mikati, Abdul Ghani; Tan, Huan; Shenkar, Robert; Li, Luying; Zhang, Lingjiao; Guo, Xiaodong; Shi, Changbin; Liu, Tian; Wang, Yi; Shah, Akash; Edelman, Robert; Christoforidis, Gregory; Awad, Issam

    2015-01-01

    Background Hyperpermeability and iron deposition are two central pathophysiological phenomena in human cerebral cavernous malformation (CCM) disease. Here we used two novel magnetic resonance imaging (MRI) techniques to establish a relationship between these phenomena. Methods Subjects with CCM disease (4 sporadic and 18 familial) underwent MRI imaging using the Dynamic Contrast Enhanced Quantitative Perfusion (DCEQP) and Quantitative Susceptibility Mapping (QSM) techniques that measure hemodynamic factors of vessel leak and iron deposition respectively, previously demonstrated in CCM disease. Regions of interest encompassing the CCM lesions were analyzed using these techniques Results Susceptibility measured by QSM was positively correlated with permeability of lesions measured using DCEQP (r=0.49, p=<0.0001). The correlation was not affected by factors including familial predisposition, lesion volume, the contrast agent and the use of statin medication. Susceptibility was correlated with lesional blood volume (r=0.4, p=0.0001), but not with lesional blood flow. Conclusion The correlation between QSM and DCEQP suggests that the phenomena of permeability and iron deposition are related in CCM; hence “more leaky lesions” also manifest a more cumulative iron burden. These techniques might be used as biomarkers to monitor the course of this disease and the effect of therapy. PMID:24302484

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

    Directory of Open Access Journals (Sweden)

    Euclides Timóteo da Rocha

    2011-01-01

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

  2. Dynamics of cerebral tissue injury and perfusion after temporary hypoxia-ischemia in the rat - Evidence for region-specific sensitivity and delayed damage

    NARCIS (Netherlands)

    Dijkhuizen, RM; Knollema, S; van der Worp, H. Bart; Ter Horst, GJ; De Wildt, DJ; van der Sprenkel, JWB; Tulleken, KAF; Nicolay, K

    1998-01-01

    Background and Purpose-Selective regional sensitivity and delayed damage in cerebral ischemia provide opportunities for directed and late therapy for stroke. Our aim was to characterize the spatial and temporal profile of ischemia-induced changes in cerebral perfusion and tissue status, with the use

  3. 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.

  4. 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.

  5. Autoradiographic imaging of cerebral ischaemia using a combination of blood flow and hypoxic markers in an animal model

    Energy Technology Data Exchange (ETDEWEB)

    Lythgoe, M.F. [Royal College of Surgeons Unit of Biophysics, Institute of Child Health, London (United Kingdom)]|[Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom); Williams, S.R. [Royal College of Surgeons Unit of Biophysics, Institute of Child Health, London (United Kingdom); Wiebe, L.I. [University of Alberta, Edmonton, AB (Canada); McEwan, A.J.B. [University of Alberta, Edmonton, AB (Canada); Gordon, I. [Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London (United Kingdom)

    1997-01-01

    Current routine clinical techniques, including angiography and perfusional single-photon emission tomography, can be used to indicate problems in cerebral vascular supply and areas of cerebral hypoperfusion following a stroke, but cannot distinguish between ischaemic core and penumbra. In order to image specifically the penumbra, a method or indicator should be able to define areas with reduced blood flow, and a degree of metabolic compromise. In this context, the tissue could be regarded as hypoxic rather than ischaemic, and we have therefore chosen to investigate the potential of radio-labelled hypoxic markers in the study of ischaemia. In order to combine a hypoxic marker with a blood flow marker we used technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) and iodine-125 iodoazomycin arabinoside ({sup 125}I-IAZA), during cerebral ischaemia in the rat middle cerebral artery occlusion model. {sup 99m}Tc-HMPAO and {sup 125}I-IAZA were injected simultaneously 2 h following occlusion of the middle cerebral artery, and 5 h before decapitation. Paired autoradiograms were produced and compared. Three distinct patterns emerged from the autoradiograms: slightly decreased perfusion with no uptake of the hypoxic marker indicating an area of misery perfusion; moderately decreased perfusion with concomitant uptake of iodoazomycin arabinoside, a region of hypoxia; and severely decreased perfusion with no retention of the hypoxic tracer. In conclusion, we present a new use for an imaging agent in the investigation of cerebral hypoxia. This agent, IAZA together with HMPAO, provides a means of separating the penumbra into regions of misery perfusion and hypoxia. The potential impact of this may be important in the clinical investigation of stroke. (orig.). With 3 figs.

  6. Dose reduction in dynamic perfusion CT of the brain: effects of the scan frequency on measurements of cerebral blood flow, cerebral blood volume, and mean transit time

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, Martin [University of Munich, Department of Neuroradiology, Muenchen (Germany); Klinikum der Universitaet Muenchen - Grosshadern, Abteilung fuer Neuroradiologie, Muenchen (Germany); Berg, Scott; Stoeckelhuber, B.M. [University of Luebeck, Department of Radiology, Luebeck (Germany); Bohner, G.; Klingebiel, R. [University Medicine Berlin, Department of Neuroradiology, Charite, Berlin (Germany); Schoepf, V.; Yousry, I.; Linn, J. [University of Munich, Department of Neuroradiology, Muenchen (Germany); Missler, U. [Evangelisches Krankenhaus Duisburg-Nord, Department of Neuroradiology, Duisburg (Germany)

    2008-12-15

    The influence of the frequency of computed tomography (CT) image acquistion on the diagnostic quality of dynamic perfusion CT (PCT) studies of the brain was investigated. Eight patients with clinically suspected acute ischemia of one hemisphere underwent PCT, performed on average 3.4 h after the onset of symptoms. Sixty consecutive images per slice were obtained with individual CT images obtained at a temporal resolution of two images per second. Eight additional data sets were reconstructed with temporal resolutions ranging from one image per second to one image per 5 s. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) measurements were performed in identical regions of interest. Two neuroradiologists evaluated the PCT images visually to identify areas of abnormal perfusion. Perfusion images created up to a temporal resolution of one image per 3 s were rated to be diagnostically equal to the original data. Even at one image per 4 s, all areas of infarction were identified. Quantitative differences of CBF, CBV and MTT measurements were {<=}10% up to one image per 3 s. For PCT of the brain, temporal resolution can be reduced to one image per 3 s without significant compromise in image quality. This significantly reduces the radiation dose of the patient. (orig.)

  7. Serial cerebral hemodynamic change after extracranial-intracranial (EC-IC) bypass surgery: evaluated by acetazolamide stress brain perfusion SPECT(acz-SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Im, Ki Chun; Kim, Euy Nyong; Mun, Dae Hyeog [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    We evaluated serial cerebral hemodynamic changes after EC-IC bypass surgery in symptomatic pts with atherosclerotic occlusion of internal carotid (lCA) or mid-cerebral artery (MCA) using Acz-SPECT. 25 symptomatic pts (M/F 19/6, 53{+-}10 y) with ICA and MCA occlusion (16 uni - and 9 bilateral) prospectively underwent Acz-SPECT using Tc-99m ECD before and 1 week after EC-IC bypass surgery. Of these, 16 underwent additional f/u Acz-SPECT 5 mo later. Cerebral perfusion and perfusion reserve of MCA territory were evaluated visually and SPECT findings were classified into 4 groups: N/N; R/N; N/R; and R/R (perfusion/perfusion reserve: N = normal, R = reduced). For semiquantitative analysis, all SPECT images were normalized to MNI template and mean counts of MCA territory and cerebellum were obtained by AAL. Cerebral perfusion index (PI =C{sub region}/C{sub cere}) and perfusion reserve index (RI = (PI{sub Acz} - PI{sub basal}) /Pl{sub basal}) were calculated. Preop SPECT findings of ipsilateral MCA in 25 pts were R/N (4%), N/R (12%), and R/R (84% ). Early postop SPECT showed improvement of perfusion (26%) and/or reserve (68%) in ipsilateral MCA. Of 16 pts with 5mo f/u SPECT, 6 (38%) showed further improvement of perfusion or reserve. However, 4 (25%) showed aggravation of perfusion and one of these underwent revision surgery. Preop PI (1.1{+-}0.1) and RI (0.11{+-}0.07) of ipsilateral MCA were significantly lower than those of contralateral hemispheres (p<0.05). After surgery, PIs of bilateral MCA did not change at early postop period but improved in ipsilateral MCA at 5mo. Rls of ipsilateral MCA increased significantly (68%) at early postop period (P<0.001) and then did not changed. Cerebral perfusion and perfusion reserve changed with different manner during 5 mo after bypass surgery and perfusion reserve changed more dramatically than perfusion. Acz-SPECT is a feasible method for evaluating cerebral hemodynamic change after EC-IC bypass surgery.

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

    Science.gov (United States)

    Mendrik, Adriënne M.; Vonken, Evert-jan; van Ginneken, Bram; de Jong, Hugo W.; Riordan, Alan; van Seeters, Tom; Smit, Ewoud J.; Viergever, Max A.; Prokop, Mathias

    2011-07-01

    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiation that can be used per sequential scan is limited, which results in a high level of noise. To detect areas of abnormal perfusion, perfusion parameters are derived from the CTP data, such as the cerebral blood flow (CBF). Algorithms to determine perfusion parameters, especially singular value decomposition, are very sensitive to noise. Therefore, noise reduction is an important preprocessing step for CTP analysis. In this paper, we propose a time-intensity profile similarity (TIPS) bilateral filter to reduce noise in 4D CTP scans, while preserving the time-intensity profiles (fourth dimension) that are essential for determining the perfusion parameters. The proposed TIPS bilateral filter is compared to standard Gaussian filtering, and 4D and 3D (applied separately to each sequential scan) bilateral filtering on both phantom and patient data. Results on the phantom data show that the TIPS bilateral filter is best able to approach the ground truth (noise-free phantom), compared to the other filtering methods (lowest root mean square error). An observer study is performed using CBF maps derived from fifteen CTP scans of acute stroke patients filtered with standard Gaussian, 3D, 4D and TIPS bilateral filtering. These CBF maps were blindly presented to two observers that indicated which map they preferred for (1) gray/white matter differentiation, (2) detectability of infarcted area and (3) overall image quality. Based on these results, the TIPS bilateral filter ranked best and its CBF maps were scored to have the best overall image quality in 100% of the cases by both observers. Furthermore, quantitative CBF and cerebral blood volume values in both the phantom and the

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

    Energy Technology Data Exchange (ETDEWEB)

    Mendrik, Adrienne M; Van Ginneken, Bram; Viergever, Max A [Image Sciences Institute, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands); Vonken, Evert-jan; De Jong, Hugo W; Riordan, Alan; Van Seeters, Tom; Smit, Ewoud J; Prokop, Mathias, E-mail: a.m.mendrik@gmail.com [Radiology Department, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht (Netherlands)

    2011-07-07

    Cerebral computed tomography perfusion (CTP) scans are acquired to detect areas of abnormal perfusion in patients with cerebrovascular diseases. These 4D CTP scans consist of multiple sequential 3D CT scans over time. Therefore, to reduce radiation exposure to the patient, the amount of x-ray radiation that can be used per sequential scan is limited, which results in a high level of noise. To detect areas of abnormal perfusion, perfusion parameters are derived from the CTP data, such as the cerebral blood flow (CBF). Algorithms to determine perfusion parameters, especially singular value decomposition, are very sensitive to noise. Therefore, noise reduction is an important preprocessing step for CTP analysis. In this paper, we propose a time-intensity profile similarity (TIPS) bilateral filter to reduce noise in 4D CTP scans, while preserving the time-intensity profiles (fourth dimension) that are essential for determining the perfusion parameters. The proposed TIPS bilateral filter is compared to standard Gaussian filtering, and 4D and 3D (applied separately to each sequential scan) bilateral filtering on both phantom and patient data. Results on the phantom data show that the TIPS bilateral filter is best able to approach the ground truth (noise-free phantom), compared to the other filtering methods (lowest root mean square error). An observer study is performed using CBF maps derived from fifteen CTP scans of acute stroke patients filtered with standard Gaussian, 3D, 4D and TIPS bilateral filtering. These CBF maps were blindly presented to two observers that indicated which map they preferred for (1) gray/white matter differentiation, (2) detectability of infarcted area and (3) overall image quality. Based on these results, the TIPS bilateral filter ranked best and its CBF maps were scored to have the best overall image quality in 100% of the cases by both observers. Furthermore, quantitative CBF and cerebral blood volume values in both the phantom and the

  10. CBF/CBV maps in normal volunteers studied with (15)O PET: a possible index of cerebral perfusion pressure.

    Science.gov (United States)

    Watabe, Tadashi; Shimosegawa, Eku; Kato, Hiroki; Isohashi, Kayako; Ishibashi, Mana; Hatazawa, Jun

    2014-10-01

    Local cerebral perfusion pressure (CPP) is a primary factor controlling cerebral circulation and previous studies have indicated that the ratio of cerebral blood flow (CBF) to cerebral blood volume (CBV) can be used as an index of the local CPP. In this study, we investigated whether the CBF/CBV ratio differs among different brain structures under physiological conditions, by means of (15)O positron emission tomography. Nine healthy volunteers (5 men and 4 women; mean age, 47.0 ± 1.2 years) were studied by H2 (15)O bolus injection for CBF measurement and by C(15)O inhalation for CBV measurement. The CBF/CBV ratio maps were created by dividing the CBF images by the CBV images after anatomical normalization. Regions of interest were placed on the CBF/CBV maps and comparing the regions. The mean CBF/CBV ratio was highest in the cerebellum (19.3 ± 5.2/min), followed by the putamen (18.2 ± 3.9), pons (16.4 ± 4.6), thalamus (14.5 ± 3.3), cerebral cortices (13.2 ± 2.4), and centrum semiovale (11.5 ± 2.1). The cerebellum and putamen showed significantly higher CBF/CBV ratios than the cerebral cortices and centrum semiovale. We created maps of the CBF/CBV ratio in normal volunteers and demonstrated higher CBF/CBV ratios in the cerebellum and putamen than in the cerebral cortices and deep cerebral white matter. The CBF/CBV may reflect the local CPP and should be studied in hemodynamically compromised patients and in patients with risk factors for small-artery diseases of the brain.

  11. Optical bedside monitoring of cerebral perfusion: technological and methodological advances applied in a study on acute ischemic stroke

    Science.gov (United States)

    Steinkellner, Oliver; Gruber, Clemens; Wabnitz, Heidrun; Jelzow, Alexander; Steinbrink, Jens; Fiebach, Jochen B.; MacDonald, Rainer; Obrig, Hellmuth

    2010-11-01

    We present results of a clinical study on bedside perfusion monitoring of the human brain by optical bolus tracking. We measure the kinetics of the contrast agent indocyanine green using time-domain near-IR spectroscopy (tdNIRS) in 10 patients suffering from acute unilateral ischemic stroke. In all patients, a delay of the bolus over the affected when compared to the unaffected hemisphere is found (mean: 1.5 s, range: 0.2 s to 5.2 s). A portable time-domain near-IR reflectometer is optimized and approved for clinical studies. Data analysis based on statistical moments of time-of-flight distributions of diffusely reflected photons enables high sensitivity to intracerebral changes in bolus kinetics. Since the second centralized moment, variance, is preferentially sensitive to deep absorption changes, it provides a suitable representation of the cerebral signals relevant for perfusion monitoring in stroke. We show that variance-based bolus tracking is also less susceptible to motion artifacts, which often occur in severely affected patients. We present data that clearly manifest the applicability of the tdNIRS approach to assess cerebral perfusion in acute stroke patients at the bedside. This may be of high relevance to its introduction as a monitoring tool on stroke units.

  12. Early whole-brain CT perfusion for detection of patients at risk for delayed cerebral ischemia after subarachnoid hemorrhage.

    Science.gov (United States)

    Malinova, Vesna; Dolatowski, Karoline; Schramm, Peter; Moerer, Onnen; Rohde, Veit; Mielke, Dorothee

    2016-07-01

    OBJECT This prospective study investigated the role of whole-brain CT perfusion (CTP) studies in the identification of patients at risk for delayed ischemic neurological deficits (DIND) and of tissue at risk for delayed cerebral infarction (DCI). METHODS Forty-three patients with aneurysmal subarachnoid hemorrhage (aSAH) were included in this study. A CTP study was routinely performed in the early phase (Day 3). The CTP study was repeated in cases of transcranial Doppler sonography (TCD)-measured blood flow velocity (BFV) increase of > 50 cm/sec within 24 hours and/or on Day 7 in patients who were intubated/sedated. RESULTS Early CTP studies revealed perfusion deficits in 14 patients, of whom 10 patients (72%) developed DIND, and 6 of these 10 patients (60%) had DCI. Three of the 14 patients (21%) with early perfusion deficits developed DCI without having had DIND, and the remaining patient (7%) had neither DIND nor DCI. There was a statistically significant correlation between early perfusion deficits and occurrence of DIND and DCI (p 50 cm/sec within 24 hours, revealing a perfusion deficit in 3 of them (38%). Two of the 3 patients (67%) developed DCI without preceding DIND and 1 patient (33%) had DIND without DCI. In 4 of the 7 patients (57%) who were sedated and/or comatose, additional CTP studies on Day 7 showed perfusion deficits. All 4 patients developed DCI. CONCLUSIONS Whole-brain CTP on Day 3 after aSAH allows early and reliable identification of patients at risk for DIND and tissue at risk for DCI. Additional CTP investigations, guided by TCD-measured BFV increase or persisting coma, do not contribute to information gain.

  13. Cerebral perfusion pressure and risk of brain hypoxia in severe head injury: a prospective observational study

    Science.gov (United States)

    Marín-Caballos, Antonio J; Murillo-Cabezas, Francisco; Cayuela-Domínguez, Aurelio; Domínguez-Roldán, Jose M; Rincón-Ferrari, M Dolores; Valencia-Anguita, Julio; Flores-Cordero, Juan M; Muñoz-Sánchez, M Angeles

    2005-01-01

    Introduction Higher and lower cerebral perfusion pressure (CPP) thresholds have been proposed to improve brain tissue oxygen pressure (PtiO2) and outcome. We study the distribution of hypoxic PtiO2 samples at different CPP thresholds, using prospective multimodality monitoring in patients with severe traumatic brain injury. Methods This is a prospective observational study of 22 severely head injured patients admitted to a neurosurgical critical care unit from whom multimodality data was collected during standard management directed at improving intracranial pressure, CPP and PtiO2. Local PtiO2 was continuously measured in uninjured areas and snapshot samples were collected hourly and analyzed in relation to simultaneous CPP. Other variables that influence tissue oxygen availability, mainly arterial oxygen saturation, end tidal carbon dioxide, body temperature and effective hemoglobin, were also monitored to keep them stable in order to avoid non-ischemic hypoxia. Results Our main results indicate that half of PtiO2 samples were at risk of hypoxia (defined by a PtiO2 equal to or less than 15 mmHg) when CPP was below 60 mmHg, and that this percentage decreased to 25% and 10% when CPP was between 60 and 70 mmHg and above 70 mmHg, respectively (p < 0.01). Conclusion Our study indicates that the risk of brain tissue hypoxia in severely head injured patients could be really high when CPP is below the normally recommended threshold of 60 mmHg, is still elevated when CPP is slightly over it, but decreases at CPP values above it. PMID:16356218

  14. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study

    Science.gov (United States)

    HONDA, Mitsuru; ICHIBAYASHI, Ryo; YOKOMURO, Hiroki; YOSHIHARA, Katsunori; MASUDA, Hiroyuki; HAGA, Daisuke; SEIKI, Yoshikatsu; KUDOH, Chiaki; KISHI, Taichi

    2016-01-01

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1–3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3–4, GCS5–6, and GCS7–8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients. PMID:27356957

  15. Effect of isovolemic, isothermic hemodialysis on cerebral perfusion and vascular stiffness using contrast computed tomography and pulse wave velocity.

    Directory of Open Access Journals (Sweden)

    Ansgar Reising

    Full Text Available BACKGROUND: Patients undergoing hemodialysis treatment have a six-fold increased risk for stroke relative to the general population. However, the effect of hemodialysis on cerebral blood flow is poorly studied and confounding factors like blood pressure and ultrafiltration as well as temperature changes have rarely been accounted for. The aim of our study was to use state-of-the-art technology to evaluate the effect of a single dialysis session on cerebral perfusion as well as on vascular stiffness. METHODS: Chronic hemodialysis patients (7 male/3 female, mean age 58 years were recruited. Cerebral blood flow and arterial pulse wave velocity were measured before and immediately after a hemodialysis session. To exclude effects of volume changes we kept ultrafiltration to a minimum, allowing no change in body weight. Isothermic conditions were maintained by using the GENIUS single-pass batch-dialysis system with a high-flux polysulfone dialyser. Cerebral blood flow was measured by contrast-enhanced computed tomography. Pulse wave velocity was measured using the SphygmoCor (AtCor Medical, USA device by a single operator. RESULTS: This study shows for the first time that isovolemic, isothermic hemodialysis neither affected blood pressure or heart rate, nor total or regional cerebral perfusion. There was also no change in pulse wave velocity. CONCLUSIONS: Mechanisms other than the dialysis procedure itself might be causative for the high incidence of ischemic strokes in this patient population. Moreover, the sole removal of uremic toxins does not lead to short-term effects on vascular stiffness, underlying the importance of volume control in this patient population.

  16. Early Cerebral Circulation Disturbance in Patients Suffering from Severe Traumatic Brain Injury (TBI): A Xenon CT and Perfusion CT Study.

    Science.gov (United States)

    Honda, Mitsuru; Ichibayashi, Ryo; Yokomuro, Hiroki; Yoshihara, Katsunori; Masuda, Hiroyuki; Haga, Daisuke; Seiki, Yoshikatsu; Kudoh, Chiaki; Kishi, Taichi

    2016-08-15

    Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). Ischemia is a common and deleterious secondary injury following TBI. Detecting early ischemia in TBI patients is important to prevent further advancement and deterioration of the brain tissue. The purpose of this study was to clarify the cerebral circulatory disturbance during the early phase and whether it can be used to predict patient outcome. A total of 90 patients with TBI underwent a xenon-computed tomography (Xe-CT) and subsequently perfusion CT to evaluate the cerebral circulation on days 1-3. We measured CBF using Xe-CT and mean transit time (MTT: the width between two inflection points [maximum upward slope and maximum downward slope from inflow to outflow of the contrast agent]) using perfusion CT and calculated the cerebral blood volume (CBV) using the AZ-7000W98 computer system. The relationships of the hemodynamic parameters CBF, MTT, and CBV to the Glasgow Coma Scale (GCS) score and the Glasgow Outcome Scale (GOS) score were examined. There were no significant differences in CBF, MTT, and CBV among GCS3-4, GCS5-6, and GCS7-8 groups. The patients with a favorable outcome (GR and MD) had significantly higher CBF and lower MTT than those with an unfavorable one (SD, VS, or D). The discriminant analysis of these parameters could predict patient outcome with a probability of 70.6%. During the early phase, CBF reduction and MTT prolongation might influence the clinical outcome of TBI. These parameters are helpful for evaluating the severity of cerebral circulatory disturbance and predicting the outcome of TBI patients.

  17. Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease: comparison with dynamic susceptibility contrast-perfusion MR imaging.

    Directory of Open Access Journals (Sweden)

    Ida,Kentaro

    2006-08-01

    Full Text Available To determine the efficacy of flow-sensitive alternating inversion recovery using half-Fourier single-shot turbo spin-echo (FAIR-HASTE in detecting cerebral hypoperfusion in chronic carotid occlusive disease, we subjected 12 patients with various degrees of cervical internal carotid artery stenoses and/or occlusion (Stenosis group and 24 volunteers (Normal group to FAIR-HASTE. In addition, 10 out of 12 patients in the Stenosis group underwent dynamic susceptibility contrast-perfusion magnetic resonance imaging (DSC-pMRI before and after revascularization in the dominantly affected side. The absolute asymmetry indexes (AIs of both cerebral hemispheres in the Normal and Stenosis groups were compared in FAIR-HASTE. In addition, the AIs were compared with those in the Stenosis group before and after revascularization in both FAIR-HASTE and regional cerebral blood flow (rCBF, calculated with DSC-pMRI. A statistically significant difference was recognized between the AIs in the Normal and Stenosis groups (AI = 2.25 +- 1.92, 8.09 +- 4.60, respectively ; p < 0.0001. Furthermore, in the Stenosis group the AIs on both FAIR-HASTE (8.88 +- 4.93, 2.22 +- 1.79, respectively ; p = 0.0003 and rCBF (7.13 +- 3.57, 1.25 +- 1.33, respectively ; p = 0.0003 significantly decreased after revascularization. In the Stenosis group, before revascularization, signal intensity on both FAIR-HASTE and rCBF had a tendency to be lower in the dominantly affected side. FAIR-HASTE imaging was useful in the detection and evaluation of cerebral hypoperfusion in chronic occlusive carotid disease.

  18. Comparison of cerebral blood volume and permeability in preoperative grading of intracranial glioma using CT perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Ding, Bei; Ling, Hua Wei; Chen, Ke Min [Shanghai Jiaotong University, Department of Radiology, Ruijin Hospital, School of Medicine, Shanghai (China); Jiang, Hong [Shanghai Jiaotong University, Department of Pathology, Ruijin Hospital, School of Medicine, Shanghai (China); Zhu, Yan Bo [Shanghai Jiaotong University, Department of Neurosurgery, Ruijin Hospital, School of Medicine, Shanghai (China)

    2006-10-15

    Regional cerebral blood volume (rCBV) and permeability surfaces (rPS) permit in vivo assessment of glioma microvasculature, which provides quite important pathophysiological information in grading gliomas. The aim of our study was to simultaneously examine rCBV and rPS in glioma patients to determine their correlation with histological grade using CT perfusion imaging. A total of 22 patients with gliomas underwent multislice CT perfusion imaging preoperatively. Low-grade and high-grade groups were categorized corresponding to WHO grade II gliomas and WHO grade III or IV gliomas, respectively, as determined by histopathological examination. rCBVs and rPSs were obtained from regions of maximal abnormality in tumor parenchyma on CBV and PS color perfusion maps. Perfusion parameters were compared using the Kruskal-Wallis test in order to evaluate the differences in relation to tumor grade. The Pearson coefficients of rCBV and rPS for each tumor grade were assessed using SPSS 13.0 software. (orig.)

  19. 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.

  20. Color-coded perfused blood volume imaging using multidetector CT: initial results of whole-brain perfusion analysis in acute cerebral ischemia

    Energy Technology Data Exchange (ETDEWEB)

    Kloska, Stephan P.; Fischer, Tobias; Fischbach, Roman; Heindel, Walter [University of Muenster, Department of Clinical Radiology, Muenster (Germany); Nabavi, Darius G.; Dittrich, Ralf; Ringelstein, E.B. [University of Muenster, Department of Neurology, Muenster (Germany); Ditt, Hendrik; Klotz, Ernst [Siemens AG, Medical Solutions, Forchheim (Germany)

    2007-09-15

    Computed tomography (CT) is still the primary imaging modality following acute stroke. To evaluate a prototype of software for the calculation of color-coded whole-brain perfused blood volume (PBV) images from CT angiography (CTA) and nonenhanced CT (NECT) scans, we studied 14 patients with suspected acute ischemia of the anterior cerebral circulation. PBV calculations were performed retrospectively. The detection rate of ischemic changes in the PBV images was compared with NECT. The volume of ischemic changes in PBV was correlated with the infarct volume on follow-up examination taking potential vessel recanalization into account. PBV demonstrated ischemic changes in 12/12 patients with proven infarction and was superior to NECT (8/12) in the detection of early ischemia. Moreover, PBV demonstrated the best correlation coefficient with the follow-up infarct volume (Pearson's R = 0.957; P = 0.003) for patients with proven recanalization of initially occluded cerebral arteries. In summary, PBV appears to be more accurate in the detection of early infarction compared to NECT and mainly visualizes the irreversibly damaged ischemic tissue. (orig.)

  1. Characteristic patterns of cerebral blood perfusion and cognitive impairment in patients with Parkinsons disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y. [Dong-A University College of medicine, Pusan (Korea, Republic of)

    2005-07-01

    Parkinsons disease (PD) is a neurodegenerative disorder that represents cognitive impairment as well as motor symptoms. Even in the early stages of PD, cognitive alterations can be demonstrated by careful neuropsychological test. The purposes of this study are to investigate the pattern of cognitive impairment and the regional cerebral blood flow (rCBF) using Tc-99m HMPAO SPECT in patients with PD. One hundred and twenty two patients with PD and 35 control subjects participated in this study. Patients with PD who had dementia clinically or K-MMSE score below 25 points or with severe motor dysfunction to interfere with the tests were also excluded. They were all matched for age (61{+-}10 vs 61{+-}8), education periods (8.8{+-}4.9 vs 8.8{+-}4.5), and K-MMSE score (27{+-}1.6 vs 27{+-}1.5). All subjects were evaluated using the Seoul Neuropsychological Screening Battery (SNSB) and Tc-99m HMPAO SPECT with SPM software to measure rCBF. Patients with PD performed worse in digit span backward, Rey Complex Figure Test, visual memory, semantic fluency, stroop test, and alternating hand movement test(p<0.05) compared with control group. On SNSB test, 100 patients (82.0%) showed some abnormalities. Eighty-six patients (70.5%) showed frontal dysfunction, 47 (38.5%) memory impairment, 33 (27.0%) language dysfunction, 25 (20.5%) attention deficit and 22 (18.3%) visuospatial dysfunction in the order of frequency. Eight patients with PD showed single memory domain MCI and 28 single non-memory domain MCI (20 frontal dysfunction). Multiple domain MCI was found in 64 patients with PD. SPM analysis of the SPECT image revealed multiple perfusion deficit in the both frontal, temporal, both limbic lobes, Lt. parietal and Lt. Putamen. It is concluded that abnormalities of cognitive function be detected very commonly in patients with PD. MCI in PD patients is most frequently involved in the item of frontal lobe function. SPECT image might be helpful to explain cognitive impairment in some

  2. Decomposing the misery index: A dynamic approach

    Directory of Open Access Journals (Sweden)

    Ivan K. Cohen

    2014-12-01

    Full Text Available The misery index (the unweighted sum of unemployment and inflation rates was probably the first attempt to develop a single statistic to measure the level of a population’s economic malaise. In this letter, we develop a dynamic approach to decompose the misery index using two basic relations of modern macroeconomics: the expectations-augmented Phillips curve and Okun’s law. Our reformulation of the misery index is closer in spirit to Okun’s idea. However, we are able to offer an improved version of the index, mainly based on output and unemployment. Specifically, this new Okun’s index measures the level of economic discomfort as a function of three key factors: (1 the misery index in the previous period; (2 the output gap in growth rate terms; and (3 cyclical unemployment. This dynamic approach differs substantially from the standard one utilised to develop the misery index, and allow us to obtain an index with five main interesting features: (1 it focuses on output, unemployment and inflation; (2 it considers only objective variables; (3 it allows a distinction between short-run and long-run phenomena; (4 it places more importance on output and unemployment rather than inflation; and (5 it weights recessions more than expansions.

  3. 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.)

  4. The Effect of Equal Ratio Ventilation on Oxygenation, Respiratory Mechanics, and Cerebral Perfusion Pressure During Laparoscopy in the Trendelenburg Position.

    Science.gov (United States)

    Jo, Youn Yi; Kim, Ji Young; Chang, Young Jin; Lee, Sehwan; Kwak, Hyun Jeong

    2016-06-01

    The aim of this study was to investigate the effects of equal ratio ventilation (ERV) on oxygenation, respiratory mechanics, and the cerebral perfusion pressure during pneumoperitoneum in the Trendelenburg position. Thirty patients undergoing laparoscopic low anterior resection (25 to 65 y) were enrolled. Mechanical ventilator was set to volume-controlled mode at an inspiratory to expiratory (I:E) ratio of 1:2 with a tidal volume of 8 mL/kg of ideal body weight with a 5 cm H2O positive end-expiratory pressure. Twenty minutes after pneumoperitoneum in the Trendelenburg position, the I:E ratio was changed to 1:1 for 20 minutes and then restored to 1:2. No significant changes in arterial oxygen tension and respiratory compliance after adopting ERV. Mean arterial pressure and cerebral perfusion pressure decreased significantly over time after adopting the Trendelenburg position during pneumoperitoneum (P=0.014 and 0.005, respectively). In conclusion, there was no improvement in oxygenation or respiratory mechanics with ERV.

  5. Three-dimensional mapping of local cerebral perfusion in alcoholic encephalopathy with and without Wernicke-Korsakoff syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Hata, T.; Meyer, J.S.; Tanahashi, N.; Ishikawa, Y.; Imai, A.; Shinohara, T.; Velez, M.; Fann, W.E.; Kandula, P.; Sakai, F.

    1987-02-01

    Seventeen severe chronic alcoholic patients with and without Wernicke-Korsakoff syndrome (WKS) were examined prospectively after being treated by withdrawal from alcohol. The WKS patients also received thiamine supplements. Three-dimensional measurements of local cerebral blood flow (LCBF) and local partition coefficients (L lambda) were made utilizing xenon contrast computed tomography (Xe CT-CBF). Results were displayed as color-coded brain maps before and after treatment and these were correlated with neurological and cognitive examinations. Before treatment chronic alcoholics without WKS (n = 10) showed diffuse reductions of LCBF values throughout all gray matter including hypothalamus, vicinity of nucleus basalis of Meynert, thalamus, and basal ganglia. Similar, but more severe, reductions were seen in patients with WKS (n = 7), however, white matter perfusion was also reduced. In WKS, most prominent reductions of LCBF were also seen in hypothalamus and basal forebrain nuclei but thalamus, basal ganglia, and limbic systems were severely reduced. After treatment, both groups with alcoholic encephalopathy showed marked clinical improvement and cerebral perfusion was restored toward normal. Chronic alcohol abuse, in the absence of thiamine deficiency, reduces CBF by direct neurotoxic effects. If thiamine deficiency is also present, more severe and localized hemodynamic reductions are superimposed.

  6. User friendly analysis of MR investigations of the cerebral perfusion: Windows {sup trademark} -based image processing; Benutzerfreundliche Auswertung von MR-Untersuchungen der zerebralen Perfusion: Windows {sup trademark} -basierte Bildverarbeitung

    Energy Technology Data Exchange (ETDEWEB)

    Wittsack, H.J.; Moedder, U. [Inst. fuer Diagnostische Radiologie, Univ. Duesseldorf (Germany); Ritzl, A. [Inst. fuer Medizin, Forschungszentrum Juelich (Germany)

    2002-06-01

    Purpose: Quick and user-friendly analysis of perfusion and diffusion weighted MRI by means of interactive computer software. Method: A Windows {sup trademark} -based software was developed for analysis of perfusion (PWI) and diffusion (DWI) MR imaging. The computer program was developed in the programming language C++ using optimized algorithms, so that a high computing speed on Win95/98/NT systems is achieved. The established SVD algorithms of Oestergaard et al. for quantitative perfusion analysis were implemented. Results: Perfusion parameter maps of the cerebral blood flow (rCBF), the mean transit time (MTT) and the cerebral blood volume (rCBV) in consideration of the arterial input function (AIF) can be calculated and visualized using color tables. Additionally, the calculation of ''time-to-peak'' maps (TTP) and of maps of the percentage change in signal intensity (PC) is possible. The analysis of n = 10 normal persons shows perfusion values that agree with those found in the literature. Discussion: With the computer program developed here color-coded perfusion parameter maps can be calculated easily. Because of the high computing speed it is possible to get information about tissue perfusion on the basis of the large MR data sets even in acute investigations. (orig.) [German] Ziel: Schnelle und bedienerfreundliche Auswertung von perfusions- und diffusions-gewichteten MRT-Daten mittels interaktiver Auswertesoftware. Methoden: Eine Windows {sup trademark} -basierte Software zur Auswertung von Perfusions- (PWI) und Diffusions-MRT (DWI) wurde entwickelt. Das Computerprogramm wurde in der Programmiersprache C++ unter Verwendung optimierter Algorithmen entwickelt, so dass eine hohe Rechengeschwindigkeit auf Win95/98/NT-Systemen erreicht wird. Die etablierten SVD-Algorithmen von Oestergaard zur quantitativen Perfusions-Auswertung wurden implementiert. Ergebnisse: Perfusions-Parameterbilder des zerebralen Blutflusses (rCBF), der mittleren

  7. ORIGINAL ARTICLES Effect of Acupuncture Signal after Brachial Plexus Blockade on Cerebral Blood Perfusion and Brain Cell Function

    Institute of Scientific and Technical Information of China (English)

    RENYong-gong; JIAShao-wei

    2003-01-01

    Objective:Using single photon emission computed tomography (SPECT)to observe the influence of the up-transmitting of acupuncture signal into the brain in health volunteers whose nerve trunk was blocked by anesthetics.Methods:Thirty-one healthy volunteers were divided into two groups,the control group of 20 cases,and the brachial plexus blockade(BPB)group of 11cases,with supraclavicular BPB route adopted.With the control group 2 acupoints were randomly selected(Hegu and Quchi of both sides),while with the BPB group Hegu and Quchi of anesthetic arm side were selected.Siemens ECAM/ICON SPECT system was used to conduct brain imaging using double imaging assay before acupuncture and 99m Tc-ECD imaging agent during acupuncture for cerebral perfusion.The data were quantitatively ana-lyzed by blood functional changing rate (BFCR%) mathematics model.Results:Before acupuncture,the control and BPB groups showed insignificant change by SPECT, but after electro-acupuncture(EA),the control group displayed improved motor and sensory cortex excitability in basal nuclei,contra-lateral thal-amus,parietal and frontal lobe; while BPB group was characterized with reduction of the blood perfusion and cell function of contra-lateral thalamus of anesthetized arm.The difference between the two groups was significant(P<0.01).Conclusion:(1)After BPB,the up-transmitting of the acupuncture signal viaupper limb into the brain,and its strength was impaired or blocked; (2)After BPB, the effect of acupunc-ture on cerebral perfusion and brain cell function of contra-lateral thalamus was impaired or blocked.

  8. 'Misery loves company': sexual trauma, psychoanalysis and the market for misery.

    Science.gov (United States)

    Bates, Victoria

    2012-06-01

    This article examines sexual 'misery memoirs', focusing on author/reader and genre/market relationships in the context of models of trauma and child sexual abuse. It shows that the success of sexual 'misery memoirs' is inextricably bound up with the popular dissemination of a feminist-psychoanalytic model of traumatic memory that has taken place since the 1970s. It also argues that, as the 'truth' of recovered and traumatic memories has been fundamental to its success, anxieties about false memory and hoax 'misery memoirs' have posed a challenge to the genre and established a market for 'retractor' narratives.

  9. The scintigraphic appearance of childhood moyamoya disease on cerebral perfusion imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miller, J.H. [Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)]|[University of Southern California School of Medicine, Los Angeles (United States); Khonsary, A. [Department of Radiology, Childrens Hospital Los Angeles, Los Angeles, CA (United States)]|[University of Southern California School of Medicine, Los Angeles (United States); Raffel, C. [Department of Surgery, Childrens Hospital Los Angeles (United States)]|[University of Southern California School of Medicine, Los Angeles (United States)

    1996-12-01

    Objective. This study was performed to evaluate the role of single photon emission computed tomography (SPECT) perfusion imaging in the evaluation of patients with moyamoya disease. Materials and methods. Five patients (four female, one male) were studied utilizing iodine-123 iodoamphetamine or technetium-99m hexamethylpropyleneamine oxime SPECT. The data were reconstructed into axial, coronal and sagittal sections for review, and compared with CT, MR and/or angiographic images. Results. All five patients had significant perfusion defects. These areas of vascular compromise were seen to cross normal vascular territories, and were greater in number and extent than seen on anatomic sectional imaging. Conclusion. Patients with moyamoya disease have a recognizable pattern of scintigraphic perfusion deficits which should be identified by pediatric imaging physicians. SPECT perfusion studies should be performed in conjunction with other imaging modalities (CT, MR or angiography). (orig.). With 3 figs.

  10. INFLUENCE OF LOCAL INFILITRATION ANESTHESIA OF SCALP-POINT ON ACUPUNCTURE INDUCED CHANGES OF CEREBRAL BLOOD PERFUSION DETECTED BY SPECT

    Institute of Scientific and Technical Information of China (English)

    郭长春; 王凡; 贾少微

    2003-01-01

    Objective: To observe the influence of local infiltration anesthesia at the scalp-point on acupuncture stimulation induced changes of cerebral blood perfusion in the brain. Methods: Experiments were conducted in 10 healthy volunteer subjects (8 males and 2 females) who were ordered to take a lying position on a specific bed with their heads keeping in a fixed position. Scalp-point used was Motor Area (MS 6). The first syringe needle (gauge-5) was inserted into the scalp from the upper 1/5 of MS-6 and the second syringe needle inserted into the scalp from the middle 2/5 of MS-6 and advanced downward, with the two needles connected to a HAN's Therapeutic Apparatus. Images of the brain were then taken before and after electroacupuncture (EA) stimulation, and after local injection of 1% lidocaine [mixed with epinephrine (1∶200,000, 3 mL)] plus EA by using Siemens ECAM/ICON Single Photo Emission Computed Tomography (SPECT). Intravenous injection of Ethyl cysteinate dimmer 555 MBq was performed before displaying cerebral images. Data of blood functional changing rat (BFCR%) were analyzed quantitatively using a mathematic model. Results: Before EA stimulation, the blood perfusion and function of cerebral cortex, thalamus, basal ganglion and cerebellum on both sides of the brain were basically symmetry. Following EA of MS-6, BFCR% of the contralateral thalamus, parietal lobe and the frontal lobe increased significantly. Following local infiltration anesthesia, BFCR% of the contralatral thalamus declined markedly (P<0.05). The results of quantitative analysis were in agreement with those of visual observation. Conclusion: Local infiltration anesthesia of the scalp-point can significantly weaken or block EA stimulation induced changes of BFCR%.

  11. Glycopyrrolate does not influence the visual or motor-induced increase in regional cerebral perfusion

    DEFF Research Database (Denmark)

    Rokamp, Kim Z; Olesen, Niels D; Larsson, Henrik B W;

    2014-01-01

    Acetylcholine may contribute to the increase in regional cerebral blood flow (rCBF) during cerebral activation since glycopyrrolate, a potent inhibitor of acetylcholine, abolishes the exercise-induced increase in middle cerebral artery mean flow velocity. We tested the hypothesis that cholinergic...... vasodilatation is important for the increase in rCBF during cerebral activation. The subjects were 11 young healthy males at an age of 24 ± 3 years (mean ± SD). We used arterial spin labeling and blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) to evaluate rCBF with and without...

  12. 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

  13. 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)

  14. Study of cerebral blood flow by magnetic resonance 0. 5 T. Estudio de la perfusion cerebral con RM de 0,5 T

    Energy Technology Data Exchange (ETDEWEB)

    Torrijo, C.; Marti-Bonmati, L.; Palop, C.; Caballero, E.; Poyatos, C.; Sopena, R. (Hospital Doctor Peset. Servicio de Diagnostico por la Imagen. Valencia (Spain))

    1993-01-01

    To asses the cerebral blood flow by magnetic resonance, 1.5 T superconductor imagers have been used, taking slices of the brain for dynamic study following rapid iv administration of gadolinium (Gd-DTPA). Our aim was to attempt to reproduce these data with a 0.5 T superconductor imager. Thirty-two dynamic studies of the head were carried out. The first 10 were used to modify the methodology until a standard technique was achieved, which was employed for the remaining 22:T2*-weighted gradient-echo sequence (TR=50msec, TE=23 msec, angle=10*, thickness=10mm, matrix=128x64, FOV=250 mm), taking 15 slices in 75 seconds following a 20 ml iv bolus of Gd-DTPA. When the signal intensity was measured at the level of the cerebral cortex, a reduction was detected in association with the passage of Gd-DTPA through the cerebral microcirculation, with a mean signal loss of 5.96%[+-]2.25. This signal loss is significant (p<0.01) when compared with that reported in studies in which no contrast agent was used (2.54%[+-]0.6). The maximum signal loss appeared at times varying between 10 and 40 seconds after administration of the contrast medium. It is concluded that passage (perfusion) through the cerebral microcirculation can be observed at 0.5 T, although the attenuation values obtained are lower than those reported by other authors in their series. The time at which the signal loss appears after iv contrast administration is unpredictable, fact which further limits the utility of this methodology. (Author)

  15. Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study

    Energy Technology Data Exchange (ETDEWEB)

    Claus, J.J. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Breteler, M.M.B. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Hasan, D. [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Krenning, E.P. [Dept. of Nuclear Medicine, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Bots, M.L. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Grobbee, D.E. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Swieten, J.C. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Harskamp, F. van [Dept. of Neurology, Univ. Hospital Rotterdam Dijkzigt, Rotterdam (Netherlands); Hofman, A. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands)

    1996-06-01

    We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d,l-hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure ({<=}60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population. (orig.)

  16. Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities

    DEFF Research Database (Denmark)

    Marstrand, J.R.; Garde, E; Rostrup, Egill;

    2002-01-01

    reported global reductions in cerebral blood flow (CBF) and cerebral vascular reactivity. In this study, we examined localized hemodynamic status to compare WMH to normal appearing white matter (NAWM). METHODS: A group of 21 normal 85-year-old subjects were studied using dynamic contrast-enhanced MRI...... together with administration of acetazolamide. From a combination of anatomic images with different signal weighting, regions of interest were generated corresponding to gray and white matter and WMH. Localized measurements of CBF and cerebral blood volume (CBV) and mean transit time were obtained directly...

  17. Accuracy of computed tomography perfusion in detecting delayed cerebral ischemia following aneurysmal subarachnoid hemorrhage: A meta-analysis

    Directory of Open Access Journals (Sweden)

    Haogeng Sun

    2013-01-01

    Full Text Available Background and Purpose: In recent years, significant literature shows that computed tomography perfusion (CTP can provide sufficient information on cerebral hemodynamics and effectively indicate delayed cerebral ischemia (DCI before the development of infarction. We aimed at performing a meta-analysis to provide a more full and accurate evaluation of CTP and CTP parameters in detecting DCI in patients with aneurysmal subarachnoid hemorrhage. Materials and Methods: We searched the PubMed, MedLine, Embase and Cochrane databases for analysis published from February 2005 to February 2013. We extracted CTP parameters, including cerebral blood volume (CBV, cerebral blood flow (CBF, mean transit time (MTT, time to peak (TTP, interhemispheric ratios for CBV and CBF and interhemispheric differences for MTT and TTP. Pooled estimates of sensitivity, specificity, positive likelihood ratio (PLR, negative likelihood ratio (NLR, diagnostic odds ratio (DOR and the summary receiver-operating characteristic curve were determined. Results: Four research studies are met the inclusion criteria for the analysis. The pooled sensitivity, specificity, PLR, NLR and DOR of CTP for detecting the DCI were 82%, 82%, 4.56, 0.22 and 20.96, respectively. Through the evaluation of absolute CTP parameters, CBF and MTT showed diagnostic value for DCI, but CBF and TTP did not. Moreover, CBF ratio, MTT difference and TTP difference showed more diagnostic value than CBV ratio in DCI detection by the assessment of relative CTP parameters. Conclusions: As a non-invasive and short time consuming screening method, CTP own a high diagnostic value for the detection of DCI after aneurysm rupture.

  18. Microvascular hemodynamics in human hypothermic circulatory arrest and selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    P.W.G. Elbers; A. Ozdemir; R.H. Heijmen; J. Heeren; M. van Iterson; E.P.A. van Dongen; C. Ince

    2010-01-01

    Objective: The behavior of the human microcirculation in the setting of cardiac arrest is largely unknown. Animal experiments have consistently revealed that global hemodynamics do not necessarily reflect microvascular perfusion. In addition, the time it takes for capillary blood flow to stop after

  19. Effect of propofol and thiopentone on intracranial pressure and cerebral perfusion pressure in patients undergoing elective craniotomy - a comparative study

    Directory of Open Access Journals (Sweden)

    Sankari Santra

    2007-01-01

    Full Text Available Advantages and disadvantages of newer agent like propofol need to be evaluated with time tested inducing drug - thiopentone in neuroanaesthesia. The aim of the study was to compare effects of propofol with thiopentone on intracranial pressure, cerebral perfusion pressure and haemodynamics during induction in neurosurgical pa-tients. Fifty adult patients of ASA grade I& II scheduled for elective craniotomy were randomly assigned to receive induction of anaesthesia with either propofol 1.5-2.5 mg.kg -1 i.v. (Group A, n=25 or thiopentone 4-5 mg.kg -1 , i.v. (Group B, n=25. Vecuronium bromide 0.1 mg.kg -1 i.v. was used as intubating muscle relaxant. Both groups received fentanyl 2 pg.kg -1 i.v., lidocaine(preservative free 1.5 mg.kg -1 i.v. and supplementary dose of same inducing agent before intubation. Changes in mean arterial pressure (MAP, cerebrospinal fluid pressure (CSFP, cerebral perfusion pressure (CPP and heart rate (HR were noted during induction and endotracheal intubation. On statistical analysis it was found that CSFP decreased significantly (P< 0.001 in both groups after induction but endotracheal intubation did not provoke any significant rise in CSFP. Maximum decrease of CSFP was 35.26% in Group A and 35.20% in Group B. Fall in MAP was more significant in Group A (P< 0.001, as a result CPP was significantly less in Group A than in Group B. The lowest mean CPP (71.12±5.86 mm Hg was observed 2 minutes after induction dose in Group A when maximum drop in MAP occurred. Heart rate did not change significantly in Group A but in Group B fluctuation of heart rate was more.

  20. Cerebral Metabolic Profiling of Hypothermic Circulatory Arrest with and Without Antegrade Selective Cerebral Perfusion: Evidence from Nontargeted Tissue Metabolomics in a Rabbit Model

    Institute of Scientific and Technical Information of China (English)

    Li-Hua Zou; Jin-Ping Liu; Hao Zhang; Shu-Bin Wu; Bing-Yang Ji

    2016-01-01

    Background:Antegrade selective cerebral perfusion (ASCP) is regarded to perform cerebral protection during the thoracic aorta surgery as an adjunctive technique to deep hypothermic circulatory arrest (DHCA).However,brain metabolism profile after ASCP has not been systematically investigated by metabolomics technology.Methods:To clarify the metabolomics profiling of ASCP,12 New Zealand white rabbits were randomly assigned into 60 min DHCA with (DHCA+ASCP [DA] group,n =6) and without (DHCA [D] group,n =6) ASCP according to the random number table.ASCP was conducted by cannulation on the right subclavian artery and cross-clamping of the innominate artery.Rabbits were sacrificed 60 min after weaning off cardiopulmonary bypass.The metabolic features of the cerebral cortex were analyzed by a nontargeted metabolic profiling strategy based on gas chromatography-mass spectrometry.Variable importance projection values exceeding 1.0 were selected as potentially changed metabolites,and then Student's t-test was applied to test for statistical significance between the two groups.Results:Metabolic profiling of brain was distinctive significantly between the two groups (Q2y =0.88 for partial least squares-DA model).In comparing to group D,62 definable metabolites were varied significantly after ASCP,which were mainly related to amino acid metabolism,carbohydrate metabolism,and lipid metabolism.Kyoto Encyclopedia of Genes and Genomes analysis revealed that metabolic pathways after DHCA with ASCP were mainly involved in the activated glycolytic pathway,subdued anaerobic metabolism,and oxidative stress.In addition,L-kynurenine (P =0.0019),5-methoxyindole-3-acetic acid (P =0.0499),and 5-hydroxyindole-3-acetic acid (P =0.0495) in tryptophan metabolism pathways were decreased,and citrulline (P =0.0158) in urea cycle was increased in group DA comparing to group D.Conclusions:The present study applied metabolomics analysis to identify the cerebral metabolic profiling in rabbits with ASCP

  1. Acute and chronic head-down tail suspension diminishes cerebral perfusion in rats

    Science.gov (United States)

    Wilkerson, M. Keith; Colleran, Patrick N.; Delp, Michael D.

    2002-01-01

    The purpose of this study was to test the hypothesis that regional brain blood flow and vascular resistance are altered by acute and chronic head-down tail suspension (HDT). Regional cerebral blood flow, arterial pressure, heart rate, and vascular resistance were measured in a group of control rats during normal standing and following 10 min of HDT and in two other groups of rats after 7 and 28 days of HDT. Heart rate was not different among conditions, whereas mean arterial pressure was elevated at 10 min of HDT relative to the other conditions. Total brain blood flow was reduced from that during standing by 48, 24, and 27% following 10 min and 7 and 28 days of HDT, respectively. Regional blood flows to all cerebral tissues and the eyes were reduced with 10 min of HDT and remained lower in the eye, olfactory bulbs, left and right cerebrum, thalamic region, and the midbrain with 7 and 28 days of HDT. Total brain vascular resistance was 116, 44, and 38% greater following 10 min and 7 and 28 days of HDT, respectively, relative to that during control standing. Vascular resistance was elevated in all cerebral regions with 10 min of HDT and remained higher than control levels in most brain regions. These results demonstrate that HDT results in chronic elevations in total and regional cerebral vascular resistance, and this may be the underlying stimulus for the HDT-induced smooth muscle hypertrophy of cerebral resistance arteries.

  2. Iterative image reconstruction for cerebral perfusion CT using a pre-contrast scan induced edge-preserving prior

    Science.gov (United States)

    Ma, Jianhua; Zhang, Hua; Gao, Yang; Huang, Jing; Liang, Zhengrong; Feng, Qianjing; Chen, Wufan

    2012-11-01

    Cerebral perfusion x-ray computed tomography (PCT) imaging, which detects and characterizes the ischemic penumbra, and assesses blood-brain barrier permeability with acute stroke or chronic cerebrovascular diseases, has been developed extensively over the past decades. However, due to its sequential scan protocol, the associated radiation dose has raised significant concerns to patients. Therefore, in this study we developed an iterative image reconstruction algorithm based on the maximum a posterior (MAP) principle to yield a clinically acceptable cerebral PCT image with lower milliampere-seconds (mA s). To preserve the edges of the reconstructed image, an edge-preserving prior was designed using a normal-dose pre-contrast unenhanced scan. For simplicity, the present algorithm was termed as ‘MAP-ndiNLM’. Evaluations with the digital phantom and the simulated low-dose clinical brain PCT datasets clearly demonstrate that the MAP-ndiNLM method can achieve more significant gains than the existing FBP and MAP-Huber algorithms with better image noise reduction, low-contrast object detection and resolution preservation. More importantly, the MAP-ndiNLM method can yield more accurate kinetic enhanced details and diagnostic hemodynamic parameter maps than the MAP-Huber method.

  3. The Application of Diffusion- and Perfusion-Weighted Magnetic Resonance Imaging in the Diagnosis and Therapy of Acute Cerebral Infarction

    Directory of Open Access Journals (Sweden)

    Ying Han

    2006-01-01

    Full Text Available Diffusion- and perfusion-weighted magnetic resonance imaging (DWI and PWI was applied for stroke diagnose in 120 acute (<48 h ischemic stroke patients. At hyperacute (<6 h stage, it is difficult to find out the infarction zone in conventional T1 or T2 image, but it is easy in DWI, apparent diffusion coefficient (ADC map; when at 3–6-hour stage it is also easy in PWI, cerebral blood flow (CBF map, cerebral blood volume (CBV map, and mean transit time (MTT map; at acute (6–48 h stage, DWI or PWI is more sensitive than conventional T1 or T2 image too. Combining DWI with ADC, acute and chronic infarction can be distinguished. Besides, penumbra which should be developed in meaning was used as an indication or to evaluate the therapeutic efficacy. There were two cases (<1.5 h that broke the model of penumbra because abnormity was found in DWI but not that in PWI, finally they recovered without any sequela.

  4. Cerebral perfusion and cerebrovascular reactivity are reduced in white matter hyperintensities

    DEFF Research Database (Denmark)

    Marstrand, J.R.; Garde, E; Rostrup, Egill;

    2002-01-01

    BACKGROUND AND PURPOSE: There is growing evidence that white matter hyperintensities (WMH) should not be considered as benign age-dependent changes on MR images but indicate pathological changes with clinical consequences. Previous studies comparing subjects with WMH to normal controls have...... reported global reductions in cerebral blood flow (CBF) and cerebral vascular reactivity. In this study, we examined localized hemodynamic status to compare WMH to normal appearing white matter (NAWM). METHODS: A group of 21 normal 85-year-old subjects were studied using dynamic contrast-enhanced MRI...... together with administration of acetazolamide. From a combination of anatomic images with different signal weighting, regions of interest were generated corresponding to gray and white matter and WMH. Localized measurements of CBF and cerebral blood volume (CBV) and mean transit time were obtained directly...

  5. Effects of Blood Pressure Fluctuations on Cerebral Perfusion after Ischemic Stroke%血压波动对脑梗死后脑灌注的影响

    Institute of Scientific and Technical Information of China (English)

    聂志余; 靳令经

    2011-01-01

    Cerebral infarction affects both cerebral autoregulation and cerebral perfusion. This review article summarizes the published evidence of cerebral autoregulation impairment and cerebral blood flow alteration after cerebral infarction, including cerebrovascular small vessel disease leading to an impairment of vasoreactivity, blood flow velocities and cerebral blood flow associated positively with systemic blood pressure, perfusion declined on the infarcted side and lower blood pressure resulting in hypoperfusion in distal area of the narrowing main cerebral artery. The question should be thought by physicians about what is the 'best blood pressure range' in patients with cerebral infarction and it will be benefit for optimal recovery.%本文主要从脑血管的自动调节与自动调节受损、脑小血管病变可导致脑血管反应性受损、脑梗死患者脑血流速度、脑血流量与血压的相关性,脑梗死侧大脑半球脑灌注降低、低血压对脑主要动脉狭窄者可导致狭窄远端脑组织局部低灌注等几个方面来讨论脑梗死后血压的变化对脑血流速度、脑血流量的影响.给临床医生提出一个思考问题,在脑梗死的急性期把血压控制在多少才是最合适的水平,对患者的功能恢复最有益.

  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. Cerebral perfusion, oxygenation and metabolism during exercise in young and elderly individuals

    DEFF Research Database (Denmark)

    Fisher, James P; Hartwich, Doreen; Seifert, Thomas

    2013-01-01

    artery blood velocity (MCA V(mean)), mean arterial pressure (MAP), cardiac output (CO) and the partial pressure of arterial carbon dioxide (PaCO(2)) were measured. Blood samples were obtained from the right internal jugular vein and brachial artery to determine concentration differences for oxygen (O(2......)), glucose and lactate across the brain. The molar ratio between the cerebral uptake of O(2) versus carbohydrate (O(2)-carbohydrate index; O(2) / [glucose + 0.5 lactate]; OCI), the cerebral metabolic rate of O(2) (CMRO(2)) and changes in mitochondrial O(2) tension (P(mito)O(2)) were calculated. W...

  8. Blood-brain barrier permeability is positively correlated with cerebral microvascular perfusion in the early fluid percussion-injured brain of the rat.

    Science.gov (United States)

    Lin, Yong; Pan, Yaohua; Wang, Mingliang; Huang, Xianjian; Yin, Yuhua; Wang, Yu; Jia, Feng; Xiong, Wenhao; Zhang, Nu; Jiang, Ji-yao

    2012-11-01

    The blood-brain barrier (BBB) opening following traumatic brain injury (TBI) provides a chance for therapeutic agents to cross the barrier, yet the reduction of the cerebral microvascular perfusion after TBI may limit the intervention. Meanwhile, optimizing the cerebral capillary perfusion by the strategies such as fluid administration may cause brain edema due to the BBB opening post trauma. To guide the TBI therapy, we characterized the relationship between the changes in the cerebral capillary perfusion and BBB permeability after TBI. First, we observed the changes of the cerebral capillary perfusion by the intracardiac perfusion of Evans Blue and the BBB disruption with magnetic resonance imaging (MRI) in the rat subjected to lateral fluid percussion (FP) brain injury. The correlation between two variables was next evaluated with the correlation analysis. Since related to BBB breakdown, matrix metalloproteinase-9 (MMP-9) activity was finally detected by gelatin zymography. We found that the ratios of the perfused microvessel numbers in the lesioned cortices were significantly reduced at 0 and 1 h post trauma compared with that in the normal cortex, which then dramatically recovered at 4 and 24 h after injury, and that the BBB permeability was greatly augmented in the ipsilateral parts at 4, 12, and 24 h, and in the contralateral area at 24 h after injury compared with that in the uninjured brain. The correlation analysis showed that the BBB permeability increase was related to the restoration of the cerebral capillary perfusion over a 24-h period post trauma. Moreover, the gelatin zymography analysis indicated that the MMP-9 activity in the injured brain increased at 4 h and significantly elevated at 12 and 24 h as compared to that at 0 or 1 h after TBI. Our findings demonstrate that the 4 h post trauma is a critical turning point during the development of TBI, and, importantly, the correlation analysis may guide us how to treat TBI.

  9. Nova técnica: operação de Norwood com perfusão regional cerebral e coronariana New technique: Norwood operation with regional cerebral and coronary perfusion

    Directory of Open Access Journals (Sweden)

    Gláucio Furlanetto

    2009-12-01

    Full Text Available OBJETIVO: Avaliar o resultado imediato da operação de Norwood modificado com nova técnica de perfusão regional cerebral (PRCeA anterógrada associado a perfusão regional coronariana (PRCoR retrógrada em substituição à parada circulatória total com hipotermia profunda em crianças portadoras da Síndrome da Hipoplasia do Coração Esquerdo (SHCE com aorta ascendente extremamente hipoplásica (AH. MÉTODOS: No período de dezembro de 2006 a fevereiro de 2008, a operação de Norwood modificado com tubo entre o ventrículo direito e as artérias pulmonares ou shunt tipo Sano foi realizada em oito crianças portadoras de SHCE e aorta ascendente com diâmetro inferior a 3 mm, (quatro do sexo masculino e quatro do sexo feminino com idade média de 9,2 dias (variando de 1 a 29 dias e peso médio de 3,3 kg (variando de 2,7 a 3,8 kg. Utilizada CEC e hipotermia a 25ºC com duas cânulas venosas e anastomose de um enxerto de politetrafluoretileno com a artéria inominada utilizado como linha arterial e para PRCeA. A PRCoR foi realizada por meio de um desvio na linha arterial e colocação de um cateter na aorta ascendente. Foram analisados o resultado cirúrgico imediato e a presença de alterações neurológicas nesse período. RESULTADOS: O resultado cirúrgico imediato revelou mortalidade de 25% e ausência de comprometimento neurológico ao exame clínico. CONCLUSÃO: A operação de Norwood modificado pode ser realizada com PRCeA e PRCoR em crianças com SHCE e AH com resultado cirúrgico imediato satisfatório e ausência de complicações neurológicas.OBJECTIVE: To assess the immediate result of the modified Norwood procedure with new technique of anterograde regional cerebral perfusion (ARCeP and retrograde regional coronary perfusion (RRCoP in substitution of profound hypothermia and circulatory arrest in children with hypoplastic left heart syndrome (HLHS with extremely hypoplastic ascending aorta (HA. METHODS: In the period of

  10. 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...

  11. [Alterations in cerebral perfusion in patients with systemic sclerosis and cognitive impairment].

    Science.gov (United States)

    Moreno-Gutiérrez, Juan; Coria-Moctezuma, Luis Alonso; del Pilar Cruz-Domínguez, María; Vera-Lastra, Olga Lidia

    2015-01-01

    Introducción: la esclerosis sistémica (ES) es una enfermedad autoinmune, sistémica, caracterizada por fibrosis, alteraciones inmunológicas y vasculares. La hipoperfusión cerebral puede ser causada por isquemia. Los trastornos cognitivos son causa importante de morbilidad. El objetivo de este estudio fue determinar la frecuencia de alteraciones en la perfusión cerebral (PC) en pacientes con ES y deterioro cognitivo (DC). Métodos: se estudiaron 88 pacientes con ES. A todos se les aplicó el Test de Montreal (TM) para evaluar el DC. A 15 pacientes con DC que cumplieron con los criterios (sin hipertensión arterial sistémica, diabetes mellitus, evento vascular cerebral, vasculitis, hipotiroidismo, depresión, sin ingesta de fármacos que interfieran con la evaluación cognitiva), se les midió la PC mediante Gamagrama Cerebral Perfusorio (GCP).Resultados: de los 88 pacientes con ES, 58 tuvieron DC con el TM. La PC se encontró disminuida en 12/15. La disminución de la PC se observó en los siguientes lóbulos (frontal en 9/15; temporal en 7/15, y parietal en 3/15. La concordancia entre el TM y GC fue 60 % para el lóbulo frontal, 46 % para el lóbulo temporal y 13 % parietal.Conclusiones: el DC es frecuente en la ES, la disminución de la PC fue más común en el lóbulo frontal, predominado en los pacientes de mayor edad y tiempo de evolución de la ES.

  12. Intraoperative blood pressure and cerebral perfusion: strategies to clarify hemodynamic goals.

    Science.gov (United States)

    Williams, Monica; Lee, Jennifer K

    2014-07-01

    Blood pressure can vary considerably during anesthesia. If blood pressure falls outside the limits of cerebrovascular autoregulation, children can become at risk of cerebral ischemic or hyperemic injury. However, the blood pressure limits of autoregulation are unclear in infants and children, and these limits can shift after brain injury. This article will review autoregulation, considerations for the hemodynamic management of children with brain injuries, and research on autoregulation monitoring techniques.

  13. Intraoperative blood pressure and cerebral perfusion: strategies to clarify hemodynamic goals

    OpenAIRE

    Williams, Monica; Lee, Jennifer K.

    2014-01-01

    Blood pressure can vary considerably during anesthesia. If blood pressure falls outside the limits of cerebrovascular autoregulation, children can become at risk of cerebral ischemic or hyperemic injury. However, the blood pressure limits of autoregulation are unclear in infants and children, and these limits can shift after brain injury. This article will review autoregulation, considerations for the hemodynamic management of children with brain injuries, and research on autoregulation monit...

  14. Changes of cerebral hemodynamics in CT perfusion imaging of rabbit models with cerebral microembolism%兔脑微栓塞模型脑血流动力学的CT灌注动态变化

    Institute of Scientific and Technical Information of China (English)

    张放; 姚振威; 冯晓源; 孙华平

    2012-01-01

    目的 探讨兔脑微栓塞模型CT灌注成像(CT perfusion imaging,CTPI)脑血流动力学的动态变化规律.方法 30只新西兰兔,随机分成两组,A组:假手术对照组5只,B组:微栓塞组25只.经颈外动脉向颈内动脉注入直径约0.5 mm的SiO2颗粒10枚,分别于栓塞后30 min、3h、6h、12 h及24 h行CTPI,24 h处死动物取脑组织行HE染色.根据HE染色结果将模型分为缺血组和梗死组,分别观察其脑血流量(cerebral blood flow,CBF)、脑血容积(cerebral blood volume,CBV)和平均通过时间(mean transit time,MTT)的动态变化规律.结果 A组CTPI及HE染色均未见明显异常.B组3只因实验意外死亡,1只因下肢静脉穿刺失败导致CTPI失败,21只行CTPI,其中18只灌注异常,3只未见明显异常.18只灌注异常的兔中,HE染色10只脑梗死,7只脑缺血,1只未见明显异常.30 min时7只缺血兔脑不同程度低灌注,表现为CBF降低,MTT延长,CBV无显著变化,3~6h低灌注进一步加重,CBV值略降低,12h低灌注不同程度恢复,24 h进一步恢复.30 min时10只梗死兔脑明显低灌注,表现为CBF及CBV显著降低,MTT显著延长,3只兔低灌注分别在3h、6h及12 h不同程度恢复,然后下一时间又迅速降低并随着时间延长进一步加剧,其余7只兔低灌注程度随时间延长逐渐加剧或在一定水平上波动.结论 脑缺血3~6h低灌注最明显,12~ 24 h低灌注不同程度恢复,而脑梗死随时间延长低灌注程度不断加重或一过性恢复后再次加重.脑缺血的特征是CBF和CBV的不匹配,缺血组织CBF显著降低,CBV无显著变化,而脑梗死则表现为这两个参数的一致性下降.%Objective To study the changes of cerebral hemodynamics revealed by CT perfusion imaging ( CTPI) in rabbit models of cerebral microembolism. Methods Thirty normal New Zealand rabbits were randomly divided into two groups; Group A (n =5) underwent sham operation, group B (n =25) underwent an operation of microembolism

  15. SPECT imaging of GABA{sub A}/benzodiazepine receptors and cerebral perfusion in mild cognitive impairment

    Energy Technology Data Exchange (ETDEWEB)

    Pappata, Sabina; Varrone, Andrea; Vicidomini, Caterina; Sansone, Valeria; Comerci, Marco; Panico, Maria Rosaria; Quarantelli, Mario [CNR, Institute of Biostructure and Bioimaging, Naples (Italy); Milan, Graziella; De Falco, Caterina; Lore, Elisa; Postiglione, Alfredo [University ' ' Federico II' ' , Department of Clinical and Experimental Medicine, Naples (Italy); Iavarone, Alessandro [Neurologic and Stroke Unit, CTO Hospital, Naples (Italy); Salvatore, Marco [CNR, Institute of Biostructure and Bioimaging, Naples (Italy); University ' ' Federico II' ' , Department of Biomorphological and Functional Sciences, Naples (Italy)

    2010-06-15

    The involvement of neocortical and limbic GABA{sub A}/benzodiazepine (BZD) receptors in Alzheimer's disease (AD) is controversial and mainly reported in advanced stages. The status of these receptors in the very early stages of AD is unclear and has not been explored in vivo. Our aims were to investigate in vivo the integrity of cerebral cortical GABA{sub A}/BZD receptors in subjects with amnestic mild cognitive impairment (MCI) and to compare possible receptor changes to those in cerebral perfusion. [{sup 123}I]Iomazenil and [{sup 99m}Tc]HMPAO SPECT images were acquired in 16 patients with amnestic MCI and in 14 normal elderly control subjects (only [{sup 123}I]iomazenil imaging in 5, only [{sup 99m}Tc]HMPAO imaging in 4, and both [{sup 123}I]iomazenil and [{sup 99m}Tc]HMPAO imaging in 5). Region of interest (ROI) analysis and voxel-based analysis were performed with cerebellar normalization. Neither ROI analysis nor voxel-based analysis showed significant [{sup 123}I]iomazenil binding changes in MCI patients compared to control subjects, either as a whole group or when considering only those patients with MCI that converted to AD within 2 years of clinical follow-up. In contrast, the ROI analysis revealed significant hypoperfusion of the precuneus and posterior cingulate cortex in the whole group of MCI patients and in MCI converters as compared to control subjects. Voxel-based analysis showed similar results. These results indicate that in the very early stages of AD, neocortical and limbic neurons/synapses expressing GABA{sub A}/BZD receptors are essentially preserved. They suggest that in MCI patients functional changes precede neuronal/synaptic loss in neocortical posterior regions and that [{sup 99m}Tc]HMPAO rCBF imaging is more sensitive than [{sup 123}I]iomazenil GABA{sub A}/BZD receptor imaging in detecting prodromal AD. (orig.)

  16. Effect of large decompressive craniectomy combined with vascular reconstruction on cerebral perfusion in patients with severe brain injury

    Directory of Open Access Journals (Sweden)

    Liang-zhen HUANG

    2015-11-01

    Full Text Available Objective To compare the efficacies of large decompressive craniectomy combined with vascular reconstruction and traditional decompressive craniectomy in treatment of severe brain injury. Methods Forty-eight patients with severe brain injury, which was dominated by brain contusion to the frontoparietal lobes, admitted to our hospital from March 2012 to March 2014 were divided equally into experimental group and control group. The patients in the experimental group underwent large decompressive craniectomy combined with vascular reconstruction, and the patients in the control group received traditional decompressive craniectomy. The hemodynamic changes including cerebral blood flow (CBF, cerebral blood volume (CBV, mean transit time (MTT, time to peak (TTP and the ratios of these values (rCBF, rCBV, rMTT and rTTP on two sides were observed by CT perfusion imaging, and the Glasgow outcome score (GOS was analyzed 6 months after operation. Results The CBF and CBV scores in experimental group were higher than those in the control group at 1 week and 1 month after the operation (P0.05. The rate of satisfactory recovery (including good recovery and moderate disability was higher in the experimental group than in the control group, while the rate of poor recovery (including severe disability, vegetative state and death was lower in the experimental group than in the control group (P<0.05. Conclusion The large decompressive craniectomy combined with vascular reconstruction can not only decrease the intracranial pressure, but also recover the blood supply of brain, thus deserving the clinical application and popularization. DOI: 10.11855/j.issn.0577-7402.2015.11.15

  17. 重型颅脑外伤灌注CT结果与脑灌注压的相关性%Correlation of brain perfusion computed tomography results and cerebral perfusion pressure in patients with severe head trauma

    Institute of Scientific and Technical Information of China (English)

    徐裕; 冯东侠; 高恒; 那汉荣; 徐伟东; 周新民

    2012-01-01

    目的 探讨重型颅脑外伤患者灌注CF结果与脑灌注压监测结果的相关性.方法 50例重型颅脑外伤患者分为两组:T组28例,C组22例,人院时头颅CT平扫有明显异常.在行灌注CT时,同时监测平均动脉压(MAP)及颅内压(ICP),计算脑灌注压(CPP).应用直线回归分析灌注CT参数[局部脑血容量(rCBV)、局部脑血流(rCBF)和平均通过时间(MTT)]与CPP的相关性.结果 根据灌注CT结果,T组分为两个亚组:T1组,16例,灌注CT结果与CPP呈弱相关;T2组,12例,两者存在强相关.T1、T2和C组间的灌注CT参数均有明显差异.T1组的rCBF为(18.8±8.0)cm3·100g1·min-2,明显低于T2组的(60.2±21.3)cm3·100g1·min-1和C组的(48.3±11.0)CM3·100g1·min-1(P<0.01).T1、T2组灌注CT参数与相应CPP值之间均显著相关(P<0.01).结论 灌注CT结合ICP监测能提供有价值的评估脑血管自动调节功能是否完好的信息,有助于指导治疗.%Objective To investigate the correlation of brain perfusion computed tomography (CT) results and cerebral perfusion pressure (CPP) in patients with severe head trauma. Methods Perfusion CT results of 50 patients with head trauma were analyzed , who were divided into two groups of T(28 cases, severe head trauma with abnormal CT findings during admission) and C(22 cases,head trauma with normal CT findings during admission). The patients underwent perfusion CT and MAP and ICP were measured at the same time, by which CPP was calculated. The correlation between perfusion CT results [regional cerebral blood volume (rCBV), regional cerebral blood flow (rCBF) and MTT] and corresponding CPP was analyzed using linear regression analysis. Results According to perfusion CT results, group T was divided into two subgroups of Tl (16 cases, characterized by a weak correlation between the perfusion-CT results and the corresponding CPP values) and T2(12 cases,characterized by a strong correlation between the perfusion-CT results and the corresponding

  18. Wavelet-based calculation of cerebral angiographic data from time-resolved CT perfusion acquisitions

    Energy Technology Data Exchange (ETDEWEB)

    Havla, Lukas; 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.; Sommer, Wieland H. [Ludwig-Maximilians-University Hospital Munich, Institute for Clinical Radiology, Munich (Germany)

    2015-08-15

    To evaluate a new approach for reconstructing angiographic images by application of wavelet transforms on CT perfusion data. Fifteen consecutive patients with suspected stroke were examined with a multi-detector CT acquiring 32 dynamic phases (∇t = 1.5s) of 99 slices (total slab thickness 99mm) at 80kV/200mAs. Thirty-five mL of iomeprol-350 was injected (flow rate = 4.5mL/s). Angiographic datasets were calculated after initial rigid-body motion correction using (a) temporally filtered maximum intensity projections (tMIP) and (b) the wavelet transform (Paul wavelet, order 1) of each voxel time course. The maximum of the wavelet-power-spectrum was defined as the angiographic signal intensity. The contrast-to-noise ratio (CNR) of 18 different vessel segments was quantified and two blinded readers rated the images qualitatively using 5pt Likert scales. The CNR for the wavelet angiography (501.8 ± 433.0) was significantly higher than for the tMIP approach (55.7 ± 29.7, Wilcoxon test p < 0.00001). Image quality was rated to be significantly higher (p < 0.001) for the wavelet angiography with median scores of 4/4 (reader 1/reader 2) than the tMIP (scores of 3/3). The proposed calculation approach for angiography data using temporal wavelet transforms of intracranial CT perfusion datasets provides higher vascular contrast and intrinsic removal of non-enhancing structures such as bone. (orig.)

  19. The relation of regional cerebral perfusion and atrophy in mild cognitive impairment (MCI) and early Alzheimer's dementia.

    Science.gov (United States)

    Luckhaus, Christian; Cohnen, Mathias; Flüss, Michael Oliver; Jänner, Michaela; Grass-Kapanke, Brigitte; Teipel, Stefan J; Grothe, Michel; Hampel, Harald; Peters, Oliver; Kornhuber, Johannes; Maier, Wolfgang; Supprian, Tillmann; Gaebel, Wolfgang; Mödder, Ulrich; Wittsack, Hans-Jörg

    2010-07-30

    The spatial and temporal relations between regional cerebral blood flow (rCBF) and brain volume (rVOL) changes in incipient and early Alzheimer's dementia (AD) are not fully understood. The participants comprised 30 subjects with mild cognitive impairment (MCI) and 15 with mild AD who were examined using structural and perfusion-weighted magnetic resonance imaging (MRI) at 1.5 Tesla. Hippocampus and amygdala volumes were measured by manual volumetry. A region-of-interest co-localisation method was used to calculate rCBF values. DNA samples were genotyped for apolipoprotein E (APO E). In comparisons of AD with MCI, rCBF was reduced in the posterior cingulum only, while profound rVOL reductions occurred in both right and left amygdala and in the right hippocampus, and as a trend, in the left hippocampus. Brain volumes of the hippocampus and the amygdala were uncorrelated with the respective rCBF variables in both MCI and AD. Hippocampal but not amygdalar volumes were associated with presence of one or two APOE epsilon4 alleles in MCI and mild AD, while there was no association of APOE epsilon4 allele with rCBF. These data support earlier indications that rCBF and rVOL changes are at least partly dissociated in the early pathogenesis of AD and heterogeneously associated with the APOE risk allele. The data also support the concept of functional compensatory brain activation and the diaschisis hypothesis as relevant in incipient and early AD.

  20. Technetium-99m d,l-HM-PAO: a new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Neirinckx, R.D.; Canning, L.R.; Piper, I.M.; Nowotnik, D.P.; Pickett, R.D.; Holmes, R.A.; Volkert, W.A.; Forster, A.M.; Weisner, P.S.; Marriott, J.A.

    1987-02-01

    Following investigation of a large number of new ligands based upon propylene amine oxime (PnAO) the d,l-diastereoisomer of hexamethyl propyleneamine oxime (HM-PAO) was selected as the preferred ligand for 99mTc as a tracer for cerebral perfusion imaging. The neutral, lipophilic 99mTc complex of d,l-HM-PAO was formed in high yield by stannous reduction of 99Mo/99mTc generator eluate using a kit formulation of the ligand. Two minutes following i.v. administration of this complex in rats, 2.25% of the injected dose appears in the brain. Little washout of the tracer is observed up to 24 hr postinjection. By qualitative autoradiographic comparison with iodoantipyrine this new radiopharmaceutical displays blood flow dependent brain uptake with little redistribution of the tracer over time. The lipophilic 99mTc complex converts slowly in vitro to a secondary complex. This conversion process may account for the ability of (99mTc)d,l-HM-PAO to be retained within the brain without redistribution.

  1. [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.

  2. Clinical Application of CT Cerebral Perfusion and Angiography in Acute Cerebral Infarction%CT脑灌注与血管造影在急性脑梗死中的临床应用

    Institute of Scientific and Technical Information of China (English)

    娄雪磊

    2015-01-01

    目的:探讨CT脑灌注与血管造影在急性脑梗死中的临床应用效果。方法选择医院2014年12月~2015年6月诊治的急性脑梗死患者中抽取75例作研究对象,对其分别进行CT脑灌注和血管造影检查,对比两种检查方法的诊断情况。结果 CT灌注图内,对应患者的临床症状的灌注异常处有63例,其阳性率是84.0%,高于CT检测的19例,其阳性率是25.3%(P<0.05);同时,经CT脑灌注和血管造影检测发现,责任血管者采取CT脑灌注检测阳性者48例,其阳性率是64.0%,无责任血管者13例,其阳性率是17.3%(P<0.05)。结论 CT脑灌注与血管造影在急性脑梗死中的临床应用效果确切,有助于为急性脑梗死预防、治疗措施的制定提供参考依据。%Objective To study the clinical application effect of CT cerebral perfusion with angiography in acute cerebral infarction.Methods In a hospital in December 2014 to June 2015 in the diagnosis and treatment of acute cerebral infarction patients from 75 cases as the research object,the CT cerebral perfusion and angiography respectively,compared to two kinds of inspection methods of diagnosis.ResultsCT perfusion in the figure, the corresponding clinical symptoms in patients with perfusion abnormalities in 63 cases,the positive rate was 84.0%,significantly higher than that of CT detection of 19 cases,the positive rate was 25.3%(P<0.05,at the same time,CT cerebral perfusion and angiographic examination found that responsibility vessels take CT cerebral perfusion was 48 cases,the positive rate was 64.0%,significantly less responsibility 13 cases of blood vessels,the positive rate was 17.3%(P<0.05). ConclusionCT cerebral perfusion with angiography in acute cerebral infarction clinical application effect of precise,help for acute cerebral infarction,to provide the reference basis for the establishment of prevention and treatment measures.

  3. Cerebral perfusion differences in women currently with and recovered from anorexia nervosa.

    Science.gov (United States)

    Sheng, Min; Lu, Hanzhang; Liu, Peiying; Thomas, Binu P; McAdams, Carrie J

    2015-05-30

    Anorexia nervosa is a serious psychiatric disorder characterized by restricted eating, a pursuit of thinness, and altered perceptions of body shape and size. Neuroimaging in anorexia nervosa has revealed morphological and functional alterations in the brain. A better understanding of physiological changes in anorexia nervosa could provide a brain-specific health marker relevant to treatment and outcomes. In this study, we applied several advanced magnetic resonance imaging (MRI) techniques to quantify regional and global cerebral blood flow (CBF) in 25 healthy women (HC), 23 patients currently with anorexia (AN-C) and 19 patients in long-term weight recovery following anorexia (AN-WR). Specifically, CBF was measured with pseudo-continuous arterial spin labeling (pCASL) MRI and then verified by a different technique, phase contrast (PC) MRI. Venous T2 values were determined by T2 relaxation under spin tagging (TRUST) MRI, and were used to corroborate the CBF results. These novel techniques were implemented on a standard 3T MRI scanner without any exogenous tracers, and the total scan duration was less than 10min. Voxel-wise comparison revealed that the AN-WR group showed lower CBF in bilateral temporal and frontal lobes than the AN-C group. Compared with the HC group, the AN-C group also showed higher CBF in the right temporal lobe. Whole-brain-averaged CBF was significantly decreased in the AN-WR group compared with the AN-C group, consistent with the PC-MRI results. Venous T2 values were lower in the AN-WR group than in the AN-C group, consistent with the CBF results. A review of prior work examining CBF in anorexia nervosa is included in the discussion. This study identifies several differences in the cerebral physiological alterations in anorexia nervosa, and finds specific differences relevant to the current state of the disorder.

  4. The Effect of Milrinone on Splanchnic and Cerebral Perfusion in Infants With Congenital Heart Disease Prior to Surgery: An Observational Study.

    Science.gov (United States)

    Bianchi, Maria Otilia; Cheung, Po-Yin; Phillipos, Ernest; Aranha-Netto, Abimael; Joynt, Chloe

    2015-08-01

    Despite the advancement in the postoperative care of neonates with congenital heart disease (CHD), there is little information on preoperative management of systemic and regional hemodynamics, which may be related to outcomes. We aimed to determine the preoperative effect of milrinone, a phosphodiesterase III inhibitor, on cardiac output and splanchnic and cerebral perfusion in neonates with CHD. Neonates with CHD requiring cardiac surgery were enrolled in a prospective, single-blinded study once a clinical decision of starting milrinone (0.75 μg/kg per minute intravenously) using institutional criteria was made. Demographic and clinical variables and outcomes were recorded. Combined cardiac output and measures of splanchnic (superior mesenteric and celiac arteries) and cerebral (anterior and middle cerebral arteries) perfusion were determined by Doppler studies at 0, 6, 24, and 48 h after milrinone infusion. Investigators were unaware of intervention time points and patients in analyzing blood flow measurements. Seventeen term (39.2 ± 1.3 weeks) neonates were included with hypoplastic left-sided heart syndrome (78.5%) as the most common diagnosis. Combined cardiac output increased by 28% within 48 h (613 ± 154 vs. 479 ± 147 mL/kg per minute at baseline, P mean velocity increased at 6 h and throughout 48 h of milrinone infusion (P mean velocities at cerebral arteries increased with milrinone infusion (P < 0.05~0.08), and the corresponding changes at celiac artery were modest. There were no significant changes in splanchnic and cerebral resistive and pulsatility indices during milrinone infusion. Milrinone increases cardiac output with concurrent effects on splanchnic and cerebral blood flows during the short-term preoperative use in neonates with CHD.

  5. The evolution of the cerebral blood volume abnormality in patients with ischemic stroke: a CT perfusion study

    Energy Technology Data Exchange (ETDEWEB)

    D' Esterre, Christopher D.; Lee, Ting Yim (Lawson Health Research Inst., London (Canada); Robarts Research Inst., London (Canada)), email: tlee@robarts.ca; Aviv, Richard I. (Sunnybrook Health Sciences Centre, Toronto (Canada))

    2012-05-15

    Background: Accurate identification of the acute infarct core abnormality is important for guiding acute stroke treatment. Abnormality volumes from diffusion-weighted MRI (DWI) and CT perfusion (CTP)-cerebral blood volume (CBV) are highly correlated. DWI lesions have been shown to be reversible at 24 h. Purpose: To examine the temporal profile of the CT perfusion (CTP)-derived CBV abnormality out to 7 days post ischemic stroke. Material and Methods: Twenty-six patients were included. Group A (n = 13) underwent a noncontrast CT (NCCT), CTP/CT angiography (CTA) within 6 h of stroke onset, CTP/CTA at 24 h, and CTP/NCCT at 5-7 days post stroke. Group B (n = 13) underwent a NCCT, CTP/CTA within 6 h of stroke onset, and NCCT at 5-7 days. Recanalization status was established in all patients. For both groups, infarct volumes were traced on 5-7 day NCCT images and superimposed onto all CTP-CBV functional maps to determine CBV. Group B (n = 13) admission images were used to define CBV infarct thresholds for gray and white matter. CBV-lesion overestimation was determined for Group A using the thresholds from Group B. Results: CBV (ml x 100g- 1; mean +- stdev) for gray/white matter, within confirmed infarcted regions (CBVI) at admission, 24 h, and 5-7 days were 1.82 +- 0.56, 1.56 +- 0.42, 1.75 +- 0.31, and 1.38 +- 0.65, 1.13 +- 0.31, 1.32 +- 0.44, respectively, when averaged over all patients (P > 0.05). Four patients had tissue time-density curves from ischemic lesions (TDCi) with an incomplete contrast medium wash-out phase (truncation) at admission and/or 24 h. Compared to admission, gray matter CBVI was higher at 5-7 days for patients with TDCi truncation (P < 0.05). There were no significant CBVI increases for the eight patients without truncation (P > 0.05). Over-estimation of acute CBV lesion was present in 3/4 (75%) and 1/9 (11%) of patients with/without TDCi truncation, respectively. Conclusion: CTP-derived CBV lesion reversal is associated with TDCi truncation

  6. Cerebral perfusion in the predementia stages of Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Binnewijzend, Maja A.A.; Wattjes, Mike P.; Berckel, Bart N.M. van; Barkhof, Frederik [VU University Medical Center, Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, Alzheimercenter Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Benedictus, Marije R.; Prins, Niels D.; Scheltens, Philip [VU University Medical Center, Department of Neurology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Center, Department of Physics and Medical Technology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Center, Department of Neurology, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Center, Department of Epidemiology and Biostatistics Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands); Teunissen, Charlotte E. [VU University Medical Center, Department of Clinical Chemistry, Neuroscience Campus Amsterdam, Alzheimer Center Amsterdam, P.O. Box 7057, Amsterdam (Netherlands)

    2016-02-15

    To investigate arterial spin-labelling (ASL) cerebral blood flow (CBF) changes in predementia stages of Alzheimer's disease (AD). Data were obtained from 177 patients with subjective complaints, mild cognitive impairment and AD from the Amsterdam Dementia Cohort. AD stages were based on diagnosis and cerebrospinal fluid biomarkers amyloid-β (Aβ) and total-tau (tau). General-linear-models were used to assess relationships between AD stages and total and regional CBF, correcting for age and sex. Decreasing CBF was related to more advanced AD stages in all supratentorial regions (p for trend < 0.05). Post-hoc testing revealed that CBF was lower in AD compared to controls and stage-1 predementia patients (i.e. abnormal Aβ and normal tau) in temporal and parietal regions, and compared to stage-2 predementia patients (i.e. abnormal Aβ and tau) in temporal regions. CBF values of stage-2 predementia patients were numerically in between those of stage-1 predementia patients and AD. The continuing decrease of CBF along the continuum of AD indicates the potential of ASL-CBF as a measure for disease progression. (orig.)

  7. Cerebral perfusion and glucose metabolism in Alzheimer's disease and frontotemporal dementia: two sides of the same coin?

    Energy Technology Data Exchange (ETDEWEB)

    Verfaillie, Sander C.J.; Adriaanse, Sofie M.; Binnewijzend, Maja A.A.; Benedictus, Marije R.; Ossenkoppele, Rik [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); Wattjes, Mike P.; Lammertsma, Adriaan A.; Boellaard, Ronald; Berckel, Bart N.M. van; Barkhof, Frederik [VU University Medical Centre, Department of Radiology and Nuclear Medicine, Amsterdam (Netherlands); Pijnenburg, Yolande A.L.; Scheltens, Philip [VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); Flier, Wiesje M. van der [VU University Medical Centre, Alzheimer Centre and Department of Neurology, P.O. Box 7057, Amsterdam (Netherlands); VU University Medical Centre, Department of Epidemiology and Biostatistics, Amsterdam (Netherlands); Kuijer, Joost P.A. [VU University Medical Centre, Department of Physics and Medical Technology, Amsterdam (Netherlands)

    2015-10-15

    Alzheimer's disease (AD) and frontotemporal (FTD) dementia can be differentiated using [{sup 18}F]-2-deoxy-2-fluoro-D-glucose (FDG)-PET. Since cerebral blood flow (CBF) is related to glucose metabolism, our aim was to investigate the extent of overlap of abnormalities between AD and FTD. Normalized FDG-PET and arterial spin labelling (ASL-MRI)-derived CBF was measured in 18 AD patients (age, 64 ± 8), 12 FTD patients (age, 61 ± 8), and 10 controls (age, 56 ± 10). Voxel-wise comparisons, region-of-interest (ROI), correlation, and ROC curve analyses were performed. Voxel-wise comparisons showed decreased CBF and FDG uptake in AD compared with controls and FTD in both precuneus and inferior parietal lobule (IPL). Compared with controls and AD, FTD patients showed both hypometabolism and hypoperfusion in medial prefrontal cortex (mPFC). ASL and FDG were related in precuneus (r = 0.62, p < 0.001), IPL (r = 0.61, p < 0.001), and mPFC across groups (r = 0.74, p < 001). ROC analyses indicated comparable performance of perfusion and metabolism in the precuneus (AUC, 0.72 and 0.74), IPL (0.85 and 0.94) for AD relative to FTD, and in the mPFC in FTD relative to AD (both 0.68). Similar patterns of hypoperfusion and hypometabolism were observed in regions typically associated with AD and FTD, suggesting that ASL-MRI provides information comparable to FDG-PET. (orig.)

  8. 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.

  9. Effects of regional cerebral blood flow perfusion on learning and memory function and its molecular mechanism in rats

    Institute of Scientific and Technical Information of China (English)

    Cunli Xu; Wenhua Wu; Lingbin Kong

    2016-01-01

    Objective:To study the effects of regional cerebral blood flow (rCBF) perfusion on learning and memory function in special brain areas and its molecular mechanism in rat. Methods: Sixty-four adult male healthy Sprague-Dawley (SD) rats were randomly divided into two groups: Afalse operation group and an operation group. The false operation group was randomly divided into four subgroups (A0, B0, C0, and D0) and the operation group was randomly divided into four subgroups (A, B, C, and D), with eight rats in each subgroup. The operation group underwent bilateral common carotid artery permanent ligation, while the other group only underwent a skin incision without the bilateral common carotid artery permanent ligation. Learning memory function of rats in each subgroup was measured using a Y-maze at 4 h, 8 h, 24 h, and 3 days after surgery. The rCBF in the right frontal lobe and hippocampus was detected using the Periflux PF model laser Doppler flowmetry and c-fos, c-jun, Bcl-2, and Bax protein expression in the right frontal lobe and hippocampus was measured using immunohistochemistry. Results: The rCBF in the right frontal lobule division and right hippocampus division was significantly lower in the operation group than in the false operation group (P Conclusions:rCBF decrease can impair learning and memory function in rats, which may be related to the increased expression of c-fos, c-jun, Bcl-2, and Bax proteins in the frontal cortex and hippocampus.

  10. The effects of sevoflurane and isoflurane on intracranial pressure and cerebral perfusion pressure after diffuse brain injury in rats.

    Science.gov (United States)

    Goren, S; Kahveci, N; Alkan, T; Goren, B; Korfali, E

    2001-04-01

    Twenty-four adult male Wistar rats, weighing 220 to 290 g, were anesthetized with 30 mg/kg intraperitoneal sodium thiopental, then underwent a tracheostomy. After diffuse impact-acceleration brain injury (BI) was induced, each rat was paralyzed and mechanically ventilated with 30% O2 in nitrous oxide (N2O). The rats were assigned randomly to two groups, each of which received one of the two volatile anesthetic agents, sevoflurane or isoflurane. The anesthetics were administered at 0.5, 0.75, 1.0, and 1.25 minimal alveolar concentration (MAC) for 30 minutes each, respectively, and anesthesia was maintained at 0.75 MAC during the last hour of the study period. Intracranial pressure (ICP), mean arterial pressure (MAP), rectal and intrahemispheric temperatures, and end-tidal volatile anesthetic concentrations were monitored continuously throughout the 3 hours, with measurements recorded every 15 minutes. At baseline, there were no significant differences between the two groups regarding the monitored physiologic values. In the sevoflurane group, MAP fell significantly after 45 minutes, and a similar change was observed in the isoflurane group after 30 minutes (P pressure increased significantly at 45 minutes in the sevoflurane group (P isoflurane group, the change was not significant. Cerebral perfusion pressure (CPP) decreased in parallel with MAP, with the reduction in the sevoflurane group being more pronounced than that in the isoflurane group. The results demonstrated that, under the conditions of diffuse BI, animals that were anesthetized with sevoflurane had higher ICP and lower CPP levels than those anesthetized with isoflurane.

  11. 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.

  12. Efeitos da fisioterapia respiratória na pressão intracraniana e pressão de perfusão cerebral no traumatismo cranioencefálico grave Effects of respiratory physiotherapy on intracranial pressure and cerebral perfusion pressure in severe traumatic brain injury patients

    Directory of Open Access Journals (Sweden)

    Cassia Toledo

    2008-12-01

    Full Text Available OBJETIVOS: Após um traumatismo cranioencefálico, a hipertensão intracraniana representa a maior causa de mortalidade, além da possibilidade de seqüelas funcionais, comportamentais e cognitivas. A escassez de estudos sobre os efeitos da fisioterapia respiratória nestes pacientes pode levar à condutas contraditórias. O objetivo deste estudo foi avaliar os efeitos de manobras usuais de fisioterapia respiratória sobre a pressão intracraniana e a pressão de perfusão cerebral em pacientes com traumatismo cranioencefálico grave. MÉTODOS: Ensaio clínico, prospectivo, em pacientes com traumatismo cranioencefálico, ventilados mecanicamente e com medida contínua da pressão intracraniana. Foram avaliados os efeitos das manobras de vibrocompressão manual e aspiração intratraqueal sem e com instilação de soro fisiológico, sobre as medidas de pressão intracraniana e de pressão de perfusão cerebral, entre o primeiro e o terceiro dia após a lesão cerebral. RESULTADOS: Foram obtidos os dados de 11 pacientes com idade de 41anos (mediana APACHE II de 19,5 ± 5. A manobra de vibrocompressão manual não determinou aumento da pressão intracraniana em nenhum dos dias avaliados. A pressão intracraniana aumentou significativamente após manobras de aspiração intratraqueal em relação à medida basal (dia 1, 9,5 ± 0,9 mm Hg vs 18,0 ± 3,2 mm Hg; dia 2, 10,6 ± 1,7 mm Hg vs 21,4 ± 3,8 mm Hg; dia 3, 14,4 ± 1,0 vs 24,9 ± 2,7 mm Hg; pOBJECTIVE: After brain injury intracranial hypertension is the major cause of mortality, in addition to the possibility of functional, behavioral and cognitive sequels. Scarcity of studies on the effects of respiratory physiotherapy on these patients may lead to contradictory performances. This study aimed to assess the effects of customary respiratory physiotherapy maneuvers on intracranial and cerebral perfusion pressures in patients with severe brain injury. METHODS: Clinical, prospective trial with

  13. 脑动脉瘤破裂手术前后的脑灌注成像探讨%The study of cerebral perfusion imaging for the ruptured cerebral aneurysms before and after the operation

    Institute of Scientific and Technical Information of China (English)

    林怡; 段玉霞; 李瑞; 陈伟建; 吴楠; 童秋云; 王殊

    2013-01-01

    目的:通过CT灌注成像观察颅内动脉瘤破裂出血手术前后的脑血流变化,为临床后续治疗提供相关信息.方法:回顾性分析颅内动脉瘤破裂手术前、后临床资料44例.所选患者术前行CT血管成像(CTA)和CT灌注成像(CTP)检查,并于术后1周行CTP复查.分别测量前后两次CTP的大脑前动脉区(ACA区)、大脑中动脉区(MCA区)、大脑后动脉区(PCA区)及基底节区灌注值.结果:44例入选患者中,34例伪彩图肉眼可见好转,患者的ACA区、MCA区、PCA区及基底节区脑血流量(CBF)与平均通过时间(MTT)变化差异有统计学意义(P< 0.05);8例肉眼可见局部灌注减低区的MTT值均延长、CBF值减低;2例灌注值未见明显异常.所有患者的脑血容量(CBV)值变化差异均无统计学意义.结论:颅内动脉瘤破裂手术前及手术后存在脑灌注调整,视个体和病情各异,脑灌注也将发生相应的变化.%Objective:To provide relevant information for clinical follow-up treatment through the observation on cerebral hemodynamic changes of ruptured intracranial aneurysm before and after operation in the CT perfusion imaging.Methods:The retrospective analysis of the pre-and post-operative clinical data in 44 patients with ruptured cerebral aneurysms was performed.These patients underwent CTA and CTP examination simultaneously before surgery,followed by CTP examination after operation.Then the perfusion values of anterior cerebral arterial territory (ACA area),middle cerebral arterial territory (MCA area),posterior cerebral arterial territory (PCA area) and basal ganglia area were respectively measured.Results:Among the 44 patients,the pseudo-color images of 34 patients showed visible improvement.In these patients,there was a significant change (P<0.05) between CBF and MTT in ACA,MCA,PCA and basal ganglia area.In the decreased perfusion area of 8 patients,which was visible to the naked eye,the MTT value was extended,and the CBF value was

  14. 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.

  15. Estudio sobre las alteraciones de la perfusión cerebral valorado mediante SPECT cerebral, en pacientes usuarios de drogas de abuso Study of brain perfusion anomalies assessed with cerebral SPECT in drug abuse patients

    Directory of Open Access Journals (Sweden)

    Eduardo Rodríguez Raimondo

    2010-06-01

    Full Text Available El abuso de sustancias psicotóxicas representa un gran problema de Salud Pública en los diferentes distritos estatales. Este trabajo pretende determinar cuáles son los efectos nocivos de estas sustancias sobre el parénquima cerebral de los pacientes en los que se ha demostrado un consumo activo de drogas prohibidas. Para ello se empleó la técnica de SPECT cerebral con ECD - 99mTc aplicada a aquellos pacientes adictos, a los cuales previamente se les realizó una encuesta para conocer el tipo de droga, el tiempo y la duración de su adicción. Como resultado se detectó que el mayor número de defectos de perfusión corticales, es decir, déficits funcionales, se localizaron en la corteza órbito-frontal y en los lóbulos temporales, lo cual explicaría los importantes trastornos de conducta y personalidad que manifiestan estos pacientes. Se demostró con este método que el SPECT cerebral es un excelente método para detectar las zonas afectadas por estas drogas psicoadictivas, su extensión y la evolución y posible respuesta al tratamiento.Psychoactive drug abuse is a major public health problem in many districts. This study seeks to determine the harmful effects of such drugs on the brain parenchyma of patients known to abuse illegal drugs. Brain scans were obtained using 99 M Tc- ECD SPECT from drug addicts that had been previously surveyed to ascertain the type of drug, the timing and duration of their addiction SPECT findings showed a larger number of cortical perfusion defects, that is to say functional defects located in the orbital-frontal cortex and in the temporal lobes that may explain the significant behavior and personality disorders these patients display. Cerebral SPECT showed to be an excellent method to detect areas affected by psychoactive drugs, their extent, likely evolution and response to treatment.

  16. 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.

  17. Volume perfusion CT (VPCT) for the differential diagnosis of patients with suspected cerebral vasospasm: Qualitative and quantitative analysis of 3D parameter maps

    Energy Technology Data Exchange (ETDEWEB)

    Dolatowski, K., E-mail: karoline.dolatowski@gmail.com [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Malinova, V., E-mail: vesna.malinova@gmail.com [Department of Neurosurgery, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Frölich, A.M.J., E-mail: a.froelich@gmail.com [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Schramm, R., E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Haberland, U., E-mail: ulrike.haberland@siemens.com [Siemens AG, Healthcare Sector, Computed Tomography, H IM CR R and D PA SC, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, E., E-mail: ernst.klotz@siemens.com [Siemens AG, Healthcare Sector, Computed Tomography, H IM CR R and D PA SC, Siemensstr. 1, 91301 Forchheim (Germany); Mielke, D., E-mail: dorothee.wachter@med.uni-goettingen.de [Department of Neurosurgery, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Knauth, M., E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, University Medicine Göttingen, Robert-Koch-Str. 40, 37075 Göttingen (Germany); Schramm, P., E-mail: Peter.Schramm@uksh.de [Department of Neuroradiology, UKSH University hospital Schleswig-Holstein Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck (Germany)

    2014-10-15

    Object: Cerebral vasospasm (CV) following subarachnoid hemorrhage (SAH) implies high risk for secondary ischemia. It requires early diagnosis to start treatment on time. We aimed to assess the utility of “whole brain” VPCT for detecting localization and characteristics of arterial vasospasm. Methods: 23 patients received a non-enhanced CT, VPCT and CTA of the brain. The distribution of ischemic lesions was analyzed on 3D-perfusion-parameter-maps of CBF, CBV, MTT, TTS, TTP, and TTD. CT-angiographic axial and coronal maximum-intensity-projections were reconstructed to determine arterial vasospasm. CT-data was compared to DSA, if performed additionally. Volume-of-interest placement was used to obtain quantitative mean VPCT values. Results: 82% patients (n = 19) had focal cerebral hypoperfusion. 100% sensitivity and 100% specificity was found for TTS (median 1.9 s), MTT (median 5.9 s) and TTD (median 7.6 s). CBV showed no significant differences. In 78% (n = 18) focal vessel aberrations could be detected either on CTA or DSA or on both. Conclusion: VPCT is a non-invasive method with the ability to detect focal perfusion deficits almost in the whole brain. While DSA remains to be the gold standard for detection of CV, VPCT has the potential to improve noninvasive diagnosis and treatment decisions.

  18. Analysis of dynamic cerebral contrast-enhanced perfusion MRI time-series based on unsupervised clustering methods

    Science.gov (United States)

    Lange, Oliver; Meyer-Baese, Anke; Wismuller, Axel; Hurdal, Monica

    2005-03-01

    We employ unsupervised clustering techniques for the analysis of dynamic contrast-enhanced perfusion MRI time-series in patients with and without stroke. "Neural gas" network, fuzzy clustering based on deterministic annealing, self-organizing maps, and fuzzy c-means clustering enable self-organized data-driven segmentation w.r.t.fine-grained differences of signal amplitude and dynamics, thus identifying asymmetries and local abnormalities of brain perfusion. We conclude that clustering is a useful extension to conventional perfusion parameter maps.

  19. Spatial frequency-based analysis of mean red blood cell speed in single microvessels: investigation of microvascular perfusion in rat cerebral cortex.

    Directory of Open Access Journals (Sweden)

    Joonas Autio

    Full Text Available BACKGROUND: Our previous study has shown that prenatal exposure to X-ray irradiation causes cerebral hypo-perfusion during the postnatal development of central nervous system (CNS. However, the source of the hypo-perfusion and its impact on the CNS development remains unclear. The present study developed an automatic analysis method to determine the mean red blood cell (RBC speed through single microvessels imaged with two-photon microscopy in the cerebral cortex of rats prenatally exposed to X-ray irradiation (1.5 Gy. METHODOLOGY/PRINCIPAL FINDINGS: We obtained a mean RBC speed (0.9±0.6 mm/sec that ranged from 0.2 to 4.4 mm/sec from 121 vessels in the radiation-exposed rats, which was about 40% lower than that of normal rats that were not exposed. These results were then compared with the conventional method for monitoring microvascular perfusion using the arteriovenous transit time (AVTT determined by tracking fluorescent markers. A significant increase in the AVTT was observed in the exposed rats (1.9±0.6 sec as compared to the age-matched non-exposed rats (1.2±0.3 sec. The results indicate that parenchyma capillary blood velocity in the exposed rats was approximately 37% lower than in non-exposed rats. CONCLUSIONS/SIGNIFICANCE: The algorithm presented is simple and robust relative to monitoring individual RBC speeds, which is superior in terms of noise tolerance and computation time. The demonstrative results show that the method developed in this study for determining the mean RBC speed in the spatial frequency domain was consistent with the conventional transit time method.

  20. Comparison of the cerebral SPECT and biological markers in the Alzheimer disease; Comparaison de la tomographie cerebrale par emission monophotonique de perfusion et des biomarqueurs dans la maladie d'Alzheimer

    Energy Technology Data Exchange (ETDEWEB)

    Ravasi, L.; Semah, F.; Steinling, M. [Unite imagerie fonctionnelle cerebrale, CHRU de Lille, (France); Bombois, S.; Pasquier, F. [centre memoire de ressources et de recherche, CHRU de Lille, (France); Schraen, S.; Buee, L. [Inserm U837, centre de biologie, CHRU de Lille, (France)

    2009-05-15

    This study aim was to compare the contribution of SPECT of cerebral perfusion and bio markers of the cerebrospinal liquid in the diagnosis of Alzheimer disease. Our preliminary conclusions show that the concordance of the SPECT and cerebrospinal liquid is good in the possible Alzheimer disease. the interest of the cerebral SPECT and bio markers of the cerebrospinal liquid, used alone or conjointly, for a more reliable diagnosis of Alzheimer disease must be evaluated of prospective way. (N.C.)

  1. Three-dimensional perfusion imaging in acute cerebral infarction%三维CT灌注成像在急性脑梗死中的应用

    Institute of Scientific and Technical Information of China (English)

    戴峰; 高歌军; 文颂; 颜利辉

    2009-01-01

    目的 探讨将三维CT脑灌注加权成像(PWM)和脑灌注血容量成像(PBV)整合优化到急性缺血性脑梗死脑CT灌注成像(CTP)联合脑CT血管成像(CTA)扫描方案中的价值.方法 对23例临床诊断急性脑梗死患者行CTP联合CTA检查,将增强CTA原始数据或增强CTA与平扫CTA减影的原始数据通过图像工作站处理,得到脑三维CT PWM和三维CT全脑PBV的伪彩图像,评价CTP与PWM、PBV在诊断急性脑梗死上的敏感性和整合运用的意义. 结果 23例临床诊断急性脑梗死患者,9例单纯CTP图像显示阴性患者中有7例在PWM、PBV图像上有阳性改变;单纯CTP观测急性脑梗死的敏感性约60.87%,CTP与PWM、PBV整合观测急性脑梗死的敏感性约91.30%. 结论 将三维CT脑PWM和脑PBV整合优化到急性脑梗死CT检查方案中,不仅能提高急性脑梗死的检出率,而且能预测患者预后.%Objective To assess the value of whole cerebral perfusion weighted map (PWM) and whole cerebral perfusion blood volume (PBV) integrating in scan protocol about CT perfusion (CTP) combined with CT angiography (CTA) in acute cerebral infarction. Methods Twenty-three patients with acute cerebral infarction proved clinically underwent CTP examination combined with CTA. The color-coded images of PWM and PBV were attained using workstation, and the raw data of contract CTA images and subtractive images between contract CTA and non-contract CTA were processed. The diagnostic sensitivity and the value of CTP and PWM, PBV integrating CTP in acute cerebral infraction were evaluated. Results Seven of 9 patients with negative results on CTP images had positive expressions on PWM and PBV images. The sensitivity of CTP was 60.87% and the sensitivity of PWM and PBV integrating CTP was 91.30%. Conclusion The scan protocol of PWM, PBV integrating CTP not only increases detection rate of acute cerebral infraction, but also has ability to predict the clinical prognosis of patients with cerebral

  2. 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.

  3. [Influence of 2-ethyl-6-methyl-3-hydroxypyridine hemisuccinate on cerebral blood perfusion in rats under experimental pathology conditions].

    Science.gov (United States)

    Gan'shina, T S; Gorbunov, A A; Gnezdilova, A V; Kurdiumov, I N; Avdiunina, N I; Piatin, B M; Mirzoian, R S

    2011-01-01

    Experiments on rats showed that 2-ethyl-6-methyl-3-hydroxypyridine hemisuccinate increases cerebral blood flow in the system of carotid arteries both in intact animals and under conditions of global transient ischemia. In combination with tropoxin, 2-ethyl-6-methyl-3-hydroxypyridine hemisuccinate enhances the blood flow in the inner carotid artery of intact rats and the local blood flow under conditions of global transient ischemia. A combination of 2-ethyl-6-methyl-3-hydroxypyridine hemisuccinate and tropoxin increases baseline cerebral blood flow and decreases the constrictor reaction of cerebral blood vessels to 5HT(2B/2C) receptor agonist meta-chlorophenylpiperazine.

  4. Time-dependent changes in cerebral blood flow after acetazolamide loading into patients with hemodynamic cerebral ischemia. Relationship to cerebral oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Masakazu [Iwate Medical Univ., Morioka (Japan). School of Medicine

    2001-10-01

    The aim of this study was to clarify the relationship between time-dependent changes in cerebral blood flow (CBF) after acetazolamide loading and cerebral oxygen metabolism (CMRO{sub 2}). The subjects consisted of 30 patients with severe stenosis or occlusion of either internal carotid, middle cerebral, or vertebro-basilar artery. Regional CBF was measured at the resting state and 6, 16 and 30 minutes after intravenous administration of 1 gram of acetazolamide using the positron emission tomography in combination with the [{sup 15}O] H{sub 2}O bolus-injection method. Prior to CBF study, regional cerebral oxygen extraction fraction (OEF) was measured using the [{sup 15}O] O{sub 2} inhalation method. Regional CMRO{sub 2} was calculated based on CBF and OEF. According to the time-dependent changes in CBF responses to acetazolamide loading, the CBF responses are classified into good response type, paradoxical response type, and poor response type. Good response type (CBF increase rate more than 20% 6 minutes after acetazolamide loading), paradoxical response type (decrease of CBF 6 minutes after acetazolamide loading) and poor response type (CBF increase rate less than 20% 6 minutes after acetazolamide loading) were identified in 39, 11 and 10 areas, respectively. Brain areas with good response type showed normal OEF and normal CMRO{sub 2}. Brain areas with paradoxical response type showed increased OEF and normal CMRO{sub 2}. Brain areas with poor response type showed normal OEF and decreased CMRO{sub 2}. In view of these findings, the writer concludes that sequential measurement of cerebral blood flow (CBF) after acetazolamide loading enables one to know the regional cerebral oxygen metabolic state in patients with hemodynamic ischemia, and CBF should be measured at an early stage after the administration of acetazolamide to accurately detect misery perfusion. (author)

  5. Perfusion MRI derived indices of microvascular shunting and flow control correlate with tumor grade and outcome in patients with cerebral glioma

    DEFF Research Database (Denmark)

    Tietze, Anna; Mouridsen, Kim; Lassen-Ramshad, Yasmin

    2015-01-01

    of microvascular flow control and the extent to which oxygen can be extracted by tumor tissue. The ability of these parameters and CBV to differentiate tumor grade were assessed by receiver operating characteristic curves and logistic regression. Their ability to predict time to progression and overall survival......Objectives: Deficient microvascular blood flow control is thought to cause tumor hypoxia and increase resistance to therapy. In glioma patients, we tested whether perfusion-weighted MRI (PWI) based indices of microvascular flow control provide more information on tumor grade and patient outcome...... than does the established PWI angiogenesis marker, cerebral blood volume (CBV). Material and Methods: Seventy-two glioma patients (sixty high-grade, twelve low-grade gliomas) were included. Capillary transit time heterogeneity (CTH) and COV, its ratio to blood mean transit time, provide indices...

  6. Association of brain amyloid-β with cerebral perfusion and structure in Alzheimer's disease and mild cognitive impairment.

    Science.gov (United States)

    Mattsson, Niklas; Tosun, Duygu; Insel, Philip S; Simonson, Alix; Jack, Clifford R; Beckett, Laurel A; Donohue, Michael; Jagust, William; Schuff, Norbert; Weiner, Michael W

    2014-05-01

    Patients with Alzheimer's disease have reduced cerebral blood flow measured by arterial spin labelling magnetic resonance imaging, but it is unclear how this is related to amyloid-β pathology. Using 182 subjects from the Alzheimer's Disease Neuroimaging Initiative we tested associations of amyloid-β with regional cerebral blood flow in healthy controls (n = 51), early (n = 66) and late (n = 41) mild cognitive impairment, and Alzheimer's disease with dementia (n = 24). Based on the theory that Alzheimer's disease starts with amyloid-β accumulation and progresses with symptoms and secondary pathologies in different trajectories, we tested if cerebral blood flow differed between amyloid-β-negative controls and -positive subjects in different diagnostic groups, and if amyloid-β had different associations with cerebral blood flow and grey matter volume. Global amyloid-β load was measured by florbetapir positron emission tomography, and regional blood flow and volume were measured in eight a priori defined regions of interest. Cerebral blood flow was reduced in patients with dementia in most brain regions. Higher amyloid-β load was related to lower cerebral blood flow in several regions, independent of diagnostic group. When comparing amyloid-β-positive subjects with -negative controls, we found reductions of cerebral blood flow in several diagnostic groups, including in precuneus, entorhinal cortex and hippocampus (dementia), inferior parietal cortex (late mild cognitive impairment and dementia), and inferior temporal cortex (early and late mild cognitive impairment and dementia). The associations of amyloid-β with cerebral blood flow and volume differed across the disease spectrum, with high amyloid-β being associated with greater cerebral blood flow reduction in controls and greater volume reduction in late mild cognitive impairment and dementia. In addition to disease stage, amyloid-β pathology affects cerebral blood flow across the span from controls to

  7. Timing-invariant reconstruction for deriving high-quality CT angiographic data from cerebral CT perfusion data.

    NARCIS (Netherlands)

    Smit, E.J.; Vonken, E.J.; Schaaf, I.C. van der; Mendrik, A.M.; Dankbaar, J.W.; Horsch, A.D.; Seeters, T. van; Ginneken, B. van; Prokop, M.

    2012-01-01

    PURPOSE: To suggest a simple and robust technique used to reconstruct high-quality computed tomographic (CT) angiographic images from CT perfusion data and to compare it with currently used CT angiography techniques. MATERIALS AND METHODS: Institutional review board approval was waived for this retr

  8. Assessment of local changes of cerebral perfusion and blood concentration by ultrasound harmonic B-mode contrast measurement in piglet.

    NARCIS (Netherlands)

    Wijk, M.C. van; Klaessens, J.H.G.M.; Hopman, J.C.W.; Liem, K.D.; Thijssen, J.M.

    2003-01-01

    This study tested the hypothesis that changes in the blood concentration, and possibly in the perfusion, of different areas in the brain can be assessed by the use of ultrasound contrast agent (CA) and (linear) echo densitometry. The experiments were performed with piglets (n=3) under general anesth

  9. Automated versus manual post-processing of perfusion-CT data in patients with acute cerebral ischemia: influence on interobserver variability

    Energy Technology Data Exchange (ETDEWEB)

    Soares, Bruno P.; Bhogal, Sumail; Dillon, William P.; Wintermark, Max [University of California, Department of Radiology, Neuroradiology Section, 505 Parnassus Avenue, Box 0628, San Francisco, CA (United States); Dankbaar, Jan Willem [University of California, Department of Radiology, Neuroradiology Section, 505 Parnassus Avenue, Box 0628, San Francisco, CA (United States); University Medical Center, Department of Radiology, Utrecht (Netherlands); Bredno, Joerg [Philips Research North America, San Francisco, CA (United States); Cheng, SuChun [University of California, Department of Epidemiology and Biostatistics, San Francisco, CA (United States)

    2009-07-15

    The purpose of this study is to compare the variability of PCT results obtained by automatic selection of the arterial input function (AIF), venous output function (VOF) and symmetry axis versus manual selection. Imaging data from 30 PCT studies obtained as part of standard clinical stroke care at our institution in patients with suspected acute hemispheric ischemic stroke were retrospectively reviewed. Two observers performed the post-processing of 30 CTP datasets. Each observer processed the data twice, the first time employing manual selection of AIF, VOF and symmetry axis, and a second time using automated selection of these same parameters, with the user being allowed to adjust them whenever deemed appropriate. The volumes of infarct core and of total perfusion defect were recorded. The cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and blood-brain barrier permeability (BBBP) values in standardized regions of interest were recorded. Interobserver variability was quantified using the Bland and Altman's approach. Automated post-processing yielded lower coefficients of variation for the volume of the infarct core and the volume of the total perfusion defect (15.7% and 5.8%, respectively) compared to manual post-processing (31.0% and 12.2%, respectively). Automated post-processing yielded lower coefficients of variation for PCT values (11.3% for CBV, 9.7% for CBF, and 9.5% for MTT) compared to manual post-processing (23.7% for CBV, 32.8% for CBF, and 16.7% for MTT). Automated post-processing of PCT data improves interobserver agreement in measurements of CBV, CBF and MTT, as well as volume of infarct core and penumbra. (orig.)

  10. Blood Pressure is Associated With Cerebral Blood Flow Alterations in Patients With T2DM as Revealed by Perfusion Functional MRI.

    Science.gov (United States)

    Xia, Wenqing; Rao, Hengyi; Spaeth, Andrea M; Huang, Rong; Tian, Sai; Cai, Rongrong; Sun, Jie; Wang, Shaohua

    2015-12-01

    Type 2 diabetes mellitus (T2DM) and hypertension are both associated with cognitive impairment and brain function abnormalities. We investigated whether abnormal cerebral blood flow (CBF) patterns exists in T2DM patients and possible relationships between aberrant CBF and cognitive performance. Furthermore, we examined the influence of hypertension on CBF alterations in T2DM patients. T2DM patients (n = 38) and non-T2DM subjects (n = 40) were recruited from clinics, hospitals, and normal community health screenings. Cerebral blood flow images were collected and analyzed using arterial spin labeling perfusion functional magnetic resonance imaging (fMRI). Regions with major CBF differences between T2DM patients and non-T2DM controls were detected via 1-way ANOVA. The interaction effects between hypertension and T2DM for CBF alterations were also examined. Correlation analyses illustrated the association between CBF values and cognitive performance and between CBF and blood pressure. Compared with non-T2DM controls, T2DM patients exhibited decreased CBF, primarily in the visual area and the default mode network (DMN); decreased CBF in these regions was correlated with cognitive performance. There was a significant interaction effect between hypertension and diabetes for CBF in the precuneus and the middle occipital gyrus. Additionally, blood pressure correlated negatively with CBF in T2DM patients.T2DM patients exhibited reduced CBF in the visual area and DMN. Hypertension may facilitate a CBF decrease in the setting of diabetes. T2DM patients may benefit from blood pressure control to maintain their brain perfusion through CBF preservation.

  11. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of /sup 18/FDG and /sup 13/NH/sub 3/

    Energy Technology Data Exchange (ETDEWEB)

    Kuhl, D.E.; Engel, J. Jr.; Phelps, M.E.; Selin, C.

    1979-01-01

    Seventeen patients with partial epilepsy had EEG monitoring concurrent with cerebral emission computed tomography (ECT) after /sup 18/F-fluorodeoxyglucose (/sup 18/FDG) and /sup 13/N-ammonia were given intravenously as indicators of local cerebral glucose utilization (LCMR/sub glc/) and relative perfusion, respectively. In 12 of 15 patients who had unilateral or focal electrical abnormalities, interictal /sup 18/FDG scan patterns clearly showed localized regions of decreased (20% to 50%) LCMR/sub glc/, which correlated anatomically with the eventual EEG localization. These hypometabolic zones appeared normal on x-ray computed tomography in all but three patients and were unchanged on scans repeated on different days. In 5 of 6 patients who underwent temporal lobectomy, the interictal /sup 18/FDG scan correctly detected the pathologically confirmed lesion as a hypometabolic zone, and removal of the lesion site resulted in marked clinical improvement. In contrast, the ictal /sup 18/FDG scan patterns clearly showed foci of increased (82% to 130%) LCMR/sub glc/, which correlated temporally and anatomically with ictal EEG spike foci and were within the zones of interictal hypometabolism (3 studies in 2 patients). /sup 13/NH/sub 3/ distributions paralleled /sup 18/FDG increases and decreases in abnormal zones, but /sup 13/NH/sub 3/ differences were of lesser magnitude. When the relationship of /sup 13/NH/sub 3/ uptake to local blood flow found in dog brain was applied as a correction to the patients' /sup 13/NH/sub 3/ scan data, local alterations in perfusion and glucose utilization were usually matched, both in the interictal and ictal states.

  12. Therapeutic Effects of Tongxinluo Capsule(通心络胶囊) on Patients with Acute Small Cerebral Infarction and Its Influence on SPECT Brain Perfusion Image

    Institute of Scientific and Technical Information of China (English)

    周盛年; 周国钰; 刘黎青

    2004-01-01

    Objective: To investigate the influence of Tongxinluo capsule (TXL, 通心络胶囊) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography ( SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI).Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group ( n = 17) was treated with the conventional treatment, i.e. 1.0g of Citicoline added into 300 mi normal saline for intravenous dripping daily for 2 weeks and 0.8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group ( n = 17)was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (BI) at the same time. Results: After treatment, the rCBF in the treatment group was significantly improved ( P<0.01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P<0.01). In addition, the SSS score was significantly lower and BI significantly higher in the treatment group than those in the control group respectively after treatment. Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.

  13. 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

  14. Comparison of cerebral blood flow data obtained by computed tomography (CT) perfusion with that obtained by xenon CT using 320-row CT.

    Science.gov (United States)

    Takahashi, Satoshi; Tanizaki, Yoshio; Kimura, Hiroaki; Akaji, Kazunori; Kano, Tadashige; Suzuki, Kentaro; Takayama, Youhei; Kanzawa, Takao; Shidoh, Satoka; Nakazawa, Masaki; Yoshida, Kazunari; Mihara, Ban

    2015-03-01

    Cerebral blood flow (CBF) data obtained by computed tomography perfusion (CTP) imaging have been shown to be qualitative data rather than quantitative, in contrast with data obtained by other imaging methods, such as xenon CT (XeCT) imaging. Thus, interpatient comparisons of CBF values themselves obtained by CTP may be inaccurate. In this study, we have compared CBF ratios as well as CBF values obtained from CTP-CBF data to those obtained from XeCT-CBF data for the same patients to determine CTP-CBF parameters that can be used for interpatient comparisons. The data used in the present study were obtained as volume data using 320-row CT. The volume data were applied to an automated region of interest-determining software (3DSRT, version 3.5.2 ) and converted to 59 slices of 2 mm interval standardized images. In the present study, we reviewed 10 patients with occlusive cerebrovascular diseases (CVDs) undergoing both CTP and XeCT in the same period. Our study shows that ratios of CBF measurements, such as hemodynamic stress distribution (perforator-to-cortical flow ratio of middle cerebral artery [MCA] region) or the left/right ratio for the region of the MCA, calculated using CTP data have been shown to correlate well with the same ratios calculated using XeCT data. These results suggest that such CBF ratios could be useful for generating interpatient comparisons of CTP-CBF data obtained by 320-row CT among patients with occlusive CVD.

  15. Intracranial pressure monitoring, cerebral perfusion pressure estimation, and ICP/CPP-guided therapy: a standard of care or optional extra after brain injury?

    Science.gov (United States)

    Kirkman, M A; Smith, M

    2014-01-01

    Measurement of intracranial pressure (ICP) and mean arterial pressure (MAP) is used to derive cerebral perfusion pressure (CPP) and to guide targeted therapy of acute brain injury (ABI) during neurointensive care. Here we provide a narrative review of the evidence for ICP monitoring, CPP estimation, and ICP/CPP-guided therapy after ABI. Despite its widespread use, there is currently no class I evidence that ICP/CPP-guided therapy for any cerebral pathology improves outcomes; indeed some evidence suggests that it makes no difference, and some that it may worsen outcomes. Similarly, no class I evidence can currently advise the ideal CPP for any form of ABI. 'Optimal' CPP is likely patient-, time-, and pathology-specific. Further, CPP estimation requires correct referencing (at the level of the foramen of Monro as opposed to the level of the heart) for MAP measurement to avoid CPP over-estimation and adverse patient outcomes. Evidence is emerging for the role of other monitors of cerebral well-being that enable the clinician to employ an individualized multimodality monitoring approach in patients with ABI, and these are briefly reviewed. While acknowledging difficulties in conducting robust prospective randomized studies in this area, such high-quality evidence for the utility of ICP/CPP-directed therapy in ABI is urgently required. So, too, is the wider adoption of multimodality neuromonitoring to guide optimal management of ICP and CPP, and a greater understanding of the underlying pathophysiology of the different forms of ABI and what exactly the different monitoring tools used actually represent.

  16. Tratamento cirúrgico das lesões da aorta torácica utilizando parada circulatória total hipotérmica com perfusão cerebral retrógrada Surgical treatment of the pathologies involving thoracic aorta using deep hypothermic total circulatory arrest with retrograde cerebral perfusion

    Directory of Open Access Journals (Sweden)

    Domingo M Braile

    1992-06-01

    Full Text Available De setembro de 1991 a fevereiro de 1992, foram operados nove pacientes com lesões da aorta torácica, usando parada circulatória total (PCT hipotérmica profunda com perfusão cerebral retrógrada (PCR, sendo seis do sexo masculino e três do feminino, com idade variando de 45 a 80 anos. Quatro deles tinham dissecção tipo A, três tinham aneurisma verdadeiro de aorta, um tinha uma associação de aneurisma verdadeiro com dissecção tipo A e um tinha ectasia ânulo-aórtica associada a dissecção tipo B. A técnica utilizada foi a instalação da circulação extracorpórea (CEC tipo cava-cava-femoral com hipotermia profunda e parada circulatória total. Utilizou-se cardioplegia retrógrada sangüínea como método de preservação de miocárdio. Durante a PCT foi feita PCR usando a linha arterial conectada à cânula da VCS, com fluxo de 250 a 300 ml/min, com PVC monitorizada no membro superior variando entre 30 e 40 cmH2O. A correção cirúrgica foi feita com tubo e patch de pericárdio bovino associados a cola biológica. O tempo de CEC variou de 75 até 169 min, com PCT de 32 até 79 min. e com PCR de 32 até 79 min. Não houve óbito associado ao ato operatório e nem ao pós-operatório (PO imediato. Houve apenas um óbito tardio por septicemia. Demais pacientes em seguimento ambulatorial. Os resultados obtidos representam um forte indicador de que a PCT com PCR protege o cérebro de forma mais eficiente que a PCT convencional, sendo vantajosa no tratamento cirúrgico das afecções da aorta torácica que requerem PCT.From September 1991 to February 1992, nine patients presenting thoracic aorta pathologies were submitted to surgery using deep hypothermic total circulatory arrest with retrograde cerebral perfusion. Six patients were male and three female, with ages ranging from 45 to 80 years. Four had type A dissection, three had true aorta aneurysm, one had true aneurysm associated with type A dissection and one had anulusaorta

  17. Effect of cerebral ventricles perfusion with morphiceptin and Met-enkephalin on trigemino-hypoglossal reflex in rats.

    Science.gov (United States)

    Zubrzycka, M; Fichna, J; Janecka, A

    2002-12-01

    Opioids administered by intracerebroventricular injections produce analgesic responses in rats. The present study was undertaken to investigate the effects of a highly selective mu-opioid receptor ligand morphiceptin on trigemino-hypoglossal reflex in rats. The analgesic effect of morphiceptin was compared with another opioid peptide, Met-enkephalin. With the experimental settings used in this study, we have demonstrated that both morphiceptin and Met-enkephalin show significant dose-dependent analgesic effects after i.c.v. administration in rats as assayed by trigemino-hypoglossal reflex test. The antinociceptive response to Met-enkephalin was short lasting and was observed 10 to 15 min after i.c.v. perfusion. Morphiceptin had a relatively longer duration of antinociceptive action, the effect was observed 20-50 min after i.c.v. perfusion. Neither morphiceptin nor Met-enkephalin produced antinociception after peripheral injections. The results of the present study indicate that both tested peptides act at mu-opioid receptors situated in the central nervous system. They also suggest that mu-opioid receptors present in the central nervous system are an important element of the trigemino-hypoglossal reflex arc. For that reason selective mu-opioid receptor ligands, like morphiceptin, inhibit the reflex more significantly.

  18. Correlation between special brain area and blood perfusion in patients with cerebral infarction at convalescent period Feasibility for quantitative determination and estimation of learning and memory function

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    BACKGROUND: Presently, clinic memory scale is used to evaluate learning memory ability in most studies,and the influence of difference in measurement condition of individuals exists.OBJECTIVE: To study the correlation between regional cerebral blood flow (rCBF) perfusion and learning memory function in special brain regions of patients with cerebral infarction at convalescent period,and to try to find out a method which can quantitatively evaluate learning ability.DESIGN: Case observation, and correlation analysis.SETTINGS: Shandong Institute for Behavioral Medicine; the Affiliated Hospital of Jining Medical College.PARTICIPANTS: Totally 70 patients with cerebral infarction admitted to Departtment of Neurology, Jining Medical College between January 2004 and December 2005 were involved. The involved patients, 58 male and 12 female, were averaged (52±3) years, and they were all right handed. They all met the diagnosis criteria instituted by the Fourth National Conference on Cerebrovascular Disease, and were confirmed as cerebral infarction by skull CT or MRI. Informed consents of detected items were obtained from all the patients and relatives.METHODS: When the patients were at convalescent period, their learning and memory ability were measured with" clinic memory scale (set A)". The 18 patients whose total mark over 100 were regarded as good learning memory function group; The 23 cases whose total mark less than 70 were regarded as poor learning memory function group. RCBF of hippocampus, nucleus amygdalae, temporal cortex and prefrontal lobe of patients between two groups were measured and compared by single photon emission computed tomography (SPECT). The total scores of the 18 good learning memory patients and 23 poor learning memory patients were taken as dependent variable Y, and their rCBFs of hippocampus, nucleus amygdale,temporal cortex and prefrontal lobe respectively as independent variable X for linear correlation analysis.MAIN OUTCOME MEASURES

  19. Does Preinterventional Flat-Panel Computer Tomography Pooled Blood Volume Mapping Predict Final Infarct Volume After Mechanical Thrombectomy in Acute Cerebral Artery Occlusion?

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Marlies, E-mail: marlies.wagner@kgu.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Kyriakou, Yiannis, E-mail: yiannis.kyriakou@siemens.com [Siemens AG, Health Care Sector (Germany); Mesnil de Rochemont, Richard du, E-mail: mesnil@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany); Singer, Oliver C., E-mail: o.singer@em.uni-frankfurt.de [Hospital of Goethe University, Department of Neurology (Germany); Berkefeld, Joachim, E-mail: berkefeld@em.uni-frankfurt.de [Hospital of Goethe University, Institute of Neuroradiology (Germany)

    2013-08-01

    PurposeDecreased cerebral blood volume is known to be a predictor for final infarct volume in acute cerebral artery occlusion. To evaluate the predictability of final infarct volume in patients with acute occlusion of the middle cerebral artery (MCA) or the distal internal carotid artery (ICA) and successful endovascular recanalization, pooled blood volume (PBV) was measured using flat-panel detector computed tomography (FPD CT).Materials and MethodsTwenty patients with acute unilateral occlusion of the MCA or distal ACI without demarcated infarction, as proven by CT at admission, and successful Thrombolysis in cerebral infarction score (TICI 2b or 3) endovascular thrombectomy were included. Cerebral PBV maps were acquired from each patient immediately before endovascular thrombectomy. Twenty-four hours after recanalization, each patient underwent multislice CT to visualize final infarct volume. Extent of the areas of decreased PBV was compared with the final infarct volume proven by follow-up CT the next day.ResultsIn 15 of 20 patients, areas of distinct PBV decrease corresponded to final infarct volume. In 5 patients, areas of decreased PBV overestimated final extension of ischemia probably due to inappropriate timing of data acquisition and misery perfusion.ConclusionPBV mapping using FPD CT is a promising tool to predict areas of irrecoverable brain parenchyma in acute thromboembolic stroke. Further validation is necessary before routine use for decision making for interventional thrombectomy.

  20. Misery Index Corrected by Informality: Applicable to Venezuela

    Directory of Open Access Journals (Sweden)

    Josefa Ramoni Perazzi

    2013-11-01

    Full Text Available This paper suggests a variation of the IMO index (Okun's Misery Index, adapting it to markets with these characteristics, adding the ESI level (Employment in the Informal Sector to the unemployment level. This research compares the evolution of several standard misery indexes in several zones during the last decades, with emphasis on the case of Venezuela, for which the new proposed index is also estimated. Results show improvement in the well-being of groups of countries under study, compared to the deterioration of the indicator in Venezuela. In general terms, the IMO is controlled by unemployment, except in Venezuela. However, preponderance of inflation over unemployment in this country seems to occur by the underestimate that the unemployment rate has on the Venezuelan labor market situation.

  1. Evaluation of a potential generator-produced PET tracer for cerebral perfusion imaging: single-pass cerebral extraction measurements and imaging with radiolabeled Cu-PTSM.

    Science.gov (United States)

    Mathias, C J; Welch, M J; Raichle, M E; Mintun, M A; Lich, L L; McGuire, A H; Zinn, K R; John, E K; Green, M A

    1990-03-01

    Copper(II) pyruvaldehyde bis(N4-methylthiosemicarbazone) (Cu-PTSM), copper(II) pyruvaldehyde bis(N4-dimethylthiosemicarbazone) (Cu-PTSM2), and copper(II) ethylglyoxal bis(N4-methylthiosemicarbazone) (Cu-ETSM), have been proposed as PET tracers for cerebral blood flow (CBF) when labeled with generator-produced 62Cu (t1/2 = 9.7 min). To evaluate the potential of Cu-PTSM for CBF PET studies, baboon single-pass cerebral extraction measurements and PET imaging were carried out with the use of 67Cu (t1/2 = 2.6 days) and 64Cu (t1/2 = 12.7 hr), respectively. All three chelates were extracted into the brain with high efficiency. There was some clearance of all chelates in the 10-50-sec time frame and Cu-PTSM2 continued to clear. Cu-PTSM and Cu-ETSM have high residual brain activity. PET imaging of baboon brain was carried out with the use of [64Cu]-Cu-PTSM. For comparison with the 64Cu brain image, a CBF (15O-labeled water) image (40 sec) was first obtained. Qualitatively, the H2(15)O and [64Cu]-Cu-PTSM images were very similar; for example, a comparison of gray to white matter uptake resulted in ratios of 2.42 for H2(15)O and 2.67 for Cu-PTSM. No redistribution of 64Cu was observed in 2 hr of imaging, as was predicted from the single-pass study results. Quantitative determination of blood flow using Cu-PTSM showed good agreement with blood flow determined with H2(15)O. This data suggests that [62Cu]-Cu-PTSM may be a useful generator-produced radiopharmaceutical for blood flow studies with PET.

  2. Normal cerebral perfusion of {sup 99m}Tc-ECD brain SPECT. Evaluation by an anatomical standardization technique

    Energy Technology Data Exchange (ETDEWEB)

    Kawashima, Ryuta; Koyama, Masamichi; Ito, Hiroshi; Yoshioka, Seiro; Sato, Kazunori; Ono, Shuichi; Goto, Ryoi; Sato, Tachio; Fukuda, Hiroshi [Tohoku Univ., Sendai (Japan). Inst. of Development, Aging and Cancer

    1996-01-01

    A single photon emitter labeled tracer, {sup 99m}Tc-ethyl cysteinate dimer ({sup 99m}Tc-ECD), has now been used for rCBF studies with SPECT. However, normal distribution pattern of this agent in the brain still remains unclear. Therefore, the specific purpose of this study was to investigate the normal distribution pattern of {sup 99m}Tc-ECD SPECT image. Regional cerebral distribution was measured with SPECT and 984{+-}17 MBq of {sup 99m}Tc-ECD in ten normal subjects. During the SPECT measurement, subjects were placed comfortably in a supine position with their eyes closed. Each SPECT image was anatomically standardized using a computerized brain atlas system of Roland et al. (HBA: Human Brain Atlas) and X-CT image. Anatomically standardized SPECT images were globally normalized to 100 count/voxel. Then, the mean and SD images of brain SPECT were calculated voxel-by-voxel basis. The highest radioactivity was found in the medial aspect of the occipital lobe. The results indicate that the normal distribution pattern of {sup 99m}Tc-ECD in the human brain may be not simply reflect the regional cerebral blood flow. (author).

  3. Simulating technetium-99m cerebral perfusion studies with a three-dimensional Hoffman brain phantom. Collimator and filter selection in SPECT neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hee-Joung; Yang, Seoung-Oh; Moon, Dae-Hyuk; Lee, Hee-Kyung [Asan Medical Center, Seoul (Korea, Republic of); Karp, J.S.; Mozley, P.D.; Kung, H.F.; Alavi, A.

    1996-02-01

    The choice of a collimator and the selection of a filter can affect the quality of clinical SPECT images of the brain. The compromises that 4 different collimators make between spatial resolution and sensitivity were studied by imaging a three-dimensional Hoffman brain phantom. The planar data were acquired with each collimator on a three-headed SPECT system and were reconstructed with both a standard Butterworth filter and a Wiener pre-filter. The reconstructed images were then evaluated by specialists in nuclear medicine and were also quantitatively analyzed with specific regions of interest (ROI) in the brain. All observers preferred the Wiener filter reconstructed images regardless of the collimator used to acquire the planar images. With this filter, the ultrahigh-resolution fan-beam collimator was the most subjectively preferable and quantitatively produced the highest contrast ratios. The findings support suggestions that higher resolution collimators are preferable to higher sensitivity collimators, and indicate that fan-beam collimators are preferable to parallel-hole collimators for clinical SPECT studies of cerebral perfusion. The results also suggest that the Wiener filter enhances the quality of SPECT brain images regardless of which collimator is used to acquire the data. (author).

  4. Cerebral blood volume calculated by dynamic susceptibility contrast-enhanced perfusion MR imaging: preliminary correlation study with glioblastoma genetic profiles.

    Directory of Open Access Journals (Sweden)

    Inseon Ryoo

    Full Text Available PURPOSE: To evaluate the usefulness of dynamic susceptibility contrast (DSC enhanced perfusion MR imaging in predicting major genetic alterations in glioblastomas. MATERIALS AND METHODS: Twenty-five patients (M:F = 13∶12, mean age: 52.1±15.2 years with pathologically proven glioblastoma who underwent DSC MR imaging before surgery were included. On DSC MR imaging, the normalized relative tumor blood volume (nTBV of the enhancing solid portion of each tumor was calculated by using dedicated software (Nordic TumorEX, NordicNeuroLab, Bergen, Norway that enabled semi-automatic segmentation for each tumor. Five major glioblastoma genetic alterations (epidermal growth factor receptor (EGFR, phosphatase and tensin homologue (PTEN, Ki-67, O6-methylguanine-DNA methyltransferase (MGMT and p53 were confirmed by immunohistochemistry and analyzed for correlation with the nTBV of each tumor. Statistical analysis was performed using the unpaired Student t test, ROC (receiver operating characteristic curve analysis and Pearson correlation analysis. RESULTS: The nTBVs of the MGMT methylation-negative group (mean 9.5±7.5 were significantly higher than those of the MGMT methylation-positive group (mean 5.4±1.8 (p = .046. In the analysis of EGFR expression-positive group, the nTBVs of the subgroup with loss of PTEN gene expression (mean: 10.3±8.1 were also significantly higher than those of the subgroup without loss of PTEN gene expression (mean: 5.6±2.3 (p = .046. Ki-67 labeling index indicated significant positive correlation with the nTBV of the tumor (p = .01. CONCLUSION: We found that glioblastomas with aggressive genetic alterations tended to have a high nTBV in the present study. Thus, we believe that DSC-enhanced perfusion MR imaging could be helpful in predicting genetic alterations that are crucial in predicting the prognosis of and selecting tailored treatment for glioblastoma patients.

  5. Normal cerebral perfusion of {sup 99m}Tc-HMPAO brain SPECT. Evaluation by an anatomical standardization technique

    Energy Technology Data Exchange (ETDEWEB)

    Koyama, Masamichi; Kawashima, Ryuta; Ito, Hiroshi [Tohoku Univ., Sendai (Japan). Inst. of Development, Aging and Cancer] [and others

    1995-09-01

    Single photon labeled tracer {sup 99m}Tc-hexamethyl-propylene amine oxime (HMPAO) has been used for rCBF studies by SPECT. However, normal perfusion pattern of this agent still remains unclear. The purpose of this study was to investigate normal {sup 99m}Tc-HMPAO SPECT image voxel by voxel. Eighteen male subjects without any prior or present history of medical illness participated in this study. All SPECT images were globally normalized to 100 count/voxel. Each subject had an X-ray CT scan at the same day of SPECT measurement. All subjects had normal X-ray CT scans. The standard anatomical structures of the computerized brain atlas of Roland et al. were fitted to X-ray CT images of a subject by linear and non-linear parameters. These parameters were subsequently used to transform SPECT images of the subject. After the anatomical standardization, mean and SD images of eight standardized images were calculated voxel-by-voxel basis. In the mean image, following structures showed relatively higher radioactivity; the putamen, the cerebellum, and the frontal lobe. In addition, the occipital lobe, parietal lobe, frontal lobe, and the putamen showed large degree of SD. Anatomical standardization of SPECT images may be useful as a reference to diagnose and evaluate various brain disorders. (author).

  6. Absolute Cerebral Blood Flow Infarction Threshold for 3-Hour Ischemia Time Determined with CT Perfusion and 18F-FFMZ-PET Imaging in a Porcine Model of Cerebral Ischemia.

    Science.gov (United States)

    Wright, Eric A; d'Esterre, Christopher D; Morrison, Laura B; Cockburn, Neil; Kovacs, Michael; Lee, Ting-Yim

    2016-01-01

    CT Perfusion (CTP) derived cerebral blood flow (CBF) thresholds have been proposed as the optimal parameter for distinguishing the infarct core prior to reperfusion. Previous threshold-derivation studies have been limited by uncertainties introduced by infarct expansion between the acute phase of stroke and follow-up imaging, or DWI lesion reversibility. In this study a model is proposed for determining infarction CBF thresholds at 3hr ischemia time by comparing contemporaneously acquired CTP derived CBF maps to 18F-FFMZ-PET imaging, with the objective of deriving a CBF threshold for infarction after 3 hours of ischemia. Endothelin-1 (ET-1) was injected into the brain of Duroc-Cross pigs (n = 11) through a burr hole in the skull. CTP images were acquired 10 and 30 minutes post ET-1 injection and then every 30 minutes for 150 minutes. 370 MBq of 18F-FFMZ was injected ~120 minutes post ET-1 injection and PET images were acquired for 25 minutes starting ~155-180 minutes post ET-1 injection. CBF maps from each CTP acquisition were co-registered and converted into a median CBF map. The median CBF map was co-registered to blood volume maps for vessel exclusion, an average CT image for grey/white matter segmentation, and 18F-FFMZ-PET images for infarct delineation. Logistic regression and ROC analysis were performed on infarcted and non-infarcted pixel CBF values for each animal that developed infarct. Six of the eleven animals developed infarction. The mean CBF value corresponding to the optimal operating point of the ROC curves for the 6 animals was 12.6 ± 2.8 mL·min-1·100g-1 for infarction after 3 hours of ischemia. The porcine ET-1 model of cerebral ischemia is easier to implement then other large animal models of stroke, and performs similarly as long as CBF is monitored using CTP to prevent reperfusion.

  7. Absolute Cerebral Blood Flow Infarction Threshold for 3-Hour Ischemia Time Determined with CT Perfusion and 18F-FFMZ-PET Imaging in a Porcine Model of Cerebral Ischemia.

    Directory of Open Access Journals (Sweden)

    Eric A Wright

    Full Text Available CT Perfusion (CTP derived cerebral blood flow (CBF thresholds have been proposed as the optimal parameter for distinguishing the infarct core prior to reperfusion. Previous threshold-derivation studies have been limited by uncertainties introduced by infarct expansion between the acute phase of stroke and follow-up imaging, or DWI lesion reversibility. In this study a model is proposed for determining infarction CBF thresholds at 3hr ischemia time by comparing contemporaneously acquired CTP derived CBF maps to 18F-FFMZ-PET imaging, with the objective of deriving a CBF threshold for infarction after 3 hours of ischemia. Endothelin-1 (ET-1 was injected into the brain of Duroc-Cross pigs (n = 11 through a burr hole in the skull. CTP images were acquired 10 and 30 minutes post ET-1 injection and then every 30 minutes for 150 minutes. 370 MBq of 18F-FFMZ was injected ~120 minutes post ET-1 injection and PET images were acquired for 25 minutes starting ~155-180 minutes post ET-1 injection. CBF maps from each CTP acquisition were co-registered and converted into a median CBF map. The median CBF map was co-registered to blood volume maps for vessel exclusion, an average CT image for grey/white matter segmentation, and 18F-FFMZ-PET images for infarct delineation. Logistic regression and ROC analysis were performed on infarcted and non-infarcted pixel CBF values for each animal that developed infarct. Six of the eleven animals developed infarction. The mean CBF value corresponding to the optimal operating point of the ROC curves for the 6 animals was 12.6 ± 2.8 mL·min-1·100g-1 for infarction after 3 hours of ischemia. The porcine ET-1 model of cerebral ischemia is easier to implement then other large animal models of stroke, and performs similarly as long as CBF is monitored using CTP to prevent reperfusion.

  8. Hypertonic saline solution increases cerebral perfusion pressure during clinical orthotopic liver transplantation for fulminant hepatic failure: preliminary results Solução salina hipertônica aumenta a pressão de perfusão cerebral no transplante do fígado para hepatite fulminante: resultados preliminares

    Directory of Open Access Journals (Sweden)

    Joel Avancini Rocha Filho

    2006-06-01

    Full Text Available During orthotopic liver transplantation for fulminant hepatic failure, some patients may develop sudden deterioration of cerebral perfusion and oxygenation, mainly due to increased intracranial pressure and hypotension, which are likely responsible for postoperative neurological morbidity and mortality. In the present study, we hypothesized that the favorable effects of hypertonic saline solution (NaCl 7.5%, 4 mL/kg infusion on both systemic and cerebral hemodynamics, demonstrated in laboratory and clinical settings of intracranial hypertension and hemorrhagic shock resuscitation, may attenuate the decrease in cerebral perfusion pressure that often occurs during orthotopic liver transplantation for fulminant hepatic failure. METHODS: 10 patients with fulminant hepatic failure in grade IV encephalopathy undergoing orthotopic liver transplantation with intracranial pressure monitoring were included in this study. The effect on cerebral and systemic hemodynamics in 3 patients who received hypertonic saline solution during anhepatic phase (HSS group was examined, comparing their data with historical controls obtained from surgical procedure recordings in 7 patients (Control group. The maximal intracranial pressure and the corresponding mean arterial pressure values were collected in 4 time periods: (T1 the last 10 min of the dissection phase, (T2 the first 10 minutes at the beginning of anhepatic phase, (T3 at the end of the anhepatic phase, and (T4 the first 5 minutes after graft reperfusion. RESULTS: Immediately after hypertonic saline solution infusion, intracranial pressure decreased 50.4%. During the first 5 min of reperfusion, the intracranial pressure remained stable in the HSS group, and all these patients presented an intracranial pressure lower than 20 mm Hg, while in the Control group, the intracranial pressure increased 46.5% (P Neste estudo testamos a hipótese de que os efeitos benéficos decorrentes da administração da solu

  9. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G. [Paracelsus Medical University, Christian-Doppler-Clinic, Department of Neurology, and Center of Cognitive Research Salzburg, Salzburg (Austria); Zauner, H. [Rehabilitation Center of the Pensionsversicherungsanstalt, Grossgmain (Austria)

    2009-05-15

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  10. Effects of Ginkgo biloba on cerebral blood flow assessed by quantitative MR perfusion imaging: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Mashayekh, Ameneh; Pham, Dzung L.; Yousem, David M.; Dizon, Mercedes; Barker, Peter B.; Lin, Doris D.M. [Johns Hopkins University School of Medicine, Department of Radiology, Division of Neuroradiology, Baltimore, MD (United States)

    2011-03-15

    Extract of Ginkgo biloba (EGb), a dietary supplement used for a number of conditions including dementia, has been suggested to increase cerebral blood flow (CBF). The purpose of this study was to determine if changes in CBF could be detected by dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSC-MRI) in elderly human subjects taking EGb. DSC-MRI was performed in nine healthy men (mean age 61 {+-} 10 years) before and after 4 weeks of 60 mg EGb taken twice daily. One subject underwent six consecutive scans to evaluate intrasubject reproducibility. CBF values were computed before and after EGb, and analyzed at three different levels of spatial resolution, using voxel-based statistical parametric mapping (SPM), and regions of interest in different lobes, and all regions combined. Normalized intrasubject CBF (nCBF) measurements had a standard deviation of 7% and 4% in gray and white matter (WM) regions, respectively. SPM using an uncorrected, voxel-level threshold of P {<=} 0.001 showed a small CBF increase in the left parietal-occipital region. CBF in individual lobar regions did not show any significant change post-EGb, but all regions combined showed a significant increase of non-normalized CBF after EGb (15% in white and 13% in gray matter, respectively, P {<=} 0.0001). nCBF measured by DSC-MRI has good intrasubject reproducibility. In this small cohort of normal elderly individuals, a mild increase in CBF is found in the left parietal-occipital WM after EGb, as well as a small but statistically significant increase in global CBF. (orig.)

  11. Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ho Young; Lee, Jae Sung; Kim, Seung Ki; Wang, Kyu Chang; Cho, Byung Kyu; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Total fifty six (M:F=33:24, age 6.7{+-}3.2 years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was 33{+-}21 months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal

  12. Modelling of cerebral hyper-perfusion after chronic forebrain ischemia in rats%大鼠慢性前脑缺血解除后脑过度灌注模型的建立

    Institute of Scientific and Technical Information of China (English)

    肖玮; 王天龙; 李俊发; 赵磊; 于培兰; 孔萃萃

    2011-01-01

    目的 建立大鼠慢性前脑缺血基础上的脑过度灌注模型.方法 选取雄性Wistar大鼠72只依随机数字表均分为两个模型建造组.缺血模型采用双侧颈总动脉结扎,随机数字表分为空白对照、假手术组、缺血2周组、缺血4周组,每组9只,结扎前后分别测定脑额叶血流、比较各组行为学评分、脑梗死面积.过度灌注模型是在缺血模型基础上,再灌注同时经尾静脉持续输注去氧肾上腺素4μg·kg-1·min-1,使再灌注后脑额叶血流超过基础值的200%.随机分为空白对照组、盐水组、过度灌注0.5 h组、过度灌注2 h组,每组9只,再灌注前后分别测定脑额叶血流,比较各组行为学评分、血脑屏障通透性、脑干湿重比值.结果 大鼠双侧颈动脉结扎后前脑血流减少可达67%±2%,脑过度灌注组与盐水输注组的脑血流变化值差异有统计学意义(P<0.01).缺血2周组的神经功能评分、脑梗死面积与正常对照组差异无统计学意义,缺血4周组的脑梗死面积与正常对照组差异有统计学意义.脑过度灌注2 h组的血脑屏障通透性改变有统计学意义(P<0.05).结论 结扎大鼠双侧颈总动脉2周后脑过度灌注2 h可较好地建立大鼠脑过度灌注综合征模型.%Objective To establish the cerebral hyper-perfusion model after chronic forebrain ischemia in rats. Methods A total of 72 male rats were equally randomized into 2 modeling groups. The ligation of bilateral common carotid artery could induce chronic forebrain ischemia. And 36 rats were randomly grouped by ischemia duration: control group ( n = 9 ), sham group ( n = 9 ), 2-wcek ischemia group ( n = 9 ) and 4-wcek ischemia group ( n = 9 ). The blood flow in frontal lobe was measured at pre- and post-ligation. The neurological score and cerebral infarction area were also compared among the groups. The min-1 via tail vein to produce cerebrally hyperperfused blood flow rate over 200% of baseline

  13. CT Perfusion and MR Perfusion Weighted Imaging in Evaluating the Effect of Vascular Reconstruction on Short-term Cerebral Blood Flow in Patients with Moyamoya Disease%CT灌注与MR灌注加权成像评价烟雾病血管重建术对烟雾病患者短期脑血流的影响

    Institute of Scientific and Technical Information of China (English)

    崔若棣; 易明岗

    2015-01-01

    Objective To study CT perfusion (CTP) and MR perfusion (PWI) weighted imaging in evaluating the effect of vascular reconstruction on short-term cerebral blood flow in patients with moyamoya disease.Methods 47 patients with unilateral vascular reconstruction confirmed by DSA in the hospital were selected as the research objects and all received vascular reconstruction. All the patients received CTP and PWI examination before and after operation to obtain parameters, such as cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP). The preoperative and postoperative distribution of cerebral middle artery (MCA) and ipsilateral cerebellar perfusion parameters in control part (rCBF, rCBV, rMTT and rTTP) were compared as well as the differences in preoperative and postoperative relative value of CTP and PWI perfusion parameters.Results Postoperative CT perfusion image showed that CBF, CBV, MTT and TTP in the right distribution area of MCA significantly changed, compared with those before operation. Postoperative PWI perfusion image showed that CBF, CBV, MTT and TTP significantly significantly changed, compared with those before operation. After operation, rCBF and rCBV values in the distribution area of operation side MCA and the control ares were significantly higher than those before operation (P<0.05) while rMTT and rTTP were significantly lower than those before operation (P<0.05).Conclusion Both of CT perfusion and MR perfusion weighted imaging are the effective observation methods to observe the changes of cerebral blood flow in patients with moyamoya disease, which can be used in clinic.%目的:研究CT灌注(CTP)与MR灌注(PWI)加权成像评价烟雾病血管重建术对烟雾病患者短期脑血流的影响。方法选取我院47例经DSA证实的单侧血管重建术患者为研究对象,均行血管重建术治疗,术前术后接受CTP、PWI检查,获得脑血容量(CBV)、脑血流量(CBF)、平均通

  14. Perfusion MRI derived indices of microvascular shunting and flow control correlate with tumor grade and outcome in patients with cerebral glioma.

    Directory of Open Access Journals (Sweden)

    Anna Tietze

    Full Text Available Deficient microvascular blood flow control is thought to cause tumor hypoxia and increase resistance to therapy. In glioma patients, we tested whether perfusion-weighted MRI (PWI based indices of microvascular flow control provide more information on tumor grade and patient outcome than does the established PWI angiogenesis marker, cerebral blood volume (CBV.Seventy-two glioma patients (sixty high-grade, twelve low-grade gliomas were included. Capillary transit time heterogeneity (CTH and the coefficient of variation (COV, its ratio to blood mean transit time, provide indices of microvascular flow control and the extent to which oxygen can be extracted by tumor tissue. The ability of these parameters and CBV to differentiate tumor grade were assessed by receiver operating characteristic curves and logistic regression. Their ability to predict time to progression and overall survival was examined by the Cox proportional-hazards regression model, and by survival curves using log-rank tests.The best prediction of grade (AUC = 0.876; p < 0.05 was achieved by combining knowledge of CBV and CTH in the enhancing tumor and peri-focal edema, and patients with glioblastoma multiforme were identified best by CTH (AUC = 0.763; p<0.001. CTH outperformed CBV and COV in predicting time to progression and survival in all gliomas and in a subgroup consisting of only high-grade gliomas.Our study confirms the importance of microvascular flow control in tumor growth by demonstrating that determining CTH improves tumor grading and outcome prediction in glioma patients compared to CBV alone.

  15. CT灌注成像对颅脑创伤病灶周围血流灌注的鉴别意义%The distinguishing meaning of CT perfusion on the blood perfusion of the area of cranio-cerebral trauma focus

    Institute of Scientific and Technical Information of China (English)

    戴君侠; 孙军; 陈茂华

    2015-01-01

    Objective: To explore the distinguishing meaning of CT perfusion (CTP) on the blood perfu-sion condition of the area of cranio-cerebral trauma focus.Methods: CT scanning was used in the patients with different cranio-cerebral trauma. Furthermore, CTP was used to examine those lesions with low-density shadow surrounding, while an analysis of the parameters of mean transit time (MTT), regional cerebral blood flow (rCBF) and regional cerebral blood volume (rCBV), and a comparison of patient prognoses were also conducted. Results: CT scan showed low-density focus of the brain parenchyma around the site of the trauma in 79 cases; CT perfusion parameters showed hypo-perfusion of the brain tissue around the trauma in 42 cases (54.4%), high perfusion in 35 cases (44.3%), while there were no obvious brain tissue perfusion abnormalities in 2 cases. Prog-nosis of low perfusion was poorer.Conclusion: CT examination should apply further CTP in the case of those patients who have been found to display low-density shadow around their cranio-cerebral trauma, in order to help clinicians to better understand the local haemodynamic state of the brain tissue. This has great signiifcance on the diagnosis of focus microcirculation disturbance of cranio-cerebral trauma.%目的:探讨CT灌注成像(CTP)对颅脑创伤病灶周围组织血流灌注情况的鉴别意义。方法:对头颅CT扫描提示有脑挫裂伤病灶,且病灶周围存在低密度影的颅脑创伤患者79例行CTP检查,将每例的平均通过时间(MTT)、局部脑血流量(rCBF)、局部脑血容量(rCBV)等参数值和格拉斯哥预后评分(GOS)进行比较分析。结果:CTP显示创伤周围脑组织低灌注42例(占54.4%),高灌注35例(占44.3%),2例未见明显脑组织灌注异常。低灌注(rCRF、rCBV降低,MTT延长)者预后较差。结论:对CT检查发现颅脑创伤病灶周围低密度影患者进一步行CTP检查,能使临床医师了解脑

  16. Application of stressed cerebral blood flow perfusion imaging in cerebrovascular disease%负荷试验脑血流灌注显像在脑血管疾病中的应用

    Institute of Scientific and Technical Information of China (English)

    尹立杰; 刘杰; 金超岭; 王荣福

    2016-01-01

    The incidence of ischemic cerebrovascular disease is currently high. The disease can be diagnosed and treated by numerous methods, including transcranial doppler, CT angiography, MRI, digital subtraction angiography and cerebral blood flow perfusion imaging of resting and stress states. In these methods, the clinical application of stressed cerebral blood flow perfusion imaging is very wide and includes vertical load tests, CO2 inhalation load tests, acetazolamide stress tests, dipyridamole stress tests, and adenosine stress tests. Stressed cerebral blood flow perfusion imaging can provide an objective basis for the early diagnosis, curative effect evaluation, prognostic estimation, and evaluation of brain reserve function.%目前,缺血性脑血管病发病率较高,对其诊治方法很多,包括经颅多普勒超声、 CT血管造影、 MRI、数字减影血管造影和静息及负荷试验脑血流灌注显像等。其中,负荷试验脑血流灌注显像包括直立负荷试验、 CO2吸入负荷试验、乙酰唑胺负荷试验、潘生丁负荷试验、腺苷负荷试验等,其临床应用非常广泛,为临床早期诊断、疗效评价、预后以及脑血流储备功能的评估提供了客观依据。

  17. 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.

  18. MELAS综合征患者脑灌注异常的MRI特征%MRI evaluation of cerebral perfusion changes in patients with MELAS syndrome

    Institute of Scientific and Technical Information of China (English)

    谢晟; 齐朝月; 肖江喜; 杨艳玲; 蒋学祥

    2008-01-01

    Objective To detect the changes of cerebral perfusion in patients with MELAs syndrome by using MR perfusion technique.Methods Thirteen patients with MELAS syndrome and 13 controls with normal neurological conditions were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T1 measurement(FAIREST).Their rCBF values were obtained in regions of bilateral basilar nuclei and thalami,as well as bilateral temporal lobes and occipital lobes.Regression analysis was carried out to determine the effect of location and side on the measurement of rCBF in controls.One-way ANOVA was conducted to compare rCBF values among the control group.the lesion ROIs and normal ROIs of the MELAS syndrome group.Results The values of rCBF were 0.83±0.23,1.17±0.30.0.93±0.28,and 1.11±0.25 for the left basilar ganglia,thalamus,temporal lobe,and occipital lobe respectively,while they were 0.77±0.15,1.03±0.34,1.06±0.23,and 1.09±0.23 for the right basilar ganglia,thalamus,temporal lobe.and occipital lobe respectively.Regression analysis revealed no effect of location and side on the rCBF (P>0.05).The rCBF value for control group was 1.00±0.28,while it was 1.01±0.31 for the normal ROIs and 1.95±0.43 for the lesion ROIs in the MELAS syndrome group(F=54.99.P<0.01).The rCBF of the lesion ROIs in the MELAS syndrome group was significantly higher than the normal ROIs and the control group.Conclusion CBF maps can reveal changes of cerebral blood flow in patients with ietal MELAS,which suggests increased perfusion in the stroke-like lesions.%目的 探讨MELAS综合征患者的MR脑血流灌注异常特征.方法 对13例确诊的MELAS综合征患者和13名对照组受试者行流速敏感交替反转恢复免除独立T1测量(FAIREST)序列扫描,通过后处理生成脑血流量(CBF)图,分别测量他们的双侧基底节区、丘脑、颢叶和枕叶的相对脑血流量(rCBF)值,采用多元回归法分析对照组中测量部位和侧别对rCBF

  19. 脑梗死前期磁共振脑灌注成像20例分析%Correlation analysis of magnetic resonance perfusion imaging and its stages of regional cerebral hypoperfusion in pre-infarction period

    Institute of Scientific and Technical Information of China (English)

    曾裕镜

    2008-01-01

    目的 探讨脑梗死前期MR脑灌注成像的表现和分期临床应用价值.方法 采用MR脑灌注成像对20例脑血管病患者的197层脑灌注图像和对照组20例非脑血管病患者的197层脑灌注成像进行分析,计算每层图像的患/健侧比值,并与对照组的正常比值及其范围比较.以非参数统计方法、多元方差分析和两两比较分析病例组和对照组脑灌注血流动力学参数及其分期.结果 病例组和对照组的4个血流动力学参数差异均有统计学意义(P<0.01).TTP(time to peak)和MTT(mean transit time)与发病的相关系数较高,分别为0.482和0.471,rCBV(regional cerebral blood volume)和rCBF(regional cerebral blood flow)较低,且为负值.脑梗死前期分期特征为:Ⅰ期一型TTP稍有延长,Ⅰ期二型MTT显著延长,Ⅱ期一型rCBF明显下降,Ⅱ期二型rCBV下降.结论 MR脑灌注成像可提供脑梗死前期的血流动力学参数变化的信息,并可以对其参数变化进行分期.%Objective To explore clinical value of application to magnetic resonance(MR) perfusion imaging and stages of regional cerebral hypoperfusion in preinfarction period and improve the diagnosis level for pre-infarction period,and prevent or decrease the incidence of cerebral infarction. Methods 20 cases of cerebral ischemia in case group and 20 cases of non-cerebral ischemia in control group were performed with dynamic perfusion. 197 MR images of case group were compared with 197 images of control group,calculating the ratios of illness side to normal for every image at hypoperfusion areas in the regional cerebral isehemia and referring and comparing their range provided by control group with methods of nonparametrie statistics and multivariate analysis of variance and multiple comparison. Results Four parameters of blood flow dynamics between two groups showed a significant difference (P<0.01). Correlation coefficients between time to peak(TTP) and time to peak(MTT) and incidence

  20. Comparison of increased venous contrast in ischemic stroke using phase-sensitive MR imaging with perfusion changes on flow-sensitive alternating inversion recovery at 3 Tesla

    Energy Technology Data Exchange (ETDEWEB)

    Yamashita, Eijiro; Kanasaki, Yoshiko; Fujii, Shinya; Ogawa, Toshihide (Div. of Radiology, Dept. of Pathophysiological and Therapeutic Science, Faculty of Medicine, Tottori Univ. Hospital, Yonago, Tottori (Japan)), email: eyamashi-ttr@umin.ac.jp; Tanaka, Takuro; Hirata, Yoshiharu (Div. of Clinical Radiology, Tottori Univ. Hospital, Yonago, Tottori (Japan))

    2011-10-15

    Background Increased venous contrast in ischemic stroke using susceptibility-weighted imaging has been widely reported, although few reports have compared increased venous contrast areas with perfusion change areas. Purpose To compare venous contrast on phase-sensitive MR images (PSI) with perfusion change on flow-sensitive alternating inversion recovery (FAIR) images, and to discuss the clinical use of PSI in ischemic stroke. Material and Methods Thirty patients with clinically suspected acute infarction of the middle cerebral artery (MCA) territory within 7 days of onset were evaluated. Phase-sensitive imaging (PSI), flow-sensitive alternating inversion recovery (FAIR), diffusion-weighted imaging (DWI) and magnetic resonance angiography (MRA) were obtained using 3 Tesla scanner. Two neuroradiologists independently reviewed the MR images, as well as the PSI, DWI, and FAIR images. They were blinded to the clinical data and to each other's findings. The abnormal area of each image was ultimately identified after both neuroradiologists reached consensus. We analyzed areas of increased venous contrast on PSI, perfusion changes on FAIR images and signal changes on DWI for each case. Results Venous contrast increased on PSI and hypoperfusion was evident on FAIR images from 22 of the 30 patients (73%). The distribution of the increased venous contrast was the same as that of the hypoperfused areas on FAIR images in 16 of these 22. The extent of these lesions was larger than that of lesions visualized by on DWI in 18 of the 22 patients. Hypointense signals reflecting hemorrhage and no increased venous contrast on PSI and hyperperfusion on FAIR images were found in six of the remaining eight patients (20%). Findings on PSI were normal and hypoperfusion areas were absent on FAIR images of two patients (7%). Conclusion Increased venous contrast on PSI might serve as an index of misery perfusion and provide useful information

  1. 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

  2. Effects of special brain area regional cerebral blood flow abnormal perfusion on learning and memory function and its molecular mechanism in rats

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    s To study the effect of special brain area regional cerebral blood flow (rCBF) abnormal perfusion on learning and memory function and its molecular mechanism,64 adult male healthy Spragne-Dawley (SD) rats were randomly divided into two groups,the false operation group (control group) and the operation group (model group).After surgical operation,the operation group undertook bilateral common carotid artery permanent ligation,while the other group did not.Learning and memory function were measured by Y-maze at 4 h,8 h,24 h and 3 d after surgical operation,respectively.The rCBF of the right frontal lobe and hippocampus was also detected by the PerifluxPF model laser Doppler flowmetry,and the expressions of c-fos or c-jun or Bcl-2 and Bax were also measured by immune histochemistry S-P method accordingly.Results showed that the rCBF of the right frontal lobe and hippocampus in the operation group was significantly lower than that in the false operation group (P < 0.05).The learning indexes,error number (EN),day of reach standard and total reaction time (TRT) in the operation group,were significantly higher than that in the false operation group (P< 0.05).However,the initiative evasion rate in the operation group was significantly lower than that in the false operation group.The study also found that the rCBF was relatively more,the indexes (EN,the day of reach standard and TRT) relatively fewer,but the initiative evasion rate and the memory keeping rate were relatively more.The positive expression and the average absorbency of Fos and Jun in the operation group were significantly higher than that in the false operation group (P< 0.05).Furthermore,Bax and Bcl-2 positive cells were all increased over time in the operation group,and the expression ratio of Bax/Bcl-2 in the operation group was significantly higher than that in the false operation group (P<0.01).In conclusion,rCBF decrease can impair the learning and memory function in rats,which may be related to

  3. Misery loves company: mood-congruent emotional responding to music.

    Science.gov (United States)

    Hunter, Patrick G; Schellenberg, E Glenn; Griffith, Andrew T

    2011-10-01

    We examined emotional responding to music after mood induction. On each trial, listeners heard a 30-s music excerpt and rated how much they liked it, whether it sounded happy or sad, and how familiar it was. When the excerpts sounded unambiguously happy or sad (Experiment 1), the typical preference for happy-sounding music was eliminated after inducing a sad mood. When the excerpts sounded ambiguous with respect to happiness and sadness (Experiment 2), listeners perceived more sadness after inducing a sad mood. Sad moods had no influence on familiarity ratings (Experiments 1 and 2). These findings imply that "misery loves company." Listeners in a sad mood fail to show the typical preference for happy-sounding music, and they perceive more sadness in music that is ambiguous with respect to mood.

  4. Exploring misery discourses: problematized Roma in labour market projects

    Directory of Open Access Journals (Sweden)

    Viktor Vesterberg

    2016-03-01

    Full Text Available The aim of this article is to analyse learning practices in labour market projects cofinanced by the European Social Fund (ESF targeting unemployed Roma in Sweden. The empirical material consists of 18 project descriptions from ESF projects, as well as national and European policy documents concerned with the inclusion of the Roma in contemporary Europe. The contemporary empirical material is analysed in relation to a government report from 1956 concerning the 'Roma issue' in Sweden. The analytical perspective of the study is governmentality, and the analysis focuses on different kinds of problematizations and the discursive positioning of the Roma subjects. One of the main findings is that unemployed Roma are situated in various discourses of misery and constructed as in need of reshaping their subjectivities in order to become educable as well as employable.

  5. Measurements of diagnostic examination performance and correlation analysis using microvascular leakage, cerebral blood volume, and blood flow derived from 3T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in glial tumor grading

    Energy Technology Data Exchange (ETDEWEB)

    Server, Andres; Nakstad, Per H. [Oslo University Hospital-Ullevaal, Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Oslo (Norway); Graff, Bjoern A. [Oslo University Hospital-Ullevaal, Department of Radiology and Nuclear Medicine, Oslo (Norway); Orheim, Tone E.D.; Gadmar, Oeystein B. [Oslo University Hospital, Interventional Centre, Oslo (Norway); Schellhorn, Till [Oslo University Hospital-Ullevaal, Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo (Norway); Josefsen, Roger [Oslo University Hospital-Ullevaal, Department of Neurosurgery, Oslo (Norway)

    2011-06-15

    To assess the diagnostic accuracy of microvascular leakage (MVL), cerebral blood volume (CBV) and blood flow (CBF) values derived from dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MR imaging) for grading of cerebral glial tumors, and to estimate the correlation between vascular permeability/perfusion parameters and tumor grades. A prospective study of 79 patients with cerebral glial tumors underwent DSC-MR imaging. Normalized relative CBV (rCBV) and relative CBF (rCBF) from tumoral (rCBVt and rCBFt), peri-enhancing region (rCBVe and rCBFe), and the value in the tumor divided by the value in the peri-enhancing region (rCBVt/e and rCBFt/e), as well as MVL, expressed as the leakage coefficient K{sub 2} were calculated. Hemodynamic variables and tumor grades were analyzed statistically and with Pearson correlations. Receiver operating characteristic (ROC) curve analyses were also performed for each of the variables. The differences in rCBVt and the maximum MVL (MVL{sub max}) values were statistically significant among all tumor grades. Correlation analysis using Pearson was as follows: rCBVt and tumor grade, r = 0.774; rCBFt and tumor grade, r = 0.417; MVL{sub max} and tumor grade, r = 0.559; MVL{sub max} and rCBVt, r = 0.440; MVL{sub max} and rCBFt, r = 0.192; and rCBVt and rCBFt, r = 0.605. According to ROC analyses for distinguishing tumor grade, rCBVt showed the largest areas under ROC curve (AUC), except for grade III from IV. Both rCBVt and MVL{sub max} showed good discriminative power in distinguishing all tumor grades. rCBVt correlated strongly with tumor grade; the correlation between MVL{sub max} and tumor grade was moderate. (orig.)

  6. Perfusão cerebral retrógrada é método eficaz de proteção cerebral?: resultados imediatos de estudo consecutivo e randomizado

    Directory of Open Access Journals (Sweden)

    FONTES Ronaldo D.

    1999-01-01

    Full Text Available Foram estudados 30 pacientes com diagnóstico de aneurisma ou dissecção de aorta tratados cirurgicamente. O método utilizado consistiu: uso de hipotermia profunda, parada circulatória total, infusão de 0,20 mg/Kg de peso de dexametasona intravenosa e 10 mg/Kg/peso de thiopental, colocação dos pacientes em Trendelemburg a 45 graus durante o período de parada respiratória. Os 30 pacientes foram operados consecutivamente e randomizados em 2 grupos. Grupo I constituído de 15 pacientes, nos quais foi utilizada a perfusão cerebral retrógrada (PCR através da veia cava superior e Grupo II também com 15 pacientes nos quais não foi utilizada PCR. Onze (36,7% pacientes tinham aneurisma da aorta ascendente e arco aórtico, 7 (23,3% tinham dissecção aguda da aorta do tipo I, 6 (20% com dissecção crônica da aorta ascendente e os 6 (20% restantes outros diagnósticos não agrupáveis. Foi realizada análise das seguintes variáveis independentes para mortalidade: idade, sexo, tempo de circulação extracorpórea, tempo de parada circulatória, diagnóstico, complicações prévias, comparando os dois grupos. A mortalidade imediata do Grupo I foi de 4/15 (insuficiência respiratória 26,6% e no Grupo II 3/15 (coma 20,0% - p =1,00. A incidência de complicações neurológicas no Grupo I foi 3/15 (20,0% e no Grupo II, 2/15 (13,3% p = 1,000. A análise estatística utilizando o teste exato de Fisher não demonstrou diferença entre os dois grupos com relação à mortalidade imediata e complicações neurológicas. As causas de óbito foram: insuficiência respiratória em 4 pacientes, alteração neurológica, hiperpotassemia e infarto do miocárdio, respectivamente nos 3 últimos. No presente trabalho, concluímos que a associação de PCR não oferece proteção cerebral mais eficaz que a parada circulatória total associada à hipotermia profunda, para o tempo de isquemia utilizado.

  7. 64层CT脑灌注联合CTA在早期缺血性脑血管病中的应用%Application of perfusion and CTA by 64 slice CT in early ischemia cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    李培秀; 都日娜; 丁俊丽; 张强

    2011-01-01

    目的 探讨64层螺旋CT脑灌注加CT血管成像技术在早期脑梗死的应用价值.方法 分析总结108例发病在6h内临床可疑脑梗死,其中105例进行CT平扫、CT脑灌注和CTA,部分复查CTP的住院患者资料,并对影像资料做统计学分析.结果 CT平扫7例脑实质密度轻微减低、脑沟变浅(6.6%),CT脑灌注83例显示与临床症状对应区域血流灌注异常(79.1%),与对侧比较CBF下降、CBV下降或正常、TTP延长.22例CT灌注未见异常(20.9%).CT血管成像显示53支动脉(39例)有不同密度斑块及管腔狭窄,3例检查未成功.结论 CT脑灌注加CTA成像技术可以快速、准确确定缺血半暗带及病变血管,对早期缺血性脑血管脑的诊断和指导治疗有重要的临床应用价值.%Objective To discuss the application of cerebral perfusion and CT blood vessel imaging technique by 64-slice CT in diagnosis of cerebral infarction in its early phase. Methods To analyze and summarize the data of 108 patients who were suspected of the ischemic infarction in 6 hours. 105 among the patients were examined by CT scanning, CT perfusion and CTA. Some of those patients needed the examination by CTP again. All data were analyzed statistically. Results CT scanning showed a slight reduction in the density of brain parenchyma in 7 cases, with brain shallow groove(6. 6%) and CT perfusion showed blood perfusion abnormal corresponding to clinical symptom region in 83 cases (79. 1%). Compared with the contra-lateral, CBF were decreased and CBV were decreased or normal while TTP was extend. 22 cases of CT perfusion showed regular!20. 9%). CT blood vessel imaging showed that 53 arteries of 39 patients had spots and the pipes were narrow. 3 cases were not successful. Conclusion Cerebral perfusion and CTA imaging technique by CT can quickly and exactly definite ischemia and pathology blood vessel, which is of great clinical importance for diagnosing and curing brain ischemia in its early phase.

  8. In Acute Stroke, Can CT Perfusion-Derived Cerebral Blood Volume Maps Substitute for Diffusion-Weighted Imaging in Identifying the Ischemic Core?

    Directory of Open Access Journals (Sweden)

    William A Copen

    Full Text Available In the treatment of patients with suspected acute ischemic stroke, increasing evidence suggests the importance of measuring the volume of the irreversibly injured "ischemic core." The gold standard method for doing this in the clinical setting is diffusion-weighted magnetic resonance imaging (DWI, but many authors suggest that maps of regional cerebral blood volume (CBV derived from computed tomography perfusion imaging (CTP can substitute for DWI. We sought to determine whether DWI and CTP-derived CBV maps are equivalent in measuring core volume.58 patients with suspected stroke underwent CTP and DWI within 6 hours of symptom onset. We measured low-CBV lesion volumes using three methods: "objective absolute," i.e. the volume of tissue with CBV below each of six published absolute thresholds (0.9-2.5 mL/100 g, "objective relative," whose six thresholds (51%-60% were fractions of mean contralateral CBV, and "subjective," in which two radiologists (R1, R2 outlined lesions subjectively. We assessed the sensitivity and specificity of each method, threshold, and radiologist in detecting infarction, and the degree to which each over- or underestimated the DWI core volume. Additionally, in the subset of 32 patients for whom follow-up CT or MRI was available, we measured the proportion of CBV- or DWI-defined core lesions that exceeded the follow-up infarct volume, and the maximum amount by which this occurred.DWI was positive in 72% (42/58 of patients. CBV maps' sensitivity/specificity in identifying DWI-positive patients were 100%/0% for both objective methods with all thresholds, 43%/94% for R1, and 83%/44% for R2. Mean core overestimation was 156-699 mL for objective absolute thresholds, and 127-200 mL for objective relative thresholds. For R1 and R2, respectively, mean±SD subjective overestimation were -11±26 mL and -11±23 mL, but subjective volumes differed from DWI volumes by up to 117 and 124 mL in individual patients. Inter-rater agreement

  9. An alternative approach to estimation of the brain perfusion index for measurement of cerebral blood flow using technetium-99m compounds

    Energy Technology Data Exchange (ETDEWEB)

    Murase, Kenya; Mochizuki, Teruhito; Ikezoe, Junpei [Dept. of Radiology, Ehime University School of Medicine, Shitsukawa, Shigenobu-cho (Japan); Inoue, Takeshi; Fujioka, Hiroyoshi; Ishimaru, Yoshihiro; Akamune, Akihisa [Dept. of Radiology, Matsuyama Shimin Hospital, Ohte-machi, Matsuyama, Ehime (Japan); Yamamoto, Yuji [Department of Neurosurgery, Matsuyama Shimin Hospital, Ohte-machi, Matsuyama, Ehime (Japan)

    1999-10-01

    Cerebral blood flow (CBF) has been quantified non-invasively using the brain perfusion index (BPI) determined from radionuclide angiographic data generated by technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) or technetium-99m ethyl cysteinate dimer ({sup 99m}Tc-ECD). The BPI is generally calculated using graphical analysis (GA). In the present study, BPI was measured using spectral analysis (SA), and its usefulness evaluated in comparison with GA. The BPI was calculated from the sum of spectral data obtained by SA. We applied this method to radionuclide angiographic data collected from the bilateral brain hemispheres of 20 patients with various brain diseases using {sup 99m}Tc-HMPAO and from those of 20 patients using {sup 99m}Tc-ECD. We also measured BPI using GA. The BPI values obtained by SA (BPI{sup S}) (x) and by GA (BPI{sup G}) (y) correlated closely (y=0.708x+0.038, r=0.945 for {sup 99m}Tc-HMPAO and y=0.559x+0.093, r=0.931 for {sup 99m}Tc-ECD). However, the BPI{sup G} values were underestimated by 22.9%{+-}6.6% (mean{+-}SD) for {sup 99m}Tc-HMPAO and by 27.9%{+-}7.5% for {sup 99m}Tc-ECD as compared with the BPI{sup S} values. The extent of underestimation tended to increase with increasing BPI{sup S} values. These findings were considered to be a result of the BPI{sup G} values being affected by the first-pass extraction fraction of the tracer. We also compared the BPI{sup S} and BPI{sup G} values with those of CBF measured using N-isopropyl-p-[{sup 123}I]iodoamphetamine (CBF{sup IMP}) in 16 patients (six for {sup 99m}Tc-HMPAO and ten for {sup 99m}Tc-ECD). Although both BPI{sup S} and BPI{sup G} values correlated significantly with the CBF{sup IMP} values, the correlation coefficient in BPI{sup S} was always better than that in BPI{sup G} (r=0.869 for {sup 99m}Tc-HMPAO and r=0.929 for {sup 99m}Tc-ECD in BPI{sup S}, r=0.629 for {sup 99m}Tc-HMPAO and r=0.856 for {sup 99m}Tc-ECD in BPI{sup G}). These results suggest that SA can provide a more

  10. A 4D CT digital phantom of an individual human brain for perfusion analysis

    NARCIS (Netherlands)

    Manniesing, R.; Brune, C.; Ginneken, B. van; Prokop, M.

    2016-01-01

    Brain perfusion is of key importance to assess brain function. Modern CT scanners can acquire perfusion maps of the cerebral parenchyma in vivo at submillimeter resolution. These perfusion maps give insights into the hemodynamics of the cerebral parenchyma and are critical for example for treatment

  11. Assessment of Cerebral Hemodynamics by 64-Row VCT Perfusion Imaging in Patients with Moya-Moya Disease%64排VCT脑灌注成像对烟雾病的血流动力学研究

    Institute of Scientific and Technical Information of China (English)

    谢安明; 丁耀军

    2014-01-01

    Objective To investigate the changes in cerebral hemodynamics (cerebral blood flow volume,blood capacity,mean transit time and time to peak)using 64-row VCT perfusion im-aging,and to provide imaging evidence for clinical intervention.Methods Thirty patients with moya-moya disease aged 13-49 years (average age 33.8 years,14 males,16 females)were recruited in this study.Cerebral perfusion imaging was performed using a GE LightSpeed VCT scanner at a rate of 5 mL/second and a dose of 50 mL.The scan delay time was 5 seconds and scan time was 45 seconds.Post-processing was conducted with Perfusion 4 software to analyze cerebral blood flow volume,blood capacity,mean transit time and time to peak.Results Of the 30 patients,9 had is-chemic type moya-moya disease and 21 had hemorrhagic type moya-moya disease.The 64-row VCT perfusion imaging showed increased regional cerebral blood flow in 3 patients,decreased re-gional cerebral blood flow in 5,increased regional cerebral blood volume in 3,normal cerebral blood volume in 27,shortened mean transit time and time to peak in 3,and prolonged mean transit time and time to peak in 8.Conclusion Most patients with ischemic type moya-moya disease are characterized by regional hypoperfusion,while patients with hemorrhagic type moya-moya disease are characterized by normal or regional hyperperfusion.The mean transit time and time to peakare sensitive indicators of changes in cerebral hemodynamics.%目的:通过对烟雾病患者进行64排VCT脑灌注成像,了解其脑血流动力学变化情况,包括脑血流量、脑血容量、平均通过时间及达峰时间,为临床干预治疗提供影像学依据。方法30例烟雾病患者,男性14例,女性16例,年龄最大为49岁,最小为13岁,平均年龄为33.8岁。利用 GE公司生产的 LightSpeed VCT螺旋扫描机对烟雾病患者进行灌注扫描,速率5 mL·s-1、剂量50 mL、扫描延迟5 s、扫描时间45 s,然后用该公司配备的 Perfu-sion4

  12. 64 row CT cerebral perfusion applied research of brain ischemia%64排CT脑灌注对脑组织缺血程度的应用研究

    Institute of Scientific and Technical Information of China (English)

    刘贯清; 肖新兰; 李晓; 黄小宁; 李五根

    2015-01-01

    Objective Application of 64 row CT cerebral perfusion brain tissue ischemia. Methods 40 cases of clinical diag-nosis of acute cerebral infarction,patients with unilateral lobe brain perfusion CT perfusion showed abnormal,in combination with MRI to determine infarct,according to the cerebral blood flow group,group A (low perfusion group) and group B (infarction group), respectively,evaluation of two groups of cerebral blood flow perfusion parameters and comparison analysis. Results Of 40 cases, 18 cases of group A,CTP anomaly low perfusion of figure is determined by MTT extend approximately 1.28 (R),decreased CBF mild,CBV basic no change Or moderately reduced,only determined by MTT extension was statistically significant (P<0.01);Infarc-tion group,22 cases of group B,infarction area surrounding IP abnormal perfusion is determined by MTT extend approximately 1. 48(R),CBF significantly decreased approximately 0.45(R),CBV moderately reduced,which extended determined by MTT was sta-tistically significant (P<0.001),decrease CBF was statistically significant (P<0.01);Infarction district performance is determined by MTT extend approximately 1.64(R),CBF significantly decreased approximately 0.36(R),significantly lower CBV (approximately 0. 37)R. Which determined by MTT extension was statistically significant (P<0.001),CBF decline was statistically significant(P<0.01). Conclusion Brain tissue hypoperfusion area with the infarction in central and peripheral IP area the perfusion parameters have significant differences,according to the variation of perfusion parameters characteristics can make the image on the degree of is-chemic infarction assessment,when rCBF<0.5,suggesting infarction risk is extremely high,the clinical guidance for early interven-tion treatment.%目的:探讨应用64排CT脑灌注评价脑组织缺血程度。方法40例临床诊断急性脑梗塞,CT灌注显示单侧脑叶灌注异常患者,结合MRI判断梗塞,根据脑血流量进行分组,A

  13. Diagnostic examination performance by using microvascular leakage, cerebral blood volume, and blood flow derived from 3-T dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging in the differentiation of glioblastoma multiforme and brain metastasis

    Energy Technology Data Exchange (ETDEWEB)

    Server, Andres; Nakstad, Per H. [Oslo University Hospital-Ullevaal, Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Oslo (Norway); University of Oslo, Oslo (Norway); Orheim, Tone E.D. [Oslo University Hospital, Interventional Centre, Oslo (Norway); Graff, Bjoern A. [Oslo University Hospital-Ullevaal, Department of Radiology and Nuclear Medicine, Oslo (Norway); Josefsen, Roger [Oslo University Hospital-Ullevaal, Department of Neurosurgery, Oslo (Norway); Kumar, Theresa [Oslo University Hospital-Ullevaal, Department of Pathology, Oslo (Norway)

    2011-05-15

    Conventional magnetic resonance (MR) imaging has limited capacity to differentiate between glioblastoma multiforme (GBM) and metastasis. The purposes of this study were: (1) to compare microvascular leakage (MVL), cerebral blood volume (CBV), and blood flow (CBF) in the distinction of metastasis from GBM using dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging (DSC-MRI), and (2) to estimate the diagnostic accuracy of perfusion and permeability MR imaging. A prospective study of 61 patients (40 GBMs and 21 metastases) was performed at 3 T using DSC-MRI. Normalized rCBV and rCBF from tumoral (rCBVt, rCBFt), peri-enhancing region (rCBVe, rCBFe), and by dividing the value in the tumor by the value in the peri-enhancing region (rCBVt/e, rCBFt/e), as well as MVL were calculated. Hemodynamic and histopathologic variables were analyzed statistically and Spearman/Pearson correlations. Receiver operating characteristic curve analysis was performed for each of the variables. The rCBVe, rCBFe, and MVL were significantly greater in GBMs compared with those of metastases. The optimal cutoff value for differentiating GBM from metastasis was 0.80 which implies a sensitivity of 95%, a specificity of 92%, a positive predictive value of 86%, and a negative predictive value of 97% for rCBVe ratio. We found a modest correlation between rCBVt and rCBFt ratios. MVL measurements in GBMs are significantly higher than those in metastases. Statistically, both rCBVe, rCBVt/e and rCBFe, rCBFt/e were useful in differentiating between GBMs and metastases, supporting the hypothesis that perfusion MR imaging can detect infiltration of tumor cells in the peri-enhancing region. (orig.)

  14. Diagnostic Value of Brain Perfusion Imaging with 64 Multi-Detector Spiral CT in Early Cerebral Infarction%64排螺旋 CT 脑灌注成像对早期脑梗死的诊断价值

    Institute of Scientific and Technical Information of China (English)

    奚彬; 盛伟华; 唐建伟; 黄松; 宋黎涛

    2014-01-01

    目的:探讨64排螺旋 CT 脑灌注成像(CT perfusion imaging,CTP)对早期脑梗死的诊断价值。方法:临床拟诊早期脑梗死患者38例,均在症状出现24 h 内行头颅 CT 平扫及 CTP 检查。将脑梗死核心区、缺血半暗带(ischemic penumbra,IP)区与健侧对应区的情况做对比分析。结果:38例患者中,15例头颅 CT 平扫发现可疑脑梗死区,主要位于大脑半球,表现为密度轻度减低、局部脑沟稍变浅等;其余23例患者 CT 平扫未发现异常。38例患者的 CTP 检查均发现灌注异常区,表现为脑梗死区脑血流量(cerebral blood flow,CBF)与脑血容量(cerebral blood volume,CBV)均较健侧对应区明显下降,对比剂平均通过时间(mean transit time,MTT)较健侧对应区缩短,对比剂达峰时间(time to peak,TTP)较健侧对应区明显延长,差异均有统计学意义(P <0.01)。早期脑梗死患者 IP 区与梗死核心区比较,CBF、CBV、MTT 及 TTP 差异均有统计学意义(P <0.01);IP区与健侧对应区比较,CBF、MTT、TTP 差异均有统计学意义(P <0.05、0.01),CBV 差异无统计学意义(P >0.05)。获得随访的18例患者中,经积极溶栓等治疗后梗死区缩小6例,梗死区消失5例,仅表现为梗死区 TTP 和 MTT 延长、CBF 和 CBV 变化不大3例,梗死区无明显变化4例。结论:64排螺旋 CTP 检查可以准确地提示早期脑梗死。%Objective:To explore the diagnostic value of CT perfusion imaging(CTP)with 64 multi-detector spiral CT in early cerebral infarction.Methods:A total of 38 patients with suspected early cerebral infarction underwent plain CT and CTP within 24 h after the onset of related symptoms.The imaging results in infarction core area,ischemic penumbra (IP) and the contralateral normal region were comparatively analyzed.Results:Early cerebral infarction,mainly in cerebral hemispheres, were suspected

  15. Study on the correlation between clinical aphasia and cerebral blood perfusion after acute cerebral infarction%急性脑梗死后失语症与脑血流灌注的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    胡军; 朱文炳; 谢瑞满; 修雁

    2002-01-01

    Objective The SPECT brain perfusion was performed to explore the correlation between the yielded image data and the clinical characteristics of aphasia.Method The language function assessment of WAB and SPECT blood perfusion imaging were applied to 21 aphasia patients with dominant ischemic stroke.The correlations between the aphasic characteristics and the ROI rCBF of language regions were analyzed.Result The significant correlations were found between the different brain regions and the different language function deficits,and the correlation between temporal lobe and language function deficits was even higher.Conclusion SPECT brain perfusion imaging can show function disorder of language and aphasia probably caused by the destruction of language nervous network.

  16. Comparison of four methods to evaluate the modifications of the cerebral perfusion in tomo-scintigraphy; Comparaison de quatre methodes d'evaluation des modifications de la perfusion cerebrale en tomoscintigraphie

    Energy Technology Data Exchange (ETDEWEB)

    Daboussi, A.; Julian, A. [Universite Paul-Sabatier, EA 3033, Radiopharmaceutiques et Traitement de l' Image, 31 - Toulouse (France); Daboussi, A.; Fourcade, O. [Centre Hospitalier Universitaire Purpan, GRC 48 Coordination Anesthesie-Reanimation, 31 - Toulouse (France); Julian, A.; Ouhayoun, E.; Esquerre, J.P.; Payoux, P. [Centre Hospitalier Universitaire Purpan, Service de Medecine Nucleaire, 31 - Toulouse (France); Tremoulet, M. [Centre Hospitalier Universitaire Purpan, Service de Neurochirurgie, 31 - Toulouse (France)

    2007-02-15

    Introduction: We compared four different methods to assess changes in cerebral blood flow in patients with normal pressure hydrocephalus using cerebral ECD SPECT before and after injection of acetazolamide. Material and methods: Eleven patients underwent cerebral SPECT before and after injection of 1 g of acetazolamide using a {sup 99m}Tc-ECD split-dose protocol with a first injection of 370 MBq and a second of 1 100 MBq. After reconstruction of volumes with Neurogam (Segami) software. we compared visual analysis to semi quantitative analysis provided by Neurogam software. ratios methods and parametric analysis under SPM99 and SPM2. Results: Visual analysis is immediate but frequently misleading. The contribution of Neurogam depends on the reader's skill and may be significant for non expert readers. The manual semi-automatic method is tedious and its results depend on the choice of the areas of interest and reference necessary for activity normalization. At last, the automatic method carried out by SPM is reliable for population analysis, but its efficiency for individual analysis remains to be evaluated. (authors)

  17. Aortic arch replacement with a beating heart: a simple method using continuous 3-way perfusion.

    Science.gov (United States)

    Abu-Omar, Y; Ali, J M; Colah, S; Dunning, J J

    2014-01-01

    We describe a simplified 3-way perfusion strategy that could be used in complex aortic procedures, which ensures continuous end-organ perfusion and minimizes the potential risks of cardiac, cerebral and peripheral ischaemic complications.

  18. 磁共振灌注加权成像在颅脑胶质瘤分级中的价值研究%Value of MR perfusion weighted imaging in differentiating the tumor grade of cerebral gliomas

    Institute of Scientific and Technical Information of China (English)

    李伟; 龙晚生; 罗学毛; 何义改; 兰勇; 蔡小琴

    2011-01-01

    目的 探讨相对脑血容积(rCBV)、相对脑血流量(rCBF)和相对平均通过时间(rMTT)在鉴别颅脑胶质瘤病理分级中的价值.方法 对病理证实为颅脑胶质瘤的患者(Ⅱ级胶质瘤9例,Ⅲ级胶质瘤11例,Ⅳ级胶质瘤14例)行MR灌注加权成像及常规MRI检查.由灌注加权成像数据获取脑血容积(CBV)图、脑血流量(CBF)图和平均通过时间(MTT)图,计算出rCBV、rCBF和rMTT值.结果 Ⅱ级胶质瘤的rCBV、rCBF和rMTT值分别为2.68±1.37、2.52±1.29和1.02±0.30,Ⅲ级胶质瘤的rCBV、rCBF和rMTT值分别为4.99±2.34、4.77±1.97和1.07±0.15,Ⅳ级胶质瘤的rCBV、rCBF和rMTT值分别为6.69±1.88、6.97±1.73和1.08±0.22,各组间rCBV和rCBF值比较差异有统计学意义(P0.05).结论 MR灌注加权成像能有效地在术前评价颅脑胶质瘤的病理级别,rCBV值结合rCBF值可以更好地对颅脑胶质瘤进行病理分级.%Objective To explore the value of relative cerebral blood volume(rCBV), relative cerebral blood flow(rCBF) and relative mean through time(rMTT) in differentiating the tumor grade of cerebral gliomas. Methods This study involved 34 patients (9 cases of grade Ⅱ,11 cases of grade Ⅲ,14 cases of grade Ⅳ) which were identified as gliomas proved by histopathologic. MR perfusion weighted imaging and conventional MR imaging were underwent on them preoperatively. The perfusion weighted imaging datas were deconvoluted to get a color map of CBV, CBF and MTT. The value of rCBV, rCBF and rMTT of each lesion were calculated and correlated with histopathologic grading of gliomas. Results The value of rCBV, rCBF and rMTT of grade Ⅱ,grade Ⅲ,grade Ⅳ gliomas was (2.68±1.37, 4.99±2.34,6.69±1.88), (2.52±1.29,4.77±1.97,6.97±1.73) and (1.02±0.30,1.07±0.15,1.08±0.22), respectively. The value of rCBV and rCBF had statistically difference in each groups (P0.05).Conclusions MR perfusion weighted imaging is useful in the preoperative assessment of the histopathologic grade

  19. 急性脑梗死320排 CT 脑灌注成像分析%The analysis of whole-brain CT perfusion imaging with 320-detector row CT in acute cerebral infarction

    Institute of Scientific and Technical Information of China (English)

    阮志兵; 段庆红

    2014-01-01

    Objective To explore the clinical value of whole-brain CT perfusion imaging with 320-detector row CT in early acute cerebral infarction.Methods The CTP parameters(CBF,CBV,MTT,TTP)and its pseudo color map of 25 patients with early acute cerebral infarction were retrospectively analysed and compared between infarction area,ischemic penumbra (IP)and the con-tralateral normal region.Results The abnormal perfusion area were found on CTP in 25 patients with early acute cerebral infarction. CTP showed cerebral blood flow (CBF)and cerebral blood volume (CBV)decreased significantly,mean transit time (MTT)short-ened significantly,time to peak (TTP)was significantly longer than those of the contralateral normal region in 7 cases of acute cere-bral infarct core.18 cases of IP lesions showed CBF decreased slightly,CBV increased slightly or maintain normal,MTT and TTP extension compared with contralateral.CBF,CBV,MTT,TTP values had significantly differences between infarct region and the contralateral corresponding normal region,between the infarct core area and IP of acute cerebral infarction (P 0.05)between IP region and the contralateral corresponding normal region,but showed a downward trend in blood flow.Parameter color maps of CTP could di-rectly,clearly and sensitively show abnormal changes region about cerebral blood flow.In particular,MTT and TTP maps shows ab-normal region clearer and sensitively.Follow-up 18 cases of IP,active lesions deduced in 6 cases,the lesions disappeared in 5 pa-tients (CT/ MRI showed no abnormal,and the clinical symptoms disappeared)after thrombolytic therapy,7 cases of MRI and CT scans confirmed infarction stove.Conclusion Whole-brain CTP with 320-detector row CT can early show the acute cerebral infarc-tion and its ischemic penumbra,it has significant important clinical value for early acute cerebral infarction.%目的:探讨320排 CT 全脑灌注成像(CTP)在早期急性脑梗死中的临床应用价值。方法回顾性分析25

  20. 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.

  1. 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 ...

  2. CT脑灌注成像临床诊断急性脑梗死价值评价与平扫CT值差值的测量价值%Value Evaluation on Clinical Diagnosis of CT Cerebral Perfusion Imaging on Acute Cerebral infarction and Measurement Value of Difference Value of Plain Scan CT Value

    Institute of Scientific and Technical Information of China (English)

    余东

    2015-01-01

    Objective This Paper is to explore the application value of CT perfusion imaging and differential value of measured CT value in the diagnosis of acute cerebral infarction. Methods Thirty six patients with acute cerebral infarction admitted the Radiology Department of the Hospital were selected as research subjects, retrospective analysis and summary were conducted according to clinical data. CT plaint scan and brain CT perfusion imaging were made respectively, The time to peak (TIP), cerebral blood flow (CBF) and cerebral blood volume (CBV) of CT perfusion imaging were evaluated, the difference of CT value on both sides of symmetric positions was measured. In addition, 36 patients with no brain disease and normal nervous function were divided into the control group, and diagnostic value of the difference between CT perfusion imaging and CT measurement value in acute cerebral infarction was analyzed. Results It is visually found that there were 17 patients with suspicious lesions with the sensitivity at 47.2%, and it was found that there were 28 patients with suspicious lesions by measuring CT value difference. It was found that the CTP of 3 patients was normal CT perfusion imaging examination, and such 2 patients were finally diagnosed to suffer from transient ischemic attack, and others were abnomal, rCBF, rCBV and rTTP changed obviously, the comparison in lesion center and perimeter and controlled side satisfied p<0.05, and the differences were statistically significant. Conclusion CT perfusion imaging and the difference value in CT value measurement delivers high application value in the diagnosis of acute cerebral infarction, and it is capable of diagnosing cerebral infarction in early differential diagnosis, the infarct area and ischemic penumbra area may be differentiated via through quantitative analysis, providing important basis for clinical determination on the existence of infarct and development of therapeutic schedule.%目的:探讨CT灌注成像

  3. 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

  4. Quantitative Cerebral Blood Flow Measurements Using MRI

    OpenAIRE

    Muir, Eric R; Watts, Lora Talley; Tiwari, Yash Vardhan; Bresnen, Andrew; Timothy Q Duong

    2014-01-01

    Magnetic resonance imaging utilized as a quantitative and noninvasive method to image cerebral blood flow. The two most common techniques used to detect cerebral blood flow are dynamic susceptibility contrast (DSC) perfusion MRI and arterial spin labeling perfusion MRI. Herein we describe the use of these two techniques to measure cerebral blood flow in rodents, including methods, analysis, and important considerations when utilizing these techniques.

  5. Perfusion harmonic imaging of the human brain

    Science.gov (United States)

    Metzler, Volker H.; Seidel, Guenter; Wiesmann, Martin; Meyer, Karsten; Aach, Til

    2003-05-01

    The fast visualisation of cerebral microcirculation supports diagnosis of acute cerebrovascular diseases. However, the commonly used CT/MRI-based methods are time consuming and, moreover, costly. Therefore we propose an alternative approach to brain perfusion imaging by means of ultrasonography. In spite of the low signal/noise-ratio of transcranial ultrasound and the high impedance of the skull, flow images of cerebral blood flow can be derived by capturing the kinetics of appropriate contrast agents by harmonic ultrasound image sequences. In this paper we propose three different methods for human brain perfusion imaging, each of which yielding flow images indicating the status of the patient's cerebral microcirculation by visualising local flow parameters. Bolus harmonic imaging (BHI) displays the flow kinetics of bolus injections, while replenishment (RHI) and diminution harmonic imaging (DHI) compute flow characteristics from contrast agent continuous infusions. RHI measures the contrast agents kinetics in the influx phase and DHI displays the diminution kinetics of the contrast agent acquired from the decay phase. In clinical studies, BHI- and RHI-parameter images were found to represent comprehensive and reproducible distributions of physiological cerebral blood flow. For DHI it is shown, that bubble destruction and hence perfusion phenomena principally can be displayed. Generally, perfusion harmonic imaging enables reliable and fast bedside imaging of human brain perfusion. Due to its cost efficiency it complements cerebrovascular diagnostics by established CT/MRI-based methods.

  6. A voxel-based analysis of cerebral perfusion with {sup 99m}Tc-ECD brain SPECT in obsessive-compulsive disorder

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo; Lee, Jong Doo; Kim, Hee Joung; Chang, Jin Woo; Kim, Chan Hyung; Lee, Hong Shick; Min, Sung Kil; Chung, Sang Sup [College of Medicine, Yonsei Univ., Seoul (Korea, Republic of)

    2000-07-01

    Many neuroimaging studies, especially metabolic imaging with PET, showed a specific frontal-subcortical brain circuit connecting the orbitofrontal cortex (OFC), anterior cingulate gyrus, elements of basal ganglia and thalamus is involved in obsessive-compulsive disorder (OCD). Despite consistent metabolic alteration on PET, blood flow studies with SPECT were inconsistent and various cortical and subcortical structures showed abnormal perfusion patterns. In this study, brain SPECT images of seven patients with OCD were evaluated with a sophisticated method of statistical parametric mapping (SPM). Seven patients with severe, primary OCD (6 males and 1 female) with mean age of 25.4 4.7 yrs (20-32 yrs) were studied. The SPECT data of the patients were compared with those of healthy subjects and patients with drug nave schizophrenia using SPM. The SPM parameters were p value of 0.001 with Z value of 3.09 (higher threshold ) or p value of 0.005 with Z value 2.58 (lower threshold). On a higher threshold (p<0.01),five of the seven patients showed hyperperfusion within the anterior cingulate cortex, however, hyperperfusion within OFC or caudate nucleus was seen in only one patient. On a lower threshold (p<0.005), hyperperfusion within the anterior cingulate cortex was seen in all patients, and followed by thalamus (n=5), lentiform nucleus (n=4), caudate nucleus (n=3), and OFC (n=3). Perfusion within the anterior cingulate cortex was also increased in OCD compared with drug nave schizophrenia. Anterior cingulate cortex appears to be an important anatomical structure in the pathogenesis of OCD symptoms. Brain SPECT using a sophisticated analysis method of SPM is useful for the diagnosis of OCD and differentiation from schizophrenia.

  7. CT脑灌注成像在短暂性脑缺血发作的应用价值探讨%To Study the Application Value of CT Cerebral Perfusion Imaging in Transient Ischemic Attack

    Institute of Scientific and Technical Information of China (English)

    杜彦挺; 夏志强; 杜光勇; 张伟; 李涛

    2016-01-01

    目的:探讨CT脑灌注成像(CT perfusion,CTP)在短暂性脑缺血发作(transient ischemic attack,TIA)的应用价值。方法收集我院从2013年4月至2015年4月收治的55例短暂性TIA患者作为研究对象,发病24h内进行CTP和CTA(CT angiography)检查,发病72h内进行头颅MRI(magnetic resonance imaging)和MRA(magnetic resonance angiography)进行检查,比较CTP与其他检查方法的检出结果差异,并对病灶侧与健康侧的脑灌注成像参数如获得达峰时间(time to peak, TTP)、平均通过时间(mean transit time, MTT)、脑血流量(cerebral blood flow, CBF)、脑血容量(cerebral blood volume, CBV)进行比较分析。结果 CTA检出35个病灶,MRI检出44个病灶,CTP检出59个病灶,CTP对病灶的检出率高于CTA和MR检查,具有统计学意义(P<0.05);CTP检出的病灶表现分型中I1期12个,I2期29个,II1期11个, II2期7个,I2期明显多于其他分型,具有统计学意义(P<0.05);CTP病灶侧的TTP值、MTT值(P<0.05);CTP病灶侧的CBV值与健康侧没有明显差异(P>0.05)。结论采用CT脑灌注成像检查短暂性脑缺血发作可以全面的诊断,对治疗短暂性脑缺血发作提供可靠的依据。%Objective To study the application value of CT cerebral perfusion imaging(CTP) in Transient ischemic attack(TIA).Methods Fifty-five cases of transient ischemic attack from April 2013 to April 2015 in our hospital were collected as research subject, all of them were performed CTP, CTA(CT angiography) in 24 hours after onset and MRI(Magnetic Resonance imaging) and MRA(Magnetic Resonance angiography) in 72 hours. The inspection results of CTA and MRI and CTP were compared, and the parameters of CTP like time to peak(TTP), mean transit time(MTT), cerebral blood flow(CBF), cerebral blood volume(CBV) were analyzed and compared between lesion side and healthy side.Results Thirty-five lesions were checked out by CTA inspection, 44 lesions by MRI, and 59

  8. Cerebral blood flow and metabolism analysis in parkinsonian disorders; Pathologie extrapyramidale. Apport de l'imagerie de perfusion et du metabolisme (TEP, TEM)

    Energy Technology Data Exchange (ETDEWEB)

    Defebvre, L. [Hopital Roger Salengro, Service de Neurologie, 59 - Lille (France)

    1999-12-01

    Main metabolic and hemodynamic abnormalities detected by single photon emission computerized tomography and positron emission tomography in extra-pyramidal disorders are reported. In the first stage of Parkinson's disease, cortical metabolism and perfusion can be in normal range or moderately and uniformly reduced. A significant decrease may appear with the disease evolution. Marked abnormalities are observed in parkinsonian patients with dementia (subcortical dementia), involving especially the frontal cortex. A marked diffuse cortical hypo-metabolism (temporal, parietal, occipital and frontal cortex) may suggest the diagnosis of dementia with Lewy bodies, especially in case of fluctuating cognitive decline with recurrent visual hallucinations. In progressive supra-nuclear palsy, a frontal cortex hypo-metabolism is reported precociously, preceding sometimes the cognitive impairment. Metabolic pattern find in multiple system atrophy reflects dysfunction of both nigrostriatal pathways and striatum, with a decrease glucose uptake in putamen and caudate nucleus which also involves cerebellum for the patients with cerebellar syndrome. In cortico-basal degeneration, asymmetric fronto-parietal and striatal hypo-metabolism observed in the controlateral hemisphere to the clinically most affected side, constitute the main characteristic well correlated with apraxia. (author)

  9. Photoacoustic & pulsed laser-doppler monitoring of blood concentration and perfusion in tissue

    OpenAIRE

    Kolkman, Roy Gerardus Maria

    2002-01-01

    In medicine there are situations that require continuous bedside monitoring of perfusion and blood volume. Such a situation can occur when children are born prematurely. Those children have a high risk to develop a handicap, which is most likely caused by cerebral damage due to impaired brain perfusion. Monitoring cerebral perfusion can provide information for preventive treatment. In this thesis we have explored the potential of photoacoustics and laser Doppler flowmetry for measurement of c...

  10. Misery is not miserly: sad and self-focused individuals spend more.

    Science.gov (United States)

    Cryder, Cynthia E; Lerner, Jennifer S; Gross, James J; Dahl, Ronald E

    2008-06-01

    Misery is not miserly: Sadness increases the amount of money that decision makers give up to acquire a commodity. The present research investigated when and why the misery-is-not-miserly effect occurs. Drawing on William James's concept of the material self, we tested a model specifying relationships among sadness, self-focus, and the amount of money that decision makers spend. Consistent with our Jamesian hypothesis, results demonstrated that the misery-is-not-miserly effect occurs only when self-focus is high. That is, self-focus moderates the effect of sadness on spending. Moreover, mediational analyses revealed that, at sufficiently high levels, self-focus mediates (explains) the relationship between sadness and spending. Because the study used real commodities and real money, the results hold implications for everyday decisions, as well as implications for the development of theory. For example, economic theories of spending may benefit from incorporating psychological theories -- specifically, theories of emotion and the self -- into their models.

  11. Application Research on Multi-slice Spiral CT Perfusion Imaging in Patients with Acute Cerebral Infarction%多层螺旋 CT 灌注成像在急性脑梗死患者的应用研究

    Institute of Scientific and Technical Information of China (English)

    罗友琛

    2014-01-01

    目的:探讨急性脑梗死患者多层螺旋 CT 灌注成像特点,及其与临床预后的关系。方法选择符合标准的患者40例,行 CT 灌注成像检查,计算脑血流量(CBF)、脑血容量(CBV)、平均通过时间(MTT)及峰值时间(TTP);分别在入院时和治疗后14d 采用美国国立卫生研究院卒中量表(NIHSS)评价临床神经功能缺损,计算缺血脑组织的可恢复比率(PRR)和神经功能恢复比率。结果脑梗死病灶中心 CBV 及 CBF 最低,健侧最高,而缺血半暗带居中,差异有统计学意义(P 0.05);PRR 与患者治疗14d 时 NIHSS 评分存在负相关性(r =-0.340, P 0. 05),negatively dependent of those at day 14 after treatment (r = - 0. 340,P < 0. 05) and positive-ly dependent of patient’s neural functional recovery ratio (r = 0. 467,P < 0. 05). Conclusion Multi-slice spiral CT perfusion im-aging can reflecthemodynamic changes in acute cerebral infarction lesions and their perihemodynamic changes. PRR is closely de-pendent of the neural functional recovery. It can serve as a reliable theoretical basis for clinical treatment.

  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. Characteristics of Brain Perfusion in Patients of Parkinson's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Young Jin; Park, Min Jung; Kim, Jae Woo; Kang, Young Kang [Dong-A University College of Medicine, Busan (Korea, Republic of)

    2008-02-15

    It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Two hundred nineteen patients (M: 70, F: 149, mean age: 62.9{+-}6.9 y/o) who were diagnosed as PD without dementia clinically and 55 patients (M: 15, F: 40, mean age: 61.4{+-}9.2 y/o) as normal controls who had no past illness history were performed {sup 99m}Tc-HMPAO brain perfusion SPECT and neuropsychological test. At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal

  14. The guiding significance of the 640 layer CT perfusion combined with the vascular imaging in thrombolysis therapy for the super acute cerebral in-farction%640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义

    Institute of Scientific and Technical Information of China (English)

    田峰; 田学实; 梁文胜

    2014-01-01

    Objective To investigate the guiding significance of 640 layer CT perfusion combined with vascular ima-ging in thrombolytic therapy for super acute cerebral infarction .Methods 30 cases of patients with superacute cere-bral infarction were taken the examination of brain CT scan and 640 CT layer perfusion combined with the vascular im-aging.The ischemic penumbra were determined according to the change of cerebral blood flow (CBF),regional cere-bral blood volume (rCBV),mean traverse time(MTT)and time to peak(TTP)in region of interest(ROI)and the ratio of left and right sides of CBF .At the same time ,38 patients were chosen to give thrombolytic therapy without CT perfu-sion imaging (20 patients with arterial thrombolytic therapy and 18 patients with intravenous thrombolytic therapy ) . Compare their discrepancy in efficacy .Results The effect of arteriovenous thrombolytic therapy guided by CT perfu-sion is better than that of non perfusion guidance of arteriovenous thrombolytic therapy .Conclusion It has a guid-ing significance in thrombolytic therapy for super acute cerebral infarction to make 640 CT perfusion combined with vascular imaging ,which can show that the degree of head and neck vascular stenosis and determine ischemic penumbra for guiding early clinical interventional thrombolytic therapy or vascular reconstruction treatment in order to save ische -mic penumbra and restore the blood perfusion of ischemic brain tissue as soon as possible .It has crucial clinical value to improve the prognosis and reduce the incidence of mortality and morbidity .%目的:探讨640层CT灌注联合血管成像在脑梗死超早期溶栓中的指导意义。方法对30例脑梗死超早期的患者,进行脑部CT平扫及640层CT灌注联合血管成像检查,根据脑血流量( CBF )、脑血容量、平均通过时间、达峰时间的变化及左右两侧CBF的比值,判定有无缺血半暗带;同时选择未做CT灌注检查的38例溶栓患者,对比它

  15. 脑血流有效灌注压的无创检测及其对急性脑梗死的临床意义%The Effective Cerebral Blood Flow Perfusion Pressure Noninvasive Monitoring and Its Relationship with the Clinical Signiifcance of Acute Cerebral Infarction

    Institute of Scientific and Technical Information of China (English)

    梁兵; 袁芳; 梁云云; 傅贤; 解龙昌; 殷建瑞; 高庆春

    2014-01-01

    目的探索脑血流有效灌注压(effective cerebral perfusion pressure,CPPe)的无创检测方法的有效性以及急性脑梗死患者CPPe与颈内动脉血管狭窄程度的相关性。  方法本研究为前瞻性研究,收集2010年1月~2012年1月在广州医科大学附属第二医院神经内科住院的41例发病1周内的急性脑梗死患者,所有患者均经数字减影血管造影(digital subtraction angiography, DSA)和经颅多普勒超声(transcranial Doppler ultrasonography,TCD)评估颈内动脉狭窄程度及大脑中动脉无创血压、有创血压及血流速度,根据上述检测结果计算CPPe,比较TCD、DSA评价CPPe的有效性。同时根据北美症状性颈动脉狭窄内膜切除研究(North American Symptomatic Carotid Endarterectomy Trial,NASCET)标准分为轻度狭窄组、中度狭窄组和重度狭窄组,比较各组间的血管狭窄危险因素、CPPe和美国国立卫生研究院卒中量表(National Institutes of Health Stroke Scale,NIHSS)评分,以及CPPe和NIHSS评分与颈内动脉血管狭窄程度的相关性。  结果所有急性脑梗死患者的有创和无创CPPe比较,结果发现有创CPPe的中位数为56.6 mmHg,无创CPPe的中位数为57.8 mmHg,两者之间的差异无显著性(P>0.05)。轻度狭窄组、中度狭窄组和重度狭窄组3组急性脑梗死患者的有创CPPe的中位数分别为60.6 mmHg、42.5 mmHg和1.6 mmHg;无创CPPe的中位数分别为62.2 mmHg、42.7 mmHg和0.27 mmHg;NIHSS评分的中位数分别为4、3和8;比较CPPe、NIHSS评分在各组间的差异有显著性,H值分别为26.906、26.906及11.233(P<0.01)。相关分析显示急性脑梗死患者CPPe与DSA显示的血管狭窄程度密切相关,相关系数分别为-0.782和-0.814,差异有显著性(P<0.01);而NIHSS评分与DSA显示的血管狭窄程度无相关性,相关系数为0.222,差异无显著性(P>0.05)。  结

  16. TLR4/NF-κB通路在深低温停循环逆行脑灌注技术脑保护机制中作用的研究%The role of TLR4/NF-κB pathway in cerebral protective effect of retrograde cerebral perfusion during deep ;hypothermic circulatory arrest

    Institute of Scientific and Technical Information of China (English)

    梁孟亚; 唐志贤; 陈光献; 荣健; 戴刚; 吴钟凯

    2013-01-01

    目的:研究TLR4/NF-κB通路是否参与深低温停循环逆行脑灌注的脑保护机制。方法五指山小型猪共10头,随机分成单纯深低温停循环组(DHCA组,n=5)与深低温停循环逆行脑灌注组(RCP组,n=5)。建立体外循环后,DHCA组降温至18℃后停循环40 min,RCP组停循环后经上腔静脉以10 ml/kg流量逆行脑灌注40 min。定期抽血检测血清IL-6水平。复灌180 min后处死动物取脑皮质组织行HE染色, Western blotting检测脑皮质TLR4,NF-κB/p65蛋白表达。结果脑皮质HE染色显示DHCA组较RCP组有更多炎症细胞浸润。在复灌60 min,复灌120 min及复灌180 min三个时点RCP的IL-6水平均显著低于DHCA组(t=7.314,P<0.01;t=5.172,P<0.01;t=4.676,P<0.01)。复灌180 min后RCP组脑皮质中TLR4水平明显低于DHCA组(t=10.212,P<0.001)。复灌180 min后RCP组脑皮质中NF-κB/p65水平明显低于DHCA组(t=3.344,P=0.011)。结论 RCP通过抑制TLR4/NF-κB信号通路而发挥抗炎作用,这可能是RCP脑保护作用的机制之一。%Objective To investigate whether TLR4/NF-κB Pathway is involved in cerebral protective effect of retrograde cerebral perfusion(RCP) during deep hypothermic circulatory arrest (DHCA). Methods Ten piglets of either sex (weigh 7.5-17.4 kg) were randomly assigned to 40 min of circulatory arrest (CA) at 18 ℃without cerebral perfusion (DHCA group, n=5) or RCP (RCP group, n=5). Blood samples were collected for assessment of serum IL-6 levels. After 3 h of reperfusion, cortical tissue was harvested for HE staining, western blotting of TLR4 and NF-κB/p65 expression. Results More severe inflammatory response was observed in brain tissue of DHCA group than RCP group. Serum IL-6 levels were significantly higher in the DHCA group than in RCP groups at 60 min, 120 min and 180 min after reperfusion (t=7.314, P<0.01; t=5.172,P<0.01; t=4.676, P<0.01 respectively). After 40 min of CA

  17. Staging of moyamoya disease by perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo [Kyushu Univ., Fukuoka (Japan). Hospital; Matsushima, Toshio; Fukui, Masashi

    2001-04-01

    Staging of moyamoya disease, based on angiography and PET have already been established. The authors have established staging of moyamoya disease based on perfusion SPECT, that can be summarized as follows: Stage I, no abnormality is seen at rest or after acetazolamide loading; Stage II, no abnormality is seen at rest, however, a decreased response (blood flow increase rate: <15%) is seen to acetazolamide loading (a, a decreased response is seen only in the frontal lobe; b, a decreased response is seen in regions other than the frontal lobe; and c, a decreased response is seen throughout the cerebrum); Stage III, localized decrease in blood flow (blood flow decrease compared with peripheral tissue: {>=}15%) and marked decrease in response to acetazolamide (blood flow increase rate: <5%) are seen at rest. In Stage III, CT and MRI show no abnormal findings or only mild lesions of the white matter; and Stage IV, multiple decreases in blood flow are seen at rest, and CT and MRI reveal infarctions and severe atrophy at the same sites. The above staging does not require determination of cerebral blood flow, and thus it can be used in children, in whom cerebral blood flow determination is difficult. The authors performed 99m-Tc ECD perfusion SPECT in 25 patients with moyamoya disease for the staging, and compared staging based on angiography with staging based on perfusion SPECT. The results did not show a correlation between the 2 staging methods. A problem inherent in the staging of moyamoya disease based on perfusion SPECT is that the relationship between cerebral blood flow and cerebral radioactivity concentrations may differ depending on the drug used to determine cerebral blood flow. Thus, although the present staging system does not depend on any specific radioactive drug to determine cerebral blood flow, further investigation is necessary to identify a more appropriate drug than those in current use. (K.H.)

  18. 甲亢患者人格特征及与脑血流灌注相关分析%The Study of Personality Traits and its Relationship to Cerebral Blood Flow Perfusion in Patients with Hyperthyroidism

    Institute of Scientific and Technical Information of China (English)

    修雁; 王建华; 虞一萍; 石洪成; 顾宇参; 胡鹏程; 刘文官; 陈雪芬; 陈曙光; 余浩军; 陈可靖

    2011-01-01

    Objective:To analyze the personality traits of patients with hyperthyroidism and its possible relationship to cerebral blood flow. Methods: Thirty-five patients (9 males, 26 females; 38. 74 ± 10. 57 ys) with hyperthyroidism were enrolled, who were divided into short duration group(equal or less 6 months,n= 15) and long duration group (longer than 6 months,n- 20). Twenty-eight healthy volunteers (males 8,females 20; 35. 8 ± 9. 41ys) were included as controls. SPECT cerebral blood flow perfusion imaging was performed at rest after 99Tcm- ECD injection. The personality traits of all patients and controls were assessed with EPQ questionnaire. Results: Hypoperfusion in limb system and frontal lobes were shown in hyperthyroidism patients. Hyperthyroidism patients had higher neuroticism and psychoticism scores, which had not changed significantly after eu-thyroid. The scores of neuroticism were correlated negatively with rCBF in thalamus, parahippocampal gyrus, posterior ento-rhinal cortex, globus pallidus and mammilary body(P<0. 05). Conclusions: Patients with hyperthyroidism have significant neuroticism and psychoticism characteristics, which might be related to impaired cerebral blood flow in specific region, besides their specific personality traits.%目的:分析甲亢患者人格特征及与脑功能变化的关系.方法:35例甲亢患者纳入研究,男性9例,女性26例;平均年龄(38.74±10.57)岁;病程为1.5个月至9年.短病程组15例(病程小于等于6个月),长病程组20例(病程大于6个月).正常对照者28例,男性8例,女性20例;平均年龄(35.8±9.41)岁.所有患者及正常对照均行静息99Tcm-ECD SPECT脑血流灌注显像.应用艾森克人格问卷(EPQ)分析人格特征;7例患者经治疗甲功正常后再次行人格特征分析及脑血流灌注显像.结果:甲亢患者具有高神经质及精神质的人格特征(P<0.05);不同病程患者人格特征无显著差异;治疗后患者人格

  19. 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,

  20. Antegrade Versus Retrograde Cerebral Perfusion in Relation to Postoperative Complications Following Aortic Arch Surgery for Acute Aortic Dissection Type A%双侧顺行与上腔逆行脑灌注在A型主动脉夹层中应用效果对比的临床研究

    Institute of Scientific and Technical Information of China (English)

    吴智勇; 王志维; 夏军; 张遵严; 陈雪芬; 邓宏平; 徐鹏; 李罗成; 王杰

    2011-01-01

    Objective Antegrade or retrograde cerebral perfusion ( RCP) , is a well - established method of brain protection in aortic arch surgery. In this retrospective study, we compard the two methods of brain perfusion. Methods From Oct 2008 to Jan 2011,63 consecutive patients were urgently operated for acute type A aortic dissection and underwent arch replacement under deep hypothermic circulatory arrest (DHCA). Our patient cohort was divided into those protected with antegrade cerebral perfusion ( ACP) (group A, n = 54) and those protected with RCP (group B, n = 9). Results There was no siguificant difference in operative time, cardiopulmonary bypass - time, myocardial blocking time, cerebral - perfusion time between groups B and A, but the incidence of temporary neurologic dysfunction, the mean extubation time,the mean ICU -stay,the hospital -stay increased. Conclusion The antegrade perfusion was related with significantly lower incidence of temporary neurological complications, earlier extubation, shorter ICU - stay, and hospitalization.%目的 深低温停循环(DHCA)的同时顺行或逆行脑灌注,是一种行之有效的脑保护方法.在这个回顾性研究中,我们比较顺行、逆行两种方法的临床疗效.方法 从2008年10月~2011年1月,63例患者行Stanford A型主动脉夹层手术,均在深低温停循环下行全弓置换.其中选择双侧顺行脑灌注的A组病人54例,B组采用上腔静脉逆灌(RCP)脑保护的病人9例.结果 B组与A组比较在手术时间、体外循环时间、心肌阻断时间、脑灌注时间差异不明显,而B组短暂脑神经功能障碍发生率、拔管时间、ICU滞留时间、住院时间有所增加.结论 顺行脑灌注较上腔逆灌降低短暂脑神经功能障碍发生率从而拔管早,缩短ICU及住院时间.

  1. Effect of anesthesia induction with muscle relaxant and opioid on intracranial pressure and cerebral perfusion pressure in patients with intracranial tumors%肌肉松弛剂和阿片类药物麻醉诱导对颅内肿瘤患者颅内压及脑灌注压的影响

    Institute of Scientific and Technical Information of China (English)

    胡玉红

    2012-01-01

    目的:探讨肌肉松弛剂和阿片类药物对颅内肿瘤患者颅内压和脑灌注压的影响.方法:选取2008-03~2011-03颅内肿瘤患者80例,随机分为2组.对照组使用常规麻醉,试验组使用肌肉松弛剂琥珀酰胆碱和阿片类药物芬太尼作诱导,再予常规麻醉,观察2组颅内压和脑灌注压的影响.结果:试验组术前、术中20 min、40 min、术毕后的颅内压、脑灌注压及术后苏醒时间与对照组相比均有显著差异(P<0.05).结论:在常规麻醉前使用肌肉松弛剂和阿片类药物进行诱导,能够有效降低麻醉中的颅内压,增加脑灌注压并缩短患者麻醉后苏醒时间.%Objective; To discuss the effect of anesthesia induction with muscle relaxant and opioid on intracranial pressure and cerebral perfusion pressure in patients with intracranial tumors. Methods: A total of 80 patients with intracranial tumors receiving surgical therapy from March 2008 to March 2011 were randomly divided into two groups: experimental group and control group. The patients in experimental group underwent anesthesia induction with muscle relaxant ( succinylcholine) and opioid (fentanyl) before conventional general anesthesia, and those in control group received conventional general anesthesia only. The intracranial pressure and cerebral perfusion pressure were observed for all patients. Results: Compared with control group, the intracranial pressure, cerebral perfusion pressure and postoperative analepsia time of patients in experimental group before operation, 20 and 40 min after starting of operation, and after finishing surgery were obviously different (P <0. 05). Conclusion:The anesthesia induction with muscle relaxant and opioid before conventional general anesthesia can decrease the intrao-perative intracranial pressure effectively, increase cerebral perfusion pressure and shorten postanesthesia analepsia time.

  2. The effect of water immersion during exercise on cerebral blood flow.

    NARCIS (Netherlands)

    Pugh, C.J.; Sprung, V.S.; Ono, K.; Spence, A.L.; Thijssen, D.H.J.; Carter, H.H.; Green, D.J.

    2015-01-01

    INTRODUCTION: Regular exercise induces recurrent increases in cerebrovascular perfusion. In peripheral arteries, such episodic increases in perfusion are responsible for improvement in arterial function and health. We examined the hypothesis that exercise during immersion augments cerebral blood flo

  3. 脑灌注显像剂99Tcm-MPBDA的研制与动物实验%Preparation and animal studies of a novel potential cerebral perfusion imaging agent

    Institute of Scientific and Technical Information of China (English)

    王荣福; 张春丽; 朱绍莉; 苗玉斌; 唐志刚; 刘伯里

    2001-01-01

    目的研制一种新的SPECT脑灌注显像剂。方法将化学合成的N2S三齿配体2-巯基丙基-1,2-苯二胺(MPBDA)用99Tcm标记;25只昆明种小白鼠静脉注射100 μL 555~740 kBq 99Tcm-MPBDA,进行体内生物分布实验;2只健康恒河猴(4~6 kg)静脉快速注入218.3~333 MBq 99Tcm-MPBDA或99Tcm-双半胱乙脂(ECD)后分别即刻连续动态采集和给药后70 min行全身显像和脑断层显像;2组小鼠和3只家兔分别进行了急性毒理和热原实验。结果 99Tcm-MPBDA的产率和放化纯度分别大于95%和97%。小鼠体内分布实验结果表明99Tcm-MPBDA能在脑内浓聚并具有很好的脑滞留,血清除半衰期小于15 min。猴脑动态血流灌注显像示注药后2 min脑放射性达高峰,1 h脑放射性占2 min的83.0%,70 min后入脑量高达2.76%ID,略低于99Tcm-ECD(2.9%ID)。断层显像可见大脑灰白质对比度好,影像轮廓较清晰。小鼠和兔子注射99Tcm-MPBDA后均无毒副反应。结论研制的99Tcm-MPBDA具有与99Tcm-ECD相近的脑血流灌注显像性能,用于活体安全可靠。%Objective To investigate a novel potential SPECT cerebral blood flow perfusion imaging agent. Methods N2S tridentated α-mercapto-propyl-1,2-benzenediamine (MPBDA) was obtained from chemical synthesis IR and was labeled with 99Tcm.Biodistribution analysis in 25 mice was performed after intravenous injection of 100 μL 555~740 kBq of 99Tcm-MPBDA. Dynamic acquisition was performed after rapid intravenoues injection of 218.3~333 MBq 99Tcm-MPBDA or 99Tcm-ECD,while whole body imaging and brain perfusion imaging were done after 70 min in 2 normal monkeys.Preclinical studies including toxicity and pyrogen tests in mice and rabbits were undertaken.Results The radiochemical synthetic yield and radiochemical purity of MPBDA labeled with 99Tcm were more than 95% and 97%, respectively. Mice biodistribution test showed the 99Tcm-MPBDA can concentrate in brain with good retention

  4. 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.

  5. 双源CT全脑灌注对短暂性脑缺血发作脑血流动力学变化的评价%The evaluation of cerebral hemodynamic changes of transient ischemic attack in dual source CT perfusion

    Institute of Scientific and Technical Information of China (English)

    卞力勇

    2015-01-01

    Objective To explore cerebral hemodynamic changes of transient ischemic attack(TIA)in dual source CT perfusion(CTP). Method Twenty patients with suspected TIA underwent plain CT and CTP within 24h of the onset of symptoms. The results of the abnormal regions of the cerebral blood flow and the contralatcral normal region were comparatively analyzed. Result Lacunar infarction were found in 15 out of 20 patients who were all with abnormal perfusion area. The imaging results demonstrated that significantly larger time to peak(TTP) delay in 20 patients with abnormal perfusion area was found compared with that in contralateral normal region(P 0.05),and no significant change of cerebral blood flow(CBF) was found.Conclusion CTP with dual source CT can accurately display cerebral hemodynamic changes of transient ischemic attack(TIA) and provides objective evidence for early diagnosis and treatment.%目的:探讨双源CT全脑灌注对短暂性脑缺血发作(transient ischemic attack, TIA)血流动力学改变的临床价值。方法临床拟诊TIA患者20例,均在症状出现24小时内行头颅CT平扫及CT Perfusion检查,将脑血流异常区与健侧对应区的情况做对比分析。结果20例患者中,15例患者出现腔梗改变。20例患者均出现灌注异常区,患侧达峰时间(time to peak,TTP)时间较健侧明显延长(P0.05),所有患者脑血流量(cerebral blood flow,CBF)无明显改变。结论双源CT全脑灌注能较好地反映TIA脑血流动力学变化,为早期诊断、治疗提供客观依据。

  6. 停循环和局部脑灌在主动脉弓中断手术中的应用%The usefulness of deep hypothermic circulatory arrest and regional cerebral perfusion in interrupted aortic arch

    Institute of Scientific and Technical Information of China (English)

    郭铮; 王伟; 张蔚; 沈佳; 唐嘉忠; 朱德明

    2013-01-01

    Objective To evaluate the effects of deep hypothermic circulatory arrest (DHCA) and regional cerebral perfusion (RCP) in interrupted aortic arch (IAA) corrective surgery.Methods Thirty-one infants younger than 3-month-old with IAA were undergone corrective surgery with DHCA or RCP.The bypass time,aortic clamp time,DHCA or RCP time,hematocrit,ventilation time,ICU stay time and post-operative complications were recorded and compared between two groups.Results The bypass time,aortic clamp time were longer in RCP group,and the RCP time was longer than DHCA time.One postoperative death and two neurological complications took place in DHCA group,while no mortality and neurological complications in RCP group.There were no significant differences in mortality and morbidity between two groups.Conclusion Because complicated surgery is undergone in IAA corrective procedure,RCP technique is safer to protect the brain function.%目的 比较深低温停循环(DHCA)与局部低流量脑灌(RCP)在小儿主动脉弓中断(IAA)纠治手术中的应用效果.方法 总结31例3个月以下的IAA合并室间隔缺损、房间隔缺损的婴儿手术病例,分为DHCA和RCP两组不同的体外循环方式,对术中转流时间,阻断时间,红细胞比容,停循环或脑灌时间,呼吸机插管时间,ICU滞留时间,术后低心排出量,肾功能衰竭,肺部炎症,出凝血障碍,多器官功能障碍,神经系统并发症,院内死亡率等情况进行分析.结果 RCP组手术的体外循环时间,阻断时间及脑灌时间显著长于DHCA组.DHCA组患儿死亡1例,神经系统并发症2例,RCP组无死亡和神经系统并发症,但两组无统计学差异.结论 IAA手术需要较长时间在主动脉上进行操作,采用RCP技术可以更好的保护神经系统功能,减少并发症.

  7. Accuracy of MR perfusion weighted imaging for cerebral glioma grading: a meta-analysis%磁共振灌注成像对胶质瘤良恶性分级的荟萃分析

    Institute of Scientific and Technical Information of China (English)

    闵志刚; 刘红娟; 李敏; 刘丽华; 金晨旺; 张明

    2010-01-01

    Objective To evaluate values of MR perfusion weighted imaging(PWI)in the grading of intracranial gliomas by a meta-analysis. Methods All English and Chinese literatures published before November 2009 in PUBMED and CNKI(China National Knowledge Infrastructure)were searched.Literature searching requirements:(1)MR PWI with region of interest(ROI)must have been applied in the grading of gliomas;(2)histopathological results must have been used as the reference standards. In addition, after data extraction, a bivariate random-effect model and hierarchical weighted symmetric summary receiver-operating curve must have been utilized to pool the data. Furthermore, a meta regression method must have been applied to detect and analyze the factors that affected the diagnostic accuracy. Results Overall, fourteen studies were included with a total amount of 1021 patients. The pooled sensitivity,specificity and diagnostic odds ratio with 95% of CI were 93%(89%-96%), 81%(73%-87%)and 55(28-107), respectively. The factors that affected the diagnostic accuracy were the sample size, the ratio of malignant glioma, the injection rate of contrast agents, the repetition time and the cutoff value.Heterogeneity did exist among the results obtained from different studies. Conclusion the relative cerebral blood volume(rCBV)of MR PWI can be referred to differentiate malignant cerebral gliomas from benign ones with sound sensitivity and specificity. However, there is not a unified threshold applied in the researches that have been conducted so far, and techniques used differ among the studies. In summary,clinical application values of rCBV of MR PWI are to be corroborated by further studies with a larger sample size.%目的 采用荟萃(Meta)分析方法评价磁共振灌注成像在胶质瘤分级中的价值.方法 检索PUBMED数据库、CNKI(中国知网)系列数据库2009年11月前国内外公开发表的所有中英文文献,要求:(1)采用磁共振灌注成像对

  8. 丁苯酞对脑小血管病患者血流灌注及认知功能影响的临床研究%Effects of Dl-3-n-butylphthalide on cerebral perfusion and cognitive function in patients with cerebral small vessel disease

    Institute of Scientific and Technical Information of China (English)

    贾朝均; 罗丽君; 余巨明; 王莉; 周睿娇

    2016-01-01

    目的:探讨丁苯酞对脑小血管病患者认知功能及脑血流灌注的影响。方法将经知情同意及医院医学伦理委员会审查,并符合入组条件的70例脑小血管病患者随机分为常规治疗组(A 组)18例、丁苯酞组(B 组)26例及尼莫地平组(C 组)26例,疗程1个月。治疗前后作蒙特利尔量表(MOCA)评分。B 组及 C 组各随机选取10例患者于治疗前后行64排螺旋 CT 灌注成像检查,计算灌注参数值变化,并对疗效进行评定。结果68例患者最终完成实验。(1)MOCA 总评分变化:①B 组及 C 组治疗后 MOCA 评分较治疗前明显改善(均 P<0.01);②B 组与 C 组治疗后 MOCA 评分较 A 组治疗后均显著改善(均 P<0.05);但 B 组与 C 组 MOCA 总评分比较无统计学差异(P>0.05)。(2)MOCA 亚项评分变化:B 组治疗后在视空间及执行力、注意力及计算力、语言、延迟记忆力和抽象评分的变化有显著性差异(均 P<0.05);C 组治疗后在视空间及执行力、注意力及计算力、语言和延迟记忆力评分的变化有统计学差异(均 P<0.05);B 组治疗后在延迟记忆力亚项评分较 C 组治疗后变化更明显,差异有统计学意义(P<0.05)。(3)基底节区层面灌注成像参数变化比较:B 组及 C 组治疗后脑血流速度(CBF)、脑血流量(CBV)及平均通过时间(MTT)较治疗前均明显改善(P<0.01)。但 B 组与 C 组比较无统计学差异(P>0.05)。结论丁苯酞软胶囊可改善脑小血管病患者的认知功能,尤其是记忆力、视空间执行能力和计算力,并能提高局部脑灌注量,其作用至少不弱于尼莫地平片,且安全无明显不良反应。%Objective To investigate the impact of Dl-3-n-butylphthalide on the local cerebral perfusion and cognitive function in patients with cerebral small vessel disease. Methods 70 patents with cerebral

  9. 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

  10. 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 ...

  11. A new type of discrepancy between cerebral blood flow measured with {sup 133}Xe and HmPAO-{sup 99}Tc perfusion; Discordances entre la mesure du debit sanguin cerebral au xenon 133 et de la perfusion cerebrale au HmPAO {sup 99m}Tc: un nouveau cas de figure

    Energy Technology Data Exchange (ETDEWEB)

    Steinling, M.; Amegassi, F.; Mazingue, A.; Rousseaux, M. [Centre Hospitalier Universitaire, 59 - Lille (France)

    2000-09-01

    We report a clinical case of a new type of discrepancy between two tracers usable for brain functional imaging: the Xenon 133 and the HmPAO-{sup 99m}Tc. A 66 year old men had presented a brutal left hemiplegia with transient troubles of consciousness in relation with a right protuberant infarct without hemispheric lesions. The functional studies were performed 4 months after the onset, successively by the Xe inhalation method and immediately after the HmPAO study. On a patient kept still on the camera bed when cerebral blood flow (CBF) study depicted both a right cerebellar low flow and a slightly decreased CBF in the controlateral hemisphere ('hemispheric diaschisis'), the HmPAO SPECT was normal. This observation illustrates both the crossed hemispheric diaschisis and a new type of discrepancy: indeed, the known cases were until now in relation with alterations of the blood: brain barrier, which doses not exist in our report. The explanation of this type of discrepancy remains unclear but is probably linked with the HMPAO retention mechanisms. (author)

  12. Effects of Yunnan Baiyao through inner layer of cerebral dura mater on cerebral perfusion and oxygen metabolism in rabbits with severe traumatic brain injury%硬脑膜夹层导入云南白药对兔重型颅脑创伤后脑灌注和氧代谢的影响

    Institute of Scientific and Technical Information of China (English)

    徐震; 吕晓皑; 尹利明; 竺国充; 张昕; 李徐; 陈祖鹏

    2012-01-01

    Objective: To explore the effects of Yunnan Baiyao through inner layer of cerebral dura mater on cerebral perfusion and oxygen metabolism in rabbits with severe traumatic brain injury. Methods: 40 New Zealand white rabbits were divided into cerebral dura mater Yunnan Baiyao group(A group), intravenous Mannitol group(B group), oral Yunnan Baiyao group (C group) and control group(D group). Record ICP, CPP and MABP. TCD measured cerebral blood flow volume. Monitor blood gas analysis in femora) artery and internal jugular venous bulb, accounting the CEO2 and D-values of glucose and lactic acid between artery and venous bulb. Results: From 12 to 36 hour after therapy: the ICP of A was highter than B, the CPP and CBFV were lower than B (P<0.05). At 48 hour: the ICP of A was highter than B and lower than C and D, the CPP was lower than B and highter than Cand D, while the CBFV of A was highter than C and D(P<0.05). From 60 to 96 hour: the ICP of A was lower than C and D, the CPP of A was highter than C and D, the CBFV of A was highter than B, C and D(P<0.05). From 36 to 96: The Glua-jv and CEO2 of A were highter than B, C and D, while the Lacjv-a was lower than B, C and D(P<0.05). Conclusion: Yunnan Baiyao through cerebral dura mater can reach effective treatment concentration in brain. By increasing the efficiency of oxygen metabolism of brain it can ameliorate brain cell hypoxia and energy metabolism handicap, adjust cerebral microcirculation, thus improves cytotoxic brain edema, decreases cerebral blood flow resistance, reduces ICP and increase the CPP and CBFV.%目的:探讨硬脑膜夹层应用云南白药对兔重型颅脑创伤后颅内压、脑血流量和脑代谢的影响.方法:将40只雄性新西兰大白兔分为硬脑膜夹层云南白药组(A组)、静脉甘露醇组(B组)、口服云南白药组(C组)和空白组(D组),制作重型颅脑创伤模型,行颅内压(ICP)监测,记录平均动脉压(MABP),计算脑灌注压(CPP),经颅多普勒(TCD)测定脑

  13. Cerebral Vasospasm Pharmacological Treatment: An Update

    OpenAIRE

    Ioannis Siasios; Kapsalaki, Eftychia Z; Fountas, Kostas N

    2013-01-01

    Aneurysmal subarachnoid hemorrhage- (aSAH-) associated vasospasm constitutes a clinicopathological entity, in which reversible vasculopathy, impaired autoregulatory function, and hypovolemia take place, and lead to the reduction of cerebral perfusion and finally ischemia. Cerebral vasospasm begins most often on the third day after the ictal event and reaches the maximum on the 5th–7th postictal days. Several therapeutic modalities have been employed for preventing or reversing cerebral vasosp...

  14. Perfusion-weighted MR imaging in persistent hemiplegic migraine

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  15. Role of magnetic resonance perfusion studies in moyamoya disease

    Directory of Open Access Journals (Sweden)

    Khanna Paritosh

    2004-04-01

    Full Text Available Moyamoya disease, Japanese for ′puff of smoke′, is a rare disease that presents most commonly with recurrent TIAs (transient ischemic attacks / stroke in childhood. Ischemic symptoms in patients with moyamoya disease are usually due to hemodynamically-mediated perfusion failure. Identification of abnormal tissue perfusion is an important aspect of the evaluation of these patients. We present the radiological features including the Magnetic Resonance (MR Perfusion findings illustrating the hemodynamic changes of cerebral ischemia in a case of moyamoya disease.

  16. Lesion area detection using source image correlation coefficient for CT perfusion imaging.

    Science.gov (United States)

    Fan Zhu; Rodriguez Gonzalez, David; Carpenter, Trevor; Atkinson, Malcolm; Wardlaw, Joanna

    2013-09-01

    Computer tomography (CT) perfusion imaging is widely used to calculate brain hemodynamic quantities such as cerebral blood flow, cerebral blood volume, and mean transit time that aid the diagnosis of acute stroke. Since perfusion source images contain more information than hemodynamic maps, good utilization of the source images can lead to better understanding than the hemodynamic maps alone. Correlation-coefficient tests are used in our approach to measure the similarity between healthy tissue time-concentration curves and unknown curves. This information is then used to differentiate penumbra and dead tissues from healthy tissues. The goal of the segmentation is to fully utilize information in the perfusion source images. Our method directly identifies suspected abnormal areas from perfusion source images and then delivers a suggested segmentation of healthy, penumbra, and dead tissue. This approach is designed to handle CT perfusion images, but it can also be used to detect lesion areas in magnetic resonance perfusion images.

  17. Cerebral perfusion semi-quantitative imaging for assessing the treatment of delayed encephalopathy from carbon monoxide poisoning%脑血流灌注半定量法显像评价高压氧联合药物治疗一氧化碳中毒迟发性脑病疗效

    Institute of Scientific and Technical Information of China (English)

    熊冰; 周游; 蔡亚利; 刘洪彪; 汤中泉; 孙达; 徐昕; 刘文明

    2009-01-01

    目的 对比研究一氧化碳中毒后迟发性脑病(DEACMP)患者在高压氧(HBO)联合药物治疗前、后单光子发射计算机断层成像(SPECT)脑血流灌注显像结果,并对其优越性及临床意义进行评价.方法 34例DEACMP患者接受20~40次HBO联合药物治疗,并在治疗前、后用双半胱乙酯(~(99m)Tc-ECD)脑SPECT血流灌注扫描半定量法进行疗效监测和对比分析.结果 HBO治疗后,DEACMP患者脑血流灌注减低区有明显改善,脑SPECT血流灌注半定量值与治疗前比较,差异有统计学意义(P<0.05),而治疗前、后脑磁共振显像无明显差异.结论 脑SPECT血流灌注半定量法显像在DEACMP的诊断和HBO治疗的疗效监测中可起重要作用.%Objective To evaluate the effects of hyperbaric oxygen (HBO) combined with drug therapy on patients with delayed encephalopathy caused by carbon monoxide poisoning ( COP). Methods Twenty to forty sessions of HBO therapy were used to treat 34 COP patients. Assessment relied on 99mTc-ethyl cysteinate dimer (~(99m)Tc-ECD) single photon emission computed tomography (SPECT) imaging of cerebral perfusion before and after treatment. Results After HBO therapy, cerebral perfusion in the COP patients improved significantly. There was a significant difference of the SPECT images before and after treatment. Conclusions SPECT imaging of cerebral perfusion can play an important role in the diagnosis of delayed encephalopathy caused by carbon monoxide poisoning, and it can be used for the therapeutic surveillance of HBO treatment.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.)

  19. CT perfusion on admission and cognitive functioning 3 months after aneurysmal subarachnoid haemorrhage

    NARCIS (Netherlands)

    Wajer, Irene M. C. Huenges; Cremers, Charlotte H. P.; van Zandvoort, Martine J. E.; Vergouwen, Mervyn D. I.; van der Schaaf, Irene C.; Velthuis, BK; Dankbaar, Jan Willem; Vos, Pieter C.; Visser-Meily, Johanna M. A.; Rinkel, Gabriel J. E.

    2015-01-01

    Many survivors of aneurysmal subarachnoid haemorrhage (aSAH) have persistent cognitive deficits. Underlying causes of these deficits have not been elucidated. We aimed to investigate if cerebral perfusion in the acute phase after aSAH measured with CT perfusion (CTP) is associated with cognitive out

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

    Science.gov (United States)

    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

  1. Mastering moral misery: Emotional and coping responses to intragroup morality (vs. competence) evaluations.

    Science.gov (United States)

    van der Lee, Romy; Ellemers, Naomi; Scheepers, Daan

    2016-01-01

    In social groups, individuals are often confronted with evaluations of their behaviour by other group members and are motivated to adapt their own behaviour accordingly. In two studies we examine emotional responses towards, and perceived coping abilities with, morality vs. competence evaluations individuals receive from other in-group members. In Study 1, we show that evaluations of one's immoral behaviour primarily induce guilt, whereas evaluations of incompetent behaviour raise anger. In Study 2, we elaborate on the psychological process associated with these emotional responses, and demonstrate that evaluations of immorality, compared to incompetence, diminish group members' perceived coping abilities, which in turn intensifies feelings of guilt. However, when anticipating an opportunity to restore one's self-image as a moral group member, perceived coping abilities are increased and the experience of guilt is alleviated. Together these studies demonstrate how group members can overcome their moral misery when restoring their self-image.

  2. MUDDY MISERY

    Institute of Scientific and Technical Information of China (English)

    LI LI

    2010-01-01

    @@ Residents of Zhouqu County,Gannan Tibetan Autonomous Prefecture in northwest China's Gansu Province,went to bed on the seemingly uneventful evening of August 7,but woke to floodwaters surging through their homes.

  3. Remembering Misery

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    A Tibetan recalls a dismal life under the old feudal serfdom system How much could a man’s life change in 50 years? For Myima Toinzhub, it has changed a lot. Once an oppressed serf in Tibet’s Gyangze County, the 75-year-old is now a well-known yak farmer earning 5,000 yuan ($220) a year selling dairy products from his 11 animals. His family also grows two hectares of highland barley, radishes and potatoes.

  4. MUDDY MISERY

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    Resources are pooled into a landslide-devastated Zhouqu County to lift it out of disaster Basic Data on Gannan Prefecture Covering an area of 45,000 square km,Gannan Tibetan Autonomous Prefecture,located in the southwestern corner of Gansu Province,administers seven counties and one city.

  5. Modification of the cerebral perfusion during a chemotherapy by arabinoside cytosine (A.R.A.C.) among patients suffering of an acute myelo-blastic leukemia (A.M.L.); Modification de la perfusion cerebrale au cours d'une chimiotherapie par cytosine arabinoside (ARAC) chez les patients atteints d'une leucemie aigue myeloblastique (LAM)

    Energy Technology Data Exchange (ETDEWEB)

    Modzelewski, R.; Vera, P. [Universite de Medecine de Rouen, QUANT.I.F-LITIS EA4108, departement de medecine nucleaire, 76 (France); Lepretre, S.; Tilly, H. [Centre Henri-Becquerel, departement d' hematologie, 76 - Rouen (France); Martinaud, O.; Hannequin, D. [CHU de Rouen, departement de neurologie, 76 (France); Habert, M.O. [CHU de la Pitie-Salpetriere, departement de medecine nucleaire, 75 - Paris (France)

    2010-07-01

    Cytosine arabinoside in high doses is a major treatment in acute myelo-blastic leukemia (A.M.L.). This treatment leads to neurological complications in 3-16% of cases, but the EEG, CT or MRI are normal.This prospective study examines brain perfusion in single photon emission tomography (SPECT) for patients receiving high dose arabinoside cytosine (H.D. A.R.A.C.). The SPECT of perfusion with hexamethyl propylene amine oxime (H.M.P.A.O.) for patients suffering of A.M.L. allowed to show a reduction of perfusion at the cerebellum level, of the occipito-parietal cortex and thalami, after conventional doses of A.R.A.C., while the patients had not any neurological accidents. (N.C.)

  6. Tissue-specific sparse deconvolution for brain CT perfusion.

    Science.gov (United States)

    Fang, Ruogu; Jiang, Haodi; Huang, Junzhou

    2015-12-01

    Enhancing perfusion maps in low-dose computed tomography perfusion (CTP) for cerebrovascular disease diagnosis is a challenging task, especially for low-contrast tissue categories where infarct core and ischemic penumbra usually occur. Sparse perfusion deconvolution has been recently proposed to effectively improve the image quality and diagnostic accuracy of low-dose perfusion CT by extracting the complementary information from the high-dose perfusion maps to restore the low-dose using a joint spatio-temporal model. However the low-contrast tissue classes where infarct core and ischemic penumbra are likely to occur in cerebral perfusion CT tend to be over-smoothed, leading to loss of essential biomarkers. In this paper, we propose a tissue-specific sparse deconvolution approach to preserve the subtle perfusion information in the low-contrast tissue classes. We first build tissue-specific dictionaries from segmentations of high-dose perfusion maps using online dictionary learning, and then perform deconvolution-based hemodynamic parameters estimation for block-wise tissue segments on the low-dose CTP data. Extensive validation on clinical datasets of patients with cerebrovascular disease demonstrates the superior performance of our proposed method compared to state-of-art, and potentially improve diagnostic accuracy by increasing the differentiation between normal and ischemic tissues in the brain.

  7. Is shared misery double misery?

    Science.gov (United States)

    Mervin, Merehau Cindy; Frijters, Paul

    2014-04-01

    The literature has shown strong associations between health, financial and social life events and mental health. However, no studies as yet have looked at the temporal nature of the effects of life events on stated mental health nor have they included the effects of the events befalling partners within a household. This paper looks at the spillover in mental health, measured with the SF-36 scale, from one partner to the other, using life events to identify this relationship. We propose a new model that allows for both a temporal spacing of effects (anticipation and adaptation) as well as a spillover factor, which we define as the degree to which the events that are experienced by the partner affect us in the same way as if these events were to happen to us. We use data from 51,380 person-year observations of the Household, Income and Labour Dynamics in Australia survey (2002-10) which consistently measures nine distinct events, including illnesses, social shocks and financial shocks. We find that the events befalling a partner on average have an effect about 15% as large as the effect of own events. We use the estimates to compute the compensation required to offset own and partner's life events. The methodology in this paper is potentially useful for estimating other spillover parameters such as the effects of others in the family or in the neighbourhood.

  8. Complications of hemorrhagic and ischemic stroke : a CT perfusion evaluation

    NARCIS (Netherlands)

    Dankbaar, J.W.

    2010-01-01

    In this thesis the use of CT-perfusion (CTP) imaging in the evaluation of the most severe complications of subarachnoid hemorrhage (SAH)) and ischemic stroke was explored. These complications are delayed cerebral ischemia (DCI) after SAH and damage to the blood-brain barrier (BBB) after ischemic str

  9. Preoperative subtyping of meningiomas by perfusion MR imaging

    NARCIS (Netherlands)

    Zhang, Hao; Roediger, Lars A.; Shen, Tianzhen; Miao, Jingtao; Oudkerk, Matthijs

    2008-01-01

    Introduction This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Materials and methods Thirty-seven menin

  10. 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.

  11. 高血压脑出血无创颅内压及脑灌注压监测临床研究%Monitoring noninvasive intracranial pressure and cerebral perfusion pressure in treatment of patients with hypertensive intracerebral hemorrhage

    Institute of Scientific and Technical Information of China (English)

    张文德; 张湘; 邹志浩; 吴勤奋; 殷捷; 王建江; 郑玺; 莫拉丁

    2012-01-01

    Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (<26.6mmHg) and CPP (> 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7%) had good recovery,20 (33.3%) were moderately disabled,5 (8.3%) severely disabled and 4 (6.7%) dead in the monitoring group while 23 (38.3%) patients had good recovery,18 (30.0%)were moderately disabled,10 (16.7%) severely disabled and 9 (15.0%) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P<0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well.%目的 探讨高血压脑出血手术前后监测无创颅内压(NICP)、脑灌注压(CPP)变化的临床意义. 方法 收集解放军第474医院神经外科自2008年6月至2010年5月收治的120例高血压脑出血手术患者,按照随机数字表法分为

  12. Perfusion CT in childhood stroke—Initial observations and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Zebedin, D., E-mail: doris.zebedin@medunigraz.at [Division of Pediatric Radiology, Department of Radiology, University Hospital LKH Graz (Austria); Sorantin, E.; Riccabona, M. [Division of Pediatric Radiology, Department of Radiology, University Hospital LKH Graz (Austria)

    2013-07-15

    Introduction: To report the preliminary results of contrast-enhanced perfusion multi-detector CT for diagnoses of perfusion disturbances in children with clinical suspicion of stroke. Patients and methods: Within the last two years emergency perfusion CT was performed in ten children (age: 8–17 years, male:female = 3:7) for assessment of suspected childhood stroke. These intracranial perfusion CT, intracranial CT-digital subtraction angiography (CT-DSA) and extracranial CT-angiography (CTA) studies were retrospectively reviewed and compared with MRI, follow-up CT, catheter angiography and final clinical diagnosis. The total dose length product (DLP) for the entire examination was recorded. The image quality of perfusion CT-maps, CT-DSA and CTA were evaluated with a subjective three-point scale ranging from very good to non-diagnostic image quality rating perfusion disturbance, intracranial peripheral vessel depiction, and motion- or streak artifacts. Results: In nine of ten children perfusion CT showed no false positive or false negative results. In one of ten children suffering from migraine focal hypo-perfusion was read as perfusion impairment potentially indicating early stroke, but MRI and MRA follow-up were negative. Overall, perfusion-CT with CT-DSA was rated very good in 80% of cases for the detection of perfusion disturbances and vessel anatomy. Conclusions: In comparison to standard CT, contrast-enhanced perfusion CT improves CTs’ diagnostic capability in the emergency examination of children with a strong suspicion of ischemic cerebral infarction.

  13. 主动脉弓部手术中单侧大脑灌注血流变化与神经系统并发症关系的分析%Analysis of the relationship between the hemodynamic changes during selective cerebral perfusion and postoperative neurological complications in aortic arch surgery

    Institute of Scientific and Technical Information of China (English)

    阳晟; 任长伟; 许尚栋; 孙立忠

    2012-01-01

    Objective: This study tries to monitor the hemodynamic changes of middle cerebral artery ( MCA) by transcranial Doppler sonography (TCD) in aortic arch surgery. Analysis of relationship between the hemodynamic changes during selective cerebral perfusion (SCP) and postoperative neurological complications. Methods: From September 2010 to January 2011, 23 patients with aortic dissection undergoing aortic arch operation were included in this study. Every patient underwent profound hypothermia (DHCA) and selective cerebral perfusion. Hemodynamic signals of bilateral MCA were monitored via TCD during operation. Data at 6 time-points were selected for analysis. All the patients were divided into four groups by the decline in the proportion of non-perfusion side flow( 30% ) , and all the postoperative neurological complications and early death after surgery were recorded in each group. Results: During the full flow of CPB, blood flow velocity of MCA at left and right side was no differences ( P = 0. 565 ) . During SCP, blood flow velocity of MCA at perfusion side (right side) was similar with blood flow velocity before SCP; and blood flow velocity of MCA at non-perfusion side (left side) was significant decreased compare with blood flow veloci-ly before SCP (P 30% groups (50% ) ,no permanent neurological dysfunction (PND) and early death was observed. Conclusion; SCP in aortic arch operation can meet the blood supply to the brain; During SCP, blood flow velocity of MCA at perfusion side (right side) was similar to the blood flow velocity before SCP; blood flow velocity of MCA at non-perfusion side (left side) was significant decreased compare with blood flow velocity before SCP. Less than 30% drop of blood flow velocity of MCA at non-perfusion side (left side) may be safe for the patients.%目的:通过经颅多普勒超声(TCD)监测主动脉弓部手术中大脑中动脉(MCA)的血流,评估选择性脑灌注(SCP)期间血流变化与术后神经系统

  14. Estimating the association between economic performance and Okun misery index in Albania: January 2005- December 2014 F

    Directory of Open Access Journals (Sweden)

    Fejzi Kolaneci

    2015-07-01

    Full Text Available The main purpose of the present study is to develop a statistical analysis of the GDP growth rate, Okun misery index and association between them for Albania during the period January 2005-December.Some results of the present study include: • The official data of the quarterly GDP growth rate for Albania during the period January 2005 – December 2014 contradict Kolmogorov’s Central Limit Theorem at the confidence level77.1%. • The GDP growth rate for Albania during the specified period is anunfair game at the confidence level78.2%. • The official data of the quarterly Okun misery index for Albania during January 2005-December 2014 contradict Central Limit Theorem at the confidence level 86.4%. • The miserably process in Albania during the specified period is an unfair game at the confidence level 98.3%. • Kendall tau rank correlation coefficient between quarterly GDP growth rate and quarterly Okun misery index is -0.0606, which indicates a quite weal negative association between these two random variables.

  15. Application of dual-source 4D-CTA combined with CT perfusion imaging in diagnosis of acute cerebral ischemic diseases%双源CT 4D- CTA联合灌注成像在急性脑缺血性疾病中的应用价值

    Institute of Scientific and Technical Information of China (English)

    程有根; 杨光钊; 茅国群; 楼明芳; 魏福全

    2013-01-01

    Objective To investigate the application of dual- source four- dimensional CT angiography (4D- CTA) com-bined with CT perfusion imaging (CTPI) in diagnosis of acute cerebral ischemic diseases. Methods Thirty patients with clinical y suspected acute cerebral ischemic disease underwent head plain CT scan and whole brain CTPI examination 2~16h after onset, the images of CBF, CBV, MTT, TTP and 4D- CTA were obtained. Patients also underwent MRI examination in 1~3 d. The findings of plain CT scan, CTPI, 4D- CTA and MRI were analyzed. Results Plain CT scan found 16 ischemic lesions in 12 cases, CTPI found 32 ischemic lesions in 26 cases, MRI found 28 ischemic lesions in 25 cases, and 4D- CTA demonstrated various degree of stenosis or occlusion in supplying vessels in 20 cases. Conclusion Dual- source 4D- CTA combined with CT perfusion imaging provides comprehensive and detailed imaging information, so that has important value for early diagnosis and treatment in pa-tients with acute cerebral ischemia.%目的:探讨双源CT 4维血管造影(4D- CTA)及灌注成像(CTPI)在急性脑缺血性疾病中的应用价值。方法对30例临床拟诊为急性脑缺血性疾病的患者于发病2~24h内行头颅CT平扫和全脑CTPI检查,获得脑血流量、脑血容量、平均通过时间、达峰时间等参数图,同时获得4D- CTA图像;于发病的1~3d后行MRI检查,分析CT平扫、CTPI、4D- CTA、MRI表现。结果 CT平扫发现12例有16个缺血病灶,CTPI发现26例32个缺血病灶,MRI发现25例28个缺血病灶,4D- CTA显示有20例责任血管有不同程度的狭窄或闭塞。结论双源CT 4D- CTA联合灌注成像能为急性脑缺血患者提供全面、详细的影像学信息,对急性缺血性脑梗死的早期诊断和治疗有重要价值。

  16. 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

  17. Displaying perfusion MRI images as color intensity projections

    CERN Document Server

    Hoefnagels, Friso; Sanchez, Ester; Lagerwaard, Frank J

    2007-01-01

    Dynamic susceptibility-weighted contrast-enhanced (DSC) MRI or perfusion-MRI plays an important role in the non-invasive assessment of tumor vascularity. However, the large number of images provided by the method makes display and interpretation of the results challenging. Current practice is to display the perfusion information as relative cerebral blood volume maps (rCBV). Color intensity projections (CIPs) provides a simple, intuitive display of the perfusion-MRI data so that regional perfusion characteristics are intrinsically integrated into the anatomy structure the T2 images. The ease of use and quick calculation time of CIPs should allow it to be easily integrated into current analysis and interpretation pipelines.

  18. Multislice CT brain image registration for perfusion studies

    Science.gov (United States)

    Lin, Zhong Min; Pohlman, Scott; Chandra, Shalabh

    2002-04-01

    During the last several years perfusion CT techniques have been developed as an effective technique for clinically evaluating cerebral hemodynamics. Perfusion CT techniques are capable of measurings functional parameters such as tissue perfusion, blood flow, blood volume, and mean transit time and are commonly used to evaluate stroke patients. However, the quality of functional images of the brain frequently suffers from patient head motion. Because the time window for an effective treatment of stroke patient is narrow, a fast motion correction is required. The purpose of the paper is to present a fast and accurate registration technique for motion correction of multi-slice CT and to demonstrate the effects of the registration on perfusion calculation.

  19. Research of CT Angiography Combined with CT Perfusion on Prognosis of Delayed Cerebral Ischemia After Onset of Subarachnoid Hemorrhage%CT血管造影联合CT灌注成像对蛛网膜下腔出血与迟发性脑缺血的相关性探讨

    Institute of Scientific and Technical Information of China (English)

    赵一平; 李松柏; 张贺; 徐克

    2013-01-01

    Objective To investigate the clinical value of CT angiography (CTA) combined with CT perfusion (CTP) on prognosis with delayed cerebral ischemia after onset of subarachnoid hemorrhage ( SAH). Methods CTP and CTA were performed in 71 patients with SAH. CTP data were analyzed using Philips Extended Brilliance Workspace Postprocessing workstation and the volume rendering (VR) images of cerebral arteries were reconstructed using advanced vessel analysis (AVA) software. Whole brain CTP maps were created using Brain Perfusion Software. CTP measurements were made on the CTP maps. CTA and CTP images were reconstructed to detect aneurysm and vasospasm. The change of CTP values on vasospasm and the relationship between perfusion characteristics and the prognosis of patients were evaluated. Results Among 71 patients, 67 cases had aneurysms which included 12 cases of two or more aneurysms; 33 cases showed severe vasospasm in CTA performance in which 14 cases occurred in the anterior cerebral artery and 19 cases occurred in the middle cerebral artery; 25 patients with the emergence of delayed cerebral ischemia (DCI) which were located in the anterior cerebral artery dominated area, accounting for 35.2% of the total number of patients with SAH. The CTP Rainbow Color Scheme had high sensitivity and specificity (78. 6% , 78% ) on diagnosis of DCI; patients with DCI whose anterior circulation cerebral blood flow in the brain had obvious hypoperfusion; these changes of cerebral blood flow and circulation time were relatively less in posterior cerebral artery circulation; the CBF which in four parameters of CTP had the highest sensi-tivity and specificity on diagnosis of DCI (72. 4% , 85. 7% ). The bad prognosis of patients had relationship with vaso-spasm, degree of vasospasm and CBF value. Conclusion CTA combined with CTP can detect the cause and vasospasm of the SAH, it can also judge the prognosis of patients on SAH.%目的 探讨CT血管造影(CTA)联合CT脑血流灌注(CTP)

  20. Improved Perfusion MR Imaging Assessment of Intracerebral Tumor Blood Volume and Antiangiogenic Therapy Efficacy in a Rat Model with Ferumoxytol

    OpenAIRE

    Gahramanov, Seymur; Muldoon, Leslie L; Li, Xin; Neuwelt, Edward A.

    2011-01-01

    Our findings suggest that, at perfusion MR imaging, more consistent estimations of relative cerebral blood volume are provided with ferumoxytol than with gadolinium-based contrast agents regardless of the permeability of the tumor vasculature.

  1. Acute ischemic stroke with tandem/terminal ICA occlusion - CT perfusion based case selection for mechanical recanalization

    Directory of Open Access Journals (Sweden)

    Rajsrinivas Parthasarathy

    2015-01-01

    Conclusion: The cerebral blood volume (CBV core estimation reliably predicted the final infarct volume. The key reasons for the significantly better outcomes seen in our cohort were the stringent perfusion imaging-based patient selection and the rapid reperfusion.

  2. 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。

  3. 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.

  4. Regional cerebral blood flow autoregulation in patients with fulminant hepatic failure

    DEFF Research Database (Denmark)

    Larsen, Fin Stolze; Strauss, Gitte Irene; Møller, Kirsten;

    2000-01-01

    The absence of cerebral blood flow autoregulation in patients with fulminant hepatic failure (FHF) implies that changes in arterial pressure directly influence cerebral perfusion. It is assumed that dilatation of cerebral arterioles is responsible for the impaired autoregulation. Recently, frontal...... blood flow was reported to be lower compared with other brain regions, indicating greater arteriolar tone and perhaps preserved regional cerebral autoregulation. In patients with severe FHF (6 women, 1 man; median age, 46 years; range, 18 to 55 years), we tested the hypothesis that perfusion...... in the anterior cerebral artery would be less affected by an increase in mean arterial pressure compared with the brain area supplied by the middle cerebral artery. Relative changes in cerebral perfusion were determined by transcranial Doppler-measured mean flow velocity (V(mean)), and resistance was determined...

  5. Sell a book and cook a dog: misery, memory and space from Siberian camps to Apartheid.

    Science.gov (United States)

    van Dongen, Els

    2004-09-01

    In this article, the life story of a Polish woman in South Africa is used to illustrate that stories of exile are 'matter out of place' in host countries. Space is a central category in both the story of exiles and in the collective history of receiving countries, but it has different emotional, social, cultural and political meanings. Sometimes stories of exile are denied a place in the social memory of a society. Therefore, recollection and making sense of experienced misery in foreign contexts is often a difficult and lonely undertaking. The article links the story to macro-political processes and attempts to answer questions regarding the consequences of the lack of meaningful space for exiles to remember. Collective and national memories and ceremonies are often exclusive and offer no place for 'alien' memories. Therapeutic repertoires often fail to address the emotional value of communal sharing a socio-cultural and (meta) physical space. It is argued that because the state does not take responsibility for providing a (symbolic) space for the mourning and reconciliation of people whose memories are out of place, transcultural psychiatry - its subsystem - will have to reflect on how to provide such a space.

  6. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  7. 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...

  8. 奇异值分解法用于MR灌注成像脑血流量估计的仿真研究%A Simulation Study on Singular Value Decomposition to Estimate the Cerebral Blood Flow in MR Perfusion Imaging

    Institute of Scientific and Technical Information of China (English)

    马栋敏; 李颖; 彭川; 郭延庆; 郭磊; 何任杰; 饶利芸

    2011-01-01

    MR脑灌注成像是MR方法中提供代谢能力度量的唯一途径,对于疾病诊断和治疗效果评估有重要意义.MR灌注成像灌注参数的确定本质上是一个逆问题的求解过程,对一种求逆估计方法一奇异值分解法的逆问题性质进行了研究.在对奇异值分解法进行理论推导后,设计仿真方案,分别针对不同的信噪比进行仿真实验,并对动脉输入函数的延迟与失真进行分析.结果表明,在信噪比分别为150和10时,奇异值分解法都可以有效地估计脑血流量.该方法对动脉输入函数的失真不敏感,但是发生动脉输入函数延迟时,高脑血流量会被低估20% ~ 30%.针对这一情况,对动脉输入函数的延迟效应进行了修正,修正后低估程度减小到±5%,得以明显改善.仿真结果表明,奇异值分解法是一种有效的估计MR灌注成像脑血流量的方法.%MR perfusion imaging provides the unique approach to measure the metabolic capacity of brain, which is important in diagnosing the disease as well as assessing the treatment. The retrieve of perfusion parameters from MR perfusion imaging of brain is typically a process of inverse problem. In this paper, singular value decomposition ( SVD ) is advocated as a solver for the inverse problem, and the SVD technique for estimating the cerebral blood flow ( CBF) is elaborated in short. Simulation schemes are designed towards revealing the properties of the inverse problem, namely the effects of signal-noise ratio, arterial input function (AIF) delay and distortion. Our simulation experiments show that the SVD technique is able to precisely reproduce flows when SNR equals to 150 or 10 respectively. The solution of SVD technique is found to be stable in the presence of the AIF distortion. However, the SVD technique is sensitive to the effect of AIF delay, where the high CBFs are underestimated about 20% ~ 30% . Hence therefore a delay correction method is developed and the

  9. The technique of cerebral perfusion CT and its clinical application at brain neoplasms%脑灌注CT成像技术及其在脑肿瘤中的临床应用

    Institute of Scientific and Technical Information of China (English)

    杨奉常; 申洪明; 李文武

    2008-01-01

    CT脑灌注扫描是一种新兴的检查技术.它通过产生脑血流量(cerebral blood flow,CBF)、脑血容量(cerebral blood volume,CBV)、平均通过时间(mean transit time,MTT)、对比剂峰值时间(time to peak.TIP)和表面通透性(permeability surface,PS)图,对脑灌注进行快速定性及定量评估,在脑肿瘤的诊断,鉴别诊断、指导治疗以及评价预后等方面有很高的临床应用价值.但目前对该技术的应用仍存在一些争议.

  10. Research of blood perfusion in cerebral cortex for patients with traumatic subdural hematoma undergoing decompressive craniotomy%创伤性硬膜下血肿去骨瓣减压术后大脑皮层血流灌注研究

    Institute of Scientific and Technical Information of China (English)

    汤可; 袁小东; 周青; 周敬安; 赵亚群; 刘策

    2013-01-01

    目的:探讨创伤性硬脑膜下血肿开颅去骨瓣减压术后短期内大脑皮层的血流灌注特征。方法15例创伤性硬脑膜下血肿患者于去骨瓣减压术后1周行颅脑320排动态容积CT扫描,于水平位选择颅骨缺损直径最大层面图像划定感兴趣区,分别计算颅骨缺损区和对侧镜像区皮层脑血流量(CBF)、脑血容量(CBV)和平均通过时间(MTT),采用配对 t 检验进行统计学分析比较。结果所有患者术后48 h内意识清醒,未遗留神经功能障碍,复查头颅CT血肿清除满意,无再次出血和颅内感染发生。颅骨缺损区皮层CBF和CBV的均值分别为91.12 ml•(100 g)-1•min-1和6.02 ml/100 g,明显高于对侧镜像区的均值69.22 ml•(100 g)-1•min-1和2.42 ml/100 g,差异有统计学意义。颅骨缺损区皮层的MTT与对侧比较差异无统计学意义。结论通过颅脑320排动态容积CT灌注扫描验证,创伤性硬脑膜下血肿开颅清除血肿去骨瓣减压术后患者的皮层脑组织血流灌注有增加的现象,为进一步病生理研究提供依据。%ObjectiveTo discuss blood perfusion features of cerebral cortex at short term follow-up after decompressive craniotomy for traumatic subdural hematoma. Methods 320 slice dynamic volume CT scans were performed for fifteen patient with traumatic subdural hematoma at 1week after decompressive craniotomy, and then, region of interest was delimited in horizontal position CT image at the plane with largest skull defect. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of cortex at the site under the skull defect and the contralateral mirror site were calculated respectively. Pairedt test was employed for statistical comparison.Results All patients had normal consciousnesses at 48 hours after surgery without neurological sequelae. Hematomas were removed completely without rebleeding and intracranial infection. Mean CBF and

  11. 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.

  12. 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...

  13. Application of DSA and CT perfusion imaging for cerebral rerascularization in treatment of unilateral moyamoya disease%DSA 及 CT 灌注成像在单侧烟雾病脑血管重建术中的应用

    Institute of Scientific and Technical Information of China (English)

    张亚男; 薛静; 高培毅

    2014-01-01

    Objectire:To explore the clinical value of DSA and CT perfusion imaging (CTPI)for cerebral revascula-rization of unilateral moyamoya disease.Methods:The clinical and imaging data of 51 patients with unilateral moyamoya di-sease undergone cerebral revascularization were analyzed restrospectively.Of 51 cases,49 and 13 cases with superficial tem-poral artery to middle cerebral artery (STA-MCA)bypass underwent pre-and post-surgery DSA respectively,all cases un-derwent CTPI before operation,33 and 13 cases underwent short-or long-term postoperative CTPI respectively.According to the DSA data,degree of cerebrovascular stenosis,classification of collateral vessel and stage of internal carotid artery (ICA)disease were analyzed.On the CTPI parameter maps (including CBF,CBV,MTT and TTP)quantitative measure-ment of five ROIs was performed,and pre-infarction stage and perfusion state after operation were evaluated.Paired t test or signed rank sum test was used for statistic analysis.Results:①Preoperative DSA showed that MCA was involved in all ca-ses,71.4% (35/49 )of which were single MCA involvement;ICA stages of 40.8% (20/49 )patients were in stage Ⅳ;moyamoya vessels at the base of the brain were existed in 49 cases,and collateral vessels originated from PCA were existed in 31 cases.In the postoperative evaluation,21 cases underwent cerebrovascular examinations after STA-MCA bypass and the patency rate of bypasses was 95.2% (20/21 );Of 21 cases,13 cases underwent DSA before and after STA-MCA by-pass,and 9 cases showed that net-like vessels at the base of brain decreased or disappeared after operation (69.2%).②pre-operative CTPI of 51 cases showed that the ipsilateral value of CBV,MTT and TTP in the MCA territory,basal ganglia and PCA territory and MTT in the ACA territory all increased,CBF in the MCA territory decreased,with statistic difference all when compared with those of the contralateral side (P <0.05 ).In addition,a qualitative evaluation showed that 66

  14. The correlationship study between the levels of serum Cystatin C and the cognitive dysfunction,the cere-bral perfusion in Alzheimer's diesease patients%老年痴呆患者血清胱氨酸蛋白酶抑制剂C与认知功能、脑灌注水平的相关性研究

    Institute of Scientific and Technical Information of China (English)

    姚朝辉; 张少锋; 刘涓

    2014-01-01

    Objective To explore the correlationship between Cystatin C and the cognitive dysfunction, encephalatrophy and the cerebral perfusion in Alzheimer's disease ( AD ) patients, and to analyze the probable mechanisms of the Cystatin C level alterations. Methods For the 61 male and 55 female AD patients,the levels of Cystatin C,Urea,Cr andβ2⁃microglobulin were detected by biochemistry analysis.The hypocampus volume and Ev⁃ans index were measured by MRI imaging. The cerebral perfusion was evaluated by magnetic resonance perfusion imaging of arterial spin labeling technique and image processing. The cognitive level of AD patients was done by MMSE scale and MoCA scale. Results The Cystatin C levels in serum of male AD patients were dramatically dif⁃ferent from female AD patients(male:(0.95±0.20)mg/L,female:(1.32±0.41)mg/L)(P=0.04). For male AD patients,age and Cystatin C had a correlationship among the hypocampus volume((6157.14±355.58)mm3),Evans index(0.33±0.02),MMSE score(21.66±7.97),and MoCA score(21.96±6.19)(age:P=0.040,0.049,0.035, 0.039;Cystatin C:P=0.035,0.038,0.037,0.035),but for female only age((79.52±8.82)years) had a correla⁃tionship with the hypocampus volume((6319.53±377.74)mm3),Evans index(0.31±0.02),MMSE score(22.93± 6.22),and MoCA score(23.41±8.20)(P=0.044,0.045,0.047,0.046). For male AD patients,the marked correla⁃tionship was showed between Cystatin C and the index of cerebral perfusion(P=0.034),but for female patients, there's no correlationship(P=0.086) . Conclusion The Cystatin C level is distinctly different in male and female AD patients. The Cystatin C level in male AD patients maybe be an index to predict the degree of the cognitive dys⁃function and the level of cerebral perfusion.%目的:探讨胱氨酸蛋白酶抑制剂C( Cystatin C)与老年痴呆患者认知功能障碍、脑萎缩和脑灌注之间的相关关系,分析老年痴呆患者Cystatin C水平变化的可能机制。方法对61例男性和55例女性

  15. Application of Whole-brain Perfusion CT with 320-detector Row CT System in Staging of Cerebral Ischemic Penumbra%320排动态容积CT全脑灌注成像在脑梗死缺血半暗带分期中的应用

    Institute of Scientific and Technical Information of China (English)

    向永华; 王波; 金科; 杨伟; 汪春红

    2012-01-01

    Purpose To investigate the feasibility of staging cerebral ischemic penumbra using 320-detector row CT whole-brain perfusion imaging. Materials and Methods The values of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT) and time to peak (TTP) were measured in infarct core area, ischemic penumbra, and mirror area in 18 cases with ischemic penumbra. The staging of the ischemic penumbra was made according to the criteria of pre-infarction period staging. Results In 18 cases with ischemic penumbra, MTT and TTP were delayed; CBF was decreased; CBV was slightly decreased, normal or slightly increased. Compared with infarct core area, CBV and CBF were increased, MTT was delayed and TTP was shortened in ischemic penumbra (P 0.05). In 18 cases, three cases were in stage I 2, nine cases in stage Ⅱ1, six cases in stage Ⅱ2. Conclusion Application of whole-brain perfusion CT with 320-detector row CT system can identify the area of cerebral lesions and the existence of ischemic penumbra.%目的 应用320排动态容积CT全脑灌注成像探讨脑梗死缺血半暗带分期的可行性.资料与方法 测量18例存在缺血半暗带脑梗死患者的梗死核心区、缺血半暗带区及其镜像对侧脑血容量(CBV)、脑血流量(CBF)、平均通过时间(MTT)及达峰时间(TTP),按脑梗死前期分期标准对缺血半暗带进行分期.结果 18例缺血半暗带区表现为MTT、TTP延长,CBF降低,CBV轻度升高、正常或轻度降低.与梗死核心区比较,缺血半暗带区CBV、CBF升高,MTT延长,TTP缩短(P<0.05);与健侧对应区比较,CBF降低,MTT及TTP延长(P<0.05),而CBV无显著差异(P>0.05).缺血半暗带分期:Ⅰ2期3例,Ⅱ1期9例,Ⅱ2期6例.结论 应用320排动态容积CT全脑灌注成像可明确脑梗死患者的病变部位、范围以及有无缺血半暗带存在,并可对缺血半暗带进行分期.

  16. Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Sun Pyo; Yoon, Joon Kee; Choi, Bong Hoi; Joo, In Soo; Yoon, Seok Nam [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2008-10-15

    Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Fifty seven {sup 99m}Tc-Ethylene Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=56{+-}17 years) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age =36{+-}10 years) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Using {sup 99m}Tc-ECD SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

  17. Ataque cerebral

    OpenAIRE

    Takeuchi Tan, Yuri; Fundación Valle de Lili

    1998-01-01

    ¿Qué es un ataque cerebral?/¿Qué tipos de ataque cerebral existen?/¿Cuáles son los síntomas de un ataque cerebral?/Factores de riesgo para un ataque cerebral/Tratamiento médico del ataque cerebral/¿por qué es importante acudir temprano cuando se presentan las señales de alarma?/ Manejo preventivo del ataque cerebral isquémico/Tratamiento quirúrgico del ataque cerebral/Enfermedad vascular cerebral hemorrágica/¿Cómo está constituido el grupo de ataque cerebral de la fundación Clínica Valle d...

  18. 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

  19. SPECT analysis of recent cerebral infarction

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Tzourio, N

    1989-01-01

    already differentiated in the subacute period. The central area presented a short phase of luxury perfusion and a longer phase of IMP hyperfixation. The peripheral area showed both a slight regional cerebral blood flow decrease and an early IMP uptake decrease similar to those previously found...

  20. Dual role of cerebral blood flow in regional brain temperature control in the healthy newborn infant.

    Science.gov (United States)

    Iwata, Sachiko; Tachtsidis, Ilias; Takashima, Sachio; Matsuishi, Toyojiro; Robertson, Nicola J; Iwata, Osuke

    2014-10-01

    Small shifts in brain temperature after hypoxia-ischaemia affect cell viability. The main determinants of brain temperature are cerebral metabolism, which contributes to local heat production, and brain perfusion, which removes heat. However, few studies have addressed the effect of cerebral metabolism and perfusion on regional brain temperature in human neonates because of the lack of non-invasive cot-side monitors. This study aimed (i) to determine non-invasive monitoring tools of cerebral metabolism and perfusion by combining near-infrared spectroscopy and echocardiography, and (ii) to investigate the dependence of brain temperature on cerebral metabolism and perfusion in unsedated newborn infants. Thirty-two healthy newborn infants were recruited. They were studied with cerebral near-infrared spectroscopy, echocardiography, and a zero-heat flux tissue thermometer. A surrogate of cerebral blood flow (CBF) was measured using superior vena cava flow adjusted for cerebral volume (rSVC flow). The tissue oxygenation index, fractional oxygen extraction (FOE), and the cerebral metabolic rate of oxygen relative to rSVC flow (CMRO₂ index) were also estimated. A greater rSVC flow was positively associated with higher brain temperatures, particularly for superficial structures. The CMRO₂ index and rSVC flow were positively coupled. However, brain temperature was independent of FOE and the CMRO₂ index. A cooler ambient temperature was associated with a greater temperature gradient between the scalp surface and the body core. Cerebral oxygen metabolism and perfusion were monitored in newborn infants without using tracers. In these healthy newborn infants, cerebral perfusion and ambient temperature were significant independent variables of brain temperature. CBF has primarily been associated with heat removal from the brain. However, our results suggest that CBF is likely to deliver heat specifically to the superficial brain. Further studies are required to assess the

  1. Comparative study of the uniform and non uniform attenuation correction in cerebral perfusion scintigraphy with E.C.D.-{sup 99m}Tc; Etude comparative de la correction d'attenuation uniforme et non uniforme en scintigraphie cerebrale de perfusion au ECD-99mTc

    Energy Technology Data Exchange (ETDEWEB)

    Farid, K.; Caillat-Vigneron, N. [Hotel-Dieu de Paris, Service de medecine nucleaire, 75 (France); Habert, M.O. [Hopital de la Pitie-Salpetriere, service de medecine nucleaire, 75 - Paris (France); Martineau, A. [Hopital Saint-Louis, service de medecine nucleaire, 75 - Paris (France); Sibon, I. [CHU de Bordeaux, service de neurologie, 33 (France)

    2010-07-01

    Brain perfusion scintigraphy is a functional imaging currently used for the evaluation of patients with cognitive impairment. Although widely available, this technique is known as less sensitive than {sup 18}FDG-PET. The optimization of technical parameters for images acquiring and processing using a non uniform attenuation correction (A.C.) and a correction of distributed (C.D.) could improve its performance. The objective of this study is to compare the non uniform correction obtained by attenuation map of computed tomography (CT) combined with CT-C.D. and C.D. + CT uniform C.A. using the Chang method considering the distributed alone (coefficient = 0.09 cm{sup -1})

  2. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  3. 小儿主动脉弓手术中深低温停循环和局部脑灌注的应用效果%Applied research of deep hypothermic circulatory arrest and regional cerebral perfusion in pediatric aortic arch surgery

    Institute of Scientific and Technical Information of China (English)

    郭铮; 郑景浩; 王伟; 付惟定; 朱德明

    2014-01-01

    目的 观察并比较深低温停循环(DHCA)和局部脑灌注(RCP)在小儿主动脉弓手术中的应用效果.方法 70例小于3个月的主动脉缩窄和主动脉弓中断合并房间隔缺损、室间隔缺损的手术患儿根据体外循环方法不同分成DHCA组和RCP组.DHCA组35例,男23例,女12例;年龄(1.33±0.80)个月;体质量(4.3±2.9)kg.RCP组35例,男20例,女15例;年龄(1.35±0.90)个月;体质量(4.4±3.2) kg.分析两组体外循环时间、主动脉阻断时间、停循环或脑灌注时间,呼吸机辅助时间、监护室停留时间,术后肾功能不全、低心排血量综合征、肺部炎症、神经系统并发症和院内死亡等情况.结果 神经系统并发症发病率,DHCA组显著高于RCP组(P<0.05).体外循环时间,RCP组显著的长于DHCA组(P<0.05).RCP时间显著长于DHCA时间(P<0.01).在主动脉阻断时间、呼吸机插管时间、监护室停留时间和术后肾功能不全、低心排血量综合征、肺部炎症及院内死亡比例等两组间差异无统计学意义.结论 RCP是一种有效的脑保护技术,同DHCA相比,能更好的对大脑进行持续的脑血流灌注,适用于复杂耗时的小儿主动脉弓手术,在神经系统保护方面较DHCA有着更好的效果.%Objective To observe and evaluate the effects of the deep hypothermic circulatory arrest(DHCA) and regional cerebral perfusion(RCP) in pediatric aortic arch surgery.Methods According to different methods of CPB,70 infants less than 3-month-old with CoA or IAA were undergone corrective surgery with DHCA or RCP.The bypass time,aortic clamp time,DHCA or RCP time,ventilation time,ICU stay time and post-operative complications were recorded and compared between two groups.Results The incidence of neurological complications was significantly higher in DHCA group.The CPB time was significantly longer in the RCP group,and the RCP time was significantly longer than DHCA time.Blocking time,ventilator intubation time

  4. Cerebral malaria Malaria cerebral

    Directory of Open Access Journals (Sweden)

    Silvia Blair Trujillo

    2003-03-01

    Full Text Available Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia. La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC.

  5. Diffusion and Perfusion Magnetic Resonance Imaging:Fundamentals and Advances

    CERN Document Server

    Assili, Sanam

    2016-01-01

    Over the past few decades, magnetic resonance imaging has been utilized as a powerful imaging modality to evaluate the structure and function of various organs in the human body,such as the brain. Additionally, diffusion and perfusion MR imaging have been increasingly used in neurovascular clinical applications. In diffusion-weighted magnetic resonance imaging, the mobility of water molecules is explored in order to obtain information about the microscopic behavior of the tissues. In contrast, perfusion weighted imaging uses tracers to exploit hemodynamic status, which enables researchers and clinicians to consider this imaging modality as an early biomarker of certain brain diseases. In this review, the fundamentals of physics for diffusion and perfusion MR imaging both of which are highly sensitive to microenvironmental alterations at the cellular level as well as their application in the treatment of aging, Alzheimer's disease, brain tumors and cerebral ischemic injury were discussed.

  6. CT perfusion imaging in the management of posterior reversible encephalopathy

    Energy Technology Data Exchange (ETDEWEB)

    Casey, S.O.; McKinney, A.; Teksam, M.; Liu, H.; Truwit, C.L. [Department of Radiology, University of Minnesota Medical School, 420 Delaware Street SE, Box 292, MN 55455, Minneapolis (United States)

    2004-04-01

    A 13-year-old girl with a renal transplant presented with hypertension and seizures. CT and MRI demonstrated typical bilateral parietal, occipital and posterior frontal cortical and subcortical edema, thought to represent posterior reversible encephalopathy syndrome. The cause was presumed to be hypertension. Antihypertensive therapy was started, lowering of the blood pressure in the range of 110-120 mmHg systolic. However, stable xenon (Xe) CT perfusion imaging revealed ischemia within the left parietal occipital region. The antihypertensive was adjusted which increased both the systolic and diastolic blood pressure by 31 mm Hg. The patient was re-imaged with Xe CT and was found to have resolution of the ischemic changes within the left parietal occipital region. In this report, we present a case in which stable Xe CT was used to monitor the degree of cerebral perfusion and guide titration of antihypertensive therapy. Such brain perfusion monitoring may have helped to prevent infarction of our patient. (orig.)

  7. 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.

  8. 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

  9. Cerebral oxygenation and hyperthermia

    Directory of Open Access Journals (Sweden)

    Anthony Richard Bain

    2014-03-01

    Full Text Available Hyperthermia is associated with marked reductions in cerebral blood flow (CBF. Increased distribution of cardiac output to the periphery, increases in alveolar ventilation and resultant hypocapnia each contribute to the fall in CBF during passive hyperthermia; however, their relative contribution remains a point of contention, and probably depends on the experimental condition (e.g. posture and degree of hyperthermia. The hyperthermia-induced hyperventilatory response reduces arterial CO2 pressure (PaCO2 causing cerebral vasoconstriction and subsequent reductions in flow. During supine passive hyperthermia, the majority of recent data indicate that reductions in PaCO2 may be the primary, if not sole, culprit for reduced CBF. On the other hand, during more dynamic conditions (e.g. hemorrhage or orthostatic challenges, an inability to appropriately decrease peripheral vascular conductance presents a condition whereby adequate cerebral perfusion pressure may be compromised secondary to reductions in systemic blood pressure. Although studies have reported maintenance of pre-frontal cortex oxygenation (assessed by near-infrared spectroscopy during exercise and severe heat stress, the influence of cutaneous blood flow is known to contaminate this measure. This review discusses the governing mechanisms associated with changes in CBF and oxygenation during moderate to severe (i.e. 1.0°C to 2.0°C increase in body core temperature levels of hyperthermia. Future research directions are provided.

  10. On Causes of Wilhelm’s Misery in Seize the Day

    Institute of Scientific and Technical Information of China (English)

    张冉冉

    2015-01-01

    Seize the Day subtly and precisely describes an isolated,lost and helpless state of an Jewish Americans,Tommy Wilhelm in modern times.This novel focuses on a single and dreadful day of Tommy Wilhelm during which he recalls what he has gone through in his former life.Tommy Wilhelm is a middle aged Jewish American who gets cheated by a star scout in college,loses his job as a salesman in middle age,gets separated with his wife,fails in a risky speculation with no money left and gets no help from anyone even from his father.In this thesis,the author uses alienation theory to analyze Wilhelm’s misery and figures out that alienation from main social value,alienation from his father,alienation from his wife and alienation from his rational self are the main causes of Wilhelm’s miserable life.%《只争朝夕》用细腻和精妙的笔触描绘了犹太裔美国人汤米•威尔汉姆在现代社会中孤独,迷茫无助的生活状态。这部小说着力叙述了威尔汉姆可怕的一天及其对之前生活经历的回想。在这部小说中,主人公汤米•威尔姆,大学时受骗于星探,中年失业,与妻子分居,投资失败,分文无存,并且孤立无援,连父亲也不伸出援手。此论文运用异化理论对威尔汉姆与主流社会价值的异化,与其父亲和妻子的异化,以及与自身理性的异化进行分析,试图得出汤米•威尔汉姆悲惨生活的原因。

  11. Role of dynamic CT perfusion study in evaluating various intracranial space-occupying lesions

    Directory of Open Access Journals (Sweden)

    Ravindra B Kamble

    2015-01-01

    Full Text Available Aims: Differentiating intracranial mass lesions on CT scan is challenging. The purpose of our study was to determine the perfusion parameters in various intracranial space-occupying lesions (ICSOL, differentiate benign and malignant lesions, and differentiate between grades of gliomas. Materials and Methods: We performed CT perfusion (CTP in 64 patients, with age ranging from 17 to 68 years, having space-occupying lesions in brain and calculated relative cerebral blood flow (rCBF and relative cerebral blood volume (rCBV. Results: We found significantly lower perfusion in low-grade gliomas as compared to high-grade tumors, lymphoma, and metastases. Similarly in infective lesions, TWT and abscesses showed significantly lower perfusion compared to TOT. In ring enhancing lesions, capsule of TWT showed significantly lower perfusion as compared to abscesses, TOT, and metastases. Conclusion: Thus, in conclusion, infective lesions can be differentiated from tumors like lymphomas, high-grade gliomas, or metastases based on perfusion parameters. The cut off value of rCBV 1.64 can be used to differentiate between low grade and high grade gliomas. However, depending only on perfusion parameters, differentiation between the tumors like lymphomas, high-grade gliomas, and metastases may not be possible.

  12. 应用颅脑CT血管成像联合CT灌注成像诊断后循环缺血的临床价值分析%Value of Cerebral CT angiography and CT perfusion imaging to diagnose posterior circulation ischemia

    Institute of Scientific and Technical Information of China (English)

    王淑敏; 王伟; 宋义周; 郑丽平; 梁文娜

    2014-01-01

    目的:采用CT血管成像(CTA)与CT灌注成像(CTPI)相结合的技术,观察后循环缺血患者的椎基底动脉情况及局部脑血流灌注情况,探讨二者结合在后循环缺血诊断中的价值。方法:收集30例后循环缺血患者及30例健康人的临床资料,同时应用64排128层螺旋CT给予CTA与CTPI检查。结果:30例PCI患者CTP上发现与临床症状相对应的异常灌注区共27例,其中MTT图上27例,CBF图上22例,而CBV图上仅14例,另外3例在所有灌注参数图上均未发现异常。病例组中,患侧及健侧的平均MTT及平均CBF差异具有统计学意义(P<0.05),患侧及健侧的平均CBV差异无统计学意义(P>0.05)。PCI组中椎基底动脉狭窄的比例均显著增加(P<0.01),椎基底动脉走行迂曲及椎动脉发育不良的例数也明显增多(P<0.05)。结论:CTA联合CTPI能够清晰的显示后循环系统及脑供血情况,是判断后循环缺血病因及脑缺血严重程度的一项较实用的客观可靠的检查手段。The case group of ipsilateral and contralateral average MTT and mean CBF had a statistically significant difference (P<0.05),The average CBV was not significant (P >0.05). PCI group of vertebrobasilar artery stenosis ratio were significantly increased (P<0.01), the number of cases of vertebrobasilar artery expanded and vertebral artery hypoplasia was significantly increased (P<0.05). Conclusion CTA combined with CTPI can clearly display the circulatory system and brain blood supply, is to determine the cause of posterior circulation ischemia and ischemic severity is an effective and reliable means of inspection.%Objectiv Using CT angiography (CTA) and CT perfusion imaging (CTPI) combined technology, observation of vertebrobasilar artery vascular and regional cerebral blood flow perfusion in patients with posterior circulation ischemia, Investigation of the value in the diagnosis of post ischemia with them

  13. Brain perfusion asymmetry in patients with oral somatic delusions.

    Science.gov (United States)

    Umezaki, Yojiro; Katagiri, Ayano; Watanabe, Motoko; Takenoshita, Miho; Sakuma, Tomomi; Sako, Emi; Sato, Yusuke; Toriihara, Akira; Uezato, Akihito; Shibuya, Hitoshi; Nishikawa, Toru; Motomura, Haruhiko; Toyofuku, Akira

    2013-06-01

    Oral cenesthopathy is a somatic delusion or hallucination involving the oral area and is categorized as a delusional disorder, somatic type. The pathophysiology of this intractable condition remains obscure. In this study, we clarified the pathophysiology of oral cenesthopathy by evaluating regional brain perfusion. We performed single photon emission computed tomography (SPECT) using (99m)Tc-ethylcysteinate dimer in 16 subjects (cenesthopathy:control = 8:8). The SPECT images were visually assessed qualitatively, and quantitative analyses were also performed using a three-dimensional stereotactic region-of-interest template. The visual assessment revealed a right > left perfusion asymmetry in broad areas of the brain among the patients. The quantitative analysis confirmed that the regional cerebral blood flow values on the right side were significantly larger than those on the left side for most areas of the brain in the patients. A comparison of the R/(R + L) ratios in both groups confirmed the significant brain perfusion asymmetry between the two sides in the callosomarginal, precentral, and temporal regions in the patients. Qualitative evaluation of the SPECT images revealed right > left brain perfusion asymmetry in broad regions of the brain. Moreover, the quantitative analyses confirmed the perfusion asymmetry between the two sides in the frontal and temporal areas. Those may provide the key for elucidation of the pathophysiology of oral cenesthopathy.

  14. Perfusion imaging with computed tomography: brain and beyond

    Energy Technology Data Exchange (ETDEWEB)

    Miles, K.A. [Div. of Clinical and Lab. Investigation, Brighton and Sussex Medical School, Univ. of Sussex, Falmer, Brighton (United Kingdom)

    2006-01-10

    The availability of rapid imaging with multidetector CT systems and commercial analysis software has made perfusion imaging with CT an everyday technique, not only for the brain but also for other body organs. Perfusion imaging is usually performed as an adjunct to a conventional CT examination and is therefore particularly appropriate when a conventional CT is part of routine clinical protocols. The derived values are reproducible and have been validated against a range of reference techniques. Within neuroradiology, perfusion CT has attracted interest in the assessment of acute stroke but can also be used to assess secondary injury in head trauma and as an adjunct to CT angiography to evaluate cerebral spasm in subarachnoid haemorrhage. Within oncology, perfusion CT provides an imaging correlate for tumour vascularity that can be used to discriminate benign and malignant lesions, as an indicator of tumour aggressiveness, to reveal occult tumour and improve the delineation of tumours during radiotherapy planning, and as a functional assessment of tumour response to therapy. By exploiting the ability of CT systems to quantify contrast enhancement. CT perfusion imaging uses contrast media to assess vascular physiology and so improve diagnosis, prognosis, treatment selection and therapy monitoring. (orig.)

  15. Usefulness of CT perfusion imaging in adult moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Bo Bae; Kim, Young Joo; Song, Ha Hun; Kim, Ki Tae [College of Medicine, The Catholic University of Korea, Uijongbu (Korea, Republic of)

    2004-12-01

    The purpose of this study was to evaluate the role of perfusion CT in adult moyamoya disease. The study population consisted of 13 adult moyamoya patients (10 women and 3 men, mean age: 40.4 years) and 11 age-matched normal controls (5 men and 6 women, mean age: 43 years). We retrospectively assessed the perfusion CT scan both visually and by a quantitative regional analysis, and we assessed the relationship between the perfusion CT scan findings and the angiographic findings. The mean relative cerebral blood volume (rCBV) values in moyamoya patients were 8.0% for the MCA area, 6.4% for the PCA area, and 7.7% for the basal ganglia. The rCBV values in the patients were higher than those in the control group with statistical significance (p<0.0001). The time to peak enhancement (TTP) values of the MCA area and the basal ganglia were delayed more than those in the controls; this was statistically significant (p<0.05). Moderate correlation was found between the rCBV in the basal ganglia area and angiographic stage of the basal moyamoya vessels. Perfusion CT demonstrates a statisticaIly significant increase in rCBV in the MCA, PCA and basal ganglia areas and the TTP in the MCA and basal ganglia areas in patients with moyamoya disease. The visual brain perfusion patterns correIate with the extent and severity of the basal moyamoya vessels.

  16. Positron CT imaging of an impending stroke

    Energy Technology Data Exchange (ETDEWEB)

    Itoh, M.; Hatazawa, J.; Watanuki, S.; Pozzilli, C.; Matsuzawa, T.; Abe, Y.; Fujiwara, T.; Satoh, T.; Fukuda, H.; Wada, T.

    1988-06-01

    We present PET findings of a case of a transient ischemic attack which later progressed to cerebral infarction. Cerebral blood flow at the stroke focus in the right parietal cortex measured after a TIA attack and before stroke was as low as 24 ml/100 g/min with some increase in oxygen extraction fraction and blood volume. The condition was compatible with 'misery perfusion'. This case may be an example suggestive that the 'misery perfusion sign' is a warning of impending stroke and its poor prognosis if left without appropriate treatments.

  17. Cerebral blood flow and oxygenation in infants after birth asphyxia. Clinically useful information?

    DEFF Research Database (Denmark)

    Greisen, Gorm

    2014-01-01

    The term 'luxury perfusion' was coined nearly 50 years ago after observation of bright-red blood in the cerebral veins of adults with various brain pathologies. The bright-red blood represents decreased oxygen extraction and hence the perfusion is 'luxurious' compared to oxygen needs. Gradual loss...

  18. 轻度过度通气对幕上占位开颅患者麻醉后颅内压、脑灌注压以及血流动力学影响%The influence of mild hyperventilation to intracranial pressure,cerebral perfusion pressure and hemodynamics during supratentorial craniotomy

    Institute of Scientific and Technical Information of China (English)

    陈一丁; 张宏伟; 唐育民; 张兆辉; 罗江辉

    2011-01-01

    Objective To observe the influence of mild hyperventilation to intracranial pressure (ICP) 、cerebral perfusion pressure (CPP) and hemodynamic during supratentorial craniotomy, and to provide evidence for applicable neurosurgical anesthesiology. Methods 21 patients with supratentorial tumor were given mild hyperventilation, with EtCO2 30 ~ 35mmHg and peak airway pressure 10 ~18cmH2O. The ICP through lumbar cerebrospinal fluid pressure, the central venous pressure (CVP) in superior vena cava, the intra-abdominal pressure (IAP) through intra-bladder pressure (IBP), the mean arterial pressure (MAP)by peripheral arterial cannulation, and CPP were analyzed during the period from anesthesia induction to opening the hard meninges. Results The mild hyperventilation significantly increased the CVP、IBP and ICP, while significantly decreased the MAP and CPP in patients under anesthesia. Conclusion It's essential to remove skull bone flap to decrease ICP as soon as possible after anesthesia and positive ventilation, to prevent the abrupt decreasing of CPP. The mild hyperventilation doesn't provide beneficial effects to cerebral perfusion, and further comparative study for ventilation strategy should be designed.%目的 观察轻度过度通气对幕上占住开颅患者麻醉后颅内压、脑灌注压以及血流动力学的影响.为临床上合理的神经外科麻醉方法提供依据.方法 对21例幕上占位开颅患者给予轻度过度通气,控制呼吸末CO 30~35mmHg和气道峰压10~18cmHO,在全麻诱导前至开硬脑膜后这一时间段,分析经腰段脑脊液监测颅内压、经上腔静脉监测中心静脉压、经膀胱监测腹腔压、经有创动脉监测平均动脉压以及脑灌注压变化.结果 轻度过度通气显著增高了全麻后患者中心静脉压,膀胱压和颅内压,降低了平均动脉压和脑灌注压.结论 麻醉正压通气后应尽快开颅减压,降低颅内压,避免脑灌注压过度下降.轻度过度通气

  19. 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

  20. 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.

  1. 深低温停循环与区域性脑灌注婴儿学龄前社会生活能力随访%Follow-up of the preschool social life abilities of children who underwent deep hypothermic circulatory arrest or regional cerebral perfusion in infancy

    Institute of Scientific and Technical Information of China (English)

    彭文英; 庄建; 陈寄梅; 陈萍; 罗丹东

    2012-01-01

    目的 评估心血管手术中使用深低温停循环(deep hypothermic circulatory arrest,DHCA)与区域性脑灌注(regional cerebral perfusion,RCP)的婴儿学龄前社会生活能力水平,评价DHCA与RCP的脑保护效果.方法 选取2007年4月至2009年2月在广东省人民医院接受DHCA和RCP行主动脉合并心内畸形矫治手术的患儿(日龄≤90 d或体质量≤6.0 kg),排除死亡及失访患儿后,参与随访的共32例,男26例,女6例;手术日龄14~187 d,中位日龄55 d;手术时体质量(4.2±0.8)kg.其中,DHCA组15例,RCP组17例,随访时间分别为(57.2±5.9)个月与(53.2±9.4)个月.采用从《婴儿-初中生社会生活能力量表》,从独立生活、运动、作业操作、交往、集体活动、自我管理6个方面对患儿进行评估,测出其社会生活能力水平.结果 DHCA组有1例患儿术后反复肺炎,生长发育差,作业操作、交往能力评分等级为轻度低下,独立生活、运动、集体活动、自我管理评分为边缘;另1例患儿集体活动评分为边缘.RCP组有1例患儿交往能力评分为边缘.其余患儿在作业操作、交往、独立生活、运动、集体活动、自我管理6个方面社会生活能力均正常.两组患儿在作业操作、交往、独立生活、运动、集体活动、自我管理6个方面评分比较,差异均无统计学意义(P>0.05).结论 婴幼儿主动脉手术使用DHCA与RCP对患儿学龄前社会生活能力无明显影响,DHCA与RCP有相似的脑保护效果.%Objectives To evaluate the cerebral protective effects of deep hypothermic circulatory arrest (DHCA) and regional cerebral perfusion (RCP) by following up the preschool social life abilities of children who underwent cardiac surgery with DHCA or RCP in their infancy. Methods Those who died or failed to respond were excluded. Then 32 patients (26 males and 6 females) who underwent aortic surgical procedures with DHCA or RCP in their infancy (age ^ 90 d or weight ^6.0 kg

  2. 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....

  3. Cerebral oximetry in cardiac anesthesia

    Science.gov (United States)

    Vretzakis, George; Georgopoulou, Stauroula; Stamoulis, Konstantinos; Stamatiou, Georgia; Tsakiridis, Kosmas; Katsikogianis, Nikolaos; Kougioumtzi, Ioanna; Machairiotis, Nikolaos; Tsiouda, Theodora; Mpakas, Andreas; Beleveslis, Thomas; Koletas, Alexander; Siminelakis, Stavros N.; Zarogoulidis, Konstantinos

    2014-01-01

    Cerebral oximetry based on near-infrared spectroscopy (NIRS) is increasingly used during the perioperative period of cardiovascular operations. It is a noninvasive technology that can monitor the regional oxygen saturation of the frontal cortex. Current literature indicates that it can stratify patients preoperatively according their risk. Intraoperatively, it provides continuous information about brain oxygenation and allows the use of brain as sentinel organ indexing overall organ perfusion and injury. This review focuses on the clinical validity and applicability of this monitor for cardiac surgical patients. PMID:24672700

  4. Diagnostic performance of whole brain volume perfusion CT in intra-axial brain tumors: Preoperative classification accuracy and histopathologic correlation

    Energy Technology Data Exchange (ETDEWEB)

    Xyda, Argyro, E-mail: argyro.xyda@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Department of Radialogy, University Hospital of Heraklion, Voutes, 71110 Heraklion, Crete (Greece); Haberland, Ulrike, E-mail: ulrike.haberland@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Klotz, Ernst, E-mail: ernst.klotz@siemens.com [Siemens AG Healthcare Sector, Computed Tomography, Siemensstr. 1, 91301 Forchheim (Germany); Jung, Klaus, E-mail: kjung1@uni-goettingen.de [Department of Medical Statistics, Georg-August University, Humboldtallee 32, 37073 Goettingen (Germany); Bock, Hans Christoph, E-mail: cbock@gmx.de [Department of Neurosurgery, Johannes Gutenberg University Hospital of Mainz, Langenbeckstraße 1, 55101 Mainz (Germany); Schramm, Ramona, E-mail: ramona.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Knauth, Michael, E-mail: michael.knauth@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany); Schramm, Peter, E-mail: p.schramm@med.uni-goettingen.de [Department of Neuroradiology, Georg-August University, University Hospital of Goettingen, Robert-Koch Strasse 40, 37075 Goettingen (Germany)

    2012-12-15

    Background: To evaluate the preoperative diagnostic power and classification accuracy of perfusion parameters derived from whole brain volume perfusion CT (VPCT) in patients with cerebral tumors. Methods: Sixty-three patients (31 male, 32 female; mean age 55.6 ± 13.9 years), with MRI findings suspected of cerebral lesions, underwent VPCT. Two readers independently evaluated VPCT data. Volumes of interest (VOIs) were marked circumscript around the tumor according to maximum intensity projection volumes, and then mapped automatically onto the cerebral blood volume (CBV), flow (CBF) and permeability Ktrans perfusion datasets. A second VOI was placed in the contra lateral cortex, as control. Correlations among perfusion values, tumor grade, cerebral hemisphere and VOIs were evaluated. Moreover, the diagnostic power of VPCT parameters, by means of positive and negative predictive value, was analyzed. Results: Our cohort included 32 high-grade gliomas WHO III/IV, 18 low-grade I/II, 6 primary cerebral lymphomas, 4 metastases and 3 tumor-like lesions. Ktrans demonstrated the highest sensitivity, specificity and positive predictive value, with a cut-off point of 2.21 mL/100 mL/min, for both the comparisons between high-grade versus low-grade and low-grade versus primary cerebral lymphomas. However, for the differentiation between high-grade and primary cerebral lymphomas, CBF and CBV proved to have 100% specificity and 100% positive predictive value, identifying preoperatively all the histopathologically proven high-grade gliomas. Conclusion: Volumetric perfusion data enable the hemodynamic assessment of the entire tumor extent and provide a method of preoperative differentiation among intra-axial cerebral tumors with promising diagnostic accuracy.

  5. 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).

  6. 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...

  7. Fractal analysis in radiological and nuclear medicine perfusion imaging: a systematic review

    Energy Technology Data Exchange (ETDEWEB)

    Michallek, Florian; Dewey, Marc [Humboldt-Universitaet zu Berlin, Freie Universitaet Berlin, Charite - Universitaetsmedizin Berlin, Medical School, Department of Radiology, Berlin (Germany)

    2014-01-15

    To provide an overview of recent research in fractal analysis of tissue perfusion imaging, using standard radiological and nuclear medicine imaging techniques including computed tomography (CT), magnetic resonance imaging (MRI), ultrasound, positron emission tomography (PET) and single-photon emission computed tomography (SPECT) and to discuss implications for different fields of application. A systematic review of fractal analysis for tissue perfusion imaging was performed by searching the databases MEDLINE (via PubMed), EMBASE (via Ovid) and ISI Web of Science. Thirty-seven eligible studies were identified. Fractal analysis was performed on perfusion imaging of tumours, lung, myocardium, kidney, skeletal muscle and cerebral diseases. Clinically, different aspects of tumour perfusion and cerebral diseases were successfully evaluated including detection and classification. In physiological settings, it was shown that perfusion under different conditions and in various organs can be properly described using fractal analysis. Fractal analysis is a suitable method for quantifying heterogeneity from radiological and nuclear medicine perfusion images under a variety of conditions and in different organs. Further research is required to exploit physiologically proven fractal behaviour in the clinical setting. (orig.)

  8. Perfusion Angiography in Acute Ischemic Stroke

    Directory of Open Access Journals (Sweden)

    Fabien Scalzo

    2016-01-01

    Full Text Available Visualization and quantification of blood flow are essential for the diagnosis and treatment evaluation of cerebrovascular diseases. For rapid imaging of the cerebrovasculature, digital subtraction angiography (DSA remains the gold standard as it offers high spatial resolution. This paper lays out a methodological framework, named perfusion angiography, for the quantitative analysis and visualization of blood flow parameters from DSA images. The parameters, including cerebral blood flow (CBF and cerebral blood volume (CBV, mean transit time (MTT, time-to-peak (TTP, and Tmax, are computed using a bolus tracking method based on the deconvolution of the time-density curve on a pixel-by-pixel basis. The method is tested on 66 acute ischemic stroke patients treated with thrombectomy and/or tissue plasminogen activator (tPA and also evaluated on an estimation task with known ground truth. This novel imaging tool provides unique insights into flow mechanisms that cannot be observed directly in DSA sequences and might be used to evaluate the impact of endovascular interventions more precisely.

  9. Technetium-99m-ECD SPECT in antiphospholipid antibody syndrome: a drastic improvement in brain perfusion by antiplatelet therapy

    Energy Technology Data Exchange (ETDEWEB)

    Tokumaru, Sunao; Yoshikai, Tomonori; Uchino, Akira; Kudo, Sho [Dept. of Radiology, Saga Medical School (Japan); Matsui, Makoto; Kuroda, Yasuo [Dept. of Neurology, Saga Medical School (Japan)

    2001-12-01

    We present a case of antiphospholipid antibody syndrome (APS) with repeated transient ischemic attacks (TIAs). Magnetic resonance imaging showed multiple cerebral infarcts and ischemic changes in the cerebral white matter. Cerebral angiographies showed no abnormalities. Technetium-99m-ethyl cysteinate dimer (Tc-99m-ECD) brain SPECT showed multiple decreased perfusion areas, which were more extensive than the lesions demonstrated on MRI. After treatment with an antiplatelet agent, the patient subsequently recovered from the TIAs. Although no interval changes were observed by MRI after therapy, follow-up Tc-99m-ECD SPECT revealed a marked improvement in brain perfusion. This is the first imaging report of remarkable post-therapy improvement in brain perfusion in APS cases. (orig.)

  10. Functional improvement after carotid endarterectomy: demonstrated by gait analysis and acetazolamide stress brain perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, G. E.; Yoo, J. Y.; Kim, D. G.; Moon, D. H. [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    Scientific documentation of neurologic improvement following carotid endarterectomy (CEA) has not been established. The purpose of this prospective study is to investigate whether CEA performed for the internal carotid artery flow lesion improves gait and cerebrovascular hemodynamic status in patients with gait disturbance. We prospectively performed pre- and postCEA gait analysis and acetazolamide stress brain perfusion SPECT (Acz-SPECT) with Tc-99m ECD in 91 patients (M/F: 81/10, mean age: 64.1 y) who had gait disturbance before receiving CEA. Gait performance was assessed using a Vicon 370 motion analyzer. The gait improvement after CEA was correlated to cerebrovascular hemodynamic change as well as symptom duration. 12 hemiparetic stroke patients (M/F=9/3, mean age: 51 y) who did not receive CEA as a control underwent gait analysis twice in a week interval to evaluate whether repeat testing of gait performance shows learning effect. Of 91 patients, 73 (80%) patients showed gait improvement (change of gait speed > 10%) and 42 (46%) showed marked improvement (change of gait speed > 20%), but no improvement was observed in control group at repeat test. Post-operative cerebrovascular hemodynamic improvement was noted in 49 (54%) of 91 patients. There was marked gait improvement in patients group with cerebrovascular hemodynamic improvement compared to no change group (p<0.05). Marked gait improvement and cerebrovascular hemodynamic improvement were noted in 53% and 61% of the patient who had less than 3 month history of symptom compared to 31% and 24% of the patients who had longer than 3 months, respectively (p<0.05). Marked gait improvement was obtained in patients who had improvement of cerebrovascular hemodynamic status on Acz-SPECT after CEA. These results suggest functional improvement such as gait can result from the improved perfusion of misery perfusion area, which is viable for a longer period compared to literatures previously reported.

  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. 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...

  13. 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.

  14. Clinical value of dipyridamole brain perfusion imaging in the diagnosis of ischemic cerebrovascular disease

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Using dipyridamole stress test to evaluate cerebral blood flow reserve in cerebrovascular disease (CVD). Dipyridamole stress tests were performed first, the baseline SPECT images were obtained under similar conditions 2-5 days later. By visual and semiquantitative analysis, the responses of cerebral blood flow to dipyridamole were divided into the following four patterns: A: The dipyridamole SPECT showed an expanded area of hypoperfusion, Asymmetry Index(AI) and Uptake Rate(UR) were all decreased; B: Rest images was normal but new hypoperfused areas appeared on stress test with decreased Al and UR; C: Hypoperfused areas were decreased in size or disappeared after stress test with increased Al and UR; D: No changes showed in cerebral perfusion imaging patterns, and in Al and UR between stress and rest studies. Dipyridarnole brain perfusion imaging may be helpful to the diagnosis of CVD, to the decision the therapeutic plan, and to predicting the therapeutic effect.

  15. Vasoespasmo cerebral

    Directory of Open Access Journals (Sweden)

    Antonio A. F. de Salles

    1987-09-01

    Full Text Available Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológicos são responsáveis pelas manifestações vasculares que ocorrem após a hemorragia subaracnóidea. Alternativas de tratamento do vasoespasmo cerebral são discutidas.

  16. Cerebral Paragonimiasis.

    Science.gov (United States)

    Miyazaki, I

    1975-01-01

    The first case of cerebral paragonimiasis was reported by Otani in Japan in 1887. This was nine years after Kerbert's discovery of the fluke in the lungs of Bengal tigers and seven years after a human pulmonary infection by the fluke was demonstrated by Baelz and Manson. The first case was a 26-year-old man who had been suffering from cough and hemosputum for one year. The patient developed convulsive seizures with subsequent coma and died. The postmortem examination showed cystic lesions in the right frontal and occipital lobes. An adult fluke was found in the occipital lesion and another was seen in a gross specimen of normal brain tissue around the affected occipital lobe. Two years after Otani's discovery, at autopsy a 29-year-old man with a history of Jacksonian seizure was reported as having cerebral paragonimiasis. Some time later, however, it was confirmed that the case was actually cerebral schistosomiasis japonica. Subsequently, cases of cerebral paragonimiasis were reported. However, the majority of these cases were not confirmed histologically. It was pointed out that some of these early cases were probably not Paragonimus infection. After World War II, reviews as well as case reports were published. Recently, investigations have been reported from Korea, with a clinicla study on 62 cases of cerebral paragonimiasis seen at the Neurology Department of the National Medical Center, Seoul, between 1958 and 1964. In 1971 Higashi described a statistical study on 105 cases of cerebral paragonimiasis that had been treated surgically in Japan.

  17. 老年痴呆患者血清胱氨酸蛋白酶抑制剂 C与认知功能、脑灌注分析%Effect of Serum Cystine Protease Inhibitors C (Cystatin C) on Senile Dementia and Analysis of Cerebral Perfusion

    Institute of Scientific and Technical Information of China (English)

    宋冬晶

    2015-01-01

    针对老年痴呆患者,探讨血清胱氨酸蛋白酶抑制剂 C(Cystatin C)与认知功能、脑灌注的关系,为日后的临床诊治工作,提供参考与指导,具有重要实际临床应用价值。为进行这一探讨,哈尔滨市第二医院选择2013年3月——2015年2月收治的老年痴呆患者60例为研究对象,进行了临床实验。结果发现,老年痴呆症患者,其年龄和血清胱氨酸蛋白酶抑制剂 C 水平,与海马体积、Evans 指数、MMSE 评分等,均存在显著的关系,P<0.05。实践证明,通过对患者的血清胱氨酸蛋白酶抑制剂 C 进行检验和分析,可进一步了解患者的认知功能情况,了解患者的脑灌注情况,为患者的临床诊治,提供较多帮助。%The relationship between serum cystine protease inhibitors C, senile dementia and cerebral perfusion was discussed to provide certain instructions for the next clinical diagnosing work.60 patients were as the clinical objects which admitted in the period of March 2013 to February 2015 by the second hospital of Harbin. The results show that, there is an significant relationship between the age and the level of serum cystine protease inhibitors C(Cystatin C),volume of hippocampal, Evans index, MMSE rating, P<0.05.the practice has shown that by testing and analyzing Cystatin C in patients, more information of the recognizing function of patients can be acquired that are helpful for the clinical diagnosing.

  18. A comparative analysis of the dependences of the hemodynamic parameters on changes in ROI's position in perfusion CT scans

    Science.gov (United States)

    Choi, Yong-Seok; Cho, Jae-Hwan; Namgung, Jang-Sun; Kim, Hyo-Jin; Yoon, Dae-Young; Lee, Han-Joo

    2013-05-01

    This study performed a comparative analysis of cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), and mean time-to-peak (TTP) obtained by changing the region of interest's (ROI) anatomical positions, during CT brain perfusion. We acquired axial source images of perfusion CT from 20 patients undergoing CT perfusion exams due to brain trauma. Subsequently, the CBV, CBF, MTT, and TTP values were calculated through data-processing of the perfusion CT images. The color scales for the CBV, CBF, MTT, and TTP maps were obtained using the image data. Anterior cerebral artery (ACA) was taken as the standard ROI for the calculations of the perfusion values. Differences in the hemodynamic average values were compared in a quantitative analysis by placing ROI and the dividing axial images into proximal, middle, and distal segments anatomically. By performing the qualitative analysis using a blind test, we observed changes in the sensory characteristics by using the color scales of the CBV, CBF, and MTT maps in the proximal, middle, and distal segments. According to the qualitative analysis, no differences were found in CBV, CBF, MTT, and TTP values of the proximal, middle, and distal segments and no changes were detected in the color scales of the the CBV, CBF, MTT, and TTP maps in the proximal, middle, and distal segments. We anticipate that the results of the study will useful in assessing brain trauma patients using by perfusion imaging.

  19. Local cortical hypoperfusion imaged with CT perfusion during postictal Todd's paresis

    Energy Technology Data Exchange (ETDEWEB)

    Mathews, Marlon S.; Binder, Devin K. [University of California, Department of Neurological Surgery, Irvine, CA (United States); Smith, Wade S. [University of California, Department of Neurology, San Francisco, CA (United States); Wintermark, Max; Dillon, William P. [University of California, Department of Radiology, San Francisco, CA (United States)

    2008-05-15

    Postictal ('Todd's') paralysis, or 'epileptic hemiplegia,' is a well-known complication of focal or generalized epileptic seizures. However, it is unclear whether the pathophysiology of Todd's paralysis is related to alterations in cerebral perfusion. We report CT perfusion findings in a patient presenting with postictal aphasia and right hemiparesis. A 62-year-old woman with a history of alcohol abuse, closed head injury and posttraumatic epilepsy, presented with acute onset aphasia and right hemiparesis. A non-contrast head CT scan demonstrated no acute hemorrhage. Left hemispheric ischemia was suspected, and the patient was considered for acute thrombolytic therapy. MRI revealed a subtle increase in signal intensity involving the left medial temporal, hippocampal and parahippocampal regions on both T2-weighted FLAIR and diffusion-weighted sequences. CT angiography and CT perfusion study were performed. The CT perfusion study and CT angiography demonstrated a dramatic reduction in cerebral blood flow and blood volume involving the entire left hemisphere, but with relative symmetry of mean transit time, ruling out a large vessel occlusion. Clinical resolution of the aphasia and hemiparesis occurred within a few hours, and correlated with normalization of perfusion to the left hemisphere (detected by MR perfusion). This unique case is the first in which clinical evidence of Todd's paralysis has been correlated with reversible postictal hemispheric changes on CT and MR perfusion studies. This is important because CT perfusion study is being used more and more in the diagnosis of acute stroke, and one needs to be careful to not misinterpret the data. (orig.)

  20. The utility of perfusion CT and CT angiography on early diagnosis and the management of vasospasm after subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Samira Zabihyan

    2015-01-01

    Full Text Available Subarachnoid hemorrhage is one of the most important and dangerous neurologic emergencies worldwide. It is characterized by a sudden and severe headache caused most commonly by the rupture of intracranial aneurysm. Cerebral vasospasm is the most important cause of disability and death in whom survived from the first event. Early diagnosis and management of cerebral vasospasm could prevent and reduce its morbidity and mortality. Thus, an ideal technique must be able to detect the vasospasm before the occurrence of neurological deficits. Perfusion computed tomography could assess vascularity of brain including cerebral blood flow, cerebral blood volume, time to peak and mean transit time. For this application, perfusion computed tomography and computed tomography angiography techniques offer significant advantages and can result in early diagnosis of vasospasm. In this review, we discuss the utility of these two techniques and their safety in the diagnosis and the management of vasospasm following subarachnoid hemorrhage.

  1. Image quality in CT perfusion imaging of the brain. The role of iodine concentration

    Energy Technology Data Exchange (ETDEWEB)

    Koenig, Matthias; Bueltmann, Eva; Bode-Schnurbus, Lucas; Koenen, Dirk; Mielke, Eckhart; Heuser, Lothar [Knappschaftskrankenhaus Langendreer, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, Ruhr-University Bochum, Bochum (Germany)

    2007-01-15

    The purpose of this study was to evaluate the impact of various iodine contrast concentrations on image quality in computed tomography (CT) perfusion studies. Twenty-one patients with suspicion of cerebral ischemia underwent perfusion CT using two different iodine contrast concentrations: 11 patients received iomeprol 300 (iodine concentration: 300 mg/ml) while ten received the same volume of iomeprol 400 (iodine concentration: 400 mg/ml). Scan parameters were kept constant for both groups. Maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and time to peak (TTP) were calculated from two adjacent slices. Quantitative comparisons were based on measurements of the maximum enhancement [Hounsfield units (HU)] and signal-to-noise index (SNI) on CBF, CBV, and TTP images. Determinations of grey-to-white-matter delineation for each iodine concentration were performed by two blinded readers. Only data from the non-ischemic hemispheres were considered. Both maximum enhancement and SNI values were higher after iomeprol 400, resulting in significantly better image quality in areas of low perfusion. No noteworthy differences were found for normal values of CBF, CBV, and TTP. Qualitative assessment of grey/white matter contrast on CBF and CBV maps revealed better performance for iomeprol 400. For brain perfusion studies, highly concentrated contrast media such as iomeprol 400 is superior to iomeprol 300. (orig.)

  2. CAD system for automatic analysis of CT perfusion maps

    Science.gov (United States)

    Hachaj, T.; Ogiela, M. R.

    2011-03-01

    In this article, authors present novel algorithms developed for the computer-assisted diagnosis (CAD) system for analysis of dynamic brain perfusion, computer tomography (CT) maps, cerebral blood flow (CBF), and cerebral blood volume (CBV). Those methods perform both quantitative analysis [detection and measurement and description with brain anatomy atlas (AA) of potential asymmetries/lesions] and qualitative analysis (semantic interpretation of visualized symptoms). The semantic interpretation (decision about type of lesion: ischemic/hemorrhagic, is the brain tissue at risk of infraction or not) of visualized symptoms is done by, so-called, cognitive inference processes allowing for reasoning on character of pathological regions based on specialist image knowledge. The whole system is implemented in.NET platform (C# programming language) and can be used on any standard PC computer with.NET framework installed.

  3. Arterial spin-labeling MR imaging of cerebral hemorrhages

    Energy Technology Data Exchange (ETDEWEB)

    Noguchi, Tomoyuki [Department of Radiology, National Center for Global Health and Medicine, Tokyo (Japan); Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Nishihara, Masashi; Egashira, Yoshiaki; Azama, Shinya; Hirai, Tetsuyoshi; Kitano, Isao; Irie, Hiroyuki [Saga University, Department of Radiology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Yakushiji, Yusuke [Saga University, Department of Neurology, Faculty of Medicine and Graduate School of Medicine, Saga (Japan); Kawashima, Masatou [Saga University, Department of Neurosurgery, Faculty of Medicine and Graduate School of Medicine, Saga (Japan)

    2015-11-15

    The purpose of this study is to identify the characteristics of brain perfusion measured by arterial spin-labeling magnetic resonance imaging (ASL-MRI) in cerebral hemorrhages. Brain blood flow values (CBF-ASL values) for cerebral and cerebellar hemispheres and segmented cerebral regions were measured by ASL-MRI in 19 putaminal hemorrhage patients and 20 thalamic hemorrhage patients in acute or subacute stages. We assessed the lateralities of CBF-ASL values and the relationships between CBF-ASL values and other imaging findings and clinical manifestations. Both the 19 putaminal hemorrhage patients and the 20 thalamic hemorrhage patients had significantly low CBF-ASL values of the contralateral cerebellum in subacute stage, suggesting that ASL-MRI might delineate crossed cerebellar diaschisis (CCD). Ipsilateral low CBF-ASL values were observed in frontal lobes and thalami with a putaminal hemorrhage and lentiform nuclei, temporal lobes, and parietal lobes with a thalamic hemorrhage, suggesting that ASL-MRI showed the ipsilateral cerebral diaschisis (ICD). In the putaminal hemorrhage patients, the hematoma volume negatively affected both the bilateral cerebellar and cerebral hemispheric CBF-ASL values. In the thalamic hemorrhage patients, a concomitant intraventricular hemorrhage caused low cerebral hemispheric CBF-ASL values. The use of ASL-MRI is sensitive to the perfusion abnormalities and could thus be helpful to estimate functional abnormalities in cerebral hemorrhage patients. (orig.)

  4. Functional MRI of CO2 induced increase in cerebral perfusion

    DEFF Research Database (Denmark)

    Rostrup, Egill; Larsson, H B; Toft, P B

    1994-01-01

    . Additional experiments were carried out using a higher spatial resolution. The largest signal increases were noted in areas corresponding to larger vessels, but significant changes were also conspicuous in deeper cortical and central grey matter. The changes appeared linearly related to the arterial CO2...... tension, within the range of PaCO2 studied. In white matter, the changes were not statistically significant....

  5. Acoustics Provide Insight in the Neonatal Brain and Cerebral Perfusion

    NARCIS (Netherlands)

    M.M.A. Raets (Marlou)

    2014-01-01

    markdownabstract__Abstract__ The incidence of preterm birth is increasing. Preterm infants are all infants born before 37 weeks of gestation. The incidence of preterm birth in the Netherlands is 7.8% of all deliveries, with 1.4% very preterm infants (below 32 weeks of gestation). Advances in prenat

  6. Vasoespasmo cerebral

    OpenAIRE

    1987-01-01

    Vasoespasmo cerebral ocorre em patologias como enxaqueca, hemorragia subaracnóidea, trauma de crânio, após isquemia e/ou hipoxia. A fisiopatologia do vasoespasmo cerebral nestas patologias não está completamente desvendada. Neste artigo são analisados os fatores neuroquímicos e morfológicos responsáveis pelo controle circulatório cerebral. As alterações circulatórias que seguem a hemorragia subaracnóidea são utilizadas como exemplo. Conclui-se que fatores bioquímicos, fisiológicos e morfológi...

  7. 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.

  8. Multi-detector CT perfusion

    Directory of Open Access Journals (Sweden)

    Ashraf M. Enite

    2016-09-01

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

  9. Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA

    Directory of Open Access Journals (Sweden)

    Kim Yong-Won

    2012-08-01

    Full Text Available Abstract Background The diagnosis of transient ischemic attack (TIA based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally diagnosed as transient neurological symptoms associated with dural arteriovenous fistula (dAVF. Case presentation Two patients presented with transient focal neurological symptoms lasting less than one hour. An isolated perfusion deficit with no diffusion change in the clinically relevant area was shown on brain MRI, indicating transient ischemia as the most plausible cause of neurological symptoms. However, cerebral angiography let to diagnosis of dAVF in both cases. Intracerebral hemorrhage occurred after the initial diagnosis of TIA in one patient, and the small area of perfusion abnormality accompanied by the enlarged cortical vein in the other case helped to identify the dAVF through the further investigation. The pattern of perfusion-weighted imaging in both cases revealed increase of mean transit time and relative cerebral blood volume denoting the venous congestion in a clinically corresponding area. Conclusion Reported cases are uncommon clinical presentation of a dAVF, which can be misdiagnosed as TIA on clinical grounds. In rare cases, the isolated perfusion deficits could be attributable to venous congestion, despite the similar pattern of clinical presentation, such as with TIA.

  10. Practical and comprehensive guidelines for bedside cerebral hemometabolic multitherapeutic optimization

    Directory of Open Access Journals (Sweden)

    Cruz Julio

    2002-01-01

    Full Text Available In recent years, noncomprehensive "guidelines" were proposed for the management of severe acute brain injuries, focusing strictly on two approaches: 1 to maintain cerebral perfusion pressure anywhere above 70 mm Hg; and 2 to maintain arterial carbon dioxide tension levels above 30 torr. Strictly following these propositions, a recently reported prospective controlled study addressed mortality rates of no less than 75-76%, far worse than mortality rates reported before those "guidelines" were published. As a humanitarian alternative, the present comprehensive guidelines are aimed at addressing practical bedside strategies to manage no only intracranial pressure and cerebral perfusion pressure but also cerebral extraction of oxygen, based on solid previously reported papers which revealed the lowest mortality rates (below 15% in the pertinent literature, in recent years.

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

    Directory of Open Access Journals (Sweden)

    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.

  12. Cerebral hemodynamics after short- and long-term reduction in blood pressure in mild and moderate hypertension.

    NARCIS (Netherlands)

    Zhang, R.; Witkowski, S.; Fu, Q.; Claassen, J.A.H.R.; Levine, B.D.

    2007-01-01

    This study tested the hypothesis that acute reduction in blood pressure (BP) at the initial stage of antihypertensive therapy compromises brain perfusion and dynamic cerebral autoregulation in patients with hypertension. Cerebral blood flow velocity and BP were measured in patients with mild and mod

  13. Quantitative analysis of CT-perfusion parameters in the evaluation of brain gliomas and metastases

    Directory of Open Access Journals (Sweden)

    Di Nallo Anna

    2009-03-01

    Full Text Available Abstract Background The paper reports a quantitative analysis of the perfusion maps of 22 patients, affected by gliomas or by metastasis, with the aim of characterizing the malignant tissue with respect to the normal tissue. The gold standard was obtained by histological exam or nuclear medicine techniques. The perfusion scan provided 11 parametric maps, including Cerebral Blood Volume (CBV, Cerebral Blood Flow (CBF, Average Perfusion (Pmean and Permeability-surface area product (PS. Methods The perfusion scans were performed after the injection of 40 ml of non-ionic contrast agent, at an injection rate of 8 ml/s, and a 40 s cine scan with 1 s interval was acquired. An expert radiologist outlined the region of interest (ROI on the unenhanced CT scan, by using a home-made routine. The mean values with their standard deviations inside the outlined ROIs and the contralateral ROIs were calculated on each map. Statistical analyses were used to investigate significant differences between diseased and normal regions. Receiving Operating Characteristic (ROC curves were also generated. Results Tumors are characterized by higher values of all the perfusion parameters, but after the statistical analysis, only the PS, PatRsq (Patlak Rsquare and Tpeak (Time to Peak resulted significant. ROC curves, confirmed both PatRsq and PS as equally reliable metrics for discriminating between malignant and normal tissues, with areas under curves (AUCs of 0.82 and 0.81, respectively. Conclusion CT perfusion is a useful and non invasive technique for evaluating brain neoplasms. Malignant and normal tissues can be accurately differentiated using perfusion map, with the aim of performing tumor diagnosis and grading, and follow-up analysis.

  14. Surfactant nebulisation prevents the adverse effects of surfactant therapy on blood pressure and cerebral blood flow in rabbits with severe respiratory failure

    NARCIS (Netherlands)

    Dijk, PH; Heikamp, A; Oetomo, SB

    1997-01-01

    Objective: Surfactant replacement therapy for the neonatal respiratory distress syndrome has shown beneficial effects on lung function and survival. Recently, rapid fluctuations of haemodynamics and cerebral perfusion following surfactant instillation have beer, described and an association with the

  15. 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.

  16. Brain perfusion CT compared with ¹⁵O-H₂O PET in patients with primary brain tumours

    DEFF Research Database (Denmark)

    Grüner, Julie Marie; Paamand, Rune Tore; Kosteljanetz, Michael;

    2012-01-01

    Perfusion CT (PCT) measurements of regional cerebral blood flow (rCBF) have been proposed as a fast and easy method for identifying angiogenically active tumours. In this study, quantitative PCT rCBF measurements in patients with brain tumours were compared to the gold standard PET rCBF with (15)O...

  17. Using the fourth dimension to distinguish between structures for anisotropic diffusion filtering in 4D CT perfusion scans

    NARCIS (Netherlands)

    Mendrik, AM; Vonken, EPA; Witkamp, TD; Prokop, Mathias; Van Ginneken, Bram; Viergever, Max A.

    2015-01-01

    High resolution 4D (3D+time) cerebral CT perfusion (CTP) scans can be used to create 3D arteriograms (showing only arteries) and venograms (only veins). However, due to the low X-ray radiation dose used for acquiring the CTP scans, they are inherently noisy. In this paper, we propose a time intensit

  18. Repair of abnormal perfusion foci in idiopathic epilepsy patients under long-term antiepileptic treatment

    Institute of Scientific and Technical Information of China (English)

    Weimin Wang; Siyu Zhao; Yaqing Liu

    2011-01-01

    Epileptic seizure control and the disappearance of epileptiform discharge are not indicative of the absence of abnormal perfusion foci.Perfusion abnormalities are a major cause of epileptic discharge, and the existence of abnormal perfusion foci implies possible relapse.Very little is known about perfusion abnormality repair in epilepsy.The present study selected 43 cases of idiopathic epilepsy under antiepileptic drug control for an average of 24 months.Comparisons between interictal single-photon emission CT (SPECT)images and long-term electroencephalogram (EEG) pre- and post-treatment showed that cases of normal SPECT increased by 48% (12/25) following treatment, with a total number of 15 reduced foci (36%, 15/41).Perfusion foci, i.e., region of interest, were altered following treatment.These changes included:normal to abnormal in 3 cases (7%, 3/43; 2 hyperperfusion and 1 hypoperfusion); abnormal to normal in 14 cases (32%, 14/43; 10 pre-treatment hypoperfusion and 4 hyperperfusion); abnormal to abnormal in 7 cases (16%, 7/43; hyperperfusion to hypoperfusion in 5 cases, hypoperfusion to hyperperfusion in 2 cases).Long-term EEG revealed in an increase in the number of normal cases by 20 (40%, 20/39), and there were 25 fewer cases with epileptiform discharges (66%, 25/38).These findings demonstrate that long-term control of anti-epileptic drugs partially repaired cerebral perfusion abnormalities and reduced epileptiform discharges in idiopathic epilepsy.

  19. 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.

  20. 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.

  1. Presymptomatic cerebral blood flow changes in CHMP2B mutation carriers of familial frontotemporal dementia (FTD-3), measured with MRI

    DEFF Research Database (Denmark)

    Lunau, Line Andersen; Mouridsen, Kim; Rodell, Anders;

    2012-01-01

    OBJECTIVES: To assess functional changes measured by cerebral blood flow (CBF) in the presymptomatic stage of frontotemporal dementia linked to chromosome 3 (FTD-3) caused by a truncating mutation in CHMP2B. DESIGN: Case-control study. SETTING: A memory clinic and tertiary referrals centre...... changes in brain tissue perfusion were measured as CBF with two different MR techniques, gradient echo (GRE) and spin echo (SE), focusing on CBF in all cerebral vessels (GRE) and cerebral capillaries (SE), respectively. As planned, data analysis included co-registration of perfusion images to structural T...

  2. Reconstruction of cerebral hemodynamics with dynamic contrast-enhanced time-resolved near-infrared measurements before and during ischemia

    Science.gov (United States)

    Elliott, Jonathan T.; Diop, Mamadou; Morrison, Laura B.; Lee, Ting-Yim; St. Lawrence, Keith

    2013-03-01

    We present a dynamic contrast-enhanced near-infrared (DCE-NIR) technique that is capable of non-invasive quantification of cerebral hemodynamics in adults. The challenge of removing extracerebral contamination is overcome through the use of multi-distance time-resolved DCE-NIR combined with the kinetic deconvolution optical reconstruction (KDOR) analytical method. As proof-of-principle, cerebral blood flow, cerebral blood volume and mean transit time recovered with DCE-NIR are compared with CT perfusion values in an adult pig during normocapnia, hypocapnia, and ischemia. Measurements of blood flow acquired with DCE-NIR were compared against concomitant measurements using CT Perfusion.

  3. Preoperative subtyping of meningiomas by perfusion MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hao [University Medical Center Groningen, University of Groningen (Netherlands); Shanghai Jiaotong University affiliated First People' s Hospital, Department of Radiology, Shanghai (China); Department of Radiology, University of Groningen (Netherlands); Roediger, Lars A.; Oudkerk, Matthijs [University Medical Center Groningen, University of Groningen (Netherlands); Department of Radiology, University of Groningen (Netherlands); Shen, Tianzhen [Fudan University Huashan Hospital, Department of Radiology, Shanghai (China); Miao, Jingtao [Shanghai Jiaotong University affiliated First People' s Hospital, Department of Radiology, Shanghai (China)

    2008-10-15

    This paper aims to evaluate the value of perfusion magnetic resonance (MR) imaging in the preoperative subtyping of meningiomas by analyzing the relative cerebral blood volume (rCBV) of three benign subtypes and anaplastic meningiomas separately. Thirty-seven meningiomas with peritumoral edema (15 meningothelial, ten fibrous, four angiomatous, and eight anaplastic) underwent perfusion MR imaging by using a gradient echo echo-planar sequence. The maximal rCBV (compared with contralateral normal white matter) in both tumoral parenchyma and peritumoral edema of each tumor was measured. The mean rCBVs of each two histological subtypes were compared using one-way analysis of variance and least significant difference tests. A p value less than 0.05 indicated a statistically significant difference. The mean rCBV of meningothelial, fibrous, angiomatous, and anaplastic meningiomas in tumoral parenchyma were 6.93{+-}3.75, 5.61{+-}4.03, 11.86{+-}1.93, and 5.89{+-}3.85, respectively, and in the peritumoral edema 0.87{+-}0.62, 1.38{+-}1.44, 0.87{+-}0.30, and 3.28{+-}1.39, respectively. The mean rCBV in tumoral parenchyma of angiomatous meningiomas and in the peritumoral edema of anaplastic meningiomas were statistically different (p<0.05) from the other types of meningiomas. Perfusion MR imaging can provide useful functional information on meningiomas and help in the preoperative diagnosis of some subtypes of meningiomas. (orig.)

  4. Brain perfusion abnormalities in patients with euthyroid autoimmune thyroiditis

    Energy Technology Data Exchange (ETDEWEB)

    Piga, M.; Serra, A.; Loi, G.L.; Satta, L. [University of Cagliari, Nuclear Medicine - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy); Deiana, L.; Liberto, M. Di; Mariotti, S. [University of Cagliari, Endocrinology - Department of Medical Sciences ' ' M. Aresu' ' , Cagliari (Italy)

    2004-12-01

    Brain perfusion abnormalities have recently been demonstrated by single-photon emission computed tomography (SPECT) in rare cases of severe Hashimoto's thyroiditis (HT) encephalopathy; moreover, some degree of subtle central nervous system (CNS) involvement has been hypothesised in HT, but no direct evidence has been provided so far. The aim of this study was to assess cortical brain perfusion in patients with euthyroid HT without any clinical evidence of CNS involvement by means of {sup 99m}Tc-ECD brain SPECT. Sixteen adult patients with HT entered this study following informed consent. The diagnosis was based on the coexistence of high titres of anti-thyroid auto-antibodies and diffuse hypoechogenicity of the thyroid on ultrasound in association with normal circulating thyroid hormone and TSH concentrations. Nine consecutive adult patients with non-toxic nodular goitre (NTNG) and ten healthy subjects matched for age and sex were included as control groups. All patients underwent {sup 99m}Tc-ECD brain SPECT. Image assessment was both qualitative and semiquantitative. Semiquantitative analysis was performed by generation of four regions of interest (ROI) for each cerebral hemisphere - frontal, temporal, parietal and occipital - and one for each cerebellar hemisphere in order to evaluate cortical perfusion asymmetry. The Asymmetry Index (AI) was calculated to provide a measurement of both magnitude and direction of perfusion asymmetry. As assessed by visual examination, {sup 99m}Tc-ECD cerebral distribution was irregular and patchy in HT patients, hypoperfusion being more frequently found in frontal lobes. AI revealed abnormalities in 12/16 HT patients, in three of the nine NTNG patients and in none of the normal controls. A significant difference in the mean AI was found between patients with HT and both patients with NTNG (p<0.003) and normal controls (p<0.001), when only frontal lobes were considered. These results show the high prevalence of brain perfusion

  5. Use of CT perfusion to discriminate between brain metastases from different primaries.

    Science.gov (United States)

    Dolgushin, Mikhail B; Pronin, Igor N; Holodny, Elena A; Fadeeva, Liudmila M; Holodny, Andrei I; Kornienko, Valeri N

    2015-01-01

    Thirty-six metastases in 22 patients were studied prospectively using computed tomography perfusion. Regions of interests were drawn around: the enhancing part of the tumor, necrotic central part, periphery, peritumoral edema, and normal white matter. Cerebral blood volume, cerebral blood flow, and mean transit time were calculated for each zone. The enhancing part of the tumor significantly differed from the other zones in 11 of 12. Metastases of different primaries can be differentiated from one another with statistically significance (Pperfusion parameter in 57% of cases.

  6. Paradoxical perfusion metrics of high-grade gliomas with an oligodendroglioma component: quantitative analysis of dynamic susceptibility contrast perfusion MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Sunwoo, Leonard; Park, Sun-Won [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Department of Radiology, Seoul (Korea, Republic of); Choi, Seung Hong [Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Seoul National University, Center for Nanoparticle Research, Institute for Basic Science, and School of Chemical and Biological Engineering, Seoul (Korea, Republic of); Yoo, Roh-Eul; Kang, Koung Mi; Yun, Tae Jin; Kim, Ji-hoon; Sohn, Chul-Ho [Seoul National University College of Medicine, Department of Radiology, Seoul (Korea, Republic of); Seoul National University Hospital, Department of Radiology, Seoul (Korea, Republic of); Kim, Tae Min; Lee, Se-Hoon [Seoul National University Hospital, Department of Internal Medicine, Seoul (Korea, Republic of); Park, Chul-Kee [Seoul National University Hospital, Department of Neurosurgery, Seoul (Korea, Republic of); Won, Jae-Kyung; Park, Sung-Hye [Seoul National University Hospital, Department of Pathology, Seoul (Korea, Republic of); Kim, Il Han [Seoul National University Hospital, Department of Radiation Oncology, Seoul (Korea, Republic of)

    2015-11-15

    The aim of this study is to investigate perfusion characteristics of glioblastoma with an oligodendroglioma component (GBMO) compared with conventional glioblastoma (GBM) using dynamic susceptibility contrast (DSC) perfusion magnetic resonance (MR) imaging and microvessel density (MVD). The study was approved by the institutional review board. Newly diagnosed high-grade glioma patients were enrolled (n = 72; 20 GBMs, 14 GBMOs, 19 anaplastic astrocytomas (AAs), 13 anaplastic oligodendrogliomas (AOs), and six anaplastic oligoastrocytomas (AOAs)). All participants underwent preoperative MR imaging including DSC perfusion MR imaging. Normalized cerebral blood volume (nCBV) values were analyzed using a histogram approach. Histogram parameters were subsequently compared across each tumor subtype and grade. MVD was quantified by immunohistochemistry staining and correlated with perfusion parameters. Progression-free survival (PFS) was assessed according to the tumor subtype. GBMO displayed significantly reduced nCBV values compared with GBM, whereas grade III tumors with oligodendroglial components (AO and AOA) exhibited significantly increased nCBV values compared with AA (p < 0.001). MVD analyses revealed the same pattern as nCBV results. In addition, a positive correlation between MVD and nCBV values was noted (r = 0.633, p < 0.001). Patients with oligodendroglial tumors exhibited significantly increased PFS compared with patients with pure astrocytomas in each grade. In contrast to grade III tumors, the presence of oligodendroglial components in grade IV tumors resulted in paradoxically reduced perfusion metrics and MVD. In addition, patients with GBMO exhibited a better clinical outcome compared with patients with GBM. (orig.)

  7. First-pass extraction fraction of iodine-123 labeled perfusion tracers in living primate brain

    Energy Technology Data Exchange (ETDEWEB)

    Moerlein, S.M.; Perlmutter, J.S.; Raichle, M.E. [Washington Univ., St. Louis, MO (United States). Edward Mallinckrodt Inst. of Radiology]|[Washington Univ., St. Louis, MO (United States). School of Medicine; Welch, M.J. [Washington Univ., St. Louis, MO (United States). Edward Mallinckrodt Inst. of Radiology

    1994-08-01

    The cerebral extraction and retention of three radioiodinated SPECT perfusion tracers were measured using residue detection in a baboon. A permeability-surface area product PS` with special relevance to SPECT was calculated from the retention of tracer in the brain after 10 min. PS` differs from the traditional PS value, which is calculated from the tracer clearance curve at 2 min. The PS` values ranged from 50 to 95 mL/min/100 g, decreased in the order [{sup 123}I]IMP > [{sup 123}I]iodoperidol=[{sup 123}I] HIPDM, and did not differ for specific activities of 10 MBq/mmol to 74 TBq/mmol. These radioiodinated compounds exhibited extraction characteristics superior to those of [{sup 99m}Tc]HMPAO but underestimated cerebral blood flow when flows were above 20-30 mL/min/100 g, underscoring the need for development of a more ideal SPECT perfusion tracer. (author).

  8. 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.

  9. Gene expression profiling in the human middle cerebral artery after cerebral ischemia

    DEFF Research Database (Denmark)

    Vikman, P; Edvinsson, L

    2006-01-01

    MCA samples distributing to the ischemic area, 7-10 days post-stroke. The gene expression was examined with real-time polymerase chain reaction (PCR) and microarray, proteins were studied with immunohistochemistry. We investigated genes previously shown to be upregulated in animal models of cerebral...... with microarray and seven genes chosen for further investigation with real-time PCR; ELK3, LY64, Metallothionin IG, POU3F4, Actin alpha2, RhoA and smoothelin. Six of these were regulated the same way when confirming array expression with real-time PCR. Gene expression studies in the human MCA leading......We have investigated the gene expression in human middle cerebral artery (MCA) after ischemia. Ischemic stroke affects the perfusion in the affected area and experimental cerebral ischemia results in upregulation of vasopressor receptors in the MCA leading to the ischemic area. We obtained human...

  10. Image analysis of intracranial high perfusion lesion by whole brain one-stop imaging technique with 320 detector rows CT

    Directory of Open Access Journals (Sweden)

    Fei-zhou DU

    2014-03-01

    Full Text Available Objective  The perfusion and vascular architecture features were investigated and evaluated by use of one-stop imaging technique with 320 rows CT for exploring the clinical value of one-stop imaging technique in the diagnosis of intracranial lesions. Methods  The perfusion parameters and vascular architecture of intracranial high perfusion lesions of 52 patients were collected in General Hospital of Chengdu Command from Oct. 2010 to Apr. 2013, who were examined by one-stop imaging technique with 320 rows CT, were retrospectively analyzed. The perfusion values of normal contralateral cerebral tissue were used as control to analyze the perfusion and vascular architecture features of injured parts. Results  Of the 52 patients, there were 16 cases of subacute cerebral infarction, 9 cases of arteriovenous malformation, 7 cases of hemangioma, 12 cases of meningioma, and 8 cases of glioma. All the patients showed elevated CBV and/or CBF and different changes in mean transit time (MTT, time to peak (TTP and delay time (Delay. In the cases of subacute cerebral infarction, the parameters of MTT, TTP and Delay increased. In the cases of arteriovenous malformation, all the parameters decreased. In the cases of hemangioma, the MTT decreased, while TTP and Delay increased. In the cases of glioma, the TTP and Delay increased, while the change of MTT varied. Meanwhile, abnormality of vascular structures was found in all the cases by CT angiography. Conclusion  With whole brain perfusion and one-stop vascular imaging with 320 rows CT, the perfusion characteristics of intracranial lesions can be revealed completely, including blood supply and microcirculation changes in the lesions, and it may be of benefit in guiding the clinical diagnosis and treatment. DOI: 10.11855/j.issn.0577-7402.2014.03.10

  11. Metabolic and perfusion responses to recurrent peri-infarct depolarization during focal ischemia in the Spontaneously Hypertensive Rat: dominant contribution of sporadic CBF decrements to infarct expansion

    OpenAIRE

    Takeda,Yoshimasa; Zhao, Liang; Jacewicz, Michael; PULSINELLI, WILLIAM A.; Nowak, Thaddeus S.

    2011-01-01

    Peri-infarct depolarizations (PIDs) contribute to the evolution of focal ischemic lesions. Proposed mechanisms include both increased metabolic demand under conditions of attenuated perfusion and overt vasoconstrictive responses to depolarization. The present studies investigated the relative contributions of metabolic and perfusion effects to PID-associated infarct expansion during middle cerebral artery (MCA) occlusion in the Spontaneously Hypertensive Rat. The initial distribution of ische...

  12. Time-varying modeling of cerebral hemodynamics.

    Science.gov (United States)

    Marmarelis, Vasilis Z; Shin, Dae C; Orme, Melissa; Rong Zhang

    2014-03-01

    The scientific and clinical importance of cerebral hemodynamics has generated considerable interest in their quantitative understanding via computational modeling. In particular, two aspects of cerebral hemodynamics, cerebral flow autoregulation (CFA) and CO2 vasomotor reactivity (CVR), have attracted much attention because they are implicated in many important clinical conditions and pathologies (orthostatic intolerance, syncope, hypertension, stroke, vascular dementia, mild cognitive impairment, Alzheimer's disease, and other neurodegenerative diseases with cerebrovascular components). Both CFA and CVR are dynamic physiological processes by which cerebral blood flow is regulated in response to fluctuations in cerebral perfusion pressure and blood CO2 tension. Several modeling studies to date have analyzed beat-to-beat hemodynamic data in order to advance our quantitative understanding of CFA-CVR dynamics. A confounding factor in these studies is the fact that the dynamics of the CFA-CVR processes appear to vary with time (i.e., changes in cerebrovascular characteristics) due to neural, endocrine, and metabolic effects. This paper seeks to address this issue by tracking the changes in linear time-invariant models obtained from short successive segments of data from ten healthy human subjects. The results suggest that systemic variations exist but have stationary statistics and, therefore, the use of time-invariant modeling yields "time-averaged models" of physiological and clinical utility.

  13. Mechanisms of Astrocyte-Mediated Cerebral Edema

    Science.gov (United States)

    Stokum, Jesse A.; Kurland, David B.; Gerzanich, Volodymyr; Simard, J. Marc

    2014-01-01

    Cerebral edema formation stems from disruption of blood brain barrier (BBB) integrity and occurs after injury to the CNS. Due to the restrictive skull, relatively small increases in brain volume can translate into impaired tissue perfusion and brain herniation. In excess, cerebral edema can be gravely harmful. Astrocytes are key participants in cerebral edema by virtue of their relationship with the cerebral vasculature, their unique compliment of solute and water transport proteins, and their general role in brain volume homeostasis. Following the discovery of aquaporins, passive conduits of water flow, aquaporin 4 (AQP4) was identified as the predominant astrocyte water channel. Normally, AQP4 is highly enriched at perivascular endfeet, the outermost layer of the BBB, whereas after injury, AQP4 expression disseminates to the entire astrocytic plasmalemma, a phenomenon termed dysregulation. Arguably, the most important role of AQP4 is to rapidly neutralize osmotic gradients generated by ionic transporters. In pathological conditions, AQP4 is believed to be intimately involved in the formation and clearance of cerebral edema. In this review, we discuss aquaporin function and localization in the BBB during health and injury, and we examine post-injury ionic events that modulate AQP4- dependent edema formation. PMID:24996934

  14. Magnetic Resonance Perfusion Imaging in Malformations of Cortical Development

    Energy Technology Data Exchange (ETDEWEB)

    Widjaja, ED.; Wilkinson, I.D.; Griffiths, P.D. [Academic Section of Radiolog y, Univ. of Sheffield, Sheffield (United Kingdom)

    2007-10-15

    Background: Malformations of cortical development vary in neuronal maturity and level of functioning. Purpose: To characterize regional relative cerebral blood volume (rCBV) and difference in first moment transit time (TTfm) in polymicrogyria and cortical tubers using magnetic resonance (MR) perfusion imaging. Material and Methods: MR imaging and dynamic T2*-weighted MR perfusion imaging were performed in 13 patients with tuberous sclerosis complex, 10 with polymicrogyria, and 18 controls with developmental delay but no macroscopic brain abnormality. Regions of interest were placed in cortical tubers or polymicrogyric cortex and in the contralateral normal-appearing side in patients with malformations. In 'control' subjects, regions of interest were placed in the frontal and parietal lobes in both hemispheres. The rCBV and TTfm of the tuber/contralateral side (rCBVRTSC and TTFMTSC) as well as those of the polymicrogyria/contralateral side (rCBVRPMG and TTFMPMG) were assessed. The right-to-left asymmetry of rCBV and TTfm in the control group was also assessed (rCBVRControls and TTFMControls). Results: There was no significant asymmetry between right and left rCBV or TTfm (P>0.05) in controls. There was significant reduction in rCBVRTSC compared to rCBVRControls (P<0.05), but no significant difference in TTFMTSC compared to TTFMControls (P>0.05). There were no significant differences between rCBVRPMG and rCBVRControls (P>0.05) or TTFMPMG and TTFMControls (P>0.05). Conclusion: Our findings imply that cerebral blood volume of polymicrogyria is similar to normal cortex, but there is reduced cerebral blood volume in cortical tubers. The lower rCBV ratio of cortical tubers may be related to known differences in pathogenetic timing of the underlying abnormalities during brain development or the presence of gliosis.

  15. Whole-Brain CT Perfusion to Quantify Acute Ischemic Penumbra and Core.

    Science.gov (United States)

    Lin, Longting; Bivard, Andrew; Krishnamurthy, Venkatesh; Levi, Christopher R; Parsons, Mark W

    2016-06-01

    Purpose To validate the use of perfusion computed tomography (CT) with whole-brain coverage to measure the ischemic penumbra and core and to compare its performance to that of limited-coverage perfusion CT. Materials and Methods Institutional ethics committee approval and informed consent were obtained. Patients (n = 296) who underwent 320-detector CT perfusion within 6 hours of the onset of ischemic stroke were studied. First, the ischemic volume at CT perfusion was compared with the penumbra and core reference values at magnetic resonance (MR) imaging to derive CT perfusion penumbra and core thresholds. Second, the thresholds were tested in a different group of patients to predict the final infarction at diffusion-weighted imaging 24 hours after CT perfusion. Third, the change in ischemic volume delineated by the optimal penumbra and core threshold was determined as the brain coverage was gradually reduced from 160 mm to 20 mm. The Wilcoxon signed-rank test, concordance correlation coefficient (CCC), and analysis of variance were used for the first, second, and third steps, respectively. Results CT perfusion at penumbra and core thresholds resulted in the least volumetric difference from MR imaging reference values with delay times greater than 3 seconds and delay-corrected cerebral blood flow of less than 30% (P = .34 and .33, respectively). When the thresholds were applied to the new group of patients, prediction of the final infarction was allowed with delay times greater than 3 seconds in patients with no recanalization of the occluded artery (CCC, 0.96 [95% confidence interval: 0.92, 0.98]) and with delay-corrected cerebral blood flow less than 30% in patients with complete recanalization (CCC, 0.91 [95% confidence interval: 0.83, 0.95]). However, the ischemic volume with a delay time greater than 3 seconds was underestimated when the brain coverage was reduced to 80 mm (P = .04) and the core volume measured as cerebral blood flow less than 30% was

  16. 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...

  17. Perfusion MR imaging for differentiation of benign and malignant meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Hao [University of Groningen, Department of Radiology, University Medical Center Groningen, Groningen (Netherlands); Shanghai Jiaotong University, Department of Radiology, First People' s Hospital, Shanghai (China); Roediger, Lars A.; Oudkerk, Matthijs [University of Groningen, Department of Radiology, University Medical Center Groningen, Groningen (Netherlands); Shen, Tianzhen [Fudan University, Department of Radiology, Huashan Hospital, Shanghai (China); Miao, Jingtao [Shanghai Jiaotong University, Department of Radiology, First People' s Hospital, Shanghai (China)

    2008-06-15

    Our purpose was to determine whether perfusion MR imaging can be used to differentiate benign and malignant meningiomas on the basis of the differences in perfusion of tumor parenchyma and/or peritumoral edema. A total of 33 patients with preoperative meningiomas (25 benign and 8 malignant) underwent conventional and dynamic susceptibility contrast perfusion MR imaging. Maximal relative cerebral blood volume (rCBV) and the corresponding relative mean time to enhance (rMTE) (relative to the contralateral normal white matter) in both tumor parenchyma and peritumoral edema were measured. The independent samples t-test was used to determine whether there was a statistically significant difference in the mean rCBV and rMTE ratios between benign and malignant meningiomas. The mean maximal rCBV values of benign and malignant meningiomas were 7.16{+-}4.08 (mean{+-}SD) and 5.89{+-}3.86, respectively, in the parenchyma, and 1.05{+-}0.96 and 3.82{+-}1.39, respectively, in the peritumoral edema. The mean rMTE values were 1.16{+-}0.24 and 1.30{+-}0.32, respectively, in the parenchyma, and 0.91{+-}0.25 and 1.24{+-}0.35, respectively, in the peritumoral edema. The differences in rCBV and rMTE values between benign and malignant meningiomas were not statistically significant (P>0.05) in the parenchyma, but both were statistically significant (P<0.05) in the peritumoral edema. Perfusion MR imaging can provide useful information on meningioma vascularity which is not available from conventional MRI. Measurement of maximal rCBV and corresponding rMTE values in the peritumoral edema is useful in the preoperative differentiation between benign and malignant meningiomas. (orig.)

  18. 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...

  19. Initial testing of a 3D printed perfusion phantom using digital subtraction angiography

    Science.gov (United States)

    Wood, Rachel P.; Khobragade, Parag; Ying, Leslie; Snyder, Kenneth; Wack, David; Bednarek, Daniel R.; Rudin, Stephen; Ionita, Ciprian N.

    2015-03-01

    Perfusion imaging is the most applied modality for the assessment of acute stroke. Parameters such as Cerebral Blood Flow (CBF), Cerebral Blood volume (CBV) and Mean Transit Time (MTT) are used to distinguish the tissue infarct core and ischemic penumbra. Due to lack of standardization these parameters vary significantly between vendors and software even when provided with the same data set. There is a critical need to standardize the systems and make them more reliable. We have designed a uniform phantom to test and verify the perfusion systems. We implemented a flow loop with different flow rates (250, 300, 350 ml/min) and injected the same amount of contrast. The images of the phantom were acquired using a Digital Angiographic system. Since this phantom is uniform, projection images obtained using DSA is sufficient for initial validation. To validate the phantom we measured the contrast concentration at three regions of interest (arterial input, venous output, perfused area) and derived time density curves (TDC). We then calculated the maximum slope, area under the TDCs and flow. The maximum slope calculations were linearly increasing with increase in flow rate, the area under the curve decreases with increase in flow rate. There was 25% error between the calculated flow and measured flow. The derived TDCs were clinically relevant and the calculated flow, maximum slope and areas under the curve were sensitive to the measured flow. We have created a systematic way to calibrate existing perfusion systems and assess their reliability.

  20. Sub-band denoising and spline curve fitting method for hemodynamic measurement in perfusion MRI

    Science.gov (United States)

    Lin, Hong-Dun; Huang, Hsiao-Ling; Hsu, Yuan-Yu; Chen, Chi-Chen; Chen, Ing-Yi; Wu, Liang-Chi; Liu, Ren-Shyan; Lin, Kang-Ping

    2003-05-01

    In clinical research, non-invasive MR perfusion imaging is capable of investigating brain perfusion phenomenon via various hemodynamic measurements, such as cerebral blood volume (CBV), cerebral blood flow (CBF), and mean trasnit time (MTT). These hemodynamic parameters are useful in diagnosing brain disorders such as stroke, infarction and periinfarct ischemia by further semi-quantitative analysis. However, the accuracy of quantitative analysis is usually affected by poor signal-to-noise ratio image quality. In this paper, we propose a hemodynamic measurement method based upon sub-band denoising and spline curve fitting processes to improve image quality for better hemodynamic quantitative analysis results. Ten sets of perfusion MRI data and corresponding PET images were used to validate the performance. For quantitative comparison, we evaluate gray/white matter CBF ratio. As a result, the hemodynamic semi-quantitative analysis result of mean gray to white matter CBF ratio is 2.10 +/- 0.34. The evaluated ratio of brain tissues in perfusion MRI is comparable to PET technique is less than 1-% difference in average. Furthermore, the method features excellent noise reduction and boundary preserving in image processing, and short hemodynamic measurement time.

  1. CT Perfusion ASPECTS in the Evaluation of Acute Ischemic Stroke: Thrombolytic Therapy Perspective

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    Niko Sillanpaa

    2011-02-01

    Full Text Available Background and Purpose: Advances in the management of acute ischemic stroke and medical imaging are creating pressure to replace the rigid one-third middle cerebral artery (MCA and non-contrast-enhanced CT (NCCT Alberta Stroke Program Early CT Score (ASPECTS thresholds used for the selection of patients eligible for intravenous thrombolytic therapy. The identification of potentially salvageable ischemic brain tissue lies at the core of this issue. In this study, the role of CT perfusion ASPECTS in the detection of reversible ischemia was analyzed. Materials and Methods: We retrospectively reviewed the clinical and imaging data of 92 consecutive patients who received intravenous thrombolytic therapy for acute (duration Results: A perfusion defect could be detected in 50% of the patients. ASPECTS correlated inversely with the clinical outcome in the following order: follow-up NCCT > cerebral blood volume (CBV > mean transit time (MTT > admission NCCT. The follow-up NCCT and the CBV displayed a statistically significant difference from the admission NCCT, while the MTT did not reach statistical significance. The threshold that best differentiated between good and bad clinical outcome on admission was CBV ASPECTS ≧7. In patients with CT perfusion ASPECTS mismatch, MTT and CBV ASPECTS essentially provided the lower and upper limits for the follow-up NCCT ASPECTS, thus defining the spectrum of possible outcomes. Furthermore, CT perfusion ASPECTS mismatch strongly correlated (r = 0.83 with the mismatch between the tissue at risk and the final infarct, i.e. the amount of salvaged tissue. This finding suggests that the CT perfusion ASPECTS mismatch adequately identifies the amount of potentially salvageable ischemic brain tissue. Conclusions: Parameters derived from the use of CT perfusion ASPECTS can detect reversible ischemia and are correlated with clinical outcome.

  2. Discordance between cerebellar metabolism and perfusion: Explanation for SPECT vs. PET differences in the cerebellum

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    Meyer, M.; Beltran, M.; Moore, M. [Univ. TN PET Center, Knoxville, TN (United States)] [and others

    1994-05-01

    The cerebellum normally has a level of HMPAO uptake that is equal to or greater than nearby frontal cortices on transaxial SPECT sections, whereas FDG PET studies shows the reverse. Since cerebral blood flow is generally coupled to metabolism in normal individuals, this study was performed to test the hypothesis that this difference represents a true discordance between cerebral perfusion and glucose metabolism of the cerebellar cortex. Thirty eight subjects underwent PET imaging after an intravenous bolus of N-13 ammonia (370 MBq) to image cerebral perfusion, later followed by an intravenous bolus of F-18 FDG (3 70 MBq) after the N-13 had disappeared by decay. All studies were acquired with a Siemens 931 ECAT camera with an initial 20 minute transmission scan of the head acquired to apply measured attenuation correction. PET imaging of N-13 ammonia was performed over the first 15 minutes after injection, and FDG imaging was performed between 40 and 55 minutes after injection. Regions of interest for both tracers in each of 38 patients were drawn over the cerebellar cortex from transaxial sections taken at the level of the dentate nuclei, and from the orbitofrontal cortex. Frontal to cerebellar cortex ratios are shown below for perfusion (open square) and metabolism (closed) for each of the 38 patients studied.

  3. Role of CT perfusion imaging in evaluating the effects of multiple burr hole surgery on adult ischemic Moyamoya disease

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    Dai, Dong Wei; Zhao, Wen Yuan; Yang, Zhi Gang; Li, Qiang; Liu, Jian Min [Second Military Medical University, Department of Neurosurgery, Changhai Hospital, Shanghai (China); Zhang, Yong Wei [Second Military Medical University, Department of Neurology, Changhai Hospital, Shanghai (China); Xu, Bing; Ma, Xiao Long; Tian, Bing [Second Military Medical University, Department of Radiology, Changhai Hospital, Shanghai (China)

    2013-12-15

    To evaluate the effects of the multiple burr hole (MBH) revascularization on ischemic type adult Moyamoya disease (MMD) by computed tomography perfusion (CTP). Eighty-six ischemic MMD patients received CTP 1 week before and 3 weeks after MBH operation. Fifty-seven patients received it again at 6 month and underwent digital subtraction angiography (DSA) and mRS follow-up. Cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), time to peak (TTP), and relative values of ischemic symptomatic hemispheres were measured. Differences in pre- and post-surgery perfusion CT values were assessed. There were significant differences of CBF, TTP, and relative time to peak (rTTP) in ischemic hemisphere between 1 week before and 3 weeks after surgery, and no significant difference in relative cerebral blood flow (rCBF), CBV, relative cerebral blood volume (rCBV), MTT, relative mean transit time (rMTT). According to whether there was symptom improvement or not on 3 weeks after MBH, the rTTP value was not statistically significant in the patients whose symptoms were not improved at all on 3 weeks after operation. Six-month follow-up showed that CBF, rCBF, and rCBV values were significantly higher than those before operation. Postoperative MTT, TTP, rMTT, and rTTP values were significantly lower than those before operation. CTP is a sensitive method to obtain functional imaging of cerebral microcirculation, which can be a noninvasive assessment of the abnormalities of intracranial arteries and cerebral perfusion changes in MMD before and after surgery. CBF and TTP map, especially the relative values of TTP, seems to have the capability of being quite sensitive to the presence of altered brain perfusion at early time after indirect revascularization. (orig.)

  4. Perfusion weighted imaging and its application in stroke

    Science.gov (United States)

    Li, Enzhong; Tian, Jie; Han, Ying; Wang, Huifang; Li, Xingfeng; Zhu, Fuping

    2003-05-01

    To study the technique and application of perfusion weighted imaging (PWI) in the diagnosis and medical treatment of acute stroke, 25 patients were examined by 1.5 T or 1.0 T MRI scanner. The Data analysis was done with "3D Med System" developed by our Lab to process the data and obtain apparent diffusion coefficient (ADC) map, cerebral blood volume (CBV) map, cerebral blood flow (CBF) map as well as mean transit time (MTT) map. In accute stage of stroke, normal or slightly hypointensity in T1-, hyperintensity in T2- and diffusion-weighted images were seen in the cerebral infarction areas. There were hypointensity in CBV map, CBF map and ADC map; and hyperintensity in MTT map that means this infarct area could be saved. If the hyperintensity area in MTT map was larger than the area in diffusion weighted imaging (DWI), the larger part was called penumbra and could be cured by an appropriate thrombolyitic or other therapy. The CBV, CBF and MTT maps are very important in the diagnosis and medical treatment of acute especially hyperacute stroke. Comparing with DWI, we can easily know the situation of penumbra and the effect of curvative therapy. Besides, we can also make a differential diagnosis with this method.

  5. Usefulness of Permeability Map by Perfusion MRI of Brain Tumor the Grade Assessment

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    Bae, Sung Jin [Dept. of Radiology, Dongsan Hospital, Keimyung University, Daegu (Korea, Republic of); Lee, Joo Young [GE Healthcare, Seoul (Korea, Republic of); Chang, Hyuk Won [Dept. of Radiology, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2009-09-15

    This study was conducted to assess how effective the permeability ratio and relative cerebral blood volume ratio are to tumor through perfusion MRI by measuring and reflecting the grade assessment and differential diagnosis and the permeability and relative cerebral blood volume of contrast media plunged from blood vessel into organ due to breakdown of blood-brain barrier in cerebral. Subject and Method : Subject of study was 29 patients whose diagnosis were confirmed by biopsy after surgery and 550 (11 slice x 50 image) perfusion MRI were used to make image of relative cerebral blood volume with the program furnished on instrument. The other method was to transmit to private computer and the image analysis was made additionally by making image of relative cerebral blood volume-reformulated singular value decomposition, rCBV-rSVD and permeability using IDL.6.2. In addition, Kruskal-wallis test tonggyein non numerical average by a comparative analysis of brain tumors Results : The rCBV ratio (Functool PF; GE Medical Systems and IDL 6.2 program by analysis) and permeability ratio of tumors were as follows; high grade glioma(n=4), (14.75, 19.25) 13.13. low grade astrocytoma(n=5) (14.80, 15.90) 11.60, glioblastoma(n=5) (10.90, 18.60), 22.00, metastasis(n=6) (11.00, 15.08). 22.33. meningioma(n=6) (18.58, 7.67), 5.58. oliogodendroglioma(n=3) (23.33, 16.33, 15.67. Conclusion : It was not easy to classify the grade with the relative cerebral blood volume ratio measured by using the relative cerebral blood image by type of tumors, however, permeability ratio measured by permeability image revealed that the higher the grade of tumor, the higher the measured permeability ratio, showing the assessment of tumor grade is more effective to differential diagnosis.

  6. 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.

  7. Improvement of image quality and radiation dose of CT perfusion of the brain by means of low-tube voltage (70 KV)

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    Li, Zhen-lin; Zhang, Kai; Li, Wang-jiang; Chen, Xian; Wu, Bin; Song, Bin [West China Hospital of Sichuan University, Department of Radiology, Chengdu, Sichuan (China); Li, Hang [Sichuan Provincial People' s Hospital, Department of Radiology, Chengdu, Sichuan (China)

    2014-08-15

    To investigate the feasibility of 70 kV cerebral CT perfusion by comparing image quality and radiation exposure to 80 kV. Thirty patients with suspected cerebral ischemia who underwent dual-source CT perfusion were divided into group A (80 kV, 150 mAs) and group B (70 kV, 150 mAs). Quantitative comparisons were used for maximum enhancement, signal-to-noise index (SNI), and values of cerebral blood flow (CBF), cerebral blood flow (CBV), mean transit time (MTT) on CBF, CBV, and MTT images, and radiation dose from these two groups. Qualitative perfusion images were assessed by two readers. Maximum enhancement for group B was higher than group A (P < 0.05). There were no significant differences between the two groups for SNI on CBF and CBV maps (P = 0.06 - 0.576), but significant differences for MTT when SNI was measured on frontal white matter and temporo-occipital white matter (P < 0.05). There were no differences among values of CBF, CBV, and MTT for both groups (P = 0.251-0.917). Mean image quality score in group B was higher than group A for CBF (P < 0.05), but no differences for CBV (P = 0.542) and MTT (P = 0.962). Radiation dose for group B decreased compared with group A. 70 kV cerebral CT perfusion reduces radiation dose without compromising image quality. (orig.)

  8. Relationship Between Cerebral Oxygenation and Hemodynamic and Oxygen Transport Parameters in Surgery for Acquired Heart Diseases

    Directory of Open Access Journals (Sweden)

    A. I. Lenkin

    2012-01-01

    Full Text Available Objective: to evaluate the relationship between cerebral oxygenation and hemodynamic and oxygen transport parameters in surgical correction of concomitant acquired heart diseases. Subjects and methods. Informed consent was received from 40 patients who required surgery because of concomitant (two or more acquired heart defects. During procedure, perioperative monitoring of oxygen transport and cerebral oxygenation was performed with the aid of PiCCO2 monitor (Pulsion Medical Systems, Germany and a Fore-Sight cerebral oximeter (CASMED, USA. Anesthesia was maintained with propofol and fen-tanyl, by monitoring the depth of anesthesia. Early postoperative intensive therapy was based on the protocol for early targeted correction of hemodynamic disorders. Oxygen transport and cerebral oxygenation parameters were estimated intraopera-tively and within 24 postoperative hours. A statistical analysis including evaluation of Spearman correlations was performed with the aid of SPSS 15.0. Results. During perfusion, there was a relationship between cerebral oximetry values and hemat-ocrit levels, and oxygen partial pressure in the venous blood. Furthermore, a negative correlation between cerebral oximetry values and blood lactate levels was found 30 minutes after initiation of extracorporeal circulation (EC. During the study, there was a positive correlation between cerebral oxygenation and values of cardiac index, central venous saturation, and oxygen delivery index. There was a negative relationship between cerebral oxygenation and extravascular lung water at the beginning of surgery and a correlation between cerebral oximetry values and oxygenation index by the end of the first 24 postoperative hours. Conclusion. The cerebral oxygenation values correlate -with the main determinants of oxygen transport during EC and after cardiac surgical procedures. Cerebral oximetry may be used in early targeted therapy for the surgical correction of acquired combined

  9. Magnetic resonance perfusion imaging without contrast media

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    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.)

  10. 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 par