Vessel encoded arterial spin labeling with cerebral perfusion: preliminary study

International Nuclear Information System (INIS)

Wu Bing; Xiao Jiangxi; Xie Cheng; Wang Xiaoying; Jiang Xuexiang; Wong, E.C.; Wang Jing; Guo Jia; Zhang Beiru; Zhang Jue; Fang Jing

2008-01-01

Objective: To evaluate a noninvasive vessel encoded imaging for selective mapping of the flow territories of the left and fight internal carotid arteries and vertebral-basilar arteries. Methods: Seven volunteers [(33.5 ± 4.1) years; 3 men, 4 women] and 6 patients [(55.2 ± 3.2) years; 2 men, 4 women] were given written informed consent approved by the institutional review board before participating in the study. A pseudo-continuous tagging pulse train is modified to encode all vessels of interest. The selectivity of this method was demonstrated. Regional perfusion imaging was developed on the same arterial spin labeling sequence. Perfusion-weighted images of the selectively labeled cerebral arteries were obtained by subtraction of the labeled from control images. The CBF values of hemisphere, white matter, and gray matter of volunteers were calculated. The vessel territories on patients were compared with DSA. The low perfusion areas were compared with high signal areas on T 2 -FLAIR. Results: High SNR maps of left carotid, right carotid, and basilar territories were generated in 8 minutes of scan time. Cerebral blood flow values measured with regional perfusion imaging in the complete hemisphere (32.6 ± 4.3) ml·min -1 · 100 g -1 , white matter (10.8 ± 0.9) ml·min -1 ·100 g -1 , and gray matter (55.6±2.9) ml·min -1 · 100 g -1 were in agreement with data in the literature. Vessel encoded imaging in patients had a good agreement with DSA. The low perfusion areas were larger than high signal areas on T 2 -FLAIR. Conclusion: We present a new method capable of evaluating both quantitatively and qualitatively the individual brain- feeding arteries in vivo. (authors)

Charge modification of the endothelial surface layer modulates the permeability barrier of isolated rat mesenteric small arteries

NARCIS (Netherlands)

van Haaren, Paul M. A.; VanBavel, Ed; Vink, Hans; Spaan, Jos A. E.

2005-01-01

We hypothesized that modulation of the effective charge density of the endothelial surface layer ( ESL) results in altered arterial barrier properties to transport of anionic solutes. Rat mesenteric small arteries ( diameter similar to 190 mu m) were isolated, cannulated, perfused, and superfused

In vivo MR perfusion imaging of renal artery stenosis

International Nuclear Information System (INIS)

Powers, T.; Lorenz, C.H.; Bain, R.; Holburn, G.; Price, R.R.

1989-01-01

Various techniques have been developed for noninvasive evaluation of renal blood flow. More important in the assessment of potential renal ischemia may be actual perfusion of the nephron mass. MR pulse sequences have been devised that allow perfusion imaging (PI) in a dog model of renal artery stenosis. Unilateral renal artery stenosis was created in mongrel dogs and quantitation of renal blood flow was obtained with radioactive microspheres. Perfusion imaging was performed on a 1.5-T system to obtain the apparent diffusion coefficient. During initial studies, it was found that the usual gradient factor used in brain PI was too high for renal studies; a factor of < 50 was found to be optimal. Additionally, respiratory gating with acquisition at end expiration was necessary to prevent renal motion. Recent studies have shown that PI reflects the asymmetry of flow in this model

CT arteriography via the right inferior phrenic artery developed parasitic perfusion into the liver

International Nuclear Information System (INIS)

Inaba, Yoshitaka; Arai, Yasuaki; Sueyoshi, Satoshi; Yamagami, Takuji; Aramaki, Takeshi; Yamaura, Hidekazu; Matsueda, Kiyoshi; Sasaki, Fumio; Takeuchi, Yoshihito.

1998-01-01

The distribution of arterial blood flow via the right inferior phrenic artery (rt-IPA) developing parasitic perfusion into the liver was evaluated by CT arteriography (CTA) in 50 cases with hepatic tumors. In all cases, CTA via rt-IPA showed hyperperfusion area including hepatic tumors in the posterior segment and the caudate lobe of the liver, and adding the left hepatic lobe in cases with hepatic arterial occlusion. In 82% of 33 cases obtained both CTA via rt-IPA and CTA via hepatic artery, the hyperperfusion area on CTA via rt-IPA exactly corresponded to perfusion defect area on CTA via hepatic artery. CTA was much useful for understanding hemodynamics in cases with parasitic perfusion into the liver and it could make transcatheter arterial therapy more effective. (author)

CT arteriography via the right inferior phrenic artery developed parasitic perfusion into the liver

Energy Technology Data Exchange (ETDEWEB)

Inaba, Yoshitaka; Arai, Yasuaki; Sueyoshi, Satoshi; Yamagami, Takuji; Aramaki, Takeshi; Yamaura, Hidekazu; Matsueda, Kiyoshi; Sasaki, Fumio [Aichi Cancer Center, Nagoya (Japan); Takeuchi, Yoshihito

1998-02-01

The distribution of arterial blood flow via the right inferior phrenic artery (rt-IPA) developing parasitic perfusion into the liver was evaluated by CT arteriography (CTA) in 50 cases with hepatic tumors. In all cases, CTA via rt-IPA showed hyperperfusion area including hepatic tumors in the posterior segment and the caudate lobe of the liver, and adding the left hepatic lobe in cases with hepatic arterial occlusion. In 82% of 33 cases obtained both CTA via rt-IPA and CTA via hepatic artery, the hyperperfusion area on CTA via rt-IPA exactly corresponded to perfusion defect area on CTA via hepatic artery. CTA was much useful for understanding hemodynamics in cases with parasitic perfusion into the liver and it could make transcatheter arterial therapy more effective. (author)

Effects of Constant Flow vs. Constant Pressure Perfusion on Fluid Filtration in Severe Hypothermic Isolated Blood-Perfused Rat Lungs.

Science.gov (United States)

Halsøy, Kathrine; Kondratiev, Timofey; Tveita, Torkjel; Bjertnaes, Lars J

2016-01-01

Victims of severe accidental hypothermia are prone to fluid extravasation but rarely develop lung edema. We hypothesize that combined hypothermia-induced increase in pulmonary vascular resistance (PVR) and a concomitant fall in cardiac output protect the lungs against edema development. Our aim was to explore in hypothermic-isolated blood-perfused rat lungs whether perfusion at constant pressure influences fluid filtration differently from perfusion at constant flow. Isolated blood-perfused rat lungs were hanging freely in a weight transducer for measuring weight changes (ΔW). Fluid filtration coefficient (Kfc), was determined by transiently elevating left atrial pressure (Pla) by 5.8 mmHg two times each during normothermia (37°C) and during hypothermia (15°C). The lung preparations were randomized to two groups. One group was perfused with constant flow (Constant flow group) and the other group with constant pulmonary artery pressure (Constant PPA group). Microvascular pressure (Pmv) was determined before and during elevation of Pla (ΔPmv) by means of the double occlusion technique. Kfc was calculated with the formula Kfc = ΔW/ΔPmv/min. All Kfc values were normalized to predicted lung weight (P LW ), which was based on body weight (BW) according to the formula: P LW  = 0.0053 BW - 0.48 and presented as Kfc PLW in mg/min/mmHg/g. At cessation, bronchoalveolar lavage (BAL) fluid/perfusate protein concentration (B/P) ratio was determined photometrically. Data were analyzed with parametric or non-parametric tests as appropriate. p  Kfc PLW and B/P ratio increased significantly by more than 10-fold during hypothermia concerted by visible signs of edema in the trachea. Hemoglobin and hematocrit increased within the Constant flow group and between the groups at cessation of the experiments. In hypothermic rat lungs perfused at constant flow, fluid filtration coefficient per gram P LW and B/P ratio increased more than 10-fold concerted by increased

Normal myocardial perfusion imaging in the presence of significant coronary artery stenosis

International Nuclear Information System (INIS)

Tian Yueqin; He Zuoxiang; Fang Wei; Yang Minfu; Shen Rui

2007-01-01

Objective: The aim of this study was to investigate the factors which might result in normal myocardial perfusion imaging in the presence of significant coronary artery stenosis. Methods: One hundred and thirty-three patients [mean age of (59±10) years, 98 men, 35 women] who underwent coronary angiography and myocardial perfusion SPECT were retrospectively analyzed. Results: Forty-six (35%) patients performed adequate bicycle exercise testing and achieved more than 85% of their predicted maximal heart rates; while 87 (65%) patients did not. Eighty-four (63%) patients had single coronary stenosis, 31(23%) two-vessel and 17(13%) three-vessel diseases. The difference in stenosis severity among the vessels in 13 (76%) cases with three-vessel diseases was not more than 20%. There were totally 202 coronary artery stenosis: 93 (46%) in left anterior descending coronary artery (LAD), 52 (26%) left circumflex coronary artery (LCX), 52(26% ) right coronary artery (RCA) and 5 (2%) left main coronary artery (LM) disease. Eighty-six(43%) vessels had 50%-70% stenosis, 100 (49%) >70%-90% and 16(8% )more than 90%. Conclusion: Normal myocardial perfusion imaging with significant coronary artery stenosis can probably due to inadequate exercise, single vessel disease and mild to moderate stenotic lesion. (authors)

Specific perfusion pattern in stress 201Tl myocardial scintigraphy of left main coronary artery disease

International Nuclear Information System (INIS)

Wakasugi, Shigetoshi; Shibata, Nobuhiko; Kobayashi, Tohru; Fudemoto, Yoshiyuki; Hasegawa, Yoshihisa; Nakano, Shunichi

1986-01-01

The usefulness of stress 201 Tl myocardial scintigraphy for identifying left main coronary artery disease was evaluated with data from 23 patients with 50% or more narrowing of the left main coronary artery and 56 patients with 75% or more narrowing of the major coronary arteries but without left main coronary artery involvement (no left main coronary artery disease). Quantitative evaluation of stress perfusion scintigrams in all five patients with narrowing of the left main coronary artery of 90% or more showed a characteristic perfusion pattern (left main pattern) of extensive homogeneous defect over the whole anterolateral segment and simultaneous defects in all radii of the high anteroseptal and high posterolateral segments. On the other hand, such a perfusion pattern was noted in only 1 of 18 patients with less than 90% stenosis of the left main coronary artery and in only 1 of 56 patients with no left coronary artery disease. (orig.)

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...

Isolated limb perfusion.

Science.gov (United States)

Gillespie, Rosalyn; Chantier, Nariane

1994-12-08

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

Myocardial perfusion SPECT in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery

International Nuclear Information System (INIS)

Padma, Subramanyam; Sundaram, Palaniswamy Shanmuga

2014-01-01

Pediatric myocardial perfusion imaging (MPI) is not a routine investigation in an Indian setting due to under referrals and logistic problems. However, MPI is a frequently performed and established modality of investigation in adults for the identification of myocardial ischemia and viability. We report myocardial perfusion scintigraphy in a case of retropulmonary looping of left coronary artery in a baby after arterial switch surgery. Adenosine stress MPI revealed a large infarct involving anterior segment with moderate reversible ischemia of the lateral left ventricular segment. Coronary angiogram later confirmed left main coronary artery ostial occlusion with retrograde collateral supply from dilated right coronary artery

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

International Nuclear Information System (INIS)

Griffin, N.; Mansfield, L.; Redmond, K.C.; Dusmet, M.; Goldstraw, P.; Mittal, T.K.; Padley, S.

2007-01-01

Aim: To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. Method: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Results: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. Conclusion: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases

Energy Technology Data Exchange (ETDEWEB)

Griffin, N. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)]. E-mail: nyreegriffin@hotmail.com; Mansfield, L. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Redmond, K.C. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Dusmet, M. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Goldstraw, P. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Mittal, T.K. [Royal Brompton and Harefield NHS Trust, London (United Kingdom); Padley, S. [Royal Brompton and Harefield NHS Trust, London (United Kingdom)

2007-03-15

Aim: To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. Method: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). Results: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. Conclusion: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.

Isolated Liver Perfusion Using Percutaneous Methods:[ql An Experimental Study in the Pig

International Nuclear Information System (INIS)

Harnek, Jan; Cwikiel, Wojciech; Bergqvist, Lennart; Persson, Bo; Stridbeck, Hans

1996-01-01

Purpose: To develop a method for isolated perfusion of the liver using radiological methods. Methods: Twenty-one pigs, weighing about 20 kg, were divided into three groups. By transjugular and transfemoral approaches two occlusion balloons were placed in the inferior vena cava cranial and caudal, respectively, to the origin of the hepatic veins. One occlusion balloon was placed transfemorally in the common hepatic artery. Another occlusion balloon was inserted in the main branch of the portal vein via the transjugular-transhepatic approach in 11 pigs (groups 1 and 2), and in 10 pigs (group 3) by a percutaneous transhepatic route. After inflation of the balloons, patency of the isolated liver circulation was evaluated by recirculation of 99 Tc m -labelled human albumin during 30 min. Blood tests were obtained after 1, 3, 5, 10, 15, and 30 min to evaluate leakage from the liver to the systemic circulation. Results: Increasing leakage to the systemic circulation from the isolated liver circulation was observed in groups 1 and 2. In the third group the leakage was less than 10%. Conclusion: In an experimental animal model, isolated perfusion of the liver with minor leakage to the systemic circulation may be achieved using radiological methods

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

DEFF Research Database (Denmark)

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

2014-01-01

AIMS: To evaluate the diagnostic power of integrating the results of computed tomography angiography (CTA) and CT myocardial perfusion (CTP) to identify coronary artery disease (CAD) defined as a flow limiting coronary artery stenosis causing a perfusion defect by single photon emission computed...... emission computed tomography (SPECT/MPI). Sixteen centres enroled 381 patients who underwent combined CTA-CTP and SPECT/MPI prior to conventional coronary angiography. All four image modalities were analysed in blinded independent core laboratories. The prevalence of obstructive CAD defined by combined ICA...... tomography (SPECT). METHODS AND RESULTS: We conducted a multicentre study to evaluate the accuracy of integrated CTA-CTP for the identification of patients with flow-limiting CAD defined by ≥50% stenosis by invasive coronary angiography (ICA) with a corresponding perfusion deficit on stress single photon...

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

DEFF Research Database (Denmark)

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

2012-01-01

OBJECTIVESWe wanted to evaluate whether preoperative myocardial perfusion scintigraphy (MPS) could predict changes in cardiac symptoms and postoperative myocardial perfusion and left ventricular function after coronary artery bypass grafting (CABG).METHODSNinety-two patients with stable angina...... in 26%. Left ventricular ejection fraction (LVEF), which was normal before operation in 45%, improved in 40% of all patients. The increase in LVEF was not related to the preoperative pattern of perfusion defects. Of 30 patients with normalized perfusion after CABG, 29 (97%) had reversible defects...... that reversible or partly reversible perfusion defects at a preoperative MPS have a high chance of normalized myocardial perfusion assessed by MPS 6 months after operation. Normal perfusion is obtained almost exclusively in territories with reversible ischaemia. Symptoms improved in nearly all patients and LVEF...

Isolated left-sided pulmonary artery agenesis with left lung hypoplasia: A report of two cases

Directory of Open Access Journals (Sweden)

V Govindaraj

2017-01-01

Full Text Available Unilateral absence of pulmonary artery or pulmonary artery agenesis (UAPA is a rare congenital malformation that can present as an isolated lesion or in association with other cardiac anomalies. Though congenital, presentation in adults are also reported. Most common presentation in adults is of exercise intolerance. The developing lung on the affected side is hypoplastic. Diagnosis of UAPA is established by imaging methods like CT and MRI . There is no specific treatment for this condition. Treatment depends on patients symptomatology, presence of pulmonary hypertension and collateral circulation. Presence of pulmonary hypertension carries a bad prognosis. We present two adult patients with isolated left sided unilateral pulmonary artery agenesis with ipsilateral lung hypoplasia. The diagnosis was confirmed by CT chest and perfusion scan.

Perfusion deficits detected by arterial spin-labeling in patients with TIA with negative diffusion and vascular imaging.

Science.gov (United States)

Qiao, X J; Salamon, N; Wang, D J J; He, R; Linetsky, M; Ellingson, B M; Pope, W B

2013-01-01

A substantial portion of clinically diagnosed TIA cases is imaging-negative. The purpose of the current study is to determine if arterial spin-labeling is helpful in detecting perfusion abnormalities in patients presenting clinically with TIA. Pseudocontinuous arterial spin-labeling with 3D background-suppressed gradient and spin-echo was acquired on 49 patients suspected of TIA within 24 hours of symptom onset. All patients were free of stroke history and had no lesion-specific findings on general MR, DWI, and MRA sequences. The calculated arterial spin-labeling CBF maps were scored from 1-3 on the basis of presence and severity of perfusion disturbance by 3 independent observers blinded to patient history. An age-matched cohort of 36 patients diagnosed with no cerebrovascular events was evaluated as a control. Interobserver agreement was assessed by use of the Kendall concordance test. Scoring of perfusion abnormalities on arterial spin-labeling scans of the TIA cohort was highly concordant among the 3 observers (W = 0.812). The sensitivity and specificity of arterial spin-labeling in the diagnosis of perfusion abnormalities in TIA was 55.8% and 90.7%, respectively. In 93.3% (70/75) of the arterial spin-labeling CBF map readings with positive scores (≥2), the brain regions where perfusion abnormalities were identified by 3 observers matched with the neurologic deficits at TIA onset. In this preliminary study, arterial spin-labeling showed promise in the detection of perfusion abnormalities that correlated with clinically diagnosed TIA in patients with otherwise normal neuroimaging results.

Nursing implications for Hepatic arterial perfusion scintigraphy

International Nuclear Information System (INIS)

Ellender, R.

1999-01-01

Nurses working in Nuclear Medicine assist in Hepatic Artery Catheter (HAC) perfusion studies. This scan is not widely performed in Australia, the St George hospital for example performs approximately five per year. The purpose of this article is firstly to review the indications and rationale of HAC patency studies. Secondly, this article will stress the clinical implications for the Nuclear Medicine Nurse during this study. Emphasis will be placed on the importance of patient education during the procedure. A brief overview of hepatic anatomy and the radiopharmaceuticals administered during the scan is discussed. Finally, a step by step protocol is presented to show how the perfusion/ shunt study is performed. Copyright (1999) The Australian and New Zealand Society of Nuclear Medicine Inc

Stress perfusion magnetic resonance imaging to detect coronary artery lesions in children.

Science.gov (United States)

Vijarnsorn, Chodchanok; Noga, Michelle; Schantz, Daryl; Pepelassis, Dion; Tham, Edythe B

2017-05-01

Stress perfusion cardiovascular magnetic resonance (CMR) is used widely in adult ischemic heart disease, but data in children is limited. We sought to evaluate feasibility, accuracy and prognostic value of stress CMR in children with suspected coronary artery disease (CAD). Stress CMR was reviewed from two pediatric centers over 5 years using a standard pharmacologic protocol. Wall motion abnormalities, perfusion deficits and late enhancement were correlated with coronary angiogram (CAG) when available, and clinical status at 1 year follow-up for major adverse cardiovascular events (MACE; coronary revascularization, non-fatal myocardial infarction and death due to CAD) was recorded. Sixty-four stress perfusion CMR studies in 48 children (10.9 ± 4.8 years) using adenosine; 59 (92%) and dipyridamole; 5 (8%), were reviewed. Indications were Kawasaki disease (39%), post arterial switch operation (12.5%), post heart transplantation (12.5%), post anomalous coronary artery repair (11%), chest pain (11%), suspected myocarditis or CAD (3%), post coronary revascularization (3%), and others (8%). Twenty-six studies were performed under sedation. Of all studies performed, 66% showed no evidence of ischemia or infarction, 28% had perfusion deficits and 6% had late gadolinium enhancement (LGE) without perfusion deficit. Compared to CAG, the positive predictive value (PPV) of stress CMR was 80% with negative predictive value (NPV) of 88%. At 1 year clinical follow-up, the PPV and NPV of stress CMR to predict MACE were 78 and 98%. Stress-perfusion CMR, in combination with LGE and wall motion-analysis is a feasible and an accurate method of diagnosing CAD in children. In difficult cases, it also helps guide clinical intervention by complementing conventional CAG with functional information.

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

International Nuclear Information System (INIS)

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

1992-01-01

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

Thallium - 201 miocardial perfusion scintigraphy in patients with mitral valve prolapse, with and without coronary artery disease

International Nuclear Information System (INIS)

Moraes, A.G. de; Sousa, J.E.M.R.; Thom, A.F.; Martins, L.R.F.; Meneghelo, R.S.; Pimentel Filho, W.A.; Marioni Filho, H.; Gimenes, V.M.L.; Pontes Junior, S.C.

1981-01-01

Thirty patients with precordial pain and mitral valve prolapse diagnosed by cineangiography and M-mode echocardiography were submitted to Thallium-201 myocardial stress perfusion scintillography. They were divided into two groups: group I - eighteen patients with mitral valve prolapse and normal coronary arteries, of which ten presented positive exercise stress test (55.6%); eight patients had a negative exercise test. Thallium-201 myocardial stress perfusion scintillagraphy was normal in 14 (77.8%) patients, and four with positive stress perfursion scintillography, (three with inferior perfusion defects and one with a lateral one); group II - twelve patients with mitral valve prolapse and severe coronary artery disease (stenosis >= 60% in at least one main vessel of the coronary circulation), of which nine presented positive exercise stress test (75%) and three negative. Thallium-201 exercise myocardial perfusion scintillography was abnormal in nine (75%), six with stress induced ischemia and three with resting defect. Myocardial perfusion scintillography with Thallium-201 was more sensitive to detect the presence of coronary artery disease in patients with mitral valve prolapse (MVP) than the exercise stress test in spite of the fact that a small number of patients (22%) with MVP and normal coronary arteries exhibited abnormal myocardial stress perfusion during scintillography. (Author) [pt

Perfusion abnormalities in congenital and neoplastic pulmonary disease: comparison of MR perfusion and multislice CT imaging

International Nuclear Information System (INIS)

Boll, Daniel T.; Lewin, Jonathan S.; Young, Philip; Gilkeson, Robert C.; Siwik, Ernest S.

2005-01-01

The aim of this work was to assess magnetic resonance (MR) perfusion patterns of chronic, nonembolic pulmonary diseases of congenital and neoplastic origin and to compare the findings with results obtained with pulmonary, contrast-enhanced multislice computed tomography (CT) imaging to prove that congenital and neoplastic pulmonary conditions require MR imaging over the pulmonary perfusion cycle to successfully and directly detect changes in lung perfusion patterns. Twenty-five patients underwent concurrent CT and MR evaluation of chronic pulmonary diseases of congenital (n=15) or neoplastic (n=10) origin. Analysis of MR perfusion and contrast-enhanced CT datasets was realized by defining pulmonary and vascular regions of interest in corresponding positions. MR perfusion calculated time-to-peak enhancement, maximal enhancement and the area under the perfusion curve. CT datasets provided pulmonary signal-to-noise ratio measurements. Vessel centerlines of bronchial arteries were determined. Underlying perfusion type, such as pulmonary arterial or systemic arterial supply, as well as regions with significant variations in perfusion were determined statistically. Analysis of the pulmonary perfusion pattern detected pulmonary arterial supply in 19 patients; six patients showed systemic arterial supply. In pulmonary arterial perfusion, MR and multislice CT imaging consistently detected the perfusion type and regions with altered perfusion patterns. In bronchial arterial supply, MR perfusion and CT imaging showed significant perfusion differences. Patients with bronchial arterial supply had bronchial arteries ranging from 2.0 to 3.6 mm compared with submillimeter diameters in pulmonary arterial perfusion. Dynamic MR imaging of congenital and neoplastic pulmonary conditions allowed characterization of the pulmonary perfusion type. CT imaging suggested the presence of systemic arterial perfusion by visualizing hypertrophied bronchial arteries. (orig.)

Double-Balloon Catheter for Isolated Liver Perfusion: An Experimental Study

International Nuclear Information System (INIS)

Cwikiel, Wojciech; Bergqvist, Lennart; Harnek, Jan

2001-01-01

Purpose: Further development of a previously described interventional method for isolated liver perfusion (ILP) with a new double-lumen balloon catheter, and evaluation of the side-effects of such isolation.Methods: In six pigs a double-balloon occlusion catheter was placed via the transjugular approach with its tip in the portal vein. One of the balloons was positioned in the inferior vena cava (IVC), cranial to the origin of the hepatic veins and the other balloon in the portal vein. By the transfemoral approach, a single-balloon occlusion catheter was placed in the IVC caudal to the origin of the hepatic veins. A third catheter was placed by the transfemoral route with the occlusion balloon in the proper hepatic artery. After inflation of all balloons 99 Tc m -labelled human serum albumin was recirculated through the liver. The isolation was evaluated by repeated measurement of radioactivity levels in peripheral blood. Laboratory tests of liver and pancreas function, and hemoglobin, were taken before, at the end of, and 3 days after the procedure. Blood gases were tested at the beginning and end of the procedure.Results: One pig died during the procedure due to technical failure and was excluded from the study. In the other pigs leakage from the isolated liver to the systemic circulation increased slowly, up to 9.7% (mean) during 30 min of recirculation of the perfusate through the liver. Laboratory tests were normal in all pigs except insignificant acidosis directly after the procedure and the slight elevation of s-ALAT after 3 days.Conclusions: Only minor leakage from the liver to the systemic circulation was noted during ILP performed with a new, double-balloon catheter. There were no serious side effects

Comprehensive Assessment of Coronary Artery Disease by Using First-Pass Analysis Dynamic CT Perfusion: Validation in a Swine Model.

Science.gov (United States)

Hubbard, Logan; Lipinski, Jerry; Ziemer, Benjamin; Malkasian, Shant; Sadeghi, Bahman; Javan, Hanna; Groves, Elliott M; Dertli, Brian; Molloi, Sabee

2018-01-01

Purpose To retrospectively validate a first-pass analysis (FPA) technique that combines computed tomographic (CT) angiography and dynamic CT perfusion measurement into one low-dose examination. Materials and Methods The study was approved by the animal care committee. The FPA technique was retrospectively validated in six swine (mean weight, 37.3 kg ± 7.5 [standard deviation]) between April 2015 and October 2016. Four to five intermediate-severity stenoses were generated in the left anterior descending artery (LAD), and 20 contrast material-enhanced volume scans were acquired per stenosis. All volume scans were used for maximum slope model (MSM) perfusion measurement, but only two volume scans were used for FPA perfusion measurement. Perfusion measurements in the LAD, left circumflex artery (LCx), right coronary artery, and all three coronary arteries combined were compared with microsphere perfusion measurements by using regression, root-mean-square error, root-mean-square deviation, Lin concordance correlation, and diagnostic outcomes analysis. The CT dose index and size-specific dose estimate per two-volume FPA perfusion measurement were also determined. Results FPA and MSM perfusion measurements (P FPA and P MSM ) in all three coronary arteries combined were related to reference standard microsphere perfusion measurements (P MICRO ), as follows: P FPA_COMBINED = 1.02 P MICRO_COMBINED + 0.11 (r = 0.96) and P MSM_COMBINED = 0.28 P MICRO_COMBINED + 0.23 (r = 0.89). The CT dose index and size-specific dose estimate per two-volume FPA perfusion measurement were 10.8 and 17.8 mGy, respectively. Conclusion The FPA technique was retrospectively validated in a swine model and has the potential to be used for accurate, low-dose vessel-specific morphologic and physiologic assessment of coronary artery disease. © RSNA, 2017.

Characterizing potential heart agents with an isolated perfused heart system

International Nuclear Information System (INIS)

Pendleton, D.B.; Sands, H.; Gallagher, B.M.; Camin, L.L.

1984-01-01

The authors have used an isolated perfused heart system for characterizing potential myocardial perfusion radiopharamaceuticals. Rabbit or guinea pig (GP) hearts are removed and perfused through the aorta with a blood-free buffer. Heart rate and ventricular pressure are monitored as indices of viability. Tc-99m-MAA is 96-100% retained in these hearts, and Tc-99m human serum albumin shows less than 5% extraction. Tl-201 is 30-40% extracted. It is known that in-vivo, Tc-99m(dmpe)/sub 2/Cl/sub 2//sup +/ is taken up by rabbit heart but not by GP or human heart. Analogous results are obtained with the isolated perfused heart model, where the complex is extracted well by the isolated rabbit heart (24%) but not by the GP heart (<5%). Values are unchanged if human, rabbit or GP blood is mixed and co-injected with the complex. Tc-99m)dmpe)/sub 3//sup +/ is also taken up by rabbit but not by GP hearts in-vivo. However, isolated perfused hearts of both species extract this complex well (45-52%). Heart uptake is diminished to <7% if the complex is pre-equilibrated with human blood. GP blood produces a moderate inhibition (in GP hearts only) and rabbit blood has no effect. This suggests that a human or GP blood factor may have a significant effect on heart uptake of this complex. Tc-99m(CN-t-butyl)/sub 6//sup +/ is taken up well by both rabbit and GP hearts in-vivo, and is extracted 100% by both isolated perfused hearts. Heart retention remains high (73-75%) in the presence of human blood

Isolated thoracic perfusion with chemofiltration for progressive malignant pleural mesothelioma

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Aigner KR

2017-06-01

Full Text Available Karl Reinhard Aigner, Emir Selak, Sabine Gailhofer Department of Surgical Oncology, Medias Klinikum, Burghausen, Germany Introduction: Therapy of malignant pleural mesothelioma and especially the adequate role of surgery in this context remain the subject of controversial discussions. Radical surgery in particular, which is associated with substantial morbidity, failed to translate into a definite survival advantage. We report on interim results of an ongoing Phase II study of regional chemotherapy in terms of isolated thoracic perfusion with chemofiltration (ITP-F.Patients and methods: Twenty-eight patients (25 male, 3 female, mean age 63.4 years with advanced pleural mesothelioma were included in this study. Isolation of the chest was achieved by insertion of a venous and arterial stop-flow balloon catheter via a femoral access. The aorta and inferior vena cava were blocked at the level of the diaphragm and the upper arms were blocked by pneumatic cuffs. Chemotherapy, consisting of 60 mg/m² cisplatin and 15 mg/m² mitoxantrone, was administered directly into the aorta. The isolated circuit was maintained for 15 minutes followed by ~45 minutes of chemofiltration with a hemoprocessor until 5 L of filtrate were reached. The endpoints of the study were overall survival and quality of life (QoL.Results: Out of 28 patients enrolled in the study, 5 had prior surgeries, 10 patients had systemic chemotherapy, and 5 patients additional irradiation. In all patients in restaging, clinical progress was noted. In all, 162 cycles were administered. Due to chemofiltration, toxicity was within tolerable limits, revealing World Health Organization grade I leucopenia and thrombocytopenia in 9 patients and mucositis grade I in 6 patients. The major surgical complication was inguinal lymphatic fistula in 40% of the cases. Gastrointestinal toxicity and/or neurotoxicity were never observed. One-year survival was 49%, 2-year and 3-year survival was 31%, and 5

Establishment of a hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol.

Science.gov (United States)

Wang, Lei; He, Fu-Liang; Liu, Fu-Quan; Yue, Zhen-Dong; Zhao, Hong-Wei

2015-08-28

To determine the feasibility and safety of establishing a porcine hepatic cirrhosis and portal hypertension model by hepatic arterial perfusion with 80% alcohol. Twenty-one healthy Guizhou miniature pigs were randomly divided into three experimental groups and three control groups. The pigs in the three experimental groups were subjected to hepatic arterial perfusion with 7, 12 and 17 mL of 80% alcohol, respectively, while those in the three control groups underwent hepatic arterial perfusion with 7, 12 and 17 mL of saline, respectively. Hepatic arteriography and direct portal phlebography were performed on all animals before and after perfusion, and the portal venous pressure and diameter were measured before perfusion, immediately after perfusion, and at 2, 4 and 6 wk after perfusion. The following procedures were performed at different time points: routine blood sampling, blood biochemistry, blood coagulation and blood ammonia tests before surgery, and at 2, 4 and 6 wk after surgery; hepatic biopsy before surgery, within 6 h after surgery, and at 1, 2, 3, 4 and 5 wk after surgery; abdominal enhanced computed tomography examination before surgery and at 6 wk after surgery; autopsy and multi-point sampling of various liver lobes for histological examination at 6 wk after surgery. In experimental group 1, different degrees of hepatic fibrosis were observed, and one pig developed hepatic cirrhosis. In experimental group 2, there were cases of hepatic cirrhosis, different degrees of increased portal venous pressure, and intrahepatic portal venous bypass, but neither extrahepatic portal-systemic bypass circulation nor death occurred. In experimental group 3, two animals died and three animals developed hepatic cirrhosis, and different degrees of increased portal venous pressure and intrahepatic portal venous bypass were also observed, but there was no extrahepatic portal-systemic bypass circulation. It is feasible to establish an animal model of hepatic cirrhosis and

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

International Nuclear Information System (INIS)

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

2006-01-01

Assessment of perfusion with 15 O-labelled water (H 2 15 O) requires measurement of the arterial input function (AIF). The arterial time activity curve (TAC) measured using the peripheral sampling scheme requires corrections for delay and dispersion. In this study, parametrizations with and without arterial spillover correction for fitting of the tissue curve are evaluated. Additionally, a completely noninvasive method for generation of the AIF from a dynamic positron emission tomography (PET) acquisition is applied to assess perfusion of pelvic tumours. This method uses a volume of interest (VOI) to extract the TAC from the femoral artery. The VOI TAC is corrected for spillover using a separate tissue TAC and for recovery by determining the recovery coefficient on a coregistered CT data set. The techniques were applied in five patients with pelvic tumours who underwent a total of 11 examinations. Delay and dispersion correction of the blood TAC without arterial spillover correction yielded in seven examinations solutions inconsistent with physiology. Correction of arterial spillover increased the fitting accuracy and yielded consistent results in all patients. Generation of an AIF from PET image data was investigated as an alternative to arterial blood sampling and was shown to have an intrinsic potential to determine the AIF noninvasively and reproducibly. The AIF extracted from a VOI in a dynamic PET scan was similar in shape to the blood AIF but yielded significantly higher tissue perfusion values (mean of 104.0 ± 52.0%) and lower partition coefficients (-31.6 ± 24.2%). The perfusion values and partition coefficients determined with the VOI technique have to be corrected in order to compare the results with those of studies using a blood AIF

Treatment of tubal pregnancy by uterine artery perfusion and embolization

International Nuclear Information System (INIS)

Ni Caifang; Zou Jianwei; Zhao Hui; Jin Yonghai; Zhu Xiaoli; Liu Yizhi; He Qi; Shen Zhongji

2006-01-01

Objective: To study the feasibility, safety, and efficacy of the treatment for tubal pregnancy by interventional technique of transuterine arterial catheterization perfusion and embolization. Methods: Using modified Seldinger technique, 42 cases of tubal pregnancy received super-selective angiography of uterine artery, followed by perfusion of 50-100 mg methotrexate (MTX) through the catheter and embolization of uterine artery with gelatin sponge. Before and after the procedure, changes of clinical symptoms, physical signs, value of β-hCG and size of pregnancy cyst of patients were studied. Concentrations of MTX in peripheral blood were studied at 0.5, 6, 12, 24, 36, 48 hours after the procedure. Results: 38 out of 42 cases were cured with successful rate of 90.5%(38/42). The average time of β-hCG decreasing to normal was 8.26 ± 2.04 days. The concentration of MTX in peripheral blood with 50 mg or 75 mg dosage could not be detected at 36 hours after the procedure but could be detected as 0.01 μmol/L at 48 hours after the procedure with a dosage of 100 mg. Conclusions: It is simple, safe and efficient in performing trans-uterine artery chemo-embolization for therapy of fallopian tubal pregnancy, especially for those who complicated with manipules bleeding and also as the first choice for prevention of high risk massive hemorrhage. (authors)

Characterization of mouse neuro-urological dynamics in a novel decerebrate arterially perfused mouse (DAPM) preparation

OpenAIRE

Ito, Hiroki; Drake, Marcus J.; Fry, Christopher H.; Kanai, Anthony J.; Pickering, Anthony E.

2018-01-01

Aim To develop the decerebrate arterially perfused mouse (DAPM) preparation, a novel voiding model of the lower urinary tract (LUT) that enables in vitro-like access with in vivo-like neural connectivity. Methods Adult male mice were decerebrated and arterially perfused with a carbogenated, Ringer's solution to establish the DAPM. To allow distinction between central and peripheral actions of interventions, experiments were conducted in both the DAPM and in a “pithed” DAPM which has no brains...

Comparison with myocardial perfusion MRI and myocardial perfusion SPECT in the diagnostic performance of coronary artery disease. A meta-analysis

International Nuclear Information System (INIS)

Iwata, Kunihiro; Kubota, Makoto; Ogasawara, Katsuhiko

2008-01-01

We compared the diagnostic abilities of stress myocardial perfusion MRI (myocardial perfusion MRI) and myocardial perfusion single photon emission computed tomography (SPECT), using a meta-analysis method. We investigated the diagnostic abilities of MRI and SPECT in similar subject groups in reports written in English or Japanese. The reports to be used for analysis were selected according to a ''screening standard,'' which was established in advance. After consolidating the data from the selected reports, we compared the integrated odds ratio, the point estimation values of sensibility/specificity, and the summary receiver operating characteristic (ROC) curve. For the analysis, six reports were selected (subjects: 153, coronary-artery target sites: 447). Meta-analysis revealed that the diagnostic ability of myocardial perfusion MRI was superior to that of myocardial perfusion SPECT regarding each of the parameters. This is considered to be supportive evidence of the usefulness of myocardial perfusion MRI. (author)

Observed Influence of Nitroglycerine on Myocardial Perfusion Scintigraphy in Patients with Multiple Vessel Coronary Artery Disease and Well-Developed Collaterals

International Nuclear Information System (INIS)

Rasulova, Nigora; Nazirova, Lyudmila; Akhmedov, Khasan; Akhmedova, Dilyafruz; Djalalov, Farrukh; Seydaliev, Amet; Iskandarov, Farkhod; Kok, T. Y.

2012-01-01

The objective of this scientific work was to evaluate the extent and severity of perfusion abnormalities on myocardial perfusion scintigraphy (MPS) at rest and with sublingual nitroglycerine, in relation to the presence and anatomical location of collaterals demonstrated by selective coronary angiography (SCA). Twenty-eight patients with unstable angina underwent selective coronary angiography. Eighteen of them were diagnosed with myocardial infarction (MI) 2–15 days prior to examination. Presence or absence of collaterals was noted, with anatomical depiction of donor and recipient arteries as well as evaluation of degree of collateral flow. As an inclusion criterion, collateral flow had to be grade 2 (partial epicardial filling of the occluded artery) or 3 (complete epicardial filling of the occluded artery) in accordance with the Rentrop collateral flow classification. Flow was noted as follows: Complete antegrade (CA), complete retrograde (CR), partial antegrade (PA), and partial retrograde (PR). Myocardial perfusion scintigraphy using Tc-99m Sestamibi at rest and after sublingual administration of nitroglycerine was performed according to a 2-day protocol. Perfusion abnormalities, which were quantified using the 20-segments model and visual 5-point system (0, normal perfusion; 4, absent perfusion), were analyzed according to donor's and recipient's territories, as well as territories with limited or without collateral flow (PA/PR, grade 0–1 flow). A total of 84 arteries were analyzed, with stenosis in 79 of them. Arteries were divided into three groups: Donors (group I), recipients (group II), and arteries with limited or without collaterals (group III). In group I, there were 28 donor arteries, with mean severity of stenosis 71.3 ± 0.65%. In group II, there were 36 recipient arteries and mean severity of stenosis was 94.8 ± 0.26%. In group III, there were 20 arteries, and all of them had either no or poorly developed collaterals (mean severity

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

Energy Technology Data Exchange (ETDEWEB)

Coenen, Adriaan; Lubbers, Marisa M.; Dedic, Admir; Chelu, Raluca G.; Geuns, Robert-Jan M. van; Nieman, Koen [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus University Medical Center, Department of Cardiology, Rotterdam (Netherlands); Kurata, Akira; Kono, Atsushi; Dijkshoorn, Marcel L. [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Rossi, Alexia [Erasmus University Medical Center, Department of Radiology, Rotterdam (Netherlands); Barts Health NHS Trust, NIHR Cardiovascular Biomedical Research Unit at Barts, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London and Department of Cardiology, London (United Kingdom)

2017-06-15

To investigate the additional value of transmural perfusion ratio (TPR) in dynamic CT myocardial perfusion imaging for detection of haemodynamically significant coronary artery disease compared with fractional flow reserve (FFR). Subjects with suspected or known coronary artery disease were prospectively included and underwent a CT-MPI examination. From the CT-MPI time-point data absolute myocardial blood flow (MBF) values were temporally resolved using a hybrid deconvolution model. An absolute MBF value was measured in the suspected perfusion defect. TPR was defined as the ratio between the subendocardial and subepicardial MBF. TPR and MBF results were compared with invasive FFR using a threshold of 0.80. Forty-three patients and 94 territories were analysed. The area under the receiver operator curve was larger for MBF (0.78) compared with TPR (0.65, P = 0.026). No significant differences were found in diagnostic classification between MBF and TPR with a territory-based accuracy of 77 % (67-86 %) for MBF compared with 70 % (60-81 %) for TPR. Combined MBF and TPR classification did not improve the diagnostic classification. Dynamic CT-MPI-based transmural perfusion ratio predicts haemodynamically significant coronary artery disease. However, diagnostic performance of dynamic CT-MPI-derived TPR is inferior to quantified MBF and has limited incremental value. (orig.)

MicroRNA-146a Regulates Perfusion Recovery in Response to Arterial Occlusion via Arteriogenesis

Directory of Open Access Journals (Sweden)

Joshua L. Heuslein

2018-01-01

Full Text Available The growth of endogenous collateral arteries that bypass arterial occlusion(s, or arteriogenesis, is a fundamental shear stress-induced adaptation with implications for treating peripheral arterial disease. MicroRNAs (miRs are key regulators of gene expression in response to injury and have strong therapeutic potential. In a previous study, we identified miR-146a as a candidate regulator of vascular remodeling. Here, we tested whether miR-146a regulates in vitro angiogenic endothelial cell (EC behaviors, as well as perfusion recovery, arteriogenesis, and angiogenesis in response to femoral arterial ligation (FAL in vivo. We found miR-146a inhibition impaired EC tube formation and migration in vitro. Following FAL, Balb/c mice were treated with a single, intramuscular injection of anti-miR-146a or scramble locked nucleic acid (LNA oligonucleotides directly into the non-ischemic gracilis muscles. Serial laser Doppler imaging demonstrated that anti-miR-146a treated mice exhibited significantly greater perfusion recovery (a 16% increase compared mice treated with scramble LNA. Moreover, anti-miR-146a treated mice exhibited a 22% increase in collateral artery diameter compared to controls, while there was no significant effect on in vivo angiogenesis or muscle regeneration. Despite exerting no beneficial effects on angiogenesis, the inhibition of mechanosensitive miR-146a enhances perfusion recovery after FAL via enhanced arteriogenesis.

Volume of myocardium perfused by coronary artery branches as estimated from 3D micro-CT images of rat hearts

Science.gov (United States)

Lund, Patricia E.; Naessens, Lauren C.; Seaman, Catherine A.; Reyes, Denise A.; Ritman, Erik L.

2000-04-01

Average myocardial perfusion is remarkably consistent throughout the heart wall under resting conditions and the velocity of blood flow is fairly reproducible from artery to artery. Based on these observations, and the fact that flow through an artery is the product of arterial cross-sectional area and blood flow velocity, we would expect the volume of myocardium perfused to be proportional to the cross-sectional area of the coronary artery perfusing that volume of myocardium. This relationship has been confirmed by others in pigs, dogs and humans. To test the body size-dependence of this relationship we used the hearts from rats, 3 through 25 weeks of age. The coronary arteries were infused with radiopaque microfil polymer and the hearts scanned in a micro- CT scanner. Using these 3D images we measured the volume of myocardium and the arterial cross-sectional area of the artery that perfused that volume of myocardium. The average constant of proportionality was found to be 0.15 +/- 0.08 cm3/mm2. Our data showed no statistically different estimates of the constant of proportionality in the rat hearts of different ages nor between the left and right coronary arteries. This constant is smaller than that observed in large animals and humans, but this difference is consistent with the body mass-dependence on metabolic rate.

Hepatic arterial perfusion increases in the early stage of severe acute pancreatitis patients: Evaluation by perfusion computed tomography

International Nuclear Information System (INIS)

Koyasu, Sho; Isoda, Hiroyoshi; Tsuji, Yoshihisa; Yamamoto, Hiroshi; Matsueda, Kazuhiro; Watanabe, Yuji; Chiba, Tsutomu; Togashi, Kaori

2012-01-01

Purpose: Although hepatic perfusion abnormalities have been reported in patients with acute pancreatitis, hepatic perfusion with severe acute pancreatitis (SAP) has not been quantitatively evaluated in humans. Therefore, we investigated hepatic perfusion in patients with SAP using perfusion CT. Materials and methods: Hepatic perfusion CT was performed in 67 patients with SAP within 3 days after symptom onset. The patients were diagnosed as having SAP according to the Atlanta criteria. Fifteen cases were established as a control group. Perfusion CT was obtained for 54 s beginning with a bolus injection of 40 ml of contrast agent (600–630 mgI/kg) at a flow rate of 4 ml/s. Perfusion data were analyzed by the dual-input maximum slope method to obtain hepatic arterial perfusion (HAP) and hepatic portal perfusion (HPP). Finally, we compared HAP and HPP in SAP patients with those in the control group, respectively. Results: Average HAP was significantly higher in SAP patients than in the control group (75.1 ± 38.0 vs. 38.2 ± 9.0 ml/min/100 ml; p < 0.001). There was no significant difference in average HPP between SAP patients and the control group (206.7 ± 54.9 vs. 204.4 ± 38.5 ml/min/100 ml; p = 0.92). Conclusion: Using quantitative analysis on perfusion CT, we first demonstrated an increase of HAP in the right hepatic lobe in SAP patients.

Clinical evaluation of 99Tcm-MIBI myocardial perfusion imaging for the detection of coronary artery disease in patients with metabolic syndrome

International Nuclear Information System (INIS)

Tian Yueqin; Wei Hongxing; Guo Xinhua; Guo Feng; He Zuoxiang

2008-01-01

Objective: Metabolic syndrome is a combination of medical disorders that consist of a collection of independent factors at risk of developing coronary artery disease. The purpose of this study was to evaluate the value of 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging for the diagnosis of coronary artery disease in patients with metabolic syndrome. Methods: A total of 251 patients [mean age (59 ± 10) years, 179 men, 72 women] were included in this study. All patients underwent exercise and rest 99 Tc m -MIBI myocardial perfusion imaging and coronary angiography. Results: Of the 163 patients with significant coronary artery stenosis, 116 showed abnormal 99 Tc m -MIBI myocardial perfusion imaging; and among the 88 patients with normal coronary angiography, 82 showed normal myocardial perfusion imaging. The sensitivity, specificity and accuracy of 99 Tc m -MIBI myocardial perfusion imaging for coronary artery disease detection were 71% (116/163), 93% (82/88) and 79% (198/251), respectively. The positive and negative predictive values were 95% (116/122) and 64% (82/129), respectively. Conclusion: 99 Tc m -MIBI myocardial perfusion imaging has important clinical value for detecting coronary artery disease in patients with metabolic syndrome. (authors)

Hepatic Arterial Perfusion Scintigraphy with '99mTc-Macroaggregated Albumin in Hepatocellular Carcinoma

International Nuclear Information System (INIS)

Kim, Gang Deuk; Sohn, Kwang Joon; Min, Kyung Yoon; Kwon, Young Mi; Kim, Chang Guhn; Noh, Byung Suk; Won, Jong Jin

1994-01-01

Hepatic arterial perfusion scintigraphy with '9 9m Tc macroggregated albumin (HAPS) study was carried out in 16 patients with hepatocellular carcinoma (HCC) and in six patients without liver tumor to evaluate HAPS findings of hepatocellular carcinoma and use fullness of HAPS. HAPS with planar and SPECT study were performed in 22 patients after conventional hepatic or celiac arteriography. For HAPS study, 4 5 mCi of MAA mixed with 2 ml of saline was injected into proper hepatic artery or its distal branches at the rate of approximately 1 ml/sec. We analysed 21 HCCs over 2 cm in diameter(average diameter: 6.4 cm) and 17 of 21 HCCs were over 4 cm in diameter. CT, sonography and angiography were performed within two week in all 16 patients and liver scan was performed in 12 patients. Three different pattern of tumor perfusion were observed in 16 patients with HCC. 1) diffuse increased perfusion in 16 of 21(76%) 2) increased peripheral perfusion in 4 of 21(19%) 3) diffuse decreased perfusion in 1 of 21 (5%) Arteriovenous shunt indicated by lung uptake of MAA were observed in 9 of 16 (56% ). In contrast, angiography demonstrates arteriovenous shunt in 2 of 16 (13%). There was no accumulation of radioactivity on RRC blood pool scan in all six patients with HCC examined. HAPS is useful study in evaluation of perfusion pattern or vascularity of HCC and in detection of arteriovenous shunt.

Pressure Myography to Study the Function and Structure of isolated small arteries

DEFF Research Database (Denmark)

Schjørring, Olav; Carlsson, Rune; Simonsen, Ulf

2015-01-01

Small arteries play an important role in regulation of peripheral resistance and organ perfusion. Here we describe a series of the methods allowing measurements in pressurized segments of small arteries from the systemic and coronary circulation of mice as well as other species. The pressure...... myography techniques described include measurements of wall structure, wall stress, strain, and of myogenic tone. The pressurized perfused small arteries also allow evaluation of responses to increases in pressure, flow, and drugs, where the main readout is changes in vascular diameter....

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

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Jiji Ronny S

2013-01-01

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

Myocardial perfusion changes in patients irradiated for left-sided breast cancer and correlation with coronary artery distribution

International Nuclear Information System (INIS)

Lind, Pehr A.; Pagnanelli, Robert; Marks, Lawrence B.; Borges-Neto, Salvador; Hu, Caroline; Zhou, S.-M.; Light, Kim; Hardenbergh, Patricia H.

2003-01-01

Purpose: To evaluate postradiation regional heart perfusion changes with single photon emission tomography (SPECT) myocardial perfusion imaging in 69 patients treated with tangential photon beams radiation therapy (RT) for left-sided breast cancer. To correlate SPECT changes with percent irradiated left ventricle (LV) volume and risk factors for coronary artery disease (CAD). Methods and Materials: Rest SPECT of the LV was acquired pre-RT and at 6-month intervals post-RT. The extent of defects (%) with a severity > 1.5 standard deviations below the mean was quantitatively analyzed for the distributions of the left anterior descending (LAD) artery, left circumflex (LCX) artery, and right coronary artery (RCA) based on computer assisted polar map reconstruction (i.e., bull's-eye-view). Changes in perfusion were correlated with percent irradiated LV receiving > 25 Gy (range 0-32%). Data on patient- and treatment-related factors were collected prospectively (e.g., cardiac premorbidity, risk factors for CAD, chemotherapy, and hormonal treatment). Results: In the LAD distribution, there were increased perfusion defects at 6 months (median 11%; interquartile range 2-23) compared with baseline (median 5%; interquartile range 1-14) (p<0.001). There were no increases in perfusion defects in the LCX or RCA distributions. In multivariate analysis, the SPECT perfusion changes in the LAD distribution at 6 months were independently associated with percent irradiated LV (p<0.001), hormonal therapy (p=0.005), and pre-RT hypercholesterolemia (p=0.006). The SPECT defects in the LAD distribution at 12 and 18 months were not statistically different from those at 6 months. The perfusion defects in the LAD distribution were limited essentially to the regions of irradiated myocardium. Conclusion: Tangential photon beam RT in patients with left-sided breast cancer was associated with short-term SPECT defects in the vascular distribution corresponding to the radiation portals. Factors

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.)

First-pass perfusion disturbance of coronary artery stenosis: an experimental study using MR imaging with Gd-DTPA enhancement

Energy Technology Data Exchange (ETDEWEB)

Chung, Kyung Il; Lee, Young Ju [Ajou Univ. College of Medicine, Seoul (Korea, Republic of); Lim, Tae Hwan [Ulsan Univ. College of Medicine, Ulsan (Korea, Republic of)] [and others

1997-11-01

In order to determine the value of first-pass MR imaging in the diagnosis of myocardial ischemia, first-pass perfusion abnormality of coronary artery stenosis was observed in MRI after gadopentate dimeglumine(GD-DTPA) enhancement. The left anterior descending(LAD) coronary arteries of six dogs were subjected to approximately 70% stenosis confirmed by coronary angiography. Half an hour after adenosine and {sup 99m}Tc-sestamibi infusion, Gd-DTPA(0.2mmol/kg) and methylene blue were administered and termination was induced with potassium chloride. SE T1-weighted and single-photon emission computed tomography(SPECT) images were subsequently obtained and the findings of perfusion defect compared with specimen stain. Three dimensionally reconstructed MR images were used to measure signal intensity(SI) of normal myocardium and perfusion defect from their sectional and total volume. Five of six dogs with LAD artey stenosis ranging from 66% to 73% displayed perfusion defect on MRI, SPECT, and specimen stain, but the remaining dog with stenosis of 58% showed no such defect. MRI showed the perfusion defect as distinct low SI, enabling the measurement of percentage perfusion defect(24.4{+-}5.4%), which increased inferiorly. SI of normal myocardium and perfusion defect decreased inferiorly; their difference indicated stenosis-induced perfusion loss according to section location. Volumetric SI of normal myocardium and perfusion defect were 3.42{+-}0.52 and 2.16{+-}0.45, respectively(p<0.05). Gd-DTPA enhanced MRI displayed first-pass perfusion abnormality of coronary artery stenosis as perfusion defect with distinct low SI; this enabled the measurement of its volume and SI changes according to section location, and thus indicated the value of first-pass MR imaging in the diagnosis of myocardial ischemia.

First-pass perfusion disturbance of coronary artery stenosis: an experimental study using MR imaging with Gd-DTPA enhancement

International Nuclear Information System (INIS)

Chung, Kyung Il; Lee, Young Ju; Lim, Tae Hwan

1997-01-01

In order to determine the value of first-pass MR imaging in the diagnosis of myocardial ischemia, first-pass perfusion abnormality of coronary artery stenosis was observed in MRI after gadopentate dimeglumine(GD-DTPA) enhancement. The left anterior descending(LAD) coronary arteries of six dogs were subjected to approximately 70% stenosis confirmed by coronary angiography. Half an hour after adenosine and 99m Tc-sestamibi infusion, Gd-DTPA(0.2mmol/kg) and methylene blue were administered and termination was induced with potassium chloride. SE T1-weighted and single-photon emission computed tomography(SPECT) images were subsequently obtained and the findings of perfusion defect compared with specimen stain. Three dimensionally reconstructed MR images were used to measure signal intensity(SI) of normal myocardium and perfusion defect from their sectional and total volume. Five of six dogs with LAD artey stenosis ranging from 66% to 73% displayed perfusion defect on MRI, SPECT, and specimen stain, but the remaining dog with stenosis of 58% showed no such defect. MRI showed the perfusion defect as distinct low SI, enabling the measurement of percentage perfusion defect(24.4±5.4%), which increased inferiorly. SI of normal myocardium and perfusion defect decreased inferiorly; their difference indicated stenosis-induced perfusion loss according to section location. Volumetric SI of normal myocardium and perfusion defect were 3.42±0.52 and 2.16±0.45, respectively(p<0.05). Gd-DTPA enhanced MRI displayed first-pass perfusion abnormality of coronary artery stenosis as perfusion defect with distinct low SI; this enabled the measurement of its volume and SI changes according to section location, and thus indicated the value of first-pass MR imaging in the diagnosis of myocardial ischemia

Assessment of the myocardial perfusion pattern in patients with multivessel coronary artery disease

International Nuclear Information System (INIS)

Iskandrian, A.S.; Hakki, A.H.; Segal, B.L.; Kane, S.A.; Amenta, A.

1983-01-01

A total of 42 symptomatic patients with coronary artery disease involving two or three vessels were studied using exercise thallium-201 myocardial scintigraphy. Qualitative analysis of the images predicted multivessel disease in 75% of the patients with two-vessel disease and in 82% of the patients with three-vessel disease. Quantitative analysis of the size of the perfusion defect indicated that approximately 40% of the left ventricular perimeter showed abnormal perfusion pattern during stress in these patients, and there was no significant difference in the size of the defect in patients with two-vessel disease or three-vessel disease (41 +/- 17% vs 42 +/- 14%, respectively, mean +/- SD). The exercise heart rate, exercise ECG response, and severity of narrowing did not correlate with the size of the perfusion defect. Patients with anterior infarction had larger defects in the distribution of the left anterior descending artery than those without infarction. Collaterals offered partial protection during exercise only when they were not jeopardized. This study confirms the value of qualitative analysis of exercise thallium-201 imaging in predicting multivessel disease, and describes a simple method of assessing the extent of perfusion abnormalities during stress in patients with multivessel disease. The results may be important in patient management and prognosis

Effect of perfusion and irrigation flow rate variations on NaCl efflux from the isolated, perfused head of the marine teleost, Myoxocephalus octodecimspinosus

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Claiborne, J.B. (Miami Univ., Coral Gables, FL (USA)); Evans, D.H. (Mt. Desert Island Biological Laboratory, Salsbury Cove, ME, USA)

1981-06-01

In vivo branchial blood pressure and unidirectional efflux values for NaCl were determined in the marine teleost, Myoxocephalus octodecimspinosus. Utilizing an isolated, perfused head preparation, perfused at in vivo pressure levels, NaCl efflux was measured and compared to in vivo values. The effect of variations in perfusion or irrigation rates on the ion efflux across the gills of the isolated head was also studied. The efflux of /sup 22/Na from the isolated, perfused head was found to be similar to in vivo values and dependent on perfusion flow and pressure. In vitro /sup 36/Cl efflux was lower than the efflux from intact animals and was determined to be flow/pressure independent. Irrigation rate changes at all rates tested did not affect the unidirectional efflux of either ion.

Perfusion of veins at arterial pressure increases the expression of KLF5 and cell cycle genes in smooth muscle cells

International Nuclear Information System (INIS)

Amirak, Emre; Zakkar, Mustafa; Evans, Paul C.; Kemp, Paul R.

2010-01-01

Vascular smooth muscle cell (VSMC) proliferation remains a major cause of veno-arterial graft failure. We hypothesised that exposure of venous SMCs to arterial pressure would increase KLF5 expression and that of cell cycle genes. Porcine jugular veins were perfused at arterial or venous pressure in the absence of growth factors. The KLF5, c-myc, cyclin-D and cyclin-E expression were elevated within 24 h of perfusion at arterial pressure but not at venous pressure. Arterial pressure also reduced the decline in SM-myosin heavy chain expression. These data suggest a role for KLF5 in initiating venous SMCs proliferation in response to arterial pressure.

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

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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)

The clinical application value of myocardial perfusion imaging in evaluating coronary artery myocardial bridge patients with symptoms

International Nuclear Information System (INIS)

Wang Yuetao; Fu Ning; Ding Xuemei; Lu Cunzhi; Zhu Feng; Wang Guanmin; Huang Yijie; Wang Linguang

2008-01-01

Objective: Myocardial bridge is a common inborn coronary artery anomaly, myocardial bridge may be associated with myocardial ischemia. Only a few patients with coronary artery myocardial bridge were evaluated with nuclear medicine techniques. The aim of this study was to investigate the role of nuclear cardiology with myocardial perfusion technique in symptomatic myocardial bridge patients. Methods Nineteen myocardial bridge patients with the symptoms of chest pain and chest distress were analyzed retrospectively. 99 Tc m -methoxyisobutylisonitrile (MIBI) myocardial perfusion images (both exercise and rest) were performed in all. Imaging results were compared with the results of movement electrocardiogram (ECG) and coronary arteriography. The t test or χ 2 test was used to statistically analyze the data with Stata 7.0 software. Results: Of the 19 patients, 18 patients had myocardial bridge locating at the left anterior descending artery, 1 patient at the left anterior descending and left circumflex artery, the mean angiographic systolic occlusion within the myocardial bridge was (65.4 ± 22.1)%. Of these 19 patients, Exercise-rest 99 Tc m -MIBI myocardial perfusion imaging defined positive myocardial ischemia in 10 and negative in 9 patients. Of the 10 patients with 99 Tc m -MIBI myocardial perfusion imaging defined myocardial ischemia, 8 had reversible radioactive defect of partial anterior wall and (or) apex, 1 had reversible defect of post lateral wall and post septal wall, and 1 had reversible defect of inferior wall. The positive predictive value of myocardial perfusion imaging was 52.6% (10/19), which was higher than movement ECG [21.1% (4/19), χ 2 = 4.07, P 99 Tc m -MIBI myocardial periusion imaging defined myocardial ischemia. Six cases with Grade II stenosis, two were 99 Tc m -MIBI myocardial perfusion imaging defined myocardial ischemia. Eight cases with Grade III stenosis, seven were 99 Tc m -MIBI myocardial perfusion imaging defined myocardial

Tissue ablation accelerated by peripheral scanning mode with high-intensity focused ultrasound: a study on isolated porcine liver perfusion.

Science.gov (United States)

Bu, Rui; Yin, Li; Yang, Han; Wang, Qi; Wu, Feng; Zou, Jian Zhong

2013-08-01

The aims of this study were to investigate the feasibility of accelerated tissue ablation using a peripheral scanning mode with high-intensity focused ultrasound (HIFU) and to explore the effect of flow rate on total energy consumption of the target tissues. Using a model of isolated porcine liver perfusion via the portal vein and hepatic artery, we conducted a scanning protocol along the periphery of the target tissues using linear-scanned HIFU to carefully adjust the varying focal depth, generator power, scanning velocity and line-by-line interval over the entire ablation range. Porcine livers were divided into four ablation groups: group 1, n = 12, with dual-vessel perfusion; group 2, n = 11, with portal vein perfusion alone; group 3, n = 10, with hepatic artery perfusion alone; and group 4, n = 11, control group with no-flow perfusion. The samples were cut open consecutively at a thickness of 3 mm, and the actual ablation ranges were calculated along the periphery of the target tissues after triphenyl tetrazolium chloride staining. Total energy consumption was calculated as the sum of the energy requirements at various focal depths in each group. On the basis of the pre-supposed scanning protocol, the peripheral region of the target tissue formed a complete coagulation necrosis barrier in each group with varying dose combinations, and the volume of the peripheral necrotic area did not differ significantly among the four groups (p > 0.05). Furthermore, total energy consumption in each group significantly decreased with the corresponding decrease in flow rate (p Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

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

DEFF Research Database (Denmark)

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

2014-01-01

%, respectively, for SPECT. CONCLUSION: The overall performance of myocardial CT perfusion imaging in the diagnosis of anatomic CAD (stenosis ≥50%), as demonstrated with the Az, was higher than that of SPECT and was driven in part by the higher sensitivity for left main and multivessel disease.......PURPOSE: To compare the diagnostic performance of myocardial computed tomographic (CT) perfusion imaging and single photon emission computed tomography (SPECT) perfusion imaging in the diagnosis of anatomically significant coronary artery disease (CAD) as depicted at invasive coronary angiography....... MATERIALS AND METHODS: This study was approved by the institutional review board. Written informed consent was obtained from all patients. Sixteen centers enrolled 381 patients from November 2009 to July 2011. Patients underwent rest and adenosine stress CT perfusion imaging and rest and either exercise...

The effect of perfusion and irrigation flow rate variations on NaCl efflux from the isolated, perfused head of the marine teleost, Myoxocephalus octodecimspinosus

International Nuclear Information System (INIS)

Claiborne, J.B.; Evans, D.H.

1981-01-01

In vivo branchial blood pressure and unidirectional efflux values for NaCl were determined in the marine teleost, Myoxocephalus octodecimspinosus. Utilizing an isolated, perfused head preparation, perfused at in vivo pressure levels, NaCl efflux was measured and compared to in vivo values. The effect of variations in perfusion or irrigation rates on the ion efflux across the gills of the isolated head was also studied. The efflux of 22 Na from the isolated, perfused head was found to be similar to in vivo values and dependent on perfusion flow and pressure. In vitro 36 Cl efflux was lower than the efflux from intact animals and was determined to be flow/pressure independent. Irrigation rate changes at all rates tested did not affect the unidirectional efflux of either ion. (Auth.)

Sulphonylurea drugs reduce hypoxic damage in the isolated perfused rat kidney.

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Engbersen, R; Moons, M M; Wouterse, A C; Dijkman, H B; Kramers, C; Smits, P; Russel, F G

2000-08-01

Sulphonylurea drugs have been shown to protect against hypoxic damage in isolated proximal tubules of the kidney. In the present study we investigated whether these drugs can protect against hypoxic damage in a whole kidney preparation. Tolbutamide (200 microM) and glibenclamide (10 microM) were applied to the isolated perfused rat kidney prior to changing the gassing from oxygen to nitrogen for 30 min. Hypoxic perfusions resulted in an increased fractional excretion of glucose (FE % glucose 14.3+/-1.5 for hypoxic perfusions vs 4.9+/-1.6 for normoxic perfusions, mean +/- s.e. mean, P<0.05), which could be completely restored by 200 microM tolbutamide (5.7+/-0.4 for tolbutamide vs 14.3+/-1.5 for untreated hypoxic kidneys, P<0.01). Furthermore, tolbutamide reduced the total amount of LDH excreted in the urine (220+/-100 mU for tolbutamide vs. 1220+/-160 mU for untreated hypoxic kidneys, P<0.01). Comparable results were obtained with glibenclamide (10 microM). In agreement with the effect on functional parameters, ultrastructural analysis of proximal tubules showed increased brush border preservation in tolbutamide treated kidneys compared to untreated hypoxic kidneys. We conclude that glibenclamide and tolbutamide are both able to reduce hypoxic damage to proximal tubules in the isolated perfused rat kidney when applied in the appropriate concentrations.

Right ventricle performances with echocardiography and 99mTc myocardial perfusion imaging in pulmonary arterial hypertension patients.

Science.gov (United States)

Liu, Jie; Fei, Lei; Huang, Guang-Qing; Shang, Xiao-Ke; Liu, Mei; Pei, Zhi-Jun; Zhang, Yong-Xue

2018-05-01

Right heart catheterization is commonly used to measure right ventricle hemodynamic parameters and is the gold standard for pulmonary arterial hypertension diagnosis; however, it is not suitable for patients' long-term follow-up. Non-invasive echocardiography and nuclear medicine have been applied to measure right ventricle anatomy and function, but the guidelines for the usefulness of clinical parameters remain to be established. The goal of this study is to identify reliable clinical parameters of right ventricle function in pulmonary arterial hypertension patients and analyze the relationship of these clinical parameters with the disease severity of pulmonary arterial hypertension. In this study, 23 normal subjects and 23 pulmonary arterial hypertension patients were recruited from January 2015 to March 2016. Pulmonary arterial hypertension patients were classified into moderate and severe pulmonary arterial hypertension groups according to their mean pulmonary arterial pressure levels. All the subjects were subjected to physical examination, chest X-ray, 12-lead electrocardiogram, right heart catheterization, two-dimensional echocardiography, and technetium 99m ( 99m Tc) myocardial perfusion imaging. Compared to normal subjects, the right heart catheterization indexes including right ventricle systolic pressure, right ventricle end diastolic pressure, pulmonary artery systolic pressure, pulmonary artery diastolic pressure, pulmonary vascular resistance, and right ventricle end systolic pressure increased in pulmonary arterial hypertension patients and were correlated with mean pulmonary arterial pressure levels. Echocardiography parameters, including tricuspid regurgitation peak velocity, tricuspid regurgitation pressure gradient, tricuspid annular plane systolic excursion and fractional area, right ventricle-myocardial performance index, were significantly associated with the mean pulmonary arterial pressure levels in pulmonary arterial hypertension patients

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

Science.gov (United States)

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

2016-03-01

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

Studies on the clinical application of MR perfusion image using arterial spin labeling method

International Nuclear Information System (INIS)

Miyasaka, Kenji

1999-01-01

A new technique for imaging brain perfusion, arterial spin labeling method was applied in clinic. Brain perfusion was imaged by FAIR and EPISTAR both of which using arterial spin labeling (ASL) method. Suitable parameters for small contamination were examined using a imaging phantom. Then normal volunteers were examined for imaging timing. Suitable time between labeling pulse and imaging pulse for brain capillary and parenchyma was 1.0 sec. For clinical application study, total 48 patients with brain diseases were examined by FAIR and/or EPISTAR. A lesion/white matter signal intensity ratio was calculated in all clinical cases. Average of signal intensity ratio in infarction, tumor and arteriovenous malformation (AVM) were 0.8, 2.2 and 18.6 at FAIR, and 0.6, 2.2 and 12.8 at EPISTAR, respectively. Low perfusion diseases such as cerebral infarction have low signal intensity ratio and high perfusion diseases such as AVM have high signal intensity ratio in both FAIR and EPISTAR. Brain lesions were imaged similarly in FAIR and EPISTAR, and no remarkable difference was found between FAIR and EPISTAR. As a result of diagnostic trial by signal intensity ratio in operated tumor, hemorrhagic cases could be diagnosed by accuracies of 75% in FAIR and 100% in EPISTAR, respectively. (author)

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

Science.gov (United States)

Obladen, Michael

2010-05-01

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

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...

Characteristics of myocardial perfusion imaging and coronary artery angiography in patients of NIDDM complicated with AMI

International Nuclear Information System (INIS)

Zhao Peiqin; Zhao Jinhua; Qin Mingzhao; Dai HaoJie; Zhang Runwu; Xiao Fen

2001-01-01

Objective: To investigate the characteristic changes of myocardial perfusion imaging and coronary artery angiography in patients of acute myocardial infarction (AMI) with underlined type 2 diabetes mellitus. Methods: 25 type 2 diabetes mellitus patients were enrolled for having clinical manifestation of AMI. Ten inpatients with AMI of simple coronary heart disease origin were served as controls. All subjects underwent both myocardial perfusion imagings (resting and nitroglycerine invention) and coronary artery angiography. Results: Compared to controls (40%), type 2 diabetes mellitus + AMI group had higher rate of multivessel disease (60%). For type 2 diabetes mellitus + AMI patients, 129/400 segments (32.25%) showed fixed defect, 25/160 segments (15.62%) in controls. Conclusions: For type 2 diabetes mellitus + AMI group, myocardial perfusion defects are widely distributed and multivessel or severe stenosis is more often presented. Good correlation exists between abnormal segments and angiographic lesions in both the number of segments involved and the severity of the lesions. Radionuclide myocardial perfusion is therefore considered a useful screening test not inferior to angiography, especially for those who are not tolerant enough to undergoing angiography

Transmural myocardial perfusion gradients in relation to coronary artery stenoses severity assessed by cardiac multidetector computed tomography

DEFF Research Database (Denmark)

Linde, Jesper James; Kühl, Jørgen Tobias; Hove, Jens Dahlgaard

2015-01-01

To assess the relationship between epicardial coronary artery stenosis severity and the corresponding regional transmural perfusion at rest and during adenosine stress, using multidetector computed tomography (MDCT). We evaluated the relationship between the severity of coronary artery diameter...

Comparison of stress-rest and rest-stress one day myocardial perfusion scintigraphies in detecting coronary artery diseases

International Nuclear Information System (INIS)

Bom, Hee Seung; Min, Jung Jun; Song, Ho Cheon; Kim, Ji Yeul

1997-01-01

It has been shown that both rest and stress myocardial perfusion imaging with technetium agents can be performed on the same day using two different doses injected within few hours. The purpose of this study was to compare the two protocols (stress-rest and rest-stress) in detecting coronary artery diseases. One hundred and sixty patients (101 males, 59 females, mean age 57±9 years) and 120 patients (79 males, 41 females, mean age 59±10 years) underwent stress-rest myocardial perfusion SPECT and rest-stress myocardial perfusion SPECT, respectively. All of them underwent both myocardial perfusion SPECT and coronary angiography within 1 month. A coronary stenosis was considered significant when it compromised the luminal diameter by ≥50%. The chi square test was used to compare differences in sensitivity, specificity and accuracy between the two groups. The overall sensitivity, specificity and accuracy of stress-rest protocol were 99%, 35% and 68%, respectively. Those of rest-stress protocol were 96%, 47% and 78%, respectively. There was no difference between the two protocols in identifying individual diseased coronary artery branches. Therefore, one day stress-rest and rest-stress myocardial SPECT using 99m Tc agents were comparable and were very sensitive tests in detecting coronary artery diseases

Scintigraphic study of blood perfusion of the pulmonary artery in pulmonary tuberculosis

International Nuclear Information System (INIS)

Certain, D.A.; Brolio, R.; Salomon, G.C.; Carvalho, N.; Barbosa, Z.L.M.

1972-01-01

Blood perfusion in the pulmonary artery is studied by pulmonary scintigraphy with macroaggregated albumin 131 I, in 74 cases of pulmonary tuberculosis. Results shown by scintigraphy are compared to those observed in roentgenography and also correlated with the extension and degree of the lesions, and with the presence of associated tuberculosis, considered capable of changing the scintigraphic picture. The reduction of blood flow in the pulmonary artery are observed in cases of infiltrative, fibrotic of caseous lesions, as well as in cases of minor lesions [pt

Scintigraphic study of blood perfusion of the pulmonary artery in pulmonary tuberculosis

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Certain, D A; Brolio, R; Salomon, G C [Sao Paulo Univ. (Brazil). Faculdade de Saude Publica; Carvalho, N [Sao Paulo Univ. (Brazil). Centro de Medicina Nuclear; Barbosa, Z L.M. [Associacao dos Sanatorios Populares de Campos do Jordao, Brazil

1972-10-01

Blood perfusion in the pulmonary artery is studied by pulmonary scintigraphy with macroaggregated albumin /sup 131/I, in 74 cases of pulmonary tuberculosis. Results shown by scintigraphy are compared to those observed in roentgenography and also correlated with the extension and degree of the lesions, and with the presence of associated tuberculosis, considered capable of changing the scintigraphic picture. The reduction of blood flow in the pulmonary artery are observed in cases of infiltrative, fibrotic of caseous lesions, as well as in cases of minor lesions.

Perfusion magnetic resonance imaging with continuous arterial spin labeling: methods and clinical applications in the central nervous system

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Detre, John A. E-mail: detre@mail.med.upenn.edu; Alsop, David C

1999-05-01

Several methods are now available for measuring cerebral perfusion and related hemodynamic parameters using magnetic resonance imaging (MRI). One class of techniques utilizes electromagnetically labeled arterial blood water as a noninvasive diffusible tracer for blood flow measurements. The electromagnetically labeled tracer has a decay rate of T1, which is sufficiently long to allow perfusion of the tissue and microvasculature to be detected. Alternatively, electromagnetic arterial spin labeling (ASL) may be used to obtain qualitative perfusion contrast for detecting changes in blood flow, similar to the use of susceptibility contrast in blood oxygenation level dependent functional MRI (BOLD fMRI) to detect functional activation in the brain. The ability to obtain blood flow maps using a non-invasive and widely available modality such as MRI should greatly enhance the utility of blood flow measurement as a means of gaining further insight into the broad range of hemodynamically related physiology and pathophysiology. This article describes the biophysical considerations pertaining to the generation of quantitative blood flow maps using a particular form of ASL in which arterial blood water is continuously labeled, termed continuous arterial spin labeling (CASL). Technical advances permit multislice perfusion imaging using CASL with reduced sensitivity to motion and transit time effects. Interpretable cerebral perfusion images can now be reliably obtained in a variety of clinical settings including acute stroke, chronic cerebrovascular disease, degenerative diseases and epilepsy. Over the past several years, the technical and theoretical foundations of CASL perfusion MRI techniques have evolved from feasibility studies into practical usage. Currently existing methodologies are sufficient to make reliable and clinically relevant observations which complement structural assessment using MRI. Future technical improvements should further reduce the acquisition times

Detection of reactive oxygen species in isolated, perfused lungs by electron spin resonance spectroscopy

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Schudt Christian

2005-07-01

Full Text Available Abstract Background The sources and measurement of reactive oxygen species (ROS in intact organs are largely unresolved. This may be related to methodological problems associated with the techniques currently employed for ROS detection. Electron spin resonance (ESR with spin trapping is a specific method for ROS detection, and may address some these technical problems. Methods We have established a protocol for the measurement of intravascular ROS release from isolated buffer-perfused and ventilated rabbit and mouse lungs, combining lung perfusion with the spin probe l-hydroxy-3-carboxy-2,2,5,5-tetramethylpyrrolidine (CPH and ESR spectroscopy. We then employed this technique to characterize hypoxia-dependent ROS release, with specific attention paid to NADPH oxidase-dependent superoxide formation as a possible vasoconstrictor pathway. Results While perfusing lungs with CPH over a range of inspired oxygen concentrations (1–21 %, the rate of CP• formation exhibited an oxygen-dependence, with a minimum at 2.5 % O2. Addition of superoxide dismutase (SOD to the buffer fluid illustrated that a minor proportion of this intravascular ROS leak was attributable to superoxide. Stimulation of the lungs by injection of phorbol-12-myristate-13-acetate (PMA into the pulmonary artery caused a rapid increase in CP• formation, concomitant with pulmonary vasoconstriction. Both the PMA-induced CPH oxidation and the vasoconstrictor response were largely suppressed by SOD. When the PMA challenge was performed at different oxygen concentrations, maximum superoxide liberation and pulmonary vasoconstriction occurred at 5 % O2. Using a NADPH oxidase inhibitor and NADPH-oxidase deficient mice, we illustrated that the PMA-induced superoxide release was attributable to the stimulation of NADPH oxidases. Conclusion The perfusion of isolated lungs with CPH is suitable for detection of intravascular ROS release by ESR spectroscopy. We employed this technique to

Localization of coronary artery disease with exercise electrocardiography: correlation with thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.F.; Freedman, B.; Bailey, I.K.; Uren, R.F.; Kelly, D.T.

1981-01-01

In 61 patients with single vessel coronary artery disease (70 percent or greater obstruction of luminal diameter in only one vessel) and no previous myocardial infarction, the sites of ischemic changes on 12 lead exercise electrocardiography and on thallium-201 myocardial perfusion scanning were related to the obstructed coronary artery. The site of exercise-induced S-T segment depression did not identify which coronary artery was obstructed. In the 37 patients with left anterior descending coronary artery disease S-T depression was most often seen in the inferior leads and leads V4 to V6, and in the 18 patients with right coronary artery disease and in the 6 patients with left circumflex artery disease S-T depression was most often seen in leads V5 and V6. Although S-T segment elevation was uncommon in most leads, it occurred in lead V1 or a VL, or both, in 51 percent of the patients with left anterior descending coronary artery disease. A reversible anterior defect on exercise thallium scanning correlated with left anterior descending coronary artery disease (probability [p] less than 0.0001) and a reversible inferior thallium defect correlated with right coronary or left circumflex artery disease (p less than 0.0001). In patients with single vessel disease, the site of S-T segment depression does not identify the obstructed coronary artery; S-T segment elevation in lead V1 or aVL, or both, identifies left anterior descending coronary artery disease; and the site of reversible perfusion defect on thallium scanning identifies the site of myocardial ischemia and the obstructed coronary artery

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

DEFF Research Database (Denmark)

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

2009-01-01

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

Unilateral absence of lung perfusion resulting from endarteritis of the pulmonary artery

International Nuclear Information System (INIS)

Calegaro, J.U.M.; Turini, T.L.

This case shows endarteritis of left pulmonary artery in the angiographic study with absent perfusion of the left lung in the MAA 131 I scintigraphy. Considerations are made conderning the presumable diagnosis of infection by 'toxocara canis' larval form. The literature review don't point out a similar case. (author) [pt

Insulin resistance is associated with lower arterial blood flow and reduced cortical perfusion in cognitively asymptomatic middle-aged adults

Science.gov (United States)

Hoscheidt, Siobhan M; Kellawan, J Mikhail; Berman, Sara E; Rivera-Rivera, Leonardo A; Krause, Rachel A; Oh, Jennifer M; Beeri, Michal S; Rowley, Howard A; Wieben, Oliver; Carlsson, Cynthia M; Asthana, Sanjay; Johnson, Sterling C; Schrage, William G

2016-01-01

Insulin resistance (IR) is associated with poor cerebrovascular health and increased risk for dementia. Little is known about the unique effect of IR on both micro- and macrovascular flow particularly in midlife when interventions against dementia may be most effective. We examined the effect of IR as indexed by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) on cerebral blood flow in macro- and microvessels utilizing magnetic resonance imaging (MRI) among cognitively asymptomatic middle-aged individuals. We hypothesized that higher HOMA-IR would be associated with reduced flow in macrovessels and lower cortical perfusion. One hundred and twenty cognitively asymptomatic middle-aged adults (57 ± 5 yrs) underwent fasting blood draw, phase contrast-vastly undersampled isotropic projection reconstruction (PC VIPR) MRI, and arterial spin labeling (ASL) perfusion. Higher HOMA-IR was associated with lower arterial blood flow, particularly within the internal carotid arteries (ICAs), and lower cerebral perfusion in several brain regions including frontal and temporal lobe regions. Higher blood flow in bilateral ICAs predicted greater cortical perfusion in individuals with lower HOMA-IR, a relationship not observed among those with higher HOMA-IR. Findings provide novel evidence for an uncoupling of macrovascular blood flow and microvascular perfusion among individuals with higher IR in midlife. PMID:27488909

Testosterone biotransformation by the isolated perfused canine pancreas

International Nuclear Information System (INIS)

Fernandez-del Castillo, C.; Diaz-Sanchez, V.; Varela-Fascinetto, G.; Altamirano, A.; Odor-Morales, A.; Lopez-Medrano, R.M.; Robles-Diaz, G.

1991-01-01

There is strong evidence indicating that the pancreas is under the influence of sex steroid hormones, and that it may even participate in their biosynthesis and metabolism. In the present study, [3H]testosterone was perfused into the isolated canine pancreas, and measured in the effluent with several of its metabolites (5 alpha-dihydrotestosterone, androstenedione, and estradiol). Results show that testosterone is readily transformed by the canine pancreas. The main product found in the effluent is androstenedione. The testis and spleen were also perfused with [3H]testosterone and used as controls. In both cases, this hormone appeared mostly unchanged in the effluent as compared to the pancreatic perfusion (p less than 0.0001). From our data, we conclude that the canine pancreas has the capacity to transform sex steroid hormones, and could be considered an extragonadal site of sex steroid biosynthesis

Testosterone biotransformation by the isolated perfused canine pancreas

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Fernandez-del Castillo, C.; Diaz-Sanchez, V.; Varela-Fascinetto, G.; Altamirano, A.; Odor-Morales, A.; Lopez-Medrano, R.M.; Robles-Diaz, G. (Instituto Nacional de la Nutricion Salvador Zubiran, Mexico City (Mexico))

1991-01-01

There is strong evidence indicating that the pancreas is under the influence of sex steroid hormones, and that it may even participate in their biosynthesis and metabolism. In the present study, (3H)testosterone was perfused into the isolated canine pancreas, and measured in the effluent with several of its metabolites (5 alpha-dihydrotestosterone, androstenedione, and estradiol). Results show that testosterone is readily transformed by the canine pancreas. The main product found in the effluent is androstenedione. The testis and spleen were also perfused with (3H)testosterone and used as controls. In both cases, this hormone appeared mostly unchanged in the effluent as compared to the pancreatic perfusion (p less than 0.0001). From our data, we conclude that the canine pancreas has the capacity to transform sex steroid hormones, and could be considered an extragonadal site of sex steroid biosynthesis.

Treatment and prevention of serious complications after arterial perfusion chemotherapy of esophageal cancer

International Nuclear Information System (INIS)

Zhang Yaoyong; Song Taimin; Guo Hongqiang; Li Naxin; Ma Guizhen; Li Huizhi

2004-01-01

Objective: To investigate the cause of severe complications after arterial perfusion for esophageal cancer and the methods of prevention. Methods: 368 cases of esophageal cancer were treated with arterial perfusion of drugs for chemotherapy. The treatment numbers were 909 including 215 males and 153 females with the age ranging from 39 to 86. These patients were verified as esophageal cancers histopathologically. Selective angiography of the relevant esophageal segments and drugs for perfusion chemotherapy were undertaken. Results: The complications included one case of paralysis due to spinal cord injury, two cases with esophageal perforation and three cases of necrotic esophagitis. The case of paralysis died of original disease one month after the treatment. Of the cases of esophageal perforation, one formed the esophagus-trachea fistula and survived for eight months after being esophageal stent implantation and the other formed esophagus-mediastinum fistula and died of massive hemorrhage after six weeks. Three cases of necrotic esophagitis occurred at the normal segments of the esophagus and formed esophgeal perforation. Of these three cases, one formed esophago-bronchial fistula and survived up to now after creating drainage stoma of stomach. Two cases of the esophagus-mediastinum and esophagus-bronchus fistula died of severe infection. Conclusions: Severe complications of esophageal arterial catheterization with drugs for chemotherapy are rare. Less harmful, non-ionization contrast medium, low cellular toxicity drugs for chemotherapy with proper doses and concentrations should be selected together with optimal speed of infusion. Esophageal internal stent placement drainage stoma creation of stomach should be the useful adjunct for severe complications. (authors)

Propofol attenuates oxidant-induced acute lung injury in an isolated perfused rabbit-lung model.

Science.gov (United States)

Yumoto, Masato; Nishida, Osamu; Nakamura, Fujio; Katsuya, Hirotada

2005-01-01

Reactive oxygen species have been strongly implicated in the pathogenesis of acute lung injury (ALI). Some animal studies suggest that free radical scavengers inhibit the onset of oxidant-induced ALI. Propofol (2,6-diisopropylphenol) is chemically similar to phenol-based free radical scavengers such as the endogenous antioxidant vitamin E. Both in vivo and in vitro studies have suggested that propofol has antioxidant potential. We hypothesized that propofol may attenuate ALI by acting as a free-radical scavenger. We investigated the effects of propofol on oxidant-induced ALI induced by purine and xanthine oxidase (XO), in isolated perfused rabbit lung, in two series of experiments. In series 1, we examined the relationship between the severity of ALI and the presence of hydrogen peroxide (H2O2). In series 2, we evaluated the effects of propofol on attenuating ALI and the dose dependence of these effects. The lungs were perfused for 90 min, and we evaluated the effects on the severity of ALI by monitoring the pulmonary capillary filtration coefficient (Kfc), pulmonary arterial pressure (Ppa), and the pulmonary capillary hydrostatic pressure (Ppc). In series 1, treatment with catalase (an H2O2 scavenger) prior to the addition of purine and XO resulted in complete prevention of ALI, suggesting that H2O2 may be involved closely in the pathogenesis of ALI. In series 2, pretreatment with propofol at concentrations in excess of 0.5 mM significantly inhibited the increases in the Kfc values, and that in excess of 0.75 mM significantly inhibited the increase in the Ppa values. Propofol attenuates oxidant-induced ALI in an isolated perfused rabbit lung model, probably due to its antioxidant action.

Comparing model-based and model-free analysis methods for QUASAR arterial spin labeling perfusion quantification.

Science.gov (United States)

Chappell, Michael A; Woolrich, Mark W; Petersen, Esben T; Golay, Xavier; Payne, Stephen J

2013-05-01

Amongst the various implementations of arterial spin labeling MRI methods for quantifying cerebral perfusion, the QUASAR method is unique. By using a combination of labeling with and without flow suppression gradients, the QUASAR method offers the separation of macrovascular and tissue signals. This permits local arterial input functions to be defined and "model-free" analysis, using numerical deconvolution, to be used. However, it remains unclear whether arterial spin labeling data are best treated using model-free or model-based analysis. This work provides a critical comparison of these two approaches for QUASAR arterial spin labeling in the healthy brain. An existing two-component (arterial and tissue) model was extended to the mixed flow suppression scheme of QUASAR to provide an optimal model-based analysis. The model-based analysis was extended to incorporate dispersion of the labeled bolus, generally regarded as the major source of discrepancy between the two analysis approaches. Model-free and model-based analyses were compared for perfusion quantification including absolute measurements, uncertainty estimation, and spatial variation in cerebral blood flow estimates. Major sources of discrepancies between model-free and model-based analysis were attributed to the effects of dispersion and the degree to which the two methods can separate macrovascular and tissue signal. Copyright © 2012 Wiley Periodicals, Inc.

Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment

International Nuclear Information System (INIS)

Sogabe, Shu; Satomi, Junichiro; Tada, Yoshiteru; Kanematsu, Yasuhisa; Kuwayama, Kazuyuki; Yagi, Kenji; Yoshioka, Shotaro; Mizobuchi, Yoshifumi; Mure, Hideo; Yamaguchi, Izumi; Kitazato, Keiko T.; Nagahiro, Shinji; Abe, Takashi; Harada, Masafumi; Yamamoto, Nobuaki; Kaji, Ryuji

2017-01-01

Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment. Our study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4). Of seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1-C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3-C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1-C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion. High IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site. (orig.)

Intra-arterial high signals on arterial spin labeling perfusion images predict the occluded internal carotid artery segment

Energy Technology Data Exchange (ETDEWEB)

Sogabe, Shu; Satomi, Junichiro; Tada, Yoshiteru; Kanematsu, Yasuhisa; Kuwayama, Kazuyuki; Yagi, Kenji; Yoshioka, Shotaro; Mizobuchi, Yoshifumi; Mure, Hideo; Yamaguchi, Izumi; Kitazato, Keiko T.; Nagahiro, Shinji [Tokushima University Graduate School, Department of Neurosurgery, Tokushima (Japan); Abe, Takashi; Harada, Masafumi [Tokushima University Graduate School, Department of Radiology, Tokushima (Japan); Yamamoto, Nobuaki; Kaji, Ryuji [Tokushima University Graduate School, Department of Clinical Neurosciences, Institute of Biomedical Biosciences, Tokushima (Japan)

2017-06-15

Arterial spin labeling (ASL) involves perfusion imaging using the inverted magnetization of arterial water. If the arterial arrival times are longer than the post-labeling delay, labeled spins are visible on ASL images as bright, high intra-arterial signals (IASs); such signals were found within occluded vessels of patients with acute ischemic stroke. The identification of the occluded segment in the internal carotid artery (ICA) is crucial for endovascular treatment. We tested our hypothesis that high IASs on ASL images can predict the occluded segment. Our study included 13 patients with acute ICA occlusion who had undergone angiographic and ASL studies within 48 h of onset. We retrospectively identified the high IAS on ASL images and angiograms and recorded the occluded segment and the number of high IAS-positive slices on ASL images. The ICA segments were classified as cervical (C1), petrous (C2), cavernous (C3), and supraclinoid (C4). Of seven patients with intracranial ICA occlusion, five demonstrated high IASs at C1-C2, suggesting that high IASs could identify stagnant flow proximal to the occluded segment. Among six patients with extracranial ICA occlusion, five presented with high IASs at C3-C4, suggesting that signals could identify the collateral flow via the ophthalmic artery. None had high IASs at C1-C2. The mean number of high IAS-positive slices was significantly higher in patients with intra- than extracranial ICA occlusion. High IASs on ASL images can identify slow stagnant and collateral flow through the ophthalmic artery in patients with acute ICA occlusion and help to predict the occlusion site. (orig.)

Hydrostatic determinants of cerebral perfusion

International Nuclear Information System (INIS)

Wagner, E.M.; Traystman, R.J.

1986-01-01

We examined the cerebral blood flow response to alterations in perfusion pressure mediated through decreases in mean arterial pressure, increases in cerebrospinal fluid (CSF) pressure, and increases in jugular venous (JV) pressure in 42 pentobarbital anesthetized dogs. Each of these three pressures was independently controlled. Cerebral perfusion pressure was defined as mean arterial pressure minus JV or CSF pressure, depending on which was greater. Mean hemispheric blood flow was measured with the radiolabeled microsphere technique. Despite 30-mm Hg reductions in mean arterial pressure or increases in CSF or JV pressure, CBF did not change as long as the perfusion pressure remained greater than approximately 60 mm Hg. However, whenever perfusion pressure was reduced to an average of 48 mm Hg, cerebral blood flow decreased 27% to 33%. These results demonstrate the capacity of the cerebral vascular bed to respond similarly to changes in the perfusion pressure gradient obtained by decreasing mean arterial pressure, increasing JV pressure or increasing CSF pressure, and thereby support the above definition of cerebral perfusion pressure

Prognostic value of gated 201Tl myocardial perfusion SPECT imaging in patients with coronary artery disease

International Nuclear Information System (INIS)

Li Zicheng; Chen Xiaoming; Xu Hao

2006-01-01

Objective: To study the prognostic value of gated 201 Tl myocardial perfusion SPECT imaging in patients with coronary artery disease and assessment of therapy strategy for the individual patient. Methods: Eighty-four patients underwent rest and exercise stress 201 Tl gated myocardial perfusion SPECT imaging and were followed up for (32.92 ± 16.77) months. Images were studied using 17 segments and 1 to 4 scoring. Global summed stress score (SSS), summed rest score (SRS) and summed difference score (SDS=SSS-SRS) were also calculated. Post-stress and rest ejection fraction (EF) were automatically measured. Results: Nine cardiac events occurred (3.90% per year). SSS, SDS, SRS and EF were the independent predictors of cardiac events (P 201 Tl myocardial perfusion SPECT imaging can provide prognostic assessment for the patients with coronary artery disease and guide in selection of therapeutic strategy. Among all of the indices SSS is the best predictors of cardiac events. (authors)

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

Science.gov (United States)

Lanzman, Rotem S; Wittsack, Hans-Jörg; Martirosian, Petros; Zgoura, Panagiota; Bilk, Philip; Kröpil, Patric; Schick, Fritz; Voiculescu, Adina; Blondin, Dirk

2010-06-01

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

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

International Nuclear Information System (INIS)

Lanzman, Rotem S.; Wittsack, Hans-Joerg; Bilk, Philip; Kroepil, Patric; Blondin, Dirk; Martirosian, Petros; Schick, Fritz; Zgoura, Panagiota; Voiculescu, Adina

2010-01-01

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

Permeability Surface of Deep Middle Cerebral Artery Territory on Computed Tomographic Perfusion Predicts Hemorrhagic Transformation After Stroke.

Science.gov (United States)

Li, Qiao; Gao, Xinyi; Yao, Zhenwei; Feng, Xiaoyuan; He, Huijin; Xue, Jing; Gao, Peiyi; Yang, Lumeng; Cheng, Xin; Chen, Weijian; Yang, Yunjun

2017-09-01

Permeability surface (PS) on computed tomographic perfusion reflects blood-brain barrier permeability and is related to hemorrhagic transformation (HT). HT of deep middle cerebral artery (MCA) territory can occur after recanalization of proximal large-vessel occlusion. We aimed to determine the relationship between HT and PS of deep MCA territory. We retrospectively reviewed 70 consecutive acute ischemic stroke patients presenting with occlusion of the distal internal carotid artery or M1 segment of the MCA. All patients underwent computed tomographic perfusion within 6 hours after symptom onset. Computed tomographic perfusion data were postprocessed to generate maps of different perfusion parameters. Risk factors were identified for increased deep MCA territory PS. Receiver operating characteristic curve analysis was performed to calculate the optimal PS threshold to predict HT of deep MCA territory. Increased PS was associated with HT of deep MCA territory. After adjustments for age, sex, onset time to computed tomographic perfusion, and baseline National Institutes of Health Stroke Scale, poor collateral status (odds ratio, 7.8; 95% confidence interval, 1.67-37.14; P =0.009) and proximal MCA-M1 occlusion (odds ratio, 4.12; 95% confidence interval, 1.03-16.52; P =0.045) were independently associated with increased deep MCA territory PS. Relative PS most accurately predicted HT of deep MCA territory (area under curve, 0.94; optimal threshold, 2.89). Increased PS can predict HT of deep MCA territory after recanalization therapy for cerebral proximal large-vessel occlusion. Proximal MCA-M1 complete occlusion and distal internal carotid artery occlusion in conjunction with poor collaterals elevate deep MCA territory PS. © 2017 American Heart Association, Inc.

Dynamic Contrast-Enhanced Perfusion MRI of High Grade Brain Gliomas Obtained with Arterial or Venous Waveform Input Function.

Science.gov (United States)

Filice, Silvano; Crisi, Girolamo

2016-01-01

The aim of this study was to evaluate the differences in dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI) perfusion estimates of high-grade brain gliomas (HGG) due to the use of an input function (IF) obtained respectively from arterial (AIF) and venous (VIF) approaches by two different commercially available software applications. This prospective study includes 20 patients with pathologically confirmed diagnosis of high-grade gliomas. The data source was processed by using two DCE dedicated commercial packages, both based on the extended Toft model, but the first customized to obtain input function from arterial measurement and the second from sagittal sinus sampling. The quantitative parametric perfusion maps estimated from the two software packages were compared by means of a region of interest (ROI) analysis. The resulting input functions from venous and arterial data were also compared. No significant difference has been found between the perfusion parameters obtained with the two different software packages (P-value < .05). The comparison of the VIFs and AIFs obtained by the two packages showed no statistical differences. Direct comparison of DCE-MRI measurements with IF generated by means of arterial or venous waveform led to no statistical difference in quantitative metrics for evaluating HGG. However, additional research involving DCE-MRI acquisition protocols and post-processing would be beneficial to further substantiate the effectiveness of venous approach as the IF method compared with arterial-based IF measurement. Copyright © 2015 by the American Society of Neuroimaging.

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

International Nuclear Information System (INIS)

Vis, Jill B. de; Hendrikse, Jeroen; Petersen, Esben T.; Vries, Linda S. de; Bel, Frank van; Alderliesten, Thomas; Negro, Simona; Groenendaal, Floris; Benders, Manon J.N.L.

2015-01-01

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

Changes in myocardial perfusion due to physical exercise in patients with stable coronary artery disease

International Nuclear Information System (INIS)

Kendziorra, Kai; Foerster, Marcus; Sabri, Osama; Kluge, Regine; Walther, Claudia; Moebius-Winkler, Sven; Conradi, Katrin; Schuler, Gerhard; Hambrecht, Rainer

2005-01-01

Percutaneous transluminal coronary angioplasty (PTCA) is one of the main therapy options for patients with coronary artery disease (CAD), resulting in an improvement in myocardial perfusion and exercise capacity. Nevertheless, studies have also demonstrated a positive effect of regular exercise training on myocardial perfusion and maximum exercise capacity. The aim of this study was to evaluate changes in myocardial stress perfusion after 1 year of exercise training in comparison with the effects of PTCA in patients with CAD. In 66 male patients with angiographically confirmed significant coronary artery stenosis in one target vessel, myocardial perfusion scintigraphy was performed at baseline and 12 months after randomisation into either a physical exercise group or a PTCA group. Circumferential count rate profiles in 16 wall segments were classified according to their relative count rate and localisation within or outside the area supplied by the stenosed vessel. Ischaemic segments showed a significant improvement in myocardial count rate within the target area after 12 months in both the PTCA and the training group (PTCA group: from 76.8±4.9% to 86.6±10.9%, p=0.03; training group: from 74.0±7.3% to 83.7±10.8%, p<0.01). Outside the target area only the training group showed a significant improvement (from 77.7±4.4% to 91.7±4.8%, p<0.01). Our data indicate a significant improvement in stress myocardial perfusion in the training group after 12 months. The ischaemia is reduced not only in the target region of the leading stenosis but also in other ischaemic myocardial areas. In contrast, after PTCA stress perfusion improves only in the initially ischaemic parts of the target area. (orig.)

Arterio-portal shunts in the cirrhotic liver: perfusion computed tomography for distinction of arterialized pseudolesions from hepatocellular carcinoma

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Fischer, Michael A. [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Karolinska Institutet, Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Marquez, Herman P.; Gordic, Sonja; Alkadhi, Hatem [University Hospital Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Leidner, Bertil; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institutet, Division of Medical Imaging and Technology. Department of Clinical Science, Intervention and Technology (CLINTEC), Stockholm (Sweden); Klotz, Ernst [Computed Tomography and Radiation Oncology, Siemens Healthcare, Forchheim (Germany)

2017-03-15

To determine perfusion computed tomography (P-CT) findings for distinction of arterial pseudolesions (APL) from hepatocellular carcinoma (HCC) in the cirrhotic liver. 32 APL and 21 HCC in 20 cirrhotic patients (15 men; 65 ± 10 years), who underwent P-CT for evaluation of HCC pre- (N = 9) or post- (N = 11) transarterial chemoembolization, were retrospectively included using CT follow-up as the standard of reference. All 53 lesions were qualitatively (visual) and quantitatively (perfusion parameters) analysed according to their shape (wedge, irregular, nodular), location (not-/adjunct to a fistula), arterial liver perfusion (ALP), portal venous liver perfusion (PLP), hepatic perfusion index (HPI). Accuracy for diagnosis of HCC was determined using receiver operating characteristics. 18/32 (56 %) APL were wedge shaped, 10/32 (31 %) irregular and 4/32 (12 %) nodular, while 11/21 (52 %) HCC were nodular or 10/21 (48 %) irregular, but never wedge shaped. Significant difference between APL and HCC was seen for lesion shape in pretreated lesions (P < 0.001), and for PLP and HPI in both pre- and post-treated lesions (all, P < 0.001). Diagnostic accuracy for HCC was best for combined assessment of lesion configuration and PLP showing an area under the curve of 0.901. Combined assessment of lesion configuration and portal venous perfusion derived from P-CT allows best to discriminate APL from HCC with high diagnostic accuracy. (orig.)

An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

International Nuclear Information System (INIS)

Ming, Zhu; Qian, Wang

2009-01-01

An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

An isolated left subclavian artery supplied by a collateral artery from the abdominal aorta

Energy Technology Data Exchange (ETDEWEB)

Ming, Zhu; Qian, Wang [Shanghai Jiaotong University School of Medicine, Department of Radiology, Shanghai Children' s Medical Center, Shanghai (China)

2009-08-15

An isolated left subclavian artery is a rare anomaly. We report a 9-month-old boy with an isolated left subclavian artery associated with tetralogy of Fallot and the right aortic arch. MRI and angiography show that the blood supply through the left subclavian artery was maintained by a large tortuous collateral artery from the abdominal aorta. This type of collateral artery structure is unique. (orig.)

The isolated perfused human skin flap model: A missing link in skin penetration studies?

Science.gov (United States)

Ternullo, Selenia; de Weerd, Louis; Flaten, Gøril Eide; Holsæter, Ann Mari; Škalko-Basnet, Nataša

2017-01-01

Development of effective (trans)dermal drug delivery systems requires reliable skin models to evaluate skin drug penetration. The isolated perfused human skin flap remains metabolically active tissue for up to 6h during in vitro perfusion. We introduce the isolated perfused human skin flap as a close-to-in vivo skin penetration model. To validate the model's ability to evaluate skin drug penetration the solutions of a hydrophilic (calcein) and a lipophilic (rhodamine) fluorescence marker were applied. The skin flaps were perfused with modified Krebs-Henseleit buffer (pH7.4). Infrared technology was used to monitor perfusion and to select a well-perfused skin area for administration of the markers. Flap perfusion and physiological parameters were maintained constant during the 6h experiments and the amount of markers in the perfusate was determined. Calcein was detected in the perfusate, whereas rhodamine was not detectable. Confocal images of skin cross-sections shoved that calcein was uniformly distributed through the skin, whereas rhodamine accumulated in the stratum corneum. For comparison, the penetration of both markers was evaluated on ex vivo human skin, pig skin and cellophane membrane. The proposed perfused flap model enabled us to distinguish between the penetrations of the two markers and could be a promising close-to-in vivo tool in skin penetration studies and optimization of formulations destined for skin administration. Copyright © 2016 Elsevier B.V. All rights reserved.

[Surgical angioplasty of the left main coronary artery].

Science.gov (United States)

Vranes, Mile; Velinović, Milos; Kocica, Mladen; Mikić, Aleksandar; Velimirović, Dusan; Djukić, Petar

2010-01-01

The conventional treatment for isolated stenosis of the left main coronary artery is bypass surgery (myocardial revascularization). However, the process of atherosclerosis is not arrested by myocardial revascularization and it will lead to the occlusion of the left main coronary artery. Revascularization will establish retrograde perfusion for 50-70% of the myocardium of the left ventricle. Direct surgical angioplasty of the left main coronary artery enables normal physiological perfusion of the whole myocardium and better myocardial function. The aim of our study is to point out a new surgical approach of treating left main coronary artery stenosis. Between October 2002 and October 2003, direct surgical angioplasty of the main left coronary artery was performed on three patients with isolated stenosis of the left main coronary artery using the anterior approach and the pericardium as a patch. The procedure was performed under total endotracheal anaesthesia and standard cardiopulmonary circulation, moderate hypothermia, anterograde St. Tomas cardioplegia and local cooling. Patients were followed clinically, echocardiographically and by load-tests. All three patients were without complications. In postoperative follow-up (54-68 months) neither angina pectoris nor electrocardiographically registered ischaemic changes were found. Load-tests performed every six months on all three patients were negative. Surgical angioplasty of isolated stenosis of the left main coronary artery is a preferred method for treating this type of coronary disease. Contraindications for this type of treatment are stenosis of the left main coronary artery with bifurcation and advanced calcification of the left main coronary artery.

Isolated limb perfusion electrochemotherapy for the treatment of an ...

African Journals Online (AJOL)

After completing staging procedures, the lesion was approached with surgery and intraoperative electrochemotherapy (ECT) administration of bleomycin in isolated limb perfusion. A second session of surgery and ECT was performed one month later, followed by three additional monthly sessions of ECT. During periodic ...

Demonstration of pulmonary perfusion heterogeneity induced by gravity and lung inflation using arterial spin labeling

Energy Technology Data Exchange (ETDEWEB)

Fan Li [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: fanli0930@163.com; Liu Shiyuan [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: fanli7938@chinaren.com; Xiao Xiangsheng [Department of Radiology, ChangZheng Hospital, Second Military Medical University, Shanghai 200003 (China)], E-mail: lizhaobin79@163.com; Sun Fei [GE Healthcare (China)], E-mail: Fei.sun@med.ge.com

2010-02-15

Objective: To evaluate the effect of gravity and lung inflation on pulmonary perfusion heterogeneity in human lung using an arterial spin labeling (ASL) sequence called flow sensitive alternating inversion recovery (FAIR). Materials and methods: Magnetic resonance imaging of lung perfusion using arterial spin labeling sequence was performed in supine position in ten healthy volunteers on a 1.5 T whole body scanner (GE Healthcare). Five coronal slices at an interval of 3 cm from dorsal to ventral (labeled as P3, P6, P9, P12, P15, sequently) were obtained when the volunteers performed breath holding on end expiration and the relative pulmonary blood flow (rPBF) was measured. Then, another coronal perfusion-weighted image of P3 slice was obtained on end inspiration. Tagging efficiency of pulmonary parenchyma with IR ({delta}SI), rPBF and area of the P3 slice were analyzed. Results: (1) Along the direction of gravity, a gradient was visually perceived as a vertical increase in rPBF. There were significant statistic differences in rPBF between any two coronal planes except that between P12 and P15. In supine position, regression coefficients of right and left lung were -4.98 and -5.16, respectively. This means that rPBF decreased 4.98 (right) and 5.16 (left) for each centimeter above the dorsal. No statistical difference was seen between ROIs placed along iso-gravitational plane. (2) For a same slice, there were significant statistic differences in {delta}SI, rPBF and area at different respiratory phases (P < 0.05). Greater {delta}SI and more perfusion were observed on end expiration than on end inspiration. The area was larger on end inspiration than on end expiration. Conclusion: Both gravity and respiratory phase are important determinants of pulmonary perfusion heterogeneity. FAIR is sensitive to demonstrate gravity- and respiratory phase-dependent differences in lung perfusion. Positioning the patient so that the area of interest is down-gravity and asking patient

Blood perfusion and pH monitoring in organs by laser-induced fluorescence spectroscopy

Science.gov (United States)

Vari, Sandor G.; Papazoglou, Theodore G.; Pergadia, Vani R.; Stavridi, Marigo; Snyder, Wendy J.; Papaioannou, Thanassis; Duffy, J. T.; Weiss, Andrew B.; Thomas, Reem; Grundfest, Warren S.

1994-01-01

Sensitivity of laser-induced fluorescence spectroscopy (LIFS) in detecting a change in tissue pH, and blood perfusion was determined. Rabbits were anesthetized, paralyzed, and mechanically ventilated. The arterial and venous blood supplies of the kidney were isolated and ligated to alter the perfusion. The femoral artery was cannulated to extract samples for blood gas analysis. A 308-nm XeCl was used as an excitation source. A 600 micrometers core diameter fiber was used for fluorescence acquisition, and the spectra analyzed by an optical multichannel analyzer (EG & G, OMA III). the corresponding intensity ratio R equals INADH / ICOLL was used as an index for respiratory acidosis. Blood perfusion was assessed using the following algorithm: (IELAS minus ICOLL) divided by (INADH minus ICOLL). The intensity ratio linearly decreased with the reduction of blood perfusion. When we totally occluded the artery the ratio decreased tenfold when compared to the ratio of a fully perfused kidney. Results of monitoring blood acidosis by laser-induced fluorescence spectroscopy shows a significant trend between pH and intensity ratio. Since all the slopes were negative, there is an obvious significant correlation between the pH and NADH.COLLAGEN RATIO. Blue-light-induced fluorescence measurements and ratio fluorometry is a sensitive method for monitoring blood perfusion and acidity or alkalinity of an organ.

Functional assessment of sequential coronary artery fistula and coronary artery stenosis with fractional flow reserve and stress adenosine myocardial perfusion imaging

Directory of Open Access Journals (Sweden)

Kuan Leong Yew

2015-10-01

Full Text Available Coronary artery fistula is an abnormal connection between one coronary artery to another coronary artery or cardiac chambers. The coronary artery fistula may cause significant shunting of blood and cause “pseudo-stenosis” or “steal phenomenon”. This will also accentuate pre-existing mild-moderate de novo coronary lesions with resultant greater pressure gradient difference across the lesions. Thus, fractional flow reserve can be a useful tool to guide intervention decision on the coronary artery fistula. There are very few published reports regarding the use of FFR to assess coronary artery fistula. In fact, there is no outcome data regarding the deferment of coronary artery fistula intervention when the FFR is not physiologically significant. This case highlighted the use of FFR to evaluate the functional significance of coronary fistula in the setting of ischemia evaluation and it was proven to be safe to defer intervention with good 3 year clinical outcome. Stress adenosine myocardial perfusion imaging correlated with the FFR result.

Resting quantitative cerebral blood flow in schizophrenia measured by pulsed arterial spin labeling perfusion MRI

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Pinkham, Amy; Loughead, James; Ruparel, Kosha; Wu, Wen-Chau; Overton, Eve; Gur, Raquel; Gur, Ruben

2011-01-01

Arterial spin labeling imaging (ASL) perfusion MRI is a relatively novel technique that can allow for quantitative measurement of cerebral blood flow (CBF) by using magnetically labeled arterial blood water as an endogenous tracer. Available data on resting CBF in schizophrenia primarily comes from invasive and expensive nuclear medicine techniques that are often limited to small samples and yield mixed results. The noninvasive nature of ASL offers promise for larger-scale studies. The utilit...

Comparing kidney perfusion using noncontrast arterial spin labeling MRI and microsphere methods in an interventional swine model.

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Artz, Nathan S; Wentland, Andrew L; Sadowski, Elizabeth A; Djamali, Arjang; Grist, Thomas M; Seo, Songwon; Fain, Sean B

2011-02-01

The purpose of this study was to assess the ability of a flow-sensitive alternating inversion recovery-arterial spin labeling (FAIR-ASL) technique to track renal perfusion changes during pharmacologic and physiologic alterations in renal blood flow using microspheres as a gold standard. Fluorescent microsphere and FAIR-ASL perfusion were compared in the cortex of the kidney for 11 swine across 4 interventional time points: (1) under baseline conditions, (2) during an acetylcholine and fluid bolus challenge to increase perfusion, (3) initially after switching to isoflurane anesthesia, and (4) after 2 hours of isoflurane anesthesia. In 10 of the 11 swine, a bag of ice was placed on the hilum of 1 kidney at the beginning of isoflurane administration to further reduce perfusion in 1 kidney. Both ASL and microspheres tracked the expected cortical perfusion changes (P values were systematically lower compared with microsphere perfusion. Very good correlation (r = 0.81, P values in the expected physiologic range (microsphere perfusion values saturated for perfusion >550 mL/min/100 g. Cortical perfusion measured with ASL correlated with microspheres and reliably detected changes in renal perfusion in response to physiologic challenge.

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 autoreg...

Tissue distribution of enrofloxacin after intramammary or simulated systemic administration in isolated perfused sheep udders.

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López Cadenas, Cristina; Fernández Martínez, Nélida; Sierra Vega, Matilde; Diez Liébana, Maria J; Gonzalo Orden, Jose M; Sahagún Prieto, Ana M; García Vieitez, Juan J

2012-11-01

To determine the tissue distribution of enrofloxacin after intramammary or simulated systemic administration in isolated perfused sheep udders by measuring its concentration at various sample collection sites. 26 udders (obtained following euthanasia) from 26 healthy lactating sheep. For each isolated udder, 1 mammary gland was perfused with warmed, gassed Tyrode solution. Enrofloxacin (1 g of enrofloxacin/5 g of ointment) was administered into the perfused gland via the intramammary route or systemically via the perfusion fluid (equivalent to a dose of 5 mg/kg). Samples of the perfusate were obtained every 30 minutes for 180 minutes; glandular tissue samples were obtained at 2, 4, 6, and 8 cm from the teat base after 180 minutes. The enrofloxacin content of the perfusate and tissue samples was analyzed via high-performance liquid chromatography with UV detection. After intramammary administration, maximun perfusate enrofloxacin concentration was detected at 180 minutes and, at this time, mean tissue enrofloxacin concentration was detected and mean tissue enrofloxacin concentration was 123.80, 54.48, 36.72, and 26.42 μg/g of tissue at 2, 4, 6, and 8 cm from the teat base, respectively. Following systemic administration, perfusate enrofloxacin concentration decreased with time and, at 180 minutes, tissue enrofloxacin concentrations ranged from 40.38 to 35.58 μg/g of tissue. By 180 minutes after administration via the intramammary or systemic route in isolated perfused sheep mammary glands, mean tissue concentration of enrofloxacin was greater than the minimum inhibitory concentration required to inhibit growth of 90% of many common mastitis pathogens in sheep. Use of either route of administration (or in combination) appears suitable for the treatment of acute mastitis in sheep.

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

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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.

Bacterial lipopolysaccharide-induced systemic inflammation alters perfusion of white matter-rich regions without altering flow in brain-irrigating arteries: Relationship to blood-brain barrier breakdown?

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Dhaya, Ibtihel; Griton, Marion; Raffard, Gérard; Amri, Mohamed; Hiba, Bassem; Konsman, Jan Pieter

2018-01-15

To better understand brain dysfunction during sepsis, cerebral arterial blood flow was assessed with Phase Contrast Magnetic Resonance Imaging, perfusion with Arterial Spin Labeling and structure with diffusion-weighted Magnetic Resonance Imaging in rats after intraperitoneal administration of bacterial lipopolysaccharides. Although cerebral arterial flow was not altered, perfusion of the corpus callosum region and diffusion parallel to its fibers were higher after lipopolysaccharide administration as compared to saline injection. In parallel, lipopolysaccharide induced perivascular immunoglobulin-immunoreactivity in white matter. These findings indicate that systemic inflammation can result in increased perfusion, blood-brain barrier breakdown and altered water diffusion in white matter. Copyright © 2017 Elsevier B.V. All rights reserved.

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

International Nuclear Information System (INIS)

Tsuchiya, Kazuhiro; Mizutani, Yoshiyuki; Inaoka, Sayuki; Hachiya, Junichi

1997-01-01

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

Developing a Benchmarking Process in Perfusion: A Report of the Perfusion Downunder Collaboration

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Baker, Robert A.; Newland, Richard F.; Fenton, Carmel; McDonald, Michael; Willcox, Timothy W.; Merry, Alan F.

2012-01-01

Abstract: Improving and understanding clinical practice is an appropriate goal for the perfusion community. The Perfusion Downunder Collaboration has established a multi-center perfusion focused database aimed at achieving these goals through the development of quantitative quality indicators for clinical improvement through benchmarking. Data were collected using the Perfusion Downunder Collaboration database from procedures performed in eight Australian and New Zealand cardiac centers between March 2007 and February 2011. At the Perfusion Downunder Meeting in 2010, it was agreed by consensus, to report quality indicators (QI) for glucose level, arterial outlet temperature, and pCO2 management during cardiopulmonary bypass. The values chosen for each QI were: blood glucose ≥4 mmol/L and ≤10 mmol/L; arterial outlet temperature ≤37°C; and arterial blood gas pCO2 ≥ 35 and ≤45 mmHg. The QI data were used to derive benchmarks using the Achievable Benchmark of Care (ABC™) methodology to identify the incidence of QIs at the best performing centers. Five thousand four hundred and sixty-five procedures were evaluated to derive QI and benchmark data. The incidence of the blood glucose QI ranged from 37–96% of procedures, with a benchmark value of 90%. The arterial outlet temperature QI occurred in 16–98% of procedures with the benchmark of 94%; while the arterial pCO2 QI occurred in 21–91%, with the benchmark value of 80%. We have derived QIs and benchmark calculations for the management of several key aspects of cardiopulmonary bypass to provide a platform for improving the quality of perfusion practice. PMID:22730861

The usefulness of planar thallium myocardial perfusion imaging in the diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Johannesen, K.A.; Andersen, K.; Foelling, M.; Vik-Mo, H.

1991-01-01

Stress thallium scintigraphy was performed in 60 patients with chest pain of uncertain origin. Myocardial ischemia was identified in 91% og the 47 patients who had angiographically significant coronary artery stenosis. Sensitivity of thallium scintigraphy was highest in patients with stenosis in the left descending coronary artery (LAD); 91% of the patients had abnormal thallium as compared with 67% of the patients with normal LAD, but significant stenosis in the circumflex artery and/or the right coronary artery. Perfusion defects in the circumflex or right coronary artery regions were detected in only 50% of the patients with multiple vessel disease. The authors conclude that stress thallium scintigraphy is a useful diagnostic procedure in patients with chest pain of uncertain origin and identifies the patients to be selected for coronary artery angiography. 15 refs., 2 figs., 2 tabs

Normothermic extracorporeal perfusion of isolated porcine liver after warm ischaemia: a preliminary report.

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Bellomo, Rinaldo; Suzuki, Satoshi; Marino, Bruno; Starkey, Graeme K; Chambers, Brenton; Fink, Michael A; Wang, Bao Zhong; Houston, Shane; Eastwood, Glenn; Calzavacca, Paolo; Glassford, Neil; Skene, Alison; Jones, Daryl A; Jones, Robert

2012-09-01

Liver transplantation is a major life-saving procedure, and donation after cardiac death (DCD) has increased the pool of potential liver donors. However, DCD livers are at increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to protect, evaluate and, in future, transplant DCD livers. We conducted proof-of-concept experiments using a DCD model in the pig to assess the short-term (4 hours) feasibility and functional efficacy of NELP. Using extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion, and physiological perfusion pressures, we achieved NELP and evidence of function (bile production, paracetamol removal, maintenance of normal ammonia and lactate levels) for 4 hours in pig livers subjected to 15 and 30 minutes of cardiac arrest before explantation. Our experiments justify further investigations of the feasibility and efficacy of human DCD liver preservation by ex-vivo perfusion.

Phosphorus nuclear magnetic resonance in isolated perfused rat pancreas

International Nuclear Information System (INIS)

Matsumoto, Takehisa; Kanno, Tomio; Seo, Yoshiteru; Murakami, Masataka; Watari, Hiroshi

1988-01-01

Phosphorus nuclear magnetic resonance spectroscopy was applied to measure phosphorus energy metabolites in isolated perfused rat pancreas. The gland was perfused with a modified Krebs-Henseleit solution at room temperature (25 degree C). 31 P resonances of creatine phosphate (PCr), ATP, ADP, inorganic phosphate (P i ) and phosphomonoesters (PMEs) were observed in all the preparations of pancreas. In different individual preparations, the resonance of PCr varied, but those of ATP were almost the same. The initial levels of PCr and ATP in individual preparations, however, remained almost unchanged during perfusion with the standard solution for 2 h. When the perfusion was stopped, the levels of ATP and PCr decreased, while the levels of PME and P i increased. At that time, the P i resonance shfted to a higher magnetic field, indicating that the tissue pH decreased. On reperfusion, the tissue levels of phosphorus compounds and the tissue pH were restored to their initial resting levels. Continuous infusion of 0.1 μM acetylcholine caused marked and sustained increases in the flow of pancreatic juice and protein output. During the stimulation the tissue levels of phosphorus compounds remained unchanged, while the tissue pH was decreased slightly

Diagnostic performance of coronary CT angiography, stress dual-energy CT perfusion, and stress perfusion single-photon emission computed tomography for coronary artery disease: Comparison with combined invasive coronary angiography and stress perfusion cardiac MRI

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Chung, Hyun Woo; Ko, Sung Min; Hwang, Hweung Kon; So, Young; Yi, Jeong Geun [Konkuk University Medical Center, Research Institute of Biomedical Science, Konkuk University School of Medicine, Seoul (Korea, Republic of); Lee, Eun Jeong [Dept. of Nuclear Medicine, Seoul Medical Center, Seoul (Korea, Republic of)

2017-06-15

To investigate the diagnostic performance of coronary computed tomography angiography (CCTA), stress dual-energy computed tomography perfusion (DE-CTP), stress perfusion single-photon emission computed tomography (SPECT), and the combinations of CCTA with myocardial perfusion imaging (CCTA + DE-CTP and CCTA + SPECT) for identifying coronary artery stenosis that causes myocardial hypoperfusion. Combined invasive coronary angiography (ICA) and stress perfusion cardiac magnetic resonance (SP-CMR) imaging are used as the reference standard. We retrospectively reviewed the records of 25 patients with suspected coronary artery disease, who underwent CCTA, DE-CTP, SPECT, SP-CMR, and ICA. The reference standard was defined as ≥ 50% stenosis by ICA, with a corresponding myocardial hypoperfusion on SP-CMR. For per-vascular territory analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 96, 96, 68, 93, and 68%, respectively, and specificities were 72, 75, 89, 85, and 94%, respectively. The areas under the receiver operating characteristic curve (AUCs) were 0.84 ± 0.05, 0.85 ± 0.05, 0.79 ± 0.06, 0.89 ± 0.04, and 0.81 ± 0.06, respectively. For per-patient analysis, the sensitivities of CCTA, DE-CTP, SPECT, CCTA + DE-CTP, and CCTA + SPECT were 100, 100, 89, 100, and 83%, respectively; the specificities were 14, 43, 57, 43, and 57%, respectively; and the AUCs were 0.57 ± 0.13, 0.71 ± 0.11, 0.73 ± 0.11, 0.71 ± 0.11, and 0.70 ± 0.11, respectively. The combination of CCTA and DE-CTP enhances specificity without a loss of sensitivity for detecting hemodynamically significant coronary artery stenosis, as defined by combined ICA and SP-CMR.

Measurement of brain perfusion in newborns: Pulsed arterial spin labeling (PASL) versus pseudo-continuous arterial spin labeling (pCASL)

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Boudes, Elodie; Gilbert, Guillaume; Leppert, Ilana Ruth; Tan, Xianming; Pike, G. Bruce; Saint-Martin, Christine; Wintermark, Pia

2014-01-01

Background Arterial spin labeling (ASL) perfusion-weighted imaging (PWI) by magnetic resonance imaging (MRI) has been shown to be useful for identifying asphyxiated newborns at risk of developing brain injury, whether or not therapeutic hypothermia was administered. However, this technique has been only rarely used in newborns until now, because of the challenges to obtain sufficient signal-to-noise ratio (SNR) and spatial resolution in newborns. Objective To compare two methods of ASL-PWI (i.e., single inversion-time pulsed arterial spin labeling [single TI PASL], and pseudo-continuous arterial spin labeling [pCASL]) to assess brain perfusion in asphyxiated newborns treated with therapeutic hypothermia and in healthy newborns. Design/methods We conducted a prospective cohort study of term asphyxiated newborns meeting the criteria for therapeutic hypothermia; four additional healthy term newborns were also included as controls. Each of the enrolled newborns was scanned at least once during the first month of life. Each MRI scan included conventional anatomical imaging, as well as PASL and pCASL PWI-MRI. Control and labeled images were registered separately to reduce the effect of motion artifacts. For each scan, the axial slice at the level of the basal ganglia was used for comparisons. Each scan was scored for its image quality. Quantification of whole-slice cerebral blood flow (CBF) was done afterwards using previously described formulas. Results A total number of 61 concomitant PASL and pCASL scans were obtained in nineteen asphyxiated newborns treated with therapeutic hypothermia and four healthy newborns. After discarding the scans with very poor image quality, 75% (46/61) remained for comparison between the two ASL methods. pCASL images presented a significantly superior image quality score compared to PASL images (p newborns. However, pCASL might be a better choice over PASL in newborns, as pCASL perfusion maps had a superior image quality that allowed a

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

International Nuclear Information System (INIS)

Lee, J. J.; Seok, J. W.; Eo, J. S.

2005-01-01

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

The influence of the maximal value and peak enhancement value of arterial and venous enhancement curve on CT perfusion parameters and signal-to-noise ratio

International Nuclear Information System (INIS)

Ju Haiyue; Gao Sijia; Xu Ke; Wang Qiang

2007-01-01

Objective: To explore the influence of the maximal value and peak enhancement value of arterial and venous enhancement curve on CT perfusion parameters and signal-to-noise ratio (SNR). Methods: Seventeen patients underwent brain CT perfusion scanning. All row data were analyzed with perfusion software for 6 times, and get different arterial and venous enhancement curves for each patient. The maximal values and peak enhancement values of each arterial and venous enhancement curves, as well as mean perfusion parameters including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), permeability surface area product (PS), and their standard deviations (SD) in homolateral white and gray matter were measured and recorded. SNR was calculated by dividing the mean perfusion parameter value by its SD. Pearson correlation analysis and two-tailed paired Student t test were used for statistics. Results: The maximal values and peak enhancement values of arterial and venous curves were correlated with mean SNR CBF , SNR CBV and SNR MTT in both white matter and gray matters (r value range: 0.332-0.922, P PS in white matter(r=0.256, P PS (in both white matter and gray matters) and arterial peak enhancement values, the maximal values and venous peak enhancement values, or between SNR PS (in gray matter) and the maximal values of venous curve(r value range: -0.058-0.210, P>0.05). (2) Mean CBF, CBV and PS values in the group with low venous peak enhancement values were significantly different from the group with high venous peak enhancement values in both white and gray matters (t value range: 3.830-5.337, P 0.05). Conclusions: The mean perfusion parameters and SNR are influenced by the maximal values and peak enhancement values of the arterial and venous curves. Peak enhancement of arterial and venous curves should be adjusted to higher level to make parameter values more reliable and increase the SNR. (authors)

Hypercapnic acidosis modulates inflammation, lung mechanics, and edema in the isolated perfused lung.

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De Smet, Hilde R; Bersten, Andrew D; Barr, Heather A; Doyle, Ian R

2007-12-01

Low tidal volume (V(T)) ventilation strategies may be associated with permissive hypercapnia, which has been shown by ex vivo and in vivo studies to have protective effects. We hypothesized that hypercapnic acidosis may be synergistic with low V(T) ventilation; therefore, we studied the effects of hypercapnia and V(T) on unstimulated and lipopolysaccharide-stimulated isolated perfused lungs. Isolated perfused rat lungs were ventilated for 2 hours with low (7 mL/kg) or moderately high (20 mL/kg) V(T) and 5% or 20% CO(2), with lipopolysaccharide or saline added to the perfusate. Hypercapnia resulted in reduced pulmonary edema, lung stiffness, tumor necrosis factor alpha (TNF-alpha) and interleukin 6 (IL-6) in the lavage and perfusate. The moderately high V(T) did not cause lung injury but increased lavage IL-6 and perfusate IL-6 as well as TNF-alpha. Pulmonary edema and respiratory mechanics improved, possibly as a result of a stretch-induced increase in surfactant turnover. Lipopolysaccharide did not induce significant lung injury. We conclude that hypercapnia exerts a protective effect by modulating inflammation, lung mechanics, and edema. The moderately high V(T) used in this study stimulated inflammation but paradoxically improved edema and lung mechanics with an associated increase in surfactant release.

Compression therapy in mixed ulcers increases venous output and arterial perfusion.

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Mosti, Giovanni; Iabichella, Maria Letizia; Partsch, Hugo

2012-01-01

This study was conducted to define bandage pressures that are safe and effective in treating leg ulcers of mixed arterial-venous etiology. In 25 patients with mixed-etiology leg ulcers who received inelastic bandages applied with pressures from 20 to 30, 31 to 40, and 41 to 50 mm Hg, the following measurements were performed before and after bandage application to ensure patient safety throughout the investigation: laser Doppler fluxmetry (LDF) close to the ulcer under the bandage and at the great toe, transcutaneous oxygen pressure (TcPo(2)) on the dorsum of the foot, and toe pressure. Ejection fraction (EF) of the venous pump was performed to assess efficacy on venous hemodynamics. LDF values under the bandages increased by 33% (95% confidence interval [CI], 17-48; P pressure ranges applied. At toe level, a significant decrease in flux of -20% (95% CI, -48 to 9; P bandage pressure >41 mm Hg. Toe pressure values and TcPo(2) showed a moderate increase, excluding a restriction to arterial perfusion induced by the bandages. Inelastic bandages were highly efficient in improving venous pumping function, increasing the reduced ejection fraction by 72% (95% CI, 50%-95%; P pressure of 21 to 30 mm Hg and by 103% (95% CI, 70%-128%; P ulceration, an ankle-brachial pressure index >0.5 and an absolute ankle pressure of >60 mm Hg, inelastic compression of up to 40 mm Hg does not impede arterial perfusion but may lead to a normalization of the highly reduced venous pumping function. Such bandages are therefore recommended in combination with walking exercises as the basic conservative management for patients with mixed leg ulcers. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

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

DEFF Research Database (Denmark)

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

2013-01-01

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

Complete inhibition of creatine kinase in isolated perfused rat hearts

International Nuclear Information System (INIS)

Fossel, E.T.; Hoefeler, H.

1987-01-01

Transient exposure of an isolated isovolumic perfused rat heart to low concentrations (0.5 mM) of perfusate-born iodoacetamide resulted in complete inhibition of creatine kinase and partial inhibition of glyceraldehyde-3-phosphate dehydrogenase in the heart. At low levels of developed pressure, hearts maintained mechanical function, ATP, and creatine phosphate levels at control values. However, iodoacetamide-inhibited hearts were unable to maintain control values of end diastolic pressure or peak systolic pressure as work load increased. Global ischemia resulted in loss of all ATP without loss of creatine phosphate, indicating lack of active creatine kinase. These results indicate that isovolumic perfused rat hearts are able to maintain normal function and normal levels of high-energy phosphates without active creatine kinase at low levels of developed pressure. 31 P-NMR of the heart was carried out

Quantitative myocardial perfusion from static cardiac and dynamic arterial CT

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Bindschadler, Michael; Branch, Kelley R.; Alessio, Adam M.

2018-05-01

Quantitative myocardial blood flow (MBF) estimation by dynamic contrast enhanced cardiac computed tomography (CT) requires multi-frame acquisition of contrast transit through the blood pool and myocardium to inform the arterial input and tissue response functions. Both the input and the tissue response functions for the entire myocardium are sampled with each acquisition. However, the long breath holds and frequent sampling can result in significant motion artifacts and relatively high radiation dose. To address these limitations, we propose and evaluate a new static cardiac and dynamic arterial (SCDA) quantitative MBF approach where (1) the input function is well sampled using either prediction from pre-scan timing bolus data or measured from dynamic thin slice ‘bolus tracking’ acquisitions, and (2) the whole-heart tissue response data is limited to one contrast enhanced CT acquisition. A perfusion model uses the dynamic arterial input function to generate a family of possible myocardial contrast enhancement curves corresponding to a range of MBF values. Combined with the timing of the single whole-heart acquisition, these curves generate a lookup table relating myocardial contrast enhancement to quantitative MBF. We tested the SCDA approach in 28 patients that underwent a full dynamic CT protocol both at rest and vasodilator stress conditions. Using measured input function plus single (enhanced CT only) or plus double (enhanced and contrast free baseline CT’s) myocardial acquisitions yielded MBF estimates with root mean square (RMS) error of 1.2 ml/min/g and 0.35 ml/min/g, and radiation dose reductions of 90% and 83%, respectively. The prediction of the input function based on timing bolus data and the static acquisition had an RMS error compared to the measured input function of 26.0% which led to MBF estimation errors greater than threefold higher than using the measured input function. SCDA presents a new, simplified approach for quantitative

A Case of Isolated Middle Cerebral Artery Stenosis with Hemichorea and Moyamoya Pattern Collateralization

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Seok Jong Chung

2013-05-01

Full Text Available Isolated middle cerebral artery (MCA stenosis in young patients with no other medical condition may be a unique pathologic entity with a benign long-term course. Generally, moyamoya disease shows a progression of stenosis from internal cerebral artery (ICA to other intracranial vessel. A 26-year-old woman was admitted for choreic movements of the right arm and leg. Brain magnetic resonance imaging showed no stroke. Conventional angiography revealed 48% stenosis of the left M1 without ICA stenosis. Single photon emission computed tomography revealed perfusion asymmetry after acetazolamide injection, suggesting decreased uptake in the left basal ganglia and the cerebral cortex. Her hemichorea was mildly decreased with risperidone. One year later, follow-up angiography showed complete occlusion of the left M1 with neovascularization suggestive of moyamoya disease. The patient underwent bypass surgery and her hemichorea disappeared. This may be an atypical presentation of moyamoya disease. The bypass surgery was an effective measure for restoring the vascular insufficiency and, resultantly, controlling her hemichorea.

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

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

2014-01-01

data was compared with Spearman's rho and Bland-Altman analysis. RESULTS: CMRI results were strongly and significantly correlated with PET results for the absolute global myocardial perfusion differences (r=0.805, p=0.001) and for global myocardial perfusion reserve (MPR) (r=0.886, p... territorial level, CMRI results were also significantly correlated with absolute PET myocardial perfusion differences (r=0.737, pr=0.818, pr=0.787, p=0.......001; left anterior descending artery (LAD): r=0.796, p=0.001; left circumflex artery (LCX): r=0.880, pr=0.895, pr=0.886, pr=0.886, p

Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

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Burgmans, Mark C., E-mail: m.c.burgmans@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands); Leede, Eleonora M. de, E-mail: e.m.de-leede@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Martini, Christian H., E-mail: c.h.martini@lumc.nl [Leiden University Medical Centre, Department of Anesthesiology (Netherlands); Kapiteijn, Ellen, E-mail: h.w.kapiteijn@lumc.nl [Leiden University Medical Centre, Department of Medical Oncology (Netherlands); Vahrmeijer, Alexander L., E-mail: a.l.vahrmeijer@lumc.nl [Leiden University Medical Centre, Department of Surgery (Netherlands); Erkel, Arian R. van, E-mail: a.r.van-erkel@lumc.nl [Leiden University Medical Centre, Department of Radiology (Netherlands)

2016-06-15

Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

Percutaneous Isolated Hepatic Perfusion for the Treatment of Unresectable Liver Malignancies

International Nuclear Information System (INIS)

Burgmans, Mark C.; Leede, Eleonora M. de; Martini, Christian H.; Kapiteijn, Ellen; Vahrmeijer, Alexander L.; Erkel, Arian R. van

2016-01-01

Liver malignancies are a major burden of disease worldwide. The long-term prognosis for patients with unresectable tumors remains poor, despite advances in systemic chemotherapy, targeted agents, and minimally invasive therapies such as ablation, chemoembolization, and radioembolization. Thus, the demand for new and better treatments for malignant liver tumors remains high. Surgical isolated hepatic perfusion (IHP) has been shown to be effective in patients with various hepatic malignancies, but is complex, associated with high complication rates and not repeatable. Percutaneous isolated liver perfusion (PHP) is a novel minimally invasive, repeatable, and safer alternative to IHP. PHP is rapidly gaining interest and the number of procedures performed in Europe now exceeds 200. This review discusses the indications, technique and patient management of PHP and provides an overview of the available data.

Cell-swelling-induced taurine release from isolated perfused rat liver

NARCIS (Netherlands)

Brand, H. S.; Meijer, A. J.; Gustafson, L. A.; Jörning, G. G.; Leegwater, A. C.; Maas, M. A.; Chamuleau, R. A.

1994-01-01

Astrocytes and lymphocytes are able to release significant amounts of taurine during periods of hypotonicity to reduce the increase in cell volume. To investigate this mechanism in the liver, we studied the release of free amino acids from isolated perfused rat liver during hypotonicity. The

Kinetics of reversible-sequestration of leukocytes by the isolated perfused rat lung

Energy Technology Data Exchange (ETDEWEB)

Goliaei, B.

1980-08-01

The kinetics and morphology of sequestration and margination of rat leukocytes were studied using an isolated perfused and ventilated rat lung preparation. Whole rat blood, bone marrow suspension, or leukocyte suspensions, were used to perfuse the isolated rat lung. The lung was also perfused with latex particle suspensions and the passage of particles through the lung capillaries was studied. When a leukocyte suspension was perfused through the lung in the single-pass mode, the rate of sequestration decreased as more cells were perfused. In contrast, latex particles of a size comparable to that of leukocytes were totally stopped by the lung. When the leukocyte suspension was recirculated through the lung, cells were rapidly removed from circulation until a steady state was reached, after which no net removal of cells by the lung occurred. These results indicate that leukocytes are reversibly sequestered from circulation. The sequestered cells marginated and attached to the luminal surface of the endothelium of post-capillary venules and veins. A mathematical model was developed based on the assumption that the attachment and detachment of leukocytes to blood vessel walls follows first-order kinetics. The model correctly predicts the following characteristics of the system: (a) the kinetics of the sequestration of leukocytes by the lung; (b) the existence of a steady state when a suspension of leukocytes is recirculated through the lung; and (c) the independence of the fraction of cells remaining in circulation from the starting concentration for all values of starting concentration. (ERB)

Perfusion by Arterial Spin labelling following Single dose Tadalafil In Small vessel disease (PASTIS)

DEFF Research Database (Denmark)

Pauls, Mathilde M H; Clarke, Natasha; Trippier, Sarah

2017-01-01

vascular territories. The aim of this trial is to test the hypothesis that tadalafil increases cerebral blood flow in older people with small vessel disease. METHODS/DESIGN: Perfusion by Arterial Spin labelling following Single dose Tadalafil In Small vessel disease (PASTIS) is a phase II randomised double......-blind crossover trial. In two visits, 7-30 days apart, participants undergo arterial spin labelling to measure cerebral blood flow and a battery of cognitive tests, pre- and post-dosing with oral tadalafil (20 mg) or placebo. SAMPLE SIZE: 54 participants are required to detect a 15% increase in cerebral blood...

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

Directory of Open Access Journals (Sweden)

Ugo Fabrizio

2010-05-01

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

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

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

2012-12-15

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

Extended normothermic extracorporeal perfusion of isolated human liver after warm ischaemia: a preliminary report.

Science.gov (United States)

Bellomo, Rinaldo; Marino, Bruno; Starkey, Graeme; Fink, Michael; Wang, Bao Zhong; Eastwood, Glenn M; Peck, Leah; Young, Helen; Houston, Shane; Skene, Alison; Opdam, Helen; Jones, Robert

2014-09-01

Donation after circulatory death (DCD) livers are at markedly increased risk of primary graft dysfunction and biliary tract ischaemia. Normothermic extracorporeal liver perfusion (NELP) may increase the ability to transplant DCD livers and may allow their use for artificial extracorporeal liver support of patients with fulminant liver failure. We conducted two proof-of-concept experiments using human livers after DCD to assess the feasibility and functional efficacy of NELP over an extended period. We applied extracorporeal membrane oxygenation, parenteral nutrition, separate hepatic artery and portal vein perfusion and physiological perfusion pressures to two livers obtained after DCD. We achieved NELP and evidence of liver function (bile production, paracetamol removal and maintenance of normal lactate levels) in both livers; one for 24 hours and the other for 43 hours. Histological examination showed areas of patchy ischaemia but preserved biliary ducts and canaliculi. Our experiments justify further investigations of the feasibility and efficacy of extended DCD liver preservation by ex-vivo perfusion.

Interventional procedures of the isolated iliac arterial aneurysm

Energy Technology Data Exchange (ETDEWEB)

Ohm, Joon Young [The Catholic Univ. of Korea College of Medicine, Bucheon (Korea, Republic of); Shin, Byung Seok; Ahn, Moon Sang [Chungnam National Univ. Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dankook Univ. Hospital, Cheonan (Korea, Republic of); Kim, Ho Jun [Konyang Univ. Hospital, Daejeon (Korea, Republic of)

2012-05-15

To report the results of treatment isolated iliac arterial aneurysms by interventional procedures. Over a period of 5 years, 7 isolated iliac artery aneurysms (4 in the common iliac artery, 3 in the internal iliac artery) in 7 patients (3 women, 4 men; mean age, 65.7 years) were treated using interventional procedures. The mean aneurysm size was 35 mm (range, 30-45 mm). The common iliac aneurysms were treated using a unilateral stent graft (2 balloon expandable, 2 self expandable) with coil embolization of the internal iliac artery (n = 3), except for 1 aneurysm that ruptured. Coil embolization alone was performed for aneurysms involving only the internal iliac artery (n = 3). All patients were treated successfully, except for 1 with an initial remnant of type 2 endoleak. There were no perioperative complications. No leakage or complication occurred at the mean follow up of 14 months (range 2-29 months). One patient with a ruptured aneurysm died of multi organ failure during the follow up period. Three aneurysms had decreased in size on follow up CT. Interventional procedures with stent grafting and coil embolization are safe and effective treatments for isolated iliac artery aneurysms.

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

Energy Technology Data Exchange (ETDEWEB)

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

2016-06-15

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

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

International Nuclear Information System (INIS)

Jeon, Chang Ho; Seong, Nak Jong; Yoon, Chang Jin

2016-01-01

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

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

Directory of Open Access Journals (Sweden)

Irfan Ahmet

2016-02-01

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

Thallium-201 exercise myocardial imaging to evaluate myocardial perfusion after coronary artery bypass surgery

International Nuclear Information System (INIS)

Hirzel, H.O.; Nuesch, K.; Sialer, G.; Horst, W.; Krayenbuehl, H.P.

1980-01-01

To assess the usefulness of thallium-201 exercise scintigraphy in evaluating myocardial perfusion after coronary artery bypass surgery, imaging was performed after submaximal bicycle ergometry and at rest in 54 patients before and within 24 +- 10 (SD) weeks after operation. Scintigraphy identified 8 out of 20 patients who were symptom free after operation and showed normal exercise electrocardiograms as still having exercise-induced ischaemia and thus as having not truly benefited from the surgical intervention. In contrast, improvement in perfusion was documented in 17 out of 31 patients despite further complaints of chest pain and persistence of a pathological exercise electrocardiogram in 6 of them. Bypass graft patency rate paralleled the scintigraphic findings in the 35 patients who were restudied arteriographically. It was concluded that thallium-201 exercise scintigraphy is a useful technique to document changes in regional perfusion after surgery and is definitely superior to the clinical evaluation of patients including the exercise electrocardiogram. (author)

Quantitative analysis of MR perfusion/diffusion images in a dog model of renal artery stenosis with microsphere correlation

International Nuclear Information System (INIS)

Lorens, C.H.; Powers, T.A.; Holburn, G.E.; Price, R.R.

1990-01-01

This paper compares MR perfusion/diffusion-derived parameters with microsphere determination of asymmetry of renal perfusion in a dog model of renal artery stenosis. A left renal artery stenosis was created by placement of a silk ligature. Nb-95-labeled microspheres were injected into the left ventricle, and a reference blood sample was drawn. The dog was imaged in a 1.5-T MR imager with both spin-echo and turbo-FLASH perfusion/diffusion-sensitive pulse sequences. The kidneys were excised, weighted, divided into sections, and counted. Two dogs have been studied to date. In dog 1, left renal blood flow (RBF) was 42 mL/min/100g and right RBF was 337 mL/min/100g. In dog 2 left RBF was 444 mL/min/100g and right RBF was 608 mL/min/100g. The apparent diffusion coefficients (ADC) reflected the asymmetry of flow in dog 1 for both spin-echo and turbo-FLASH sequences (RADC/LADC = 1.7) and showed essentially equal flow in dog 2(RADC/LADC = 0.7)

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

NARCIS (Netherlands)

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

2016-01-01

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

Isolated anomalous origin of the vertebral artery from the common carotid artery.

Science.gov (United States)

Kesler, William W; Sabat, Shyamsunder B

2018-04-18

Anomalous origins of the vertebral arteries are uncommon and typically associated with other abnormalities of the great vessels. We present a case of an isolated origin of the right vertebral artery from the ipsilateral common carotid artery detected using magnetic resonance angiography. Such variants can significantly affect endovascular and surgical planning.

Visceral Perfusion Scintigraphy with {sup 131}I-Labelled Albumin Macroaggregates

Energy Technology Data Exchange (ETDEWEB)

Ueda, H.; Yamada, H.; Kitani, K.; Nagatani, M.; Takeda, T.; Migita, T.; Iio, M; Kameda, H. [University of Tokyo, Tokyo (Japan)

1969-05-15

The blood supply through the hepatic artery, superior mesenteric artery and portal vein to the visceral organs was studied in 60 cases of various hepatic disorders by scintigraphy after the selective introduction of {sup 131}I MAA by means of visceral arterial catheterization or percutaneous splenic puncture. A comparison of the radioactivities of the liver and the spleen after celiac arterial infusion (celiac perfusion scanning) indicated how much blood in the celiac artery was distributed to the two major arterial branches - the hepatic and splenic. Dominant perfusion was found through the hepatic branch in liver cirrhosis, whereas significantly dominant splenic blood perfusion was found in idiopathic non-cirrhotic portal hypertension. This remarkable contrast of the mode of celiac perfusion in two disorders indicated the etiological difference of these diseases. In malignant neoplasm of the liver, the dominant or exclusive celiac arterial perfusion was found in the tumour region. In these cases, liver scanning by the splenic injection of MAA (portal perfusion scanning) delineated the tumour region as a negative defect similar to the conventional {sup 198}Au colloid scanning. Consequently, from these two perfusion scintigrams the 'key and key-hole' pattern was demonstrated. It was concluded that a neoplastic lesion, primary or metastatic, has the predominant blood supply through the hepatic artery rather than through the portal vein. Celiac perfusion scanning of liver cystosis revealed multiple negative defects. This information was useful for differentiating a malignant tumour, which is usually impossible by conventional liver scanning. Celiac perfusion scanning was also useful for the diagnosis of arterial venous communication. In one case of liver .cancer with cirrhosis and another case with stomach varices, the arterial-v.enous communication was indicated by the appearance of the lung contour in the celiac perfusion scan. In both cases, the combined presence

Head-to-Head Visual Comparison between Brain Perfusion SPECT and Arterial Spin-Labeling MRI with Different Postlabeling Delays in Alzheimer Disease.

Science.gov (United States)

Kaneta, T; Katsuse, O; Hirano, T; Ogawa, M; Yoshida, K; Odawara, T; Hirayasu, Y; Inoue, T

2017-08-01

Arterial spin-labeling MR imaging has been recently developed as a noninvasive technique with magnetically labeled arterial blood water as an endogenous contrast medium for the evaluation of CBF. Our aim was to compare arterial spin-labeling MR imaging and SPECT in the visual assessment of CBF in patients with Alzheimer disease. In 33 patients with Alzheimer disease or mild cognitive impairment due to Alzheimer disease, CBF images were obtained by using both arterial spin-labeling-MR imaging with a postlabeling delay of 1.5 seconds and 2.5 seconds (PLD 1.5 and PLD 2.5 , respectively) and brain perfusion SPECT. Twenty-two brain regions were visually assessed, and the diagnostic confidence of Alzheimer disease was recorded. Among all arterial spin-labeling images, 84.9% of PLD 1.5 and 9% of PLD 2.5 images showed the typical pattern of advanced Alzheimer disease (ie, decreased CBF in the bilateral parietal, temporal, and frontal lobes). PLD 1.5 , PLD 2.5 , and SPECT imaging resulted in obviously different visual assessments. PLD 1.5 showed a broad decrease in CBF, which could have been due to an early perfusion. In contrast, PLD 2.5 did not appear to be influenced by an early perfusion but showed fewer pathologic findings than SPECT. The distinctions observed by us should be carefully considered in the visual assessments of Alzheimer disease. Further studies are required to define the patterns of change in arterial spin-labeling-MR imaging associated with Alzheimer disease. © 2017 by American Journal of Neuroradiology.

Regional myocardial perfusion of cardioplegic solutions

International Nuclear Information System (INIS)

Eugene, J.; Lyons, K.P.; Ott, R.A.; Gelezunas, V.L.; Chang, C.W.; Kowall, M.G.; Haiduc, N.J.

1987-01-01

We compared the regional myocardial perfusion of blood cardioplegic solution (BCP) and crystalloid cardioplegic solution (CCP) in 14 mongrel dogs. Cardiopulmonary bypass was established at 28 degrees C, and a hydraulic occluder was placed around the proximal left anterior descending (LAD) coronary artery. In group 1 (N = 7) collateral coronary arteries were ligated; in group 2 (N = 7) collateral coronary arteries were left in situ. After the aorta was clamped, BCP and CCP were alternately perfused at 200 ml/min. The occluder was inflated to produce moderate, severe, and critical LAD stenosis, and regional perfusion was measured by xenon-133 washout with the Silicon Avalanche Radiation Detector. BCP infusion produced a consistently higher aortic pressure, but CCP flow was better than BCP flow under all conditions, particularly without coronary collaterals. Regional myocardial perfusion of CCP is superior to BCP

Reverse ventilation--perfusion mismatch

International Nuclear Information System (INIS)

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

1984-01-01

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

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

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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.

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

International Nuclear Information System (INIS)

Chiu, Fang-Ying; Kao, Yi-Hsuan; Teng, Michael Mu Huo; Chung, Hsiao-Wen; Chang, Feng-Chi; Cho, I-Chieh; Chen, Wen-Chun

2012-01-01

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.

Arterial spin labelling perfusion MRI of breast cancer using FAIR TrueFISP: Initial results

International Nuclear Information System (INIS)

Buchbender, S.; Obenauer, S.; Mohrmann, S.; Martirosian, P.; Buchbender, C.; Miese, F.R.; Wittsack, H.J.; Miekley, M.; Antoch, G.; Lanzman, R.S.

2013-01-01

Aim: To assess the feasibility of an unenhanced, flow-sensitive, alternating inversion recovery-balanced steady-state free precession (FAIR TrueFISP) arterial spin labelling (ASL) magnetic resonance imaging (MRI) technique for quantification of breast cancer perfusion. Materials and methods: Eighteen untreated breast tumour patients (mean age 53 ± 17 years, range 30–68 years) and four healthy controls (mean age 51 ± 14 years, range 33–68 years) were enrolled in this study and were imaged using a clinical 1.5 T MRI machine. Perfusion measurements were performed using a coronal single-section ASL FAIR TrueFISP technique in addition to a routine breast MRI examination. T1 relaxation time of normal breast parenchyma was determined in four healthy volunteers using the variable flip angle approach. The definitive diagnosis was obtained at histology after biopsy or surgery and was available for all patients. Results: ASL perfusion was successfully acquired in 13 of 18 tumour patients and in all healthy controls. The mean ASL perfusion of invasive ductal carcinoma tissue was significantly higher (88.2 ± 39.5 ml/100 g/min) compared to ASL perfusion of normal breast parenchyma (24.9 ± 12.7 ml/100 g/min; p < 0.05) and invasive lobular carcinoma (30.5 ± 4.3 ml/100 g/min; p < 0.05). No significant difference was found between the mean ASL perfusion of normal breast parenchyma and invasive lobular carcinoma tissue (p = 0.97). Conclusion: ASL MRI enables quantification of breast cancer perfusion without the use of contrast material. However, its impact on diagnosis and therapy management of breast tumours has to be evaluated in larger patient studies

Myocardial performance and perfusion during exercise in patients with coronary artery disease caused by Kawasaki disease

International Nuclear Information System (INIS)

Paridon, S.M.; Ross, R.D.; Kuhns, L.R.; Pinsky, W.W.

1990-01-01

For a study of the natural history of coronary artery lesions after Kawasaki disease and their effect on myocardial blood flow reserve with exercise, five such patients underwent exercise testing on a bicycle. Oxygen consumption, carbon dioxide production, minute ventilation, and electrocardiograms were monitored continuously. Thallium-201 scintigraphy was performed for all patients. One patient stopped exercise before exhaustion of cardiovascular reserve but had no evidence of myocardial perfusion abnormalities. Four patients terminated exercise because of exhaustion of cardiovascular reserve; one had normal cardiovascular reserve and thallium scintiscans, but the remaining patients had diminished cardiovascular reserve. Thallium scintigrams showed myocardial ischemia in two and infarction in one. No patient had exercise-induced electrocardiographic changes. These results indicate that patients with residual coronary artery lesions after Kawasaki disease frequently have reduced cardiovascular reserve during exercise. The addition of thallium scintigraphy and metabolic measurements to exercise testing improved the detection of exercise-induced abnormalities of myocardial perfusion

EFFECT OF ETHANOL ON HEPATOBILIARY TRANSPORT OF CATIONIC DRUGS - A STUDY IN THE ISOLATED-PERFUSED RAT-LIVER, RAT HEPATOCYTES AND RAT MITOCHONDRIA

NARCIS (Netherlands)

STEEN, H; MEIJER, DKF; Merema, M.T.

The effect of ethanol on the hepatic uptake of various cationic drugs was studied in isolated perfused rat livers, isolated rat hepatocytes and isolated rat liver mitochondria. In isolated rat hepatocytes and in isolated perfused rat livers, the uptake of the model organic cation

Classification of arterial and venous cerebral vasculature based on wavelet postprocessing of CT perfusion data.

Science.gov (United States)

Havla, Lukas; Schneider, Moritz J; Thierfelder, Kolja M; Beyer, Sebastian E; Ertl-Wagner, Birgit; Reiser, Maximilian F; Sommer, Wieland H; Dietrich, Olaf

2016-02-01

The purpose of this study was to propose and evaluate a new wavelet-based technique for classification of arterial and venous vessels using time-resolved cerebral CT perfusion data sets. Fourteen consecutive patients (mean age 73 yr, range 17-97) with suspected stroke but no pathology in follow-up MRI were included. A CT perfusion scan with 32 dynamic phases was performed during intravenous bolus contrast-agent application. After rigid-body motion correction, a Paul wavelet (order 1) was used to calculate voxelwise the wavelet power spectrum (WPS) of each attenuation-time course. The angiographic intensity A was defined as the maximum of the WPS, located at the coordinates T (time axis) and W (scale/width axis) within the WPS. Using these three parameters (A, T, W) separately as well as combined by (1) Fisher's linear discriminant analysis (FLDA), (2) logistic regression (LogR) analysis, or (3) support vector machine (SVM) analysis, their potential to classify 18 different arterial and venous vessel segments per subject was evaluated. The best vessel classification was obtained using all three parameters A and T and W [area under the curve (AUC): 0.953 with FLDA and 0.957 with LogR or SVM]. In direct comparison, the wavelet-derived parameters provided performance at least equal to conventional attenuation-time-course parameters. The maximum AUC obtained from the proposed wavelet parameters was slightly (although not statistically significantly) higher than the maximum AUC (0.945) obtained from the conventional parameters. A new method to classify arterial and venous cerebral vessels with high statistical accuracy was introduced based on the time-domain wavelet transform of dynamic CT perfusion data in combination with linear or nonlinear multidimensional classification techniques.

Combined evaluation of regional coronary artery calcium and myocardial perfusion by {sup 82}Rb PET/CT in the identification of obstructive coronary artery disease

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Zampella, Emilia; Assante, Roberta; Nappi, Carmela; Mainolfi, Ciro Gabriele; Green, Roberta; Cantoni, Valeria; Klain, Michele; Cuocolo, Alberto [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); Acampa, Wanda [University Federico II, Department of Advanced Biomedical Sciences, Naples (Italy); National Council of Research, Institute of Biostructure and Bioimaging, Naples (Italy); Gaudieri, Valeria; Panico, Mariarosaria [National Council of Research, Institute of Biostructure and Bioimaging, Naples (Italy); Petretta, Mario [University Federico II, Department of Translational Medical Sciences, Naples (Italy); Slomka, Piotr J. [Cedars-Sinai Medical Center, Department of Medicine, Los Angeles, CA (United States); UCLA, David Geffen School of Medicine, Los Angeles, CA (United States)

2018-04-15

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

The clinical value of adenosine triphosphate stress myocardial perfusion tomography for detecting coronary artery disease

International Nuclear Information System (INIS)

Yao Zhiming; He Qing; Qu Wanying; Yu Xue; Han Lijun; Yu Zhiguo; Li Wei; Zeng Xuezhai; Zhu Ming; Zhao Hongshan

2002-01-01

Objective: To study the clinical value of adenosine triphosphate stress myocardial perfusion tomography imaging (ATP-MPI) in detection of coronary artery disease (CAD). Methods: There were 278 patients underwent ATP-MPI, 51 patients of them also underwent coronary angiography (CAG). Seventy-three patients underwent stress-rest myocardial perfusion tomography imaging with multi-stage submaximal exercise test (ST-MPI) and CAG serving as control group. Results: 1) Side effects: there were 11 different symptoms and atrioventricular conduction block (10 patients), sinoatrial conduction block (2 patients) occurred during ATP stress. Allopathy or interruption of ATP stress did not happen. 2) The sensitivity and specificity of ATP-MPI in detection of CAD were 97.1% and 82.4%, respectively, and those in detection of ≥50% narrowing coronary artery were 91.0% and 94.7%, respectively. 3) In patients without myocardial infarction, the sensitivity and specificity of ATP-MPI in detection of myocardial ischemia were comparable to those of ST-MPI. Conclusion: ATP-MPI is an accurate, safe modality and is comparable to ST-MPI in the detection of CAD

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-01-15

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

Self-limiting Spontaneous Isolated Celiac Artery Dissection: A Case Report

Directory of Open Access Journals (Sweden)

A.D. Morzycki

Full Text Available : Introduction: Isolated dissection of the celiac artery is rare, with less then 100 cases reported to date. Although some patients present with epigastric pain and tenderness, many cases are asymptomatic and found incidentally on CT. The appropriate management of isolated celiac artery dissections is unclear. This report illustrates an observational approach to a symptomatic case of isolated celiac artery dissection. Report: A 55-year-old Caucassian male presented to the emergency department with epigastric pain. His Initial CT revealed possible celiac artery dissection with associated intramural hematoma. Due to continued pain, a subsequent CTA was ordered. This scan showed progression of the intramural hematoma to near occlusion of the hepatic artery. Despite this, there were no signs of ischemic hepatitis as indicated by normal levels of liver transaminases. There was also no evidence to suggest propagation of the dissection or pseudo-aneurysm formation. We therefore choose a conservative and observational approach to this isolated celiac artery dissection. His dissection was managed with ASA and metoprolol, and he was discharged after 1 week of observation. 3 week follow-up CTA showed spontaneous resolution of the intramural hematoma and improved patency of the hepatic artery. There was no change at 3 months follow-up. Conclusion: This case highlights that an observational approach to cases of isolated celiac artery dissection may be indicated if there is no evident end organ disease or malperfusion. Keywords: Celiac artery, Dissection, Management

Studies on blood supply of liver metastasis with DSA, CT and portal vein perfusion CT during superior mesenteric arterial portography

International Nuclear Information System (INIS)

Li Zhigang; Shi Gaofeng; Huang Jingxiang; Li Shunzong; Liang Guoqing; Wang Hongguang; Han Pengyin; Wang Qi; Gu Tieshu

2008-01-01

Objective: To probe the blood supply of liver metastasis by celiac artery, proper hepatic artery DSA, portal vein perfusion CT during superior mesenteric arterial portography (PCTAP). Methods: One hundred patients with liver metastases were examined prospectively by plain CT scan, multiphase enhanced CT scan, celiac arteriography and proper hepatic arteriography. Of them, 56 patients were examined by PCTAP. All primary lesions were confirmed by operation and (or) pathology examination. In order to investigate the blood supply of metastasis lesions, the software of Photoshop was used to obtain the time-attenuation curves (TDC) of tumor center, tumor edge, portal vein and normal liver parenchyma adjacent to the tumor to calculate liver perfusion for DSA image analysis, while a deconvolution model from CT perfusion software was designed for the dual blood supply. Results: DSA findings: TDC of proper hepatic arteriography showed: the mean peak concentration (K value) in tumor centers was (67 ± 12)%, and it was (76 ± 15)% for peritumor tissue, (51 ± 10)% in normal liver parenchyma. TDC of celiac arteriogaphy showed that the contrast concentration of tumor centers and tumor edge increased fast in early stage, then maintained a slight upward plateau, in the meanwhile, the contrast concentration of normal liver parenchyma kept increasing slowly. PCTAP findings: tumors exhibited no enhancement during 30 s continued scans. Conclusion: The blood supply of liver metastasis mainly comes from hepatic artery, but barely from portal vein. (authors)

Isolated Unilateral Pulmonary Artery Agenesis complicated by Symptomatic Aspergilloma

LENUS (Irish Health Repository)

Daly, A

2017-11-01

Isolated unilateral pulmonary artery agenesis is a rare diagnosis. Poor blood flow to the lung parenchyma renders the tissue susceptible to opportunistic infections. We present the unusual case of isolated unilateral pulmonary artery agenesis complicated by aspergilloma. Management options and considerations are discussed.

Myocardial perfusion in patients with left bundle branch block and without coronary artery disease

International Nuclear Information System (INIS)

Narita, Michihiro; Kurihara, Tadashi; Murano, Kenichi; Usami, Masahisa; Honda, Minoru

1992-01-01

For the evaluation of myocardial perfusion in patients with left bundle branch block (LBBB), we performed exercise stress (Ex)-redistribution (RD) myocardial tomography with thallium-201 ( 201 Tl) in 23 patients with LBBB and without coronary artery disease (CAD). Myocardial images in patients with LBBB were compared with those of 9 patients with CAD who showed Ex induced transient septal defect. Bull'-eye maps ( 201 Tl distribution maps at Ex and RD and 201 Tl washout rate [WOR] map) were made from myocardial tomograms. In 23 patients with LBBB, 15 patients (65%) developed myocardial perfusion abnormality. In 10 (67%) of these 15 patients, transient perfusion defect appeared in the entire septum (diffuse type). On the other hand in 5 patients (33%), localized fixed perfusion defect developed at the boundary between septum and anterior wall (focal type). In focal type, every patient had other disease such as hypertension, aortic stenosis or sick sinus syndrome. While in patients with diffuse type, other diseases were observed in 30% (p 201 Tl WOR and 201 Tl uptake ratio of septum to lateral wall indicated that exercise induced septal defect was slighter in diffuse type than CAD. These points might be useful to differentiate whether CAD participates in the septal defect or not in patients with LBBB. (author)

Homocysteine plasma levels in patients suspected coronary artery disease: Relation to myocardial perfusion image

International Nuclear Information System (INIS)

Yao, Z.Y.; He, Q.; Qu, W.

2002-01-01

Purpose: Although there is considerable epidemiologic evidence for a relationship between plasma homocysteine (Hcy) levels and coronary artery disease (CAD), not all studies, especially prospective ones have shown such a relationship. The purpose of this study was to investigate a possible association between Hcy plasma levels and myocardial perfusion defect by SPECT in patients suspected CAD. Methods and Materials: A cohort of 238 patients suspected CAD (age: 60.65±10.43, male to female: 172: 66) was examined for Hcy, tetrahydrofolic acid (FH4), vitamine B12 and coronary angiography (CAG). Furthermore, 42 patients also underwent 99m Tc-MIBI myocardial perfusion images (MPI) to assess the myocardial perfusion. Results: There were 69 patients with normal CAG and 63, 60, 42 and 4 patients with 1 vessel, two vessel, 3 vessel and left main coronary stenosis. The plasma Hcy of this group was significantly increased, p 0.05. In patients with >=3 segments myocardial perfusion defect, 10 of them had normal Hcy, and 7 with hyperhomocysteinemia, in patients with 0.05). Conclusion: Our data may indicate that hyperhomocysteinemia represents an independent risk factor in patients with high possibility of CAD rather than a mark of myocardial ischemia or coronary stenosis

Concentration of (+/-)-propranolol in isolated, perfused lungs of rat.

Science.gov (United States)

Dollery, C T; Junod, A F

1976-01-01

1 The metabolism and the accumulation of (+/-)-propranolol have been studied in isolated lungs of the rat, perfused with an artificial medium. 2 Little or no metabolism took place during the perfusion periods (up to 10 minutes). 3 Accumulation was observed with high tissue/medium ratios for substrate concentrations of 0.2 muM to 1 mM; there was evidence for saturability, but no real plateau could be seen. The presence of two binding sites with different affinities was established. 4 Cold greatly inhibited the accumulation process at low substrate concentrations, but had no effect at 1 mM propranolol. 5 Inhibition of accumulation was measured in the presence of imipramine, desmethylimipramine, nortryptiline, chlorpromazine and of Na+-free medium. Cocaine, 5-hydroxytryptamine and noradrenaline had no effect. Lidocaine enhanced the accumulation process. Release of previously bound propranolol was accelerated in the presence of propranolol and imipramine, unaffected by a Na+-free medium and decreased by cold and by lidocaine. 6 Experiments on lung tissue slices yielded qualitatively similar results to those obtained with perfused lungs. Ouabain and KCN had no or little effect on propranolol accumulation. PMID:1276542

Prognostic value of myocardial perfusion SPECT imaging in elderly patients without history of coronary artery disease and low prevalence of them

International Nuclear Information System (INIS)

Arja, V.J.; Balestrini, V.R.; Sandrin, A.L.; Conci, E.C.; Serra, C.M.; Joekes, S.

2002-01-01

Elderly patients without history of coronary artery disease are difficult to characterized because the clinical symptoms are often atypical, occult or absent. On the other hand, these patients frequently cannot achieve adequate level of exercise during stress testing and this limitation can compromise the diagnostic and prognostic ability of the test. Generally the prognostic value of myocardial perfusion SPECT is well established for a general population but not for elderly patients. Aim: This study assessed the prognostic value of Tc99m-sestamibi SPECT in a group of patients older than 65 years with low prevalence of coronary artery disease. Material and Methods: Population: 161 consecutive patients older than 65 years without history of coronary artery disease and low prevalence of them were studied with Tc99m-sestamibi SPECT perfusion imaging. Mean age 71 years old (65-87), male 55%, mean pretest likelihood 11%. Risk factors: diabetes 17%, high blood pressure 74%, high cholesterol 45%, smokers 88%. Stress test: bicycle exercise 39% and dipyridamole 61%. Myocardial perfusion SPECT: semiquantitative analysis to evaluate perfusion defects with a 14-segments model and 4-point scoring system for uptake reduction. Scintigraphic indices: SSS (sum of the stress scores), SRS (sum of the rest scores) and SDS (SSS-SRS). Follow up: cardiac events: hard (acute myocardial infarction and cardiac death) and soft (need for PTCA/CABG and angina). Results: Mean follow up: 508 days. Events rate: hard 0.6% (1 acute myocardial infarction), soft 5.6%. Univariate analysis identified sex (p=0.017) and SDS (p=0.009) as cardiac events predictors. Complete or reduced (independent variables which predicted events) logistic regression analysis correctly predicted the absence of events but did not predict the presence of events. Conclusion: In this elderly population with a low clinical risk where the stress test is a suboptimal method of study for coronary artery disease, semiquantitative

Diagnostic value of transesophageal atrial pacing myocardial perfusion imaging in coronary artery disease

International Nuclear Information System (INIS)

Jia Yongping; Li Zhiling; Li Yunqian

1994-01-01

Transesophageal atrial pacing (TAP) SPECT myocardial perfusion imaging (MPI) with 99m Tc-MIBI was performed in 46 patients with coronary artery disease (CAD) and 15 normal subjects. The results were compared with exercise SPECT MPI. The results showed that the sensitivity and specificity of TAP SPECT to evaluate CAD were 86,96% and 93.33%. TAP SPECT MPI had a significant correlation with exercise SPECT MPI to detect ischemic segment of CAD (r = 0.95)

Tl-201 myocardial perfusion scanning in patients with right bundle branch block coronary artery disease

International Nuclear Information System (INIS)

Shirani, J.; Malpani, A.R.; Blend, M.J.; Bekerman, C.

1990-01-01

This paper evaluates the specificity of stress T1-201 myocardial perfusion studies (T1-201 MPS) for coronary artery disease (CAD) in patients with right bundle branch block (RBBB). Twenty-four patients with RBBB and atypical chest pain with ECG findings limited to RBBB, adequate stress test (ie, >85% of maximal heart rate for age), and no clinical, hemodynamic, or ECG evidence of ischemia during exercise underwent T1-201 MPS. These perfusion patterns were compared with an equal number of age- and gender-matched controls with a normal ECG who met all other criteria mentioned above. Patients with RBBB showed a significantly higher frequency of reversible inferoposterior T1-201 defects (62.5% vs 20.8%)

Patterns of disturbed myocardial perfusion in patients with coronary artery disease. Regional myocardial perfusion in angina pectoris

International Nuclear Information System (INIS)

Selwyn, A.P.; Forse, G.; Fox, K.; Jonathan, A.; Steiner, R.

1981-01-01

Fifty patients who presented with angina pectoris were studied to examine the disturbances of regional myocardial perfusion during stress. Each patient underwent 16-point precordial mapping of the ECG during an exercise test, and coronary and left ventricular angiography. Regional myocardial perfusion was assessed using an atrial pacing test and a short-lived radionuclide, krypton-81m. Eleven patients had negative exercise tests and uniform increases in myocardial activity of krypton-81m of 98 +/- 18.0% during pacing. Ten patients performed 30,000-43,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and increases in myocardial activity of krypton-81m to remote and jeopardized myocardium at the onset of pacing. However, further pacing produced a decrease in activity in the affected segment of 68.0 +/- 9.0% accompanied by ST-segment depression and angina. Twelve patients achieved 26,000-32,000 J in positive exercise tests and had significant coronary artery disease. Atrial pacing produced increased activity of krypton-81m to remote myocardium. The jeopardized segment at first showed no change and then a decrease in regional activity of krypton-81m (89.0 +/- 17%) accompanied by ST-segment depression and chest pain. Seventeen patients achieved only 7000-22,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and developed decreases in regional activity of krypton-81m to the affected segment of myocardium starting at the onset of atrial pacing and decreasing by 88 +/- 0 7.0% below control. We conclude that different patterns of disturbed myocardial distribution of krypton-81m are present during stress-induced ischemia in patients with coronary artery disease. There was a close temporal relationship between these disturbances and ST-segment depression

Dynamic CT myocardial perfusion imaging

International Nuclear Information System (INIS)

Caruso, Damiano; Eid, Marwen; Schoepf, U. Joseph; Jin, Kwang Nam; Varga-Szemes, Akos; Tesche, Christian; Mangold, Stefanie

2016-01-01

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

Dynamic CT myocardial perfusion imaging

Energy Technology Data Exchange (ETDEWEB)

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

2016-10-15

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

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

International Nuclear Information System (INIS)

San Millan Ruiz, Diego; Murphy, Kieran; Gailloud, Philippe

2010-01-01

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

Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

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Oki, Glaucia Celeste Rossatto [Clinica Diagnoson and Hospital Aristides Maltez, Salvador, BA (Brazil). Servicos de Medicina Nuclear; Pavin, Elizabeth Joao; Parisi, Maria Candida R. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Endocrinology; Coelho, Otavio Rizzi; Almeida, Raitany C. [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Internal Medicine. Service of Cardiology; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario, E-mail: cdramos@unicamp.br [Universidade Estadual de Campinas (Unicamp), Campinas, SP (Brazil). Department of Radiology. Service of Nuclear Medicine; Camargo, Edwaldo Eduardo [Hospital Sirio-Libanes, Campinas, SP (Brazil). Service of Nuclear Medicine

2013-01-15

Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with {sup 99m}Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

International Nuclear Information System (INIS)

Oki, Glaucia Celeste Rossatto; Pavin, Elizabeth Joao; Parisi, Maria Candida R.; Coelho, Otavio Rizzi; Almeida, Raitany C.; Etchebehere, Elba Cristina Sa de Camargo; Ramos, Celso Dario; Camargo, Edwaldo Eduardo

2013-01-01

Objective: This study was aimed to evaluate myocardial perfusion in asymptomatic patients with type 1 (DM1) and type 2 diabetes mellitus (DM2) without previous diagnoses of coronary artery disease (CAD) or cerebral infarction. Materials and Methods: Fifty-nine consecutive asymptomatic patients (16 DM1, 43 DM2) underwent myocardial perfusion scintigraphy with 99m Tc-sestamibi (MPS). They were evaluated for body mass index, metabolic control of DM, type of therapy, systemic arterial hypertension, dyslipidemia, nephropathy, retinopathy, peripheral neuropathy, smoking, and familial history of CAD. Results: MPS was abnormal in 15 patients (25.4%): 12 (20.3%) with perfusion abnormalities, and 3 with isolated left ventricular dysfunction. The strongest predictors for abnormal myocardial perfusion were: age 60 years and above (p = 0.017; odds ratio [OR] = 6.0), peripheral neuropathy (p = 0.028; OR = 6.1), nephropathy (p = 0.031; OR = 5.6), and stress ECG positive for ischemia (p = 0.049; OR = 4.08). Conclusion: Silent myocardial ischemia occurs in more than one in five asymptomatic diabetic patients. The strongest predictors of ischemia in this study were: patient age, peripheral neuropathy, nephropathy, retinopathy and a stress ECG positive for ischemia. (author)

Management of isolated nonresectable liver metastases in colorectal cancer patients: a case-control study of isolated hepatic perfusion with melphalan versus systemic chemotherapy

NARCIS (Netherlands)

van Iersel, L. B. J.; Koopman, M.; van de Velde, C. J. H.; Mol, L.; van Persijn van Meerten, E. L.; Hartgrink, H. H.; Kuppen, P. J. K.; Vahrmeijer, A. L.; Nortier, J. W. R.; Tollenaar, R. A. E. M.; Punt, C.; Gelderblom, H.

2010-01-01

To compare the median overall survival of patients with isolated nonresectable liver metastases in comparable groups of patients treated with either isolated hepatic perfusion (IHP) with melphalan or systemic chemotherapy. Colorectal cancer patients with isolated liver metastases, who underwent IHP,

Visualization of myocardial perfusion derived from coronary anatomy

NARCIS (Netherlands)

Termeer, M.A.; Bescos, J.O.; Breeuwer, M.; Vilanova, A.; Gerritsen, F.A.; Gröller, M.E.; Nagel, Eike

2008-01-01

Visually assessing the effect of the coronary artery anatomy on the perfusion of the heart muscle in patients with coronary artery disease remains a challenging task. We explore the feasibility of visualizing this effect on perfusion using a numerical approach. We perform a computational simulation

Diagnostic value of myocardial perfusion SPECT in the prediction of restenosis after coronary artery bypass graft surgery

International Nuclear Information System (INIS)

Paeng, J. C.; Lee, D. S.; Kang, W. J.; Kim, K. B.; Chung, J. K.; Lee, M. C.

2002-01-01

Myocardial SPECT has been reported to be sensitive in the detection of restenosis after revascularization. However, the diagnostic value is not well established in bypass graft surgery (CABG), due to significant influences of characteristics of graft vessels and the time interval between CABG and the SPECT. In this study, we evaluated the diagnostic value of myocardial SPECT for the restenosis after CABG. A total of 160 patients with coronary artery disease (M:F=118:42, 60±8 yr) who had undergone CABG were included. Rest T1-201/ dipyridamole stress Tc-99m-MIBI SPECT was performed 3 months (103±16 days) after CABG. Segmental perfusion was quantified using a 20-segment model, and segments of reversible perfusion defect (REV) were defined. Follow-up coronary angiography was performed 1 year (397±104 days) after CABG. The segments of REV were compared between arterial and venous graft groups. And the diagnostic power of 3-month SPECT was evaluated for the prediction of restenosis. On the 3-month SPECT, 620 segments showed REV. The segments of REV were 37% of artery-grafted segments and 36% of vein-grafted segments (p=n.s.). On 1-year coronary angiography, 113 graft vessels (28%) showed restenosis. The overall sensitivity and specificity of REV on 3-month SPECT for the prediction of restenosis were 46% and 67%, respectively, but 52% and 68%, in artery-graft group. REV detected on 3-month SPECT has a predictive value, especially, high specificity for the prediction of restenosis after CABG, which was more definite in artery-graft group

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

International Nuclear Information System (INIS)

Kramme, Johanna; Diehl, Volker; Madai, Vince I.; Sobesky, Jan; Guenther, Matthias

2015-01-01

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

The uptake and metabolism of cystamine and taurine by isolated, ventilated and perfused rat and rabbit lungs

International Nuclear Information System (INIS)

Sharma, R.; Kodavanti, U.P.; Smith, L.L.; Mehendale, H.M.

1991-01-01

Cystamine has been reported to be taken up by the lung slices and metabolized to taurine via hypotaurine through enzymatic processes. The objective of these studies was to determine whether intact isolated, ventilated and perfused rat and rabbit lungs also posses similar characteristics. The lungs were isolated from male New Zealand white rabbits and S-D rats and perfused with 20 μM [ 14 C] cystamine (Sp. Act., 16.4 mCi/mmol) for 60 min and 30 min, respectively. Cystamine and its metabolites in lung as well as in perfusate were separated by TLC and quantitated using scintillation spectrometry. Similar experiments were also conducted with 20 μM taurine to investigate its fate in perfused lungs. Significant pulmonary uptake of cystamine and taurine occurred during perfusion. Cystamine was metabolized to [ 14 C] hypotaurine and [ 14 C] taurine. No further metabolism of taurine was evident in rat or rabbit lungs. Inclusion of 1 nM GSH did not significantly alter the ability of lungs to sequester cystamine, but the metabolism of hypotaurine to taurine was decreased. It was evident that cystamine was metabolized to taurine by perfused lungs in the same way as in lung slices

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

DEFF Research Database (Denmark)

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

2016-01-01

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

Pulmonary O2 transfer during pulsatile and non-pulsatile perfusion.

Science.gov (United States)

Hauge, A; Nicolaysen, G

1980-07-01

The importance of the perfusion pattern for the oxygen transfer has been examined in isolated rabbit lungs perfused with plasma at constant volume inflow. The lungs were ventilated with constant tidal volume and constant end-expiratory pressure. Following a standardized rise in FIO2 the rate of rise in pulmonary venous PO2 (delta PO2/delta t) was measured during alternately pulsatile and non-pulsatile perfusion in normal lungs and in lungs made edematous by elevation of left atrial pressure. In normal lungs there was no difference in delta PO2/delta t when the two modes of perfusion were compared. In edematous lungs delta PO/delta t was statistically higher during pulsatile perfusion, indicating a beneficial effect of flow- and pressure pulsations, e.g. a better distribution of V/Q ratios throughout the lungs. In a separate series of expts. the advancement of a high O2 front through the airways was measured, and the two perfusion patterns compared. Since no difference was found, we suggest that the phenomenon of "cardiogenic gas mixing" in the airways in vivo is a result of a direct action of the heart on the lungs rather than arterial pulsations.

Metabolism of 1-[14C]nitropyrene in isolated perfused rat livers

International Nuclear Information System (INIS)

Bond, J.A.; Medinsky, M.A.; Dutcher, J.S.

1984-01-01

1-Nitropyrene (1-NP), a constituent of diesel exhaust, is carcinogenic to rats and is a bacterial and mammalian mutagen. Biliary and fecal excretion of 1-NP metabolites are the major routes of excretion in rats, suggesting that hepatic metabolism plays a dominant role in determining the biological fate of 1-NP. The purpose of this investigation was to quantitate 1-[14C]NP metabolites formed in isolated perfused rat livers and excreted in bile from rats. Perfused rat livers displayed a capacity for oxidation, reduction, acetylation, and conjugation of 1-NP (or its metabolites). Reduction of 1-NP followed by N-acetylation was the major metabolic pathway observed in the perfused livers. Acetylaminopyrene (AAP) was the major metabolite detected, with total quantities (150 nmol) accounting for about 60% of the total 1-[14C]NP dose (258 nmol) added to the perfusate. Considerably smaller quantities of aminopyrene and hydroxynitropyrenes were also detected. Livers perfused with 1-[14C]NP excreted about 36 nmol equivalents of 1-[14C]NP (12% of the total 1-NP dose) in bile after 60 min. Some of the biliary metabolites were tentatively identified as metabolites of the mercapturic acid pathway. The spectrum of biliary metabolites was qualitatively identical to that seen in bile from intact rats. Quantities of 14C covalently bound to hepatic macromolecules from perfused livers were 0.4 nmol 1-NP eq/g liver. The data from this study indicate that the liver may be an important site for metabolism of 1-NP

Pretest clinical diagnosis of coronary artery disease and stress myocardial perfusion scintigram

International Nuclear Information System (INIS)

Kasalicky, J.; Kovac, I.; Lanska, V.

2001-01-01

To assess the probability of perfusion defects at exercise stress myocardial perfusion SPECT scintigraphy from pretest clinical diagnosis (medical personal history, previous ergometric investigation). To determine the value of clinical factors for probability of scintigraphic defects with respect to avoiding unnecessary investigation in subjects with low probability of abnormal scintigrams. 2143 subjects (1235 men, 908 women) were investigated by SPECT perfusion scintigraphy at stepwise increasing exercise stress. They were divided into three groups with regard to their medical history and exercise test at scintigraphy: subjects without any signs of coronary artery disease (CAD), patients with high likelihood of CAD (i.e., typical anginal pain, in particular at stress, positive stress ECG changes, angiographically documented important CAD) and patients after myocardial infarction (MI). Important risk factors (hypertension, diabetes, age and sex), as well as the role of revascularisation procedures, were taken into account for multiple logistic regression in order to express their importance for the odds of scintigraphic defect visualisation. Perfusion scintigraphic defects (PSD) were found in 5.2% of subjects without signs of CAD, in contrast to patients with manifest CAD (68.8% with PSD) and in those after MI (90.2% with PSD). There were other important factors corroborating the likelihood of PSD (in decreasing order of importance): diabetes, male, ECG changes at stress, increasing age. Successful revascularisation improved scintigraphic images. The examination of CAD symptom-free subjects, in particular with atypical chest discomfort, is useless. SMPS in patients after documented MI is to be carried out for other intended purposes, not for CAD diagnosis only. SMPS is highly recommended in patients with CAD symptoms and high CAD probability in order to decide further treatment and prognosis. (author)

Improved visualization of delayed perfusion in lung MRI

International Nuclear Information System (INIS)

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

2011-01-01

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

Can Stress Echocardiography Compete with Perfusion Scintigraphy in the Detection of Coronary Artery Disease and Cardiac Risk Assessment?

NARCIS (Netherlands)

M.L. Geleijnse (Marcel); A. Elhendy (Abdou)

2000-01-01

textabstractAims: The aim of this review was to define the place of stress echocardiography in the context of perfusion scintigraphy for the detection of coronary artery disease (CAD) and the assessment of cardiac risk. Stress echocardiography has the benefits of widespread availability, relatively

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

International Nuclear Information System (INIS)

Qayyum, Abbas A.; Hasbak, Philip; Larsson, Henrik B.W.; Christensen, Thomas E.; Ghotbi, Adam A.; Mathiasen, Anders B.

2014-01-01

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2014-07-15

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

New method of isolation and perfusion of rat pancreas for phosphorus nucletic resonance study

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Takehisa; Kanno, Tomio; Murakami, Masataka; Watari, Hiroshi; Seo, Yoshiteru

1988-02-01

Phosphorus nuclear magnetic resonance (/sup 31/P-NMR) was applied to measure phosphorus metabolites in the pancreas. Rat pancreatic gland was isolated and perfused with a modified Krebs-Henseleit solution at room temperature (25 deg C). Removal of the duodenum from the pancreas made it possible to record /sup 31/P-NMR spectra only from the pancreatic tissue. /sup 31/P signals of creatine phosphate (PCr), ATP and inorganic phosphate (Pi) were observed in all the glands. In different individual glands, the Signal intensity of PCr varied, but those of ATP were almost the same. The initial levels of all the phosphorus metabolites in individual glands remained almost unchanged during perfusion with the standard solution for 2 hours. When the perfusion was stopped, signal intensity of ATP and PCr decreased while Pi resonance increased and shifted to a higher magnetic field, indicating tissue acidification. On re-perfusion, each resonance and tissue pH were restored to the respective initial resting levels. Continuous stimulation with 0.3 ..mu..M acetylcholine (ACh) or 0.1 nM CCK-8 caused a markedly larger increase in pancreatic exocrine secretion than that observed in the perfused pancreas which was prepared by the previous method. Continuous stimulation with 0.1 ..mu..M ACh caused a marked and sustained increase in pancreatic exocrine secretion. During the stimulation, the resonances of phosphorus energy metabolites and tissue pH remained almost unchanged. These results indicate that the isolated perfused rat pancreas which is prepared by our new method is a useful preparation for analysis of secretion-metabolism coupling in the exocrine pancreas.

Whole-brain dynamic CT angiography and perfusion imaging

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

2011-06-15

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

Major amputation for intractable extremity melanoma after failure of isolated limb perfusion

NARCIS (Netherlands)

Kapma, M. R.; Vrouenraets, B. C.; Nieweg, O. E.; van Geel, A. N.; Noorda, E. M.; Eggermont, A. M. M.; Kroon, B. B. R.

2005-01-01

AIM: The aim of this study was to analyse indications and results of amputation for intractable extremity melanoma after failure of isolated limb perfusion (ILP). METHODS: Between 1978 and 2001, 451 patients with loco-regional advanced extremity melanoma underwent 505 ILPs. Amputation of the

Effect of Citrus paradisi extract and juice on arterial pressure both in vitro and in vivo.

Science.gov (United States)

Díaz-Juárez, J A; Tenorio-López, F A; Zarco-Olvera, G; Valle-Mondragón, L Del; Torres-Narváez, J C; Pastelín-Hernández, G

2009-07-01

Citrus paradisi (grapefruit) consumption is considered as beneficial and it is popularly used for the treatment of a vast array of diseases, including hypertension. In the present study, the coronary vasodilator and hypotensive effects of Citrus paradisi peel extract were assessed in the Langendorff isolated and perfused heart model and in the heart and lung dog preparation. In both models, Citrus paradisi peel extract decreased coronary vascular resistance and mean arterial pressure when compared with control values (60 +/- 15 x 10(7) dyn s cm(-5) vs 100 +/- 10 x 10(7) dyn s cm(-5) and 90 mmHg vs 130 +/- 15 mmHg, respectively). These decreases in coronary vascular resistance and mean arterial pressure were blocked when isolated and perfused hearts and mongrel dogs were pre-treated with L-NAME. In humans, Citrus paradisi juice decreased diastolic arterial pressure and systolic arterial pressure both in normotensive and hypertensive subjects. Citrus paradisi juice produced a greater decrease in mean arterial pressure when compared with Citrus sinensis juice, cow milk and a vitamin C-supplemented beverage. However, more detailed studies are required to isolate, purify and evaluate the chemical compounds responsible for this pharmacological effect and to clarify its possible role for treating hypertension. Copyright 2009 John Wiley & Sons, Ltd.

Calcium-sensitivity of smooth muscle contraction in the isolated ...

African Journals Online (AJOL)

sensitivity of smooth muscle contraction were studied in the isolated perfused rat tail artery, employing the activators noradrenaline (NA) (3ìM) sand potassium chloride (KC1) (100mM). Experiments were conduced in Ca2+ - buffered saline.

Selective Heart, Brain and Body Perfusion in Open Aortic Arch Replacement.

Science.gov (United States)

Maier, Sven; Kari, Fabian; Rylski, Bartosz; Siepe, Matthias; Benk, Christoph; Beyersdorf, Friedhelm

2016-09-01

Open aortic arch replacement is a complex and challenging procedure, especially in post dissection aneurysms and in redo procedures after previous surgery of the ascending aorta or aortic root. We report our experience with the simultaneous selective perfusion of heart, brain, and remaining body to ensure optimal perfusion and to minimize perfusion-related risks during these procedures. We used a specially configured heart-lung machine with a centrifugal pump as arterial pump and an additional roller pump for the selective cerebral perfusion. Initial arterial cannulation is achieved via femoral artery or right axillary artery. After lower body circulatory arrest and selective antegrade cerebral perfusion for the distal arch anastomosis, we started selective lower body perfusion simultaneously to the selective antegrade cerebral perfusion and heart perfusion. Eighteen patients were successfully treated with this perfusion strategy from October 2012 to November 2015. No complications related to the heart-lung machine and the cannulation occurred during the procedures. Mean cardiopulmonary bypass time was 239 ± 33 minutes, the simultaneous selective perfusion of brain, heart, and remaining body lasted 55 ± 23 minutes. One patient suffered temporary neurological deficit that resolved completely during intensive care unit stay. No patient experienced a permanent neurological deficit or end-organ dysfunction. These high-risk procedures require a concept with a special setup of the heart-lung machine. Our perfusion strategy for aortic arch replacement ensures a selective perfusion of heart, brain, and lower body during this complex procedure and we observed excellent outcomes in this small series. This perfusion strategy is also applicable for redo procedures.

Myocardial perfusion imaging with dual energy CT

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Jin, Kwang Nam [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, SMG-SNU Boramae Medical Center, Seoul (Korea, Republic of); De Cecco, Carlo N. [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Caruso, Damiano [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiological Sciences, Oncology and Pathology, University of Rome “Sapienza”, Rome (Italy); Tesche, Christian [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Center Munich-Bogenhausen, Munich (Germany); Spandorfer, Adam; Varga-Szemes, Akos [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Division of Cardiovascular Imaging, Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Division of Cardiology, Department of Medicine, Medical University of South Carolina, Charleston, SC (United States)

2016-10-15

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

A two-stage model for in vivo assessment of brain tumor perfusion and abnormal vascular structure using arterial spin labeling.

Directory of Open Access Journals (Sweden)

Patrick W Hales

Full Text Available The ability to assess brain tumor perfusion and abnormalities in the vascular structure in vivo could provide significant benefits in terms of lesion diagnosis and assessment of treatment response. Arterial spin labeling (ASL has emerged as an increasingly viable methodology for non-invasive assessment of perfusion. Although kinetic models have been developed to describe perfusion in healthy tissue, the dynamic behaviour of the ASL signal in the brain tumor environment has not been extensively studied. We show here that dynamic ASL data acquired in brain tumors displays an increased level of 'biphasic' behaviour, compared to that seen in healthy tissue. A new two-stage model is presented which more accurately describes this behaviour, and provides measurements of perfusion, pre-capillary blood volume fraction and transit time, and capillary bolus arrival time. These biomarkers offer a novel contrast in the tumor and surrounding tissue, and provide a means for measuring tumor perfusion and vascular structural abnormalities in a fully non-invasive manner.

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-04-15

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

Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

Energy Technology Data Exchange (ETDEWEB)

Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Monbaron, David; Ruiz, Juan [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland); Koehli, Melanie [Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Nuclear Medicine, Lausanne (Switzerland); Centre Hospitalier Universitaire Vaudois (CHUV University Hospital), Division of Endocrinology, Diabetology and Metabolism, Lausanne (Switzerland)

2005-01-01

Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, {sup 99m}Tc-sestamibi, {sup 201}Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS{>=}4) was observed in 49 (37%) patients (SSS=4.9{+-}8.4, SDS=2.4{+-}4.7), reversible perfusion defects (SDS{>=}2) in 40 (30%) patients [SSS=13.3{+-}10.9; SDS=8.0{+-}5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9{+-}11.3; SDS=7.4{+-}1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify

Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

International Nuclear Information System (INIS)

Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae

2005-01-01

Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 ± 8.5%, range:3 ∼ 35%) and mild to moderate severity (-71 ± 42.7%, range:-217 ∼ -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome

Abnormal perfusion on myocardial perfusion SPECT in patients with Wolff-Parkinson-White syndrome

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Kang, Do Young; Cha, Kwang Soo; Han, Seung Ho; Park, Tae Ho; Kim, Moo Hyun; Kim, Young Dae [Donga University College of Medicine, Busan (Korea, Republic of)

2005-02-15

Abnormal myocardial perfusion may be caused by ventricular preexcitation, but its location, extent, severity and correlation with accessory pathway (AP) are not established. We evaluated perfusion patterns on myocardial perfusion SPECT and location of AP in patients with WPW (Wolff-Parkison-White) syndrome. Adenosine Tc-99m MIBI or Tl-201 myocardial perfusion SPECT was performed in 11 patients with WPW syndrome. Perfusion defects (PD) were compared to AP location based on ECT with Fitzpatrick's algorithm of electrophysiologic study and radiofrequency catheter ablation. Patients had atypical chest discomfort or no symptom. Risk of coronary artery disease (CAD) was below 0.1 in 11 patients using the nomogram to estimate the probability of CAD. Coronary angiography was performed in 4 patients(mid-LAD 50% in one, normal in others). In 4 patients, AP localization was done by electrophysiologic study and radiofrequency catheter ablation (RFCA). Small to large extent (11.0 {+-} 8.5%, range:3 {approx} 35%) and mild to moderate severity (-71 {+-} 42.7%, range:-217 {approx} -39%) of reversible (n=9) or fixed (n=1) perfusion defects were noted. One patients with right free wall (right lateral) AP showed normal. PD locations were variable following the location of AP. One patient with left lateral wall AP was followed 6 weeks after RFCA and showed significantly decreased PD on SPECT with successful ablation. Myocardial perfusion defect showed variable extent, severity and location in patients with WPW syndrome. Abnormal perfusion defect showed in most of all patients, but if did not seem to be correlated specifically with location of accessory pathway and coronary artery disease. Therefore myocardial perfusion SPECT should be interpreted carefully in patients with WPW syndrome.

Uptake, incorporation and metabolism of (3H)triolein in the isolated perfused rabbit heart

International Nuclear Information System (INIS)

Weis, M.T.; Palazzo, A.J.; Williams, J.L. Jr.; Malik, K.U.

1990-01-01

The purpose of these experiments was to study the uptake and metabolism of exogenous triglyceride in the isolated perfused rabbit heart. When infused into the rabbit heart, [9,10-3H(N)]triolein was retained and incorporated into a lipid fraction that had the chromatographic mobility of authentic triolein. Incorporation of labeled triolein was not likely to be the result of a lipoprotein lipase-mediated lipolysis/resynthesis cycle, since: (i) The distribution of radioactivity following administration of [3H]oleic acid was markedly different from the distribution of radioactivity following the administration of [3H]triolein; (ii) heparin was administered to the rabbits at the time of sacrifice; and (iii) the hearts were perfused with a protein-free buffer for 20 min prior to the labelling period. When isoproterenol was administered to hearts labelled with [3H]triolein, there was an increased output of total radioactivity, composed of labelled free fatty acids, diacylglycerol and monoacylglycerol. In these same hearts, there was an increased output of glycerol in response to isoproterenol. However, following the administration of bradykinin or angiotensin II, neither the radioactivity nor the glycerol content of the perfusate was changed. These data suggest that [3H]triolein is selectively incorporated into the triglyceride pool of the isolated perfused rabbit heart. Furthermore, this [3H]triolein is available to hormonally-activated lipolytic enzymes

[Dynamics of the amino acid composition of the medium during cultivation of isolated organs by the directed perfusion method].

Science.gov (United States)

Barashkov, V A; Gitel'zon, I I; Nefedov, V P; Trubachev, I N

1975-07-01

The dynamics of the amino acid composition of the medium under conditions of adequate perfusion of the isolated organs of a dog (sternum, kidney and liver) was studied. It was found that after a 6-hour perfusion of the complex of organs the amount in the perfusion medium of such amino acids as histidine, lysine, alanine, considerably increased, whereas the amount of arginine, serine, aspartic acid, threonine with glutamine, isoleucine, proline, leucine and valine decreased as compared with their initial concentration. The dynamics of the amino acid medium composition during a 4-hour perfusion was studied in experiments with the isolated sternum. The concentration of alanine, lysine and histidine increased in the medium. At the same time there was seen a decrease in the concentration of serine, aspartic acid, isoleucine, tyrosine and phenyl-alanine.

Radiation exposure to surgical staff during hyperthermic isolated limb perfusion with 99m Technetium labeled red blood cells

DEFF Research Database (Denmark)

Kristoffersen, Ulrik Sloth; Straalman, Kristina; Schmidt, Grethe

2009-01-01

PURPOSE: Hyperthermic isolated limb perfusion (HILP) is an effective method in the treatment of recurrent melanomas and soft tissue sarcomas. To avoid systemic toxicity, leakage from the limb perfusate into the systemic circulation is real-time monitored by administration of a radioactive agent...

Assessment of foot perfusion in patients with a diabetic foot ulcer.

Science.gov (United States)

Forsythe, Rachael O; Hinchliffe, Robert J

2016-01-01

Assessment of foot perfusion is a vital step in the management of patients with diabetic foot ulceration, in order to understand the risk of amputation and likelihood of wound healing. Underlying peripheral artery disease is a common finding in patients with foot ulceration and is associated with poor outcomes. Assessment of foot perfusion should therefore focus on identifying the presence of peripheral artery disease and to subsequently estimate the effect this may have on wound healing. Assessment of perfusion can be difficult because of the often complex, diffuse and distal nature of peripheral artery disease in patients with diabetes, as well as poor collateralisation and heavy vascular calcification. Conventional methods of assessing tissue perfusion in the peripheral circulation may be unreliable in patients with diabetes, and it may therefore be difficult to determine the extent to which poor perfusion contributes to foot ulceration. Anatomical data obtained on cross-sectional imaging is important but must be combined with measurements of tissue perfusion (such as transcutaneous oxygen tension) in order to understand the global and regional perfusion deficit present in a patient with diabetic foot ulceration. Ankle-brachial pressure index is routinely used to screen for peripheral artery disease, but its use in patients with diabetes is limited in the presence of neuropathy and medial arterial calcification. Toe pressure index may be more useful because of the relative sparing of pedal arteries from medial calcification but may not always be possible in patients with ulceration. Fluorescence angiography is a non-invasive technique that can provide rapid quantitative information about regional tissue perfusion; capillaroscopy, iontophoresis and hyperspectral imaging may also be useful in assessing physiological perfusion but are not widely available. There may be a future role for specialized perfusion imaging of these patients, including magnetic resonance

Single Coronary Artery with Aortic Regurgitation

International Nuclear Information System (INIS)

Katsetos, Manny C.; Toce, Dale T.

2003-01-01

An isolated single coronary artery can be associated with normal life expectancy; however, patients are at an increased risk of sudden death. A case is reported of a 54-year-old man with several months of chest pressure with activity. On exercise Sestamibi stress testing, the patient developed a hypotensive response with no symptoms and minimal electrocardiographic changes. Nuclear scanning demonstrated reversible septal and lateral perfusion defects consistent with severe ischemia. Coronary angiography revealed a single coronary artery with the right coronary artery arising from the left main. There were high-grade stenotic lesions in the left anterior descending and circumflex arteries with only moderate atherosclerotic disease in the right coronary artery. An aortogram showed 2-3+ aortic regurgitation, with an ejection fraction of 45% on ventriculography. The patient underwent four-vessel revascularization and aortic valve replacement and did well postoperatively

Simultaneous determination of left ventricular perfusion and function

International Nuclear Information System (INIS)

Gremillet, E.; Champailler, A.; Esquerre, J.P.; Ouhayoun, E.; Coca, F.; Furber, A.; Le Jeune, J.J.

1997-01-01

Myocardial perfusion scintigraphy is a very useful tool for the diagnosis and prognosis of coronary artery disease. The evaluation of left ventricular function during stress testing in also very useful to determine the prognosis of coronary artery disease. This chapter highlights three different imaging methods to assess left ventricular function and myocardial perfusion/ The first one consists of sequential dual isotope myocardial SPECT with ECG-gating. The second concerns magnetic resonance imaging and the third explores first pass exercise ventriculography and myocardial perfusion scintigraphy simultaneously evaluated by means of 99m Tc-sestamibi. (authors)

Reproducibility of Dynamic Computed Tomography Brain Perfusion Measurements in Patients with Significant Carotid Artery Stenosis

International Nuclear Information System (INIS)

Serafin, Z.; Kotarski, M.; Karolkiewicz, M.; Mindykowski, R.; Lasek, W.; Molski, S.; Gajdzinska, M.; Nowak-Nowacka, A.

2009-01-01

Background: Perfusion computed tomography (PCT) determination is a minimally invasive and widely available technique for brain blood flow assessment, but its application may be restricted by large variation of results. Purpose: To determine the intraobserver, interobserver, and inter examination variability of brain PCT absolute measurements in patients with significant carotid artery stenosis (CAS), and to evaluate the effect of the use of relative perfusion values on PCT reproducibility. Material and Methods: PCT imaging was completed in 61 patients before endarterectomy, and in 38 of these within 4 weeks after treatment. Cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and peak enhancement intensity (PEI) were calculated with the maximum slope method. Inter examination variability was evaluated based on perfusion of hemisphere contralateral to the treated CAS, from repeated examinations. Interobserver and intraobserver variability were established for the untreated side, based on pretreatment examination. Results: Interobserver and intraobserver variability were highest for CBF measurement (28.8% and 32.5%, respectively), and inter examination variability was the highest for CBV (24.1%). Intraobserver and interobserver variability were higher for absolute perfusion values compared with their respective ratios for CBF and TTP. The only statistically significant difference between perfusion values measured by two observers was for CBF (mean 78.3 vs. 67.5 ml/100 g/min). The inter examination variability of TTP (12.1%) was significantly lower than the variability of other absolute perfusion measures, and the inter examination variability of ratios was significantly lower than absolute values for all the parameters. Conclusion: In longitudinal studies of patients with chronic cerebral ischemia, PCT ratios and either TTP or CBV are more suitable measures than absolute CBF values, because of their considerably lower inter- and intraobserver

Reproducibility of Dynamic Computed Tomography Brain Perfusion Measurements in Patients with Significant Carotid Artery Stenosis

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Serafin, Z.; Kotarski, M.; Karolkiewicz, M.; Mindykowski, R.; Lasek, W.; Molski, S.; Gajdzinska, M.; Nowak-Nowacka, A. (Dept. of Radiology and Diagnostic Imaging, and Dept. of General and Vascular Surgery, Nicolaus Copernicus Univ., Collegium Medicum, Bydgoszcz (Poland))

2009-02-15

Background: Perfusion computed tomography (PCT) determination is a minimally invasive and widely available technique for brain blood flow assessment, but its application may be restricted by large variation of results. Purpose: To determine the intraobserver, interobserver, and inter examination variability of brain PCT absolute measurements in patients with significant carotid artery stenosis (CAS), and to evaluate the effect of the use of relative perfusion values on PCT reproducibility. Material and Methods: PCT imaging was completed in 61 patients before endarterectomy, and in 38 of these within 4 weeks after treatment. Cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), and peak enhancement intensity (PEI) were calculated with the maximum slope method. Inter examination variability was evaluated based on perfusion of hemisphere contralateral to the treated CAS, from repeated examinations. Interobserver and intraobserver variability were established for the untreated side, based on pretreatment examination. Results: Interobserver and intraobserver variability were highest for CBF measurement (28.8% and 32.5%, respectively), and inter examination variability was the highest for CBV (24.1%). Intraobserver and interobserver variability were higher for absolute perfusion values compared with their respective ratios for CBF and TTP. The only statistically significant difference between perfusion values measured by two observers was for CBF (mean 78.3 vs. 67.5 ml/100 g/min). The inter examination variability of TTP (12.1%) was significantly lower than the variability of other absolute perfusion measures, and the inter examination variability of ratios was significantly lower than absolute values for all the parameters. Conclusion: In longitudinal studies of patients with chronic cerebral ischemia, PCT ratios and either TTP or CBV are more suitable measures than absolute CBF values, because of their considerably lower inter- and intraobserver

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

International Nuclear Information System (INIS)

Krix, Martin; Krakowski-Roosen, Holger; Armarteifio, Erick; Fuerstenberger, Susanne; Delorme, Stefan; Kauczor, Hans-Ulrich; Weber, Marc-Andre

2011-01-01

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

Enhanced magnetic resonance pulmonary perfusion imaging in diagnosing pulmonary embolism: preliminary investigation

International Nuclear Information System (INIS)

Huang Xiaoyong; Du Jing; Zhang Zhaoqi; Guo Xi; Yan Zixu; Jiang Hong; Wang Wei

2005-01-01

Objective: This study was designed to investigate the sensitivity and specificity of magnetic resonance pulmonary perfusion imaging (MRPP) in diagnosing pulmonary embolism (PE) compared with enhanced magnetic resonance pulmonary angiography (MRPA) and pulmonary radionuclide perfusion imaging. Methods: Fourteen patients were definitely diagnosed as PE, whose ages were from 19 to 71 years old and mean 45.5 ± 19.8 years old. All patients under went MRPA and MRPP and 3 patients were examined again after thrombolytic treatment. Five patients underwent pulmonary radionuclide perfusion imaging. Setting ROI in top, middle, bottom of lung area and abnormal area respectively, we detected signal intensity and time-signal curve to obtain the transformation rate of signal (TROS) during perfusion peak value. Results: In 14 pulmonary embolism patients, MRPA found 62 branches of pulmonary artery obstruction. Fifty-five abnormal pulmonary perfusion zones were found by MRPP, and the above results were very alike. The coincidence was 88.71%. In 14 cases, MRPP could show 25 subsegments lesion below segments. In 5 patients who had both results Of MRPP and ECT at the same time. MRPP shows 33 perfusion defect zones and 37 segments were found by ECT, the sensitivity was 89.19%. After thrombolytic treatment, both the status of the affected pulmonary artery improved markedly and perfusion defect zones reduced obviously in 3 cases by MRPP and MRPA. TROS in normal perfusion zones perfusion defect zones and low perfusion zones had significant difference (t=22.882, P<0.01). Conclusion: Contrast enhanced MR pulmonary perfusion can show both perfusion defect zones and low perfusion zones in pulmonary embolism. Time-signal curve can show the period of maximum no perfusion zones in pulmonary artery embolism zones. And the amplitude of fluctuation is small with miminum TROS. MRPP has significant values especially in showing pulmonary artery embolism in segments and subsegments. Using both MRPP and

Differential uptake of FDG and DG during post-ischaemic reperfusion in the isolated, perfused rat heart

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Garlick, P.B.; Medina, R.A.; Southworth, R.; Marsden, P.K. [Department of Radiological Sciences, Guy' s, King' s and St. Thomas' School of Medicine, London (United Kingdom)

1999-10-01

Fluorine-18 2-fluoro-2-deoxyglucose (FDG) and 2-deoxyglucose (DG) are widely used as tracers of glucose uptake in the myocardium. Although there is agreement that the two analogues behave similarly to glucose under control conditions, there is growing evidence that some interventions (e.g. insulin stimulation or ischaemia/reperfusion) cause differential changes in their behaviour. The addition of a two-surface coil nuclear magnetic resonance (NMR) probe and a dual-perfusion cannula to our recently developed PET and NMR dual-acquisition (PANDA) system allows us to collect PET (FDG) images and phosphorus-31 NMR (2-deoxyglucose-6-phosphate) spectra simultaneously from each independently perfused coronary bed of the heart. We have used this technique to study the effect of regional ischaemia/reperfusion on FDG and DG uptake in the isolated, perfused rat heart. During control perfusion, FDG uptake was almost identical in both coronary beds. When one coronary bed was made ischaemic, FDG uptake ceased on that side but continued on the control side. Reperfusion failed to restore FDG uptake. In contrast, NMR spectra showed that, during reperfusion, the uptake and phosphorylation of DG did not differ between the two coronary beds. The results thus demonstrate that regional myocardial ischaemia/reperfusion has different effects on the uptake of FDG and DG in the isolated, perfused rat heart. (orig.)

Differential uptake of FDG and DG during post-ischaemic reperfusion in the isolated, perfused rat heart

International Nuclear Information System (INIS)

Garlick, P.B.; Medina, R.A.; Southworth, R.; Marsden, P.K.

1999-01-01

Fluorine-18 2-fluoro-2-deoxyglucose (FDG) and 2-deoxyglucose (DG) are widely used as tracers of glucose uptake in the myocardium. Although there is agreement that the two analogues behave similarly to glucose under control conditions, there is growing evidence that some interventions (e.g. insulin stimulation or ischaemia/reperfusion) cause differential changes in their behaviour. The addition of a two-surface coil nuclear magnetic resonance (NMR) probe and a dual-perfusion cannula to our recently developed PET and NMR dual-acquisition (PANDA) system allows us to collect PET (FDG) images and phosphorus-31 NMR (2-deoxyglucose-6-phosphate) spectra simultaneously from each independently perfused coronary bed of the heart. We have used this technique to study the effect of regional ischaemia/reperfusion on FDG and DG uptake in the isolated, perfused rat heart. During control perfusion, FDG uptake was almost identical in both coronary beds. When one coronary bed was made ischaemic, FDG uptake ceased on that side but continued on the control side. Reperfusion failed to restore FDG uptake. In contrast, NMR spectra showed that, during reperfusion, the uptake and phosphorylation of DG did not differ between the two coronary beds. The results thus demonstrate that regional myocardial ischaemia/reperfusion has different effects on the uptake of FDG and DG in the isolated, perfused rat heart. (orig.)

Simultaneous assessment of myocardial perfusion and function during mental stress in patients with chronic coronary artery disease.

Science.gov (United States)

Arrighi, James A; Burg, Matthew; Cohen, Ira S; Soufer, Robert

2003-01-01

Mental stress (MS) is an important provocateur of myocardial ischemia in many patients with chronic coronary artery disease. The majority of laboratory assessments of ischemia in response to MS have included measurements of either myocardial perfusion or function alone. We performed this study to determine the relationship between alterations in perfusion and ventricular function during MS. Methods and results Twenty-eight patients with reversible perfusion defects on exercise or pharmacologic stress myocardial perfusion imaging (MPI) underwent simultaneous technetium 99m sestamibi single photon emission computed tomography (SPECT) MPI and transthoracic echocardiography at rest and during MS according to a mental arithmetic protocol. In all cases the MS study was performed within 4 weeks of the initial exercise or pharmacologic MPI that demonstrated ischemia. SPECT studies were analyzed visually with the use of a 13-segment model and quantitatively by semiautomated circumferential profile analysis. Echocardiograms were graded on a segmental model for regional wall motion on a 4-point scale. Of 28 patients, 18 (64%) had perfusion defects and/or left ventricular dysfunction develop during MS: 9 (32%) had myocardial perfusion defects develop, 6 (21%) had regional or global left ventricular dysfunction develop, and 3 (11%) had both perfusion defects and left ventricular dysfunction develop. The overall concordance between perfusion and function criteria for ischemia during MS was only 46%. Among 9 patients with MS-induced left ventricular dysfunction, 5 had new regional wall motion abnormalities and 4 had a global decrement in function. In patients with MS-induced ischemia by SPECT, the number of reversible perfusion defects was similar during both MS and exercise/pharmacologic stress (2.8 +/- 2.0 vs 3.5 +/- 1.8, P =.41). Hemodynamic changes during MS were similar whether patients were divided on the basis of perfusion defects or left ventricular dysfunction during MS

Myocardial perfusion after prolonged submaximal exercise in patients with coronary artery disease

International Nuclear Information System (INIS)

Flotats, A.; Mena, E.; Camacho, V.; Tembl, A.; Hernandez, M.A.; Estorch, M.; Carrio, I.; Serra-Grima, R.

2002-01-01

Aim: Exercise training in patients with coronary artery disease (CAD) has established benefits. We assessed myocardial perfusion after submaximal but prolonged exercise in patients with CAD, who were enrolled in supervised exercise rehabilitation programs. Material and Methods: Nine patients with CAD enrolled in supervised exercise rehabilitation programs (7 men, 2 women; mean age 54±9 years), 7 with prior AMI and 2 with re-vascularized (CABG) multiple vessel disease, were encouraged to walk/run actively around the perimeter of our Hospital during the annual social sporting event organised in our Institution. Patients were studied by means of perfusion Tc-99m tetrofosmin SPECT imaging after prolonged exercise and at rest (gated SPECT), for two consecutive years. All patients remained symptom free during this interval period. Quantitative analysis was performed dividing polar map images in 13 segments. Tracer activity 9% in the resting image. The analysis was focused on those segments showing perfusion defects. Results: No symptoms other than fatigue were registered during prolonged exercise (range 1-2 hr). There were no significant differences in distance covered (7,462±3,031 m vs. 8,456±2,998 m), heart rate (92±11 bpm vs. 85±13 bpm) and rate-pressure product at the end of exercise (10,804±2,467 vs. 10,403±2,955) or gated SPECT calculated LVEF (44%±19 vs. 46%±20) between the two consecutive annual sporting events. Tracer activity in segments with perfusion defects did not significantly differ between both events. Overall agreement between both examinations regarding patient classification as having scar/ischemia was 77% (kappa=0.49). There was one patient who showed partial reversibility in three segments, consistent with mild anteroapical ischemia, only in the first examination. On the other hand, another patient showed reversibility in one segment (medium septum), only in the second examination, when he covered a distance 1.3 times superior. Conclusions

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

Science.gov (United States)

Li, Xiufeng; Sarkar, Subhendra N.; Purdy, David E.; Briggs, Richard W.

2014-01-01

To facilitate quantification of cerebellum cerebral blood flow (CBF), studies were performed to systematically optimize arterial spin labeling (ASL) parameters for measuring cerebellum perfusion, segment cerebellum to obtain separate CBF values for grey matter (GM) and white matter (WM), and compare FAIR ASST to PICORE. Cerebellum GM and WM CBF were measured with optimized ASL parameters using FAIR ASST and PICORE in five subjects. Influence of volume averaging in voxels on cerebellar grey and white matter boundaries was minimized by high-probability threshold masks. Cerebellar CBF values determined by FAIR ASST were 43.8 ± 5.1 mL/100 g/min for GM and 27.6 ± 4.5 mL/100 g/min for WM. Quantitative perfusion studies indicated that CBF in cerebellum GM is 1.6 times greater than that in cerebellum WM. Compared to PICORE, FAIR ASST produced similar CBF estimations but less subtraction error and lower temporal, spatial, and intersubject variability. These are important advantages for detecting group and/or condition differences in CBF values. PMID:24949416

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

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Xiufeng Li

2014-01-01

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

Quantifying cerebellum grey matter and white matter perfusion using pulsed arterial spin labeling.

Science.gov (United States)

Li, Xiufeng; Sarkar, Subhendra N; Purdy, David E; Briggs, Richard W

2014-01-01

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

MDMA ‘ecstasy’ increases cerebral cortical perfusion determined by bolus-tracking arterial spin labelling (btASL) MRI

Science.gov (United States)

Rouine, J; Gobbo, O L; Campbell, M; Gigliucci, V; Ogden, I; McHugh Smith, K; Duffy, P; Behan, B; Byrne, D; Kelly, M E; Blau, C W; Kerskens, C M; Harkin, A

2013-01-01

Background and Purpose The purpose of this study was to assess cerebral perfusion changes following systemic administration of the recreational drug 3,4-methylendioxymethamphetamine (MDMA ‘ecstasy’) to rats. Experimental Approach Cerebral perfusion was quantified using bolus-tracking arterial spin labelling (btASL) MRI. Rats received MDMA (20 mg·kg−1; i.p.) and were assessed 1, 3 or 24 h later. Rats received MDMA (5 or 20 mg·kg−1; i.p.) and were assessed 3 h later. In addition, rats received MDMA (5 or 10 mg·kg−1; i.p.) or saline four times daily over 2 consecutive days and were assessed 8 weeks later. Perfusion-weighted images were generated in a 7 tesla (7T) MRI scanner and experimental data was fitted to a quantitative model of cerebral perfusion to generate mean transit time (MTT), capillary transit time (CTT) and signal amplitude. Key Results MDMA reduces MTT and CTT and increases amplitude in somatosensory and motor cortex 1 and 3 h following administration, indicative of an increase in perfusion. Prior exposure to MDMA provoked a long-term reduction in cortical 5-HT concentration, but did not produce a sustained effect on cerebral cortical perfusion. The response to acute MDMA challenge (20 mg·kg−1; i.p.) was attenuated in these animals indicating adaptation in response to prior MDMA exposure. Conclusions and Implications MDMA provokes changes in cortical perfusion, which are quantifiable by btASL MRI, a neuroimaging tool with translational potential. Future studies are directed towards elucidation of the mechanisms involved and correlating changes in cerebrovascular function with potential behavioural deficits associated with drug use. PMID:23517012

Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

International Nuclear Information System (INIS)

Bair, H.J.; Platsch, G.; Wolf, F.; Guenter, E.; Becker, D.; Rupprecht, H.; Neumayer, H.H.

1997-01-01

Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [de

Magnetic resonance myocardial perfusion imaging-First experience at 3.0 T

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

2009-01-15

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

Carbon Dioxide Flush of an Integrated Minimized Perfusion Circuit Prior to Priming Prevents Spontaneous Air Release Into the Arterial Line During Clinical Use.

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Stehouwer, Marco C; de Vroege, Roel; Hoohenkerk, Gerard J F; Hofman, Frederik N; Kelder, Johannes C; Buchner, Bas; de Mol, Bastian A; Bruins, Peter

2017-11-01

Recently, an oxygenator with an integrated centrifugal blood pump (IP) was designed to minimize priming volume and to reduce blood foreign surface contact even further. The use of this oxygenator with or without integrated arterial filter was compared with a conventional oxygenator and nonintegrated centrifugal pump. To compare the air removal characteristics 60 patients undergoing coronary artery bypass grafting were alternately assigned into one of three groups to be perfused with a minimized extracorporeal circuit either with the conventional oxygenator, the oxygenator with IP, or the oxygenator with IP plus integrated arterial filter (IAF). Air entering and leaving the three devices was measured accurately with a bubble counter during cardiopulmonary bypass. No significant differences between all groups were detected, considering air entering the devices. Our major finding was that in both integrated devices groups incidental spontaneous release of air into the arterial line in approximately 40% of the patients was observed. Here, detectable bolus air (>500 µm) was shown in the arterial line, whereas in the minimal extracorporeal circulation circuit (MECC) group this phenomenon was not present. We decided to conduct an amendment of the initial design with METC-approval. Ten patients were assigned to be perfused with an oxygenator with IP and IAF. Importantly, the integrated perfusion systems used in these patients were flushed with carbon dioxide (CO 2 ) prior to priming of the systems. In the group with CO 2 flush no spontaneous air release was observed in all cases and this was significantly different from the initial study with the group with the integrated device and IAF. This suggests that air spilling may be caused by residual air in the integrated device. In conclusion, integration of a blood pump may cause spontaneous release of large air bubbles (>500 µm) into the arterial line, despite the presence of an integrated arterial filter. CO 2 flushing of

Isolation of the right subclavian artery in a patient with d-transposition of the great arteries.

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Arunamata, Alisa; Perry, Stanton B; Kipps, Alaina K; Vasanawala, Shreyas S; Axelrod, David M

2015-01-01

Isolation of the right subclavian artery (RSCA) is rare, and this finding in association with d-transposition of the great arteries (d-TGA) is extremely unusual. We present a case of an isolated RSCA in a newborn with d-TGA in whom the clinical presentation was diagnostic. We discuss the imaging modalities used to confirm the diagnosis, the embryological basis of the finding, and the surgical repair.

Prevalence of symptomatic and silent stress-induced perfusion defects in diabetic patients with suspected coronary artery disease referred for myocardial perfusion scintigraphy

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Prior, John O.; Calcagni, Maria-Lucia; Bischof Delaloye, Angelika; Monbaron, David; Ruiz, Juan; Koehli, Melanie

2005-01-01

Silent myocardial ischaemia - as evaluated by stress-induced perfusion defects on myocardial perfusion scintigraphy (MPS) in patients without a history of chest pain - is frequent in diabetes and is associated with increased rates of cardiovascular events. Its prevalence has been determined in asymptomatic diabetic patients, but remains largely unknown in diabetic patients with suspected coronary artery disease (CAD) in the clinical setting. In this study we therefore sought (a) to determine the prevalence of symptomatic and silent perfusion defects in diabetic patients with suspected CAD and (b) to characterise the eventual predictors of abnormal perfusion. The patient population comprised 133 consecutive diabetic patients with suspected CAD who had been referred for MPS. Studies were performed with exercise (41%) or pharmacological stress testing (1-day protocol, 99m Tc-sestamibi, 201 Tl or both). We used semi-quantitative analysis (20-segment polar maps) to derive the summed stress score (SSS) and the summed difference score (SDS). Abnormal MPS (SSS≥4) was observed in 49 (37%) patients (SSS=4.9±8.4, SDS=2.4±4.7), reversible perfusion defects (SDS≥2) in 40 (30%) patients [SSS=13.3±10.9; SDS=8.0±5.6; 20% moderate to severe (SDS>4), 7% multivessel] and fixed defects in 21 (16%) patients. Results were comparable between patients with and patients without a history of chest pain. Of 75 patients without a history of chest pain, 23 (31%, 95% CI=21-42%) presented reversible defects (SSS=13.9±11.3; SDS=7.4±1.2), indicative of silent ischaemia. Reversible defects were associated with inducible ST segment depression during MPS stress (odds ratio (OR)=3.2, p<0.01). Fixed defects were associated with erectile dysfunction in males (OR=3.7, p=0.02) and lower aspirin use (OR=0.25, p=0.02). Silent stress-induced perfusion defects occurred in 31% of the patients, a rate similar to that in patients with a history of chest pain. MPS could identify these patients with a

Evaluation of changes in the parameters of brain tissue perfusion in multi-slice computed tomography in patients after carotid artery stenting

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Szarmach, Arkadiusz; Halena, Grzegorz; Buczny, Jacek; Studniarek, Michał; Markiet, Karolina; Szurowska, Edyta; Retkowski, Mariusz; Piskunowicz, Maciej

BACKGROUND: CT perfusion of the brain allows functional evaluation of cerebral blood flow. Patients with chronic internal carotid artery (ICA) stenosis may suffer from malperfusion. Improvement of cerebral blood flow and remission of neurological symptoms indicate the effectiveness of treatment of

Isolation of the right subclavian artery in a patient with d-transposition of the great arteries

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Alisa Arunamata

2015-01-01

Full Text Available Isolation of the right subclavian artery (RSCA is rare, and this finding in association with d-transposition of the great arteries (d-TGA is extremely unusual. We present a case of an isolated RSCA in a newborn with d-TGA in whom the clinical presentation was diagnostic. We discuss the imaging modalities used to confirm the diagnosis, the embryological basis of the finding, and the surgical repair.

Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery

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Rajsrinivas Parthasarathy

2016-01-01

Full Text Available Embryonic carotid – basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA. The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo.

Initial intramuscular perfusion pressure predicts early skeletal muscle function following isolated tibial fractures

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Haas Norbert P

2008-04-01

Full Text Available Abstract Background The severity of associated soft tissue trauma in complex injuries of the extremities guides fracture treatment and decisively determines patient's prognosis. Trauma-induced microvascular dysfunction and increased tissue pressure is known to trigger secondary soft tissue damage and seems to adversely affect skeletal muscle function. Methods 20 patients with isolated tibial fractures were included. Blood pressure and compartment pressure (anterior and deep posterior compartment were measured continuously up to 24 hours. Corresponding perfusion pressure was calculated. After 4 and 12 weeks isokinetic muscle peak torque and mean power of the ankle joint in dorsal and plantar flexion were measured using a Biodex dynamometer. Results A significant inverse correlation between the anterior perfusion pressure at 24 hours and deficit in dorsiflexion at 4 weeks was found for both, the peak torque (R = -0.83; p Conclusion The functional relationship between the decrease in intramuscular perfusion pressures and muscle performance in the early rehabilitation period indicate a causative and prognostic role of early posttraumatic microcirculatory derangements and skeletal muscle function. Therapeutic concepts aimed at effective muscle recovery, early rehabilitation, and decreased secondary tissue damage, should consider the maintenance of an adequate intramuscular perfusion pressure.

A comparative study of 99Tcm-MIBI exercise myocardial perfusion imaging and the coronary arteriography in the diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Huang Xiaohong; Yan Aiping; Li Yuren; Hou Zhenwen; Jiang Ningyi; Lu Xianping

2003-01-01

Objective: A comparative evaluation of 99 Tc m -MIBI exercise myocardial perfusion imaging (MPI) and coronary arteriography (CAG) in diagnosis of coronary artery disease. Methods: MPI and CAG were performed on 92 patients with clinical equivocal diagnosis of coronary artery disease. The results were comparatively studied. Results: The sensitivity and specificity of MPI were 83.9% and 69.1%. Both modalities matched in 78.3% cases. Conclusion: MPI offers useful information for the diagnosis of coronary artery disease. And patients with a normal MPI don't need a further coronary angiography

Toxicity and Kinetics of (3H)Microcystin-LR in Isolated Perfused Rat Livers

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1990-03-20

with a Waters 490 multiwavelength detector, as described by Robinson et al. (1989). A C-18 column (Adsorbosphere HS, 4.6 x 250 mm, 5 Am, Alltech ...1988). The isolated perfused liver has several advantages over other model systems for the study of hepatotoxins. Unlike the in-vitro cell systems

Monitoring system for isolated limb perfusion based on a portable gamma camera

International Nuclear Information System (INIS)

Orero, A.; Muxi, A.; Rubi, S.; Duch, J.; Vidal-Sicart, S.; Pons, F.; Roe, N.; Rull, R.; Pavon, N.; Pavia, J.

2009-01-01

Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-α) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-α and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is ±1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-α and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-α and melphalan has been indicated. (orig.)

Monitoring system for isolated limb perfusion based on a portable gamma camera

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Orero, A.; Muxi, A.; Rubi, S.; Duch, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Vidal-Sicart, S.; Pons, F. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); Red Tematica de Investigacion Cooperativa en Cancer (RTICC), Barcelona (Spain); Roe, N. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain); Rull, R. [Servei de Cirurgia, Hospital Clinic, Barcelona (Spain); Pavon, N. [Inst. de Fisica Corpuscular, CSIC - UV, Valencia (Spain); Pavia, J. [Servei de Medicina Nuclear, Hospital Clinic, Barcelona (Spain); Inst. d' Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona (Spain); CIBER de Bioingenieria, Biomateriales y Nanomedicina (CIBER-BBN), Barcelona (Spain)

2009-07-01

Background: The treatment of malignant melanoma or sarcomas on a limb using extremity perfusion with tumour necrosis factor (TNF-{alpha}) and melphalan can result in a high degree of systemic toxicity if there is any leakage from the isolated blood territory of the limb into the systemic vascular territory. Leakage is currently controlled by using radiotracers and heavy external probes in a procedure that requires continuous manual calculations. The aim of this work was to develop a light, easily transportable system to monitor limb perfusion leakage by controlling systemic blood pool radioactivity with a portable gamma camera adapted for intraoperative use as an external probe, and to initiate its application in the treatment of MM patients. Methods: A special collimator was built for maximal sensitivity. Software for acquisition and data processing in real time was developed. After testing the adequacy of the system, it was used to monitor limb perfusion leakage in 16 patients with malignant melanoma to be treated with perfusion of TNF-{alpha} and melphalan. Results: The field of view of the detector system was 13.8 cm, which is appropriate for the monitoring, since the area to be controlled was the precordial zone. The sensitivity of the system was 257 cps/MBq. When the percentage of leakage reaches 10% the associated absolute error is {+-}1%. After a mean follow-up period of 12 months, no patients have shown any significant or lasting side-effects. Partial or complete remission of lesions was seen in 9 out of 16 patients (56%) after HILP with TNF-{alpha} and melphalan. Conclusion: The detector system together with specially developed software provides a suitable automatic continuous monitoring system of any leakage that may occur during limb perfusion. This technique has been successfully implemented in patients for whom perfusion with TNF-{alpha} and melphalan has been indicated. (orig.)

Myocardial perfusion scintigraphy with technetium 99m-MIBI in the diagnosis of coronary artery disease in women

International Nuclear Information System (INIS)

Peix, C. Amalia; Chacon, Deylis; Llerena, Lorenzo; Torres, Maritza; Garcia, Ernesto Javier; Cabrera, Lazaro Omar

2006-01-01

The results of technetium 99 m - methoxy-isobutyl-isonitrile scintigraphy in a one-day protocol: rest - physical or combined stress bicycle plus endovenoous dipyridamole were compared with those of coronary angiography in 20 women referred for the evaluation of pre cordial pain and of the usefulness of myocardial perfusion scintigraphy. The uptake of the radio drug under stress and at rest varied from 93 + - 9 to 94 + - 7 % in the 204 segments with normal uptake under stress, from 67 He articulates it analyzes the reasons or utility of the employment of the radioactive iodine in the diagnosis and treatment of the thyroid affections + - 9 to 75 + - 17 % in the 89 with moderate reduction, and from 33 + - 9 to 64 + - 28 % in the 27 with severe reduction. The qualitative and quantitative uptake analyses coincided in 18 patients. The perfusion scintigraphy and the angiography agreed in 70 % of the patients. It was concluded that the myocardial perfusion scintigraphy with technetium 99 -MIBI contributes to the diagnosis of the coronary artery disease in women

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

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Miranda, Maria J; Olofsson, Kern; Sidaros, Karam

2006-09-01

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 neonates. Examinations were performed on unsedated infants at postmenstrual age of 39-40 wk in both groups. Due to motion, reliable data were obtained from 23 preterm and 6 term infants. Perfusion in the basal ganglia (39 and 30 mL/100 g/min for preterm and term neonates, respectively) was significantly higher (p neonates at term-equivalent age and in term neonates. Perfusion was significantly higher (p = 0.01) in the preterm group than in the term infants, indicating that RCP may be influenced by developmental and postnatal ages. This study demonstrates, for the first time, that noninvasive ASL at 3T may be used to measure RCP in healthy unsedated preterm and term neonates. ASL is, therefore, a viable tool that will allow serial studies of RCP in high-risk neonates.

The Impact of Carotid Artery Stenting on Cerebral Perfusion, Functional Connectivity, and Cognition in Severe Asymptomatic Carotid Stenosis Patients

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Tao Wang

2017-08-01

Full Text Available Background and purposeAsymptomatic carotid artery stenosis can lead to not only stroke but also cognition impairment. Although it has been proven that carotid artery stenting (CAS can reduce the risk of future strokes, the effect of CAS on cognition is conflicting. In recent years, pulsed arterial spin labeling (pASL MRI and resting-state functional MRI (R-fMRI have been employed in cognitive impairment studies. For the present study, cognition is evaluated in severe asymptomatic carotid artery stenosis patients undergoing CAS, and the mechanisms underlying the cognitive change are explored by pASL MRI and R-fMRI.Materials and methodsWe prospectively enrolled 24 asymptomatic, severe (≥70%, unilateral internal carotid artery stenosis patients, who were expecting the intervention of CAS. Cognition assessment (including the Montreal Cognitive Assessment Beijing Version, the Minimum Mental State Examination, the Digit Symbol Test, the Rey Auditory Verbal Learning Test, and the Verbal Memory Test and an integrated MRI program (pASL MRI, and R-fMRI were administered 7 days before and 3 months after CAS.Results16 subjects completed the follow-up study. After stenting, significant improvement in the scores of the MMSE, the Verbal Memory test, and the delayed recall was found. No significant difference was found in the scores of the Montreal Cognitive Assessment Beijing Version, the Digit Symbol Test, and the immediate recall. After CAS treatment, asymptomatic carotid artery stenosis patients showed increased perfusion in the left frontal gyrus, increased amplitude of low-frequency fluctuation (ALFF in the right precentral gyrus, and increased connectivity to the posterior cingulate cortex (PCC in the right supra frontal gyrus. However, no significant correlations were found between these imaging changes and cognition assessments.ConclusionSuccessful CAS can partly improve cognition in asymptomatic carotid artery stenosis patients. The cognition

Quantitative perfusion imaging in magnetic resonance imaging

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Zoellner, F.G.; Gaa, T.; Zimmer, F.; Ong, M.M.; Riffel, P.; Hausmann, D.; Schoenberg, S.O.; Weis, M.

2016-01-01

Magnetic resonance imaging (MRI) is recognized for its superior tissue contrast while being non-invasive and free of ionizing radiation. Due to the development of new scanner hardware and fast imaging techniques during the last decades, access to tissue and organ functions became possible. One of these functional imaging techniques is perfusion imaging with which tissue perfusion and capillary permeability can be determined from dynamic imaging data. Perfusion imaging by MRI can be performed by two approaches, arterial spin labeling (ASL) and dynamic contrast-enhanced (DCE) MRI. While the first method uses magnetically labelled water protons in arterial blood as an endogenous tracer, the latter involves the injection of a contrast agent, usually gadolinium (Gd), as a tracer for calculating hemodynamic parameters. Studies have demonstrated the potential of perfusion MRI for diagnostics and also for therapy monitoring. The utilization and application of perfusion MRI are still restricted to specialized centers, such as university hospitals. A broad application of the technique has not yet been implemented. The MRI perfusion technique is a valuable tool that might come broadly available after implementation of standards on European and international levels. Such efforts are being promoted by the respective professional bodies. (orig.) [de

Assessment of the brain areas perfused by superselective intra-arterial chemotherapy using single photon emission computed tomography with technetium-99m-hexamethyl-propyleneamine oxime. Technical note

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Namba, Hiroki; Iwadate, Yasuo; Saegusa, Takashi; Sueyoshi, Kanji [Chiba Cancer Center Hospital (Japan); Kobayashi, Shigeki; Sato, Akira; Watanabe, Yoshiro

1994-12-01

The brain areas perfused by superselective intra-arterial (i.a.) chemotherapy were assessed using single photon emission computed tomography (SPECT) with technetium-99m-hexamethyl-propyleneamine oxime ({sup 99m}Tc-HMPAO). A superselective catheter was introduced into the anterior, middle, or posterior cerebral artery of patients with malignant glioma for i.a. chemotherapy. {sup 99m}Tc-HMPAO was subsequently injected via the same catheter used for chemotherapy, and a higher dose of {sup 99m}Tc-HMPAO was injected intravenously to obtain adequate background brain images. Comparison of the SPECT images with magnetic resonance images could confirm complete perfusion of the tumor tissue. In two patients with malignant glioma, regions of interest were selected in the peritumoral brain area and a reference brain area, and the radioactivity was measured. The concentration of {sup 99m}Tc-HMPAO was about 50 times higher in tissue perfused by superselective injection into anterior or middle cerebral artery compared to intravenous injection. {sup 99m}Tc-HMPAO SPECT is readily available in many institutions and the information provided is useful for planning more effective and safe i.a. chemotherapy. (author).

NMR study of damage on isolated perfused rat heart exposed to ischemia and hypoxia

International Nuclear Information System (INIS)

Luo Xuechun; Yan Yongbin; Zhang Riqing; Fan Lili

2001-01-01

Myocardial ischemia is the most common and primary cause of myocardium damage. Numerous conventional techniques and methods have been developed for ischemia and reperfusion studies. However, because of damage to the heart sample, most of these techniques can not be used to continuously monitor the full dynamic course of the myocardial metabolic pathway. The nuclear magnetic resonance (NMR) surface coil technique, which overcomes the limitations of conventional instrumentation, can be used to quantitatively study every stage of the perfused heart (especially after perfusion stoppage) continuously, dynamically, and without damage under normal or designed physiological conditions at the molecular level. In this paper, 31 P-NMR was used to study the effects of ischemia and hypoxia on isolated perfused hearts. The results show that complete hypoxia caused more severe functional damage to the myocardial cells than complete ischemia

Hemodynamic study on liver cirrhosis: clinical application of CT perfusion imaging

International Nuclear Information System (INIS)

Jiang Li; Yang Jianyong; Xie Hongbo; Yang Xufeng; Yan Chaogui; Li Ziping; Zeng Fang

2004-01-01

Objective: To estimate hepatic perfusion parameters with helical CT, and to study the relationship between hepatic perfusion parameters and the severity of liver cirrhosis. Methods: Dynamic single-section computed tomography (CT) of the liver was performed in 40 participants, including 27 patients with liver cirrhosis and 13 patients without liver disease (control subjects). CT scans were obtained at a single level to include the liver, spleen, aorta, and portal vein. On each CT scan, the attenuation of these organs was measured in regions of interest to provide time-density curves. The arterial, portal venous, and total perfusion of the liver and the hepatic perfusion index were assessed. Results: In the control group, hepatic arterial perfusion, portal venous perfusion, and total hepatic perfusion were (0.2823 ± 0.0969) ml·min -1 ·ml -1 , (1.1788 ± 0.4004) ml·min -1 ·ml -1 , and (1.4563 ± 0.4439) ml·min -1 ·ml -1 , respectively. Hepatic perfusion index was (19.73 ±5.81)%. These hepatic perfusion parameters correlated significantly with the severity of liver cirrhosis. Hepatic arterial perfusion decreased in Child A and B cirrhotic patients [ (0.1685 ± 0.1068) ml·min -1 ·ml -1 and (0.1921 ± 0.0986) ml·min -1 ·ml -1 , respectively]. Comparing to Child A and B cirrhotic patients, hepatic arterial perfusion in Child C cirrhotic patients [(0.3072 · 0.1145) ml·min -1 ·ml -1 ] raised significantly. Portal venous perfusion decreased significantly in Child B and C cirrhotic patients [(0.6331±0.2070) ml·min -1 ·ml -1 and (0.5702 ± 0.3562) ml·min -1 ·ml -1 , respectively]. Total hepatic blood flow reduced markedly in Child B and C cirrhotic patients [(0.8252 ± 0.2952) ml·min -1 ·ml -1 and (0.8774 ± 0.4118) ml·min -1 ·ml -1 , respectively]. Hepatic perfusion index increased in Child C cirrhotic patients (37.48 ± 16.65)%. Conclusion: Dynamic single-section CT showed potential in quantifying hepatic perfusion parameters, and hepatic perfusion

Unsatisfactory hepatic perfusion after placement of the infusaid pump: Angiographic correlation

International Nuclear Information System (INIS)

Andrews, J.C.; Williams, D.M.; Cho, K.J.; Knol, J.A.; Wahl, R.L.; Ensminger, W.D.

1988-01-01

Complete perfusion limited to the liver is essential to the success of regional chemotherapy for hepatic malignancy. Thirty-three patients with unsatisfactory hepatic artery perfusion scintigrams after surgical placement of a pump and catheter system were evaluated with selective angiography (31 cases) or digital subtraction angiography (DSA) via the pump side port (six cases). The cause of the perfusion defect was hepatic artery thrombosis (14 cases), extrahepatic flow through collaterals (13 cases), misplaced catheter (three cases), short proper hepatic artery without adequate length for mixing (two cases), and undefined (one case). DSA findings were diagnostic in only two cases. Angiographic findings directed attempted correction in 22 of 33 cases

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

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

2010-09-15

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

Computed Tomography Perfusion of the liver: Assessment of Pure Portal Blood Flow Studied with CT Perfusion During Superior Mesenteric Arterial Portography

International Nuclear Information System (INIS)

Kojima, H.; Tanigawa, N.; Komemushi, A.; Kariya, S.; Sawada, S.

2004-01-01

Purpose: To quantitatively assess the portal component of hepatic blood flow using computed tomography (CT) perfusion studies during superior mesenteric arterial portography. Material and Methods: Thirty-four patients with hepatocellular carcinoma and liver cirrhosis (LC) and 13 patients with liver metastasis without chronic liver disease were enrolled in this study. Ten milliliters of a non-ionic contrast medium (150 mgI) was injected at a rate of 5 ml/s via a catheter placed in the superior mesenteric artery. Single-slice cine CT images at the level of the main trunk or the right/left main trunk of the portal vein were acquired over 40 s. The deconvolution method was then used on these CT images to measure blood flow (BF), blood volume (BV), and mean transit time (MTT) in (a) liver parenchyma in patients with HCC and liver cirrhosis; (b) liver parenchyma in patients with liver metastasis without cirrhosis; (c) directly in the HCC; and (d) directly in one of the metastases. Results: In 34 LC patients (a), BF, BV, and MTT in the liver parenchyma were 44.7±24.5 ml/min/100 g, 3.9±2.4 ml/100 g, and 10.9±5.5 s, respectively. In 13 patients without cirrhosis (b), BF, BV, and MTT in the liver parenchyma were 89.6±52.0 ml/min/100 g, 6.3 ±3.2 ml/100 g, and 8.7±3.6 sec, respectively. A significant difference in BF and BV was seen in patients with liver cirrhosis compared to those without cirrhosis. BF, BV, and MTT measured directly in HCC (c) were 6.5±4.5 ml/min/100 g, 0.4±0.4 ml/100 g, and 3.0±3.1 sec respectively, and BF, BV, and MTT in liver metastases (d) were 19.3 ± 21.7 ml/min/100 g, 0.6±0.8 ml/100 g, and 1.8±1.6 s, respectively. Conclusion: CT perfusion studies during superior mesenteric arterial portography allow quantitative assessment of pure portal blood flow in the liver

Modification of sympathetic neuronal function in the rat tail artery by dietary lipid treatment

International Nuclear Information System (INIS)

Panek, R.L.; Dixon, W.R.; Rutledge, C.O.

1985-01-01

The effect of dietary lipid treatment on sympathetic neuronal function was examined in isolated perfused tail arteries of adult rats. The hypothesis that dietary manipulations alter the lipid environment of receptor proteins which may result in the perturbation of specific membrane-associated processes that regulate peripheral adrenergic neurotransmission in the vasculature was the basis for this investigation. In the present study, rats were fed semisynthetic diets enriched in either 16% coconut oil (saturated fat) or 16% sunflower oil (unsaturated fat). The field stimulation-evoked release of endogenous norepinephrine and total 3 H was decreased significantly in rats receiving the coconut oil diet when compared to either sunflower oil- or standard lab chow-fed rats. Norepinephrine content in artery segments from coconut oil-treated rats was significantly higher compared to either sunflower oil- or standard lab chow-fed rats. Tail arteries from rats receiving the coconut oil diet displayed significantly lower perfusion pressure responses to nerve stimulation at all frequencies tested when compared to the sunflower oil- or standard lab chow-fed rats. Vasoconstrictor responses of perfused tail arteries exposed to exogenous norepinephrine resulted in an EC50 for norepinephrine that was not changed by the dietary treatment, but adult rats receiving the sunflower oil diet displayed a significantly greater maximum response to exogenous norepinephrine (10(-5) M) compared to arteries from either coconut oil- or standard lab chow-fed rats

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

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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.

The Myocardial Perfusion Scintigraphy in Predicting Risk for Coronary Artery Disease in Patients with Anxiety and Depression Symptoms

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Billur Çalışkan

2016-06-01

Full Text Available INTRODUCTION: An association between psychological factors and cardiovascular disease, has long been suspected. However it is not clear whether chest pain is caused by emotional distress or whether coronary spasms are caused by the onset of coronary artery disease (CAD. We aimed to predict the risk for CAD in patients referred to myocardial perfusion imaging (MPI with chest pain using depression, stress, and anxiety symptoms. METHODS: The emotional status of all patients was evaluated using the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, the State and Trait Anxiety Inventory (STAI-1 and STAI-2, the Perceived Stress Scale (PSS, and the Anxiety Sensitivity Index-3 (ASI. Myocardial perfusion was measured using a 17-segment model and 5-point scoring system (0: normal perfusion; 4: no perfusion. RESULTS: MPI revealed reversible perfusion defects in 24 of 141 patients and no perfusion defects in 117 patients. The STAI-2 and HADS-A and HADS-D scores were significantly higher in patients with myocardial ischemia than in those without (STAI-2: 50.8 ± 7.5 vs. 46.3 ± 7.1, respectively; p = 0.008; HADS-A: 9.5 ± 3.9 vs. 7.8 ± 3.4, respectively; p = 0.033; HADS-D: 8.7 ± 3.0 vs. 7.3 ± 3.0, respectively; p = 0.05. Unadjusted correlation analysis showed that there was statistically significant correlation between reversible perfusion defects and anxiety scores (r=0.186, p= 0.029. DISCUSSION AND CONCLUSION: The patients with symptoms of depression and high-trait anxiety may be at higher risk of myocardial ischemia than patients without such symptoms. Thus, the emotional status of patients should be taken into consideration during clinical evaluation for CAD.

Polarographic measurement of ascorbate washout in isolated perfused rabbit hearts

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Arts, T.; Kuikka, J.T.; Reneman, R.S.; Bassingthwaighte, J.B.

1985-01-01

To study the myocardial washout of ascorbate, the applicability of polarographic detection of ascorbate ions by a platinum electrode (sensitive area 0.03 mm2) was investigated, in both a calibration setup (sampling flow along the electrode: 100 microliter X s-1) and isolated, retrogradely perfused rabbit hearts. In the calibration setup at pH 7.4, the sensitivity of the electrode was 70 microA/mol. This sensitivity increased moderately with increasing pH (13%/unit pH) and increasing sampling flow rate (14% at an increase from 100 to 150 microliter X s-1). In the isolated hearts, ascorbate infused into the aorta was detected in a right ventricular drain by the electrode as well as by the use of 14 C-labeled ascorbate. Both recorded time courses were similar except for a scaling factor dependent on flow velocity. During continuous infusion the arteriovenous difference of ascorbate was 2 +/- 2% (SD), indicating a relatively low consumption of ascorbate by the isolated heart. The authors conclude that polarographic measurement of ascorbate in the coronary effluent of an isolated rabbit heart can be performed on-line and relatively easily

Luminal and basolateral uptake of insulin in isolated perfused, proximal tubules

International Nuclear Information System (INIS)

Nielsen, S.; Nielsen, J.T.; Christensen, E.I.

1987-01-01

The present study was performed to quantitate compare the luminal and the peritubular uptake of 125 I-insulin in isolated, perfused, proximal tubules from rabbit kidneys. 125 I-insulin was added in physiological concentrations to either the perfusate or the bath fluid for 30 min. The luminal uptake in 30 min averaged 0.76 pg/mm at physiological concentrations and 18.0 pg/mm at high insulin concentrations. About 15-41% of the absorbed insulin was digested and 125 I-insulin at physiological and high concentrations in the bath was 0.136 and 0.318 pg, respectively. The data indicates that insulin is bound/absorbed at the basolateral membranes both by a saturable specific mechanism and a nonspecific, nonsaturable mechanism. The basolateral absorption constituted 15.2 and 1.8% of the total tubular extraction of insulin at physiological and high insulin concentrations, respectively. Electron microscope autoradiography showed that, after luminal as well as basolateral endocytosis, insulin was exclusively accumulated in endocytic vacuoles and lysosomes

Myocardial perfusion imaging by digital subtraction angiography

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Kadowaki, Hiroyuki; Ishikawa, Kinji; Ogai, Toshihiro; Katori, Ryo

1986-01-01

Several methods of digital subtraction angiography (DSA) were compared to determine which could better visualize regional myocardial perfusion using coronary angiography in seven patients with myocardial infarction, two with angina pectoris and five with normal coronary arteries. Satisfactory DSA was judged to be achieved if the shape of the heart on the mask film was identical to that on the live film and if both films were exactly superimposed. To obtain an identical mask film in the shape of each live film, both films were selected from the following three phases of the cardiac cycle; 1) at the R wave of the electrocardiogram, 2) 100 msec before the R wave, and 3) 200 msec before the R wave. The last two were superior for obtaining mask and live films which were similar in shape, because the cardiac motion in these phases was relatively small. Using these mask and live films, DSA was performed either with the continuous image mode (CI mode) or the time interval difference mode (TID mode). The overall perfusion of contrast medium through the artery to the vein was adequately visualized using the CI mode. Passage of contrast medium through the artery, capillary and vein was visualized at each phase using TID mode. Subtracted images were displayed and photographed, and the density of the contrast medium was adequate to display contour lines as in a relief map. Using this DSA, it was found that regional perfusion of the contrast medium was not always uniform in normal subjects, depending on the typography of the coronary artery. In all patients with anterior myocardial infarction, low perfusion was observed at the infarcted portion compared to the non-infarcted myocardium. In patients with inferior myocardial infarction, this low perfusion area was not observed because right coronary angiography was not subjected to DSA in this study. (J.P.N.)

Correlation between melphalan pharmacokinetics and hepatic toxicity following hyperthermic isolated liver perfusion for unresectable metastatic disease.

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Mocellin, Simone; Pilati, Pierluigi; Da Pian, Pierpaolo; Forlin, Marco; Corazzina, Susanna; Rossi, Carlo Riccardo; Innocente, Federico; Ori, Carlo; Casara, Dario; Ujka, Francesca; Nitti, Donato; Lise, Mario

2007-02-01

In the present work, we report on the results of our pilot study of hyperthermic isolated hepatic perfusion (IHP) with melphalan alone for patients with unresectable metastatic liver tumors refractory to conventional treatments, with particular regard to the correlation between pharmacokinetic findings and hepatic toxicity. Inclusion criteria were unresectable liver metastases, hepatic parenchyma replacement isolation of the liver and drug distribution volumes of the perfusion circuit were assessed by a radiolabeled albumin-based method. Drug concentrations in perfusate and plasma were measured by means of high-performance liquid chromatography (HPLC). Twenty patients with unresectable liver metastases underwent IHP. No intraoperative mortality occurred. Treatment-related systemic toxicity was minimal and reversible. Three patients (15%) experienced grade 4 hepatic toxicity and died due to liver failure and subsequent multiorgan failure. Other six patients had significant (grade 3-4) but transitory hepatic toxicity. Complete and partial responses were observed in three and nine out of 17 evaluable patients, respectively (overall response rate = 70%). The pharmacokinetics study showed a 3% mean perfusate-to-plasma drug leakage (range 1-6%). Logistic regression analysis showed that drug concentration in the perfusate circuit, but not preoperative tests, significantly and independently correlated with hepatic toxicity (P = 0.028). Following melphalan-based IHP, objective tumor regression could be observed in a remarkable percentage of patients refractory to standard treatments. However, hepatic toxicity and related mortality were significant. Our findings suggest that drug dosage personalization based on the measurement of drug distribution volumes might minimize

Reverse 201Tl myocardial redistribution induced by coronary artery spasm

International Nuclear Information System (INIS)

Xiang Dingcheng; Yin Jilin; Gong Zhihua; Xie Zhenhong; Zhang Jinhe; Wen Yanfei; Yi Shaodong

2010-01-01

Objective: To investigate the mechanism of reverse redistribution (RR) on dipyridamole 201 Tl myocardial perfusion studies in the patients with coronary artery spasm. Methods: Twenty-six patients with coronary artery spasm and presented as RR on dipyridamole 201 Tl myocardial perfusion studies were enlisted as RR group, while other 16 patients with no coronary artery stenosis nor RR were enlisted as control group. Dipyridamole test was repeated during coronary angiography. Corrected thrombolysis in myocardial infarction (TIMI) frame count (CTFC) and TIMI myocardial perfusion grade (TMPG) were measured at RR related and non-RR related coronary arteries before and after dipyridamole infusion respectively. All of the data were analyzed by Student's t-test or χ 2 -test and correlation analysis. Results: Coronary artery angiography showed slower blood flow and lower myocardial perfusion in RR related vessels when compared with non-RR related vessels in RR group, but there was no significant difference among the main coronary arteries in control group. The perfusion defects of RR area at rest were positively related to slower blood velocity at corresponding coronary arteries (r = 0.79, t =10.18, P 0.05). Conclusion: RR is related to the decreased blood flow and myocardial perfusion induced by coronary artery spasm at rest, which may be improved by stress test such as intravenous dipyridamole infusion. (authors)

Role of adenosine 99MTc sestamibi myocardial perfusion spect in evaluation of symptomatic hypertensives with recent onset left bundle branch block

International Nuclear Information System (INIS)

Padma, S.; Sundaram, P.S.; Zachariah, M.; Hariads, K.K.

2004-01-01

Objectives: Adenosine pharmacological stress Myocardial Perfusion Imaging (AMPI) is the preferred imaging modality for IHD evaluation in pts with Left Bundle Branch Block (LBBB). Good prognosis has been reported in recent onset LBBB pts with normal MPI. Our aim was to evaluate the utility and analyze the predictive value of SestaMIBI AMPI in symptomatic recent onset LBBB hypertensives for coronary artery disease evaluation. Methods: 29 hypertensive pts, age range 36-72yrs, mean 54+ 6 yrs, M:F- 21:8 with recent onset complete LBBB, under evaluation for typical/atypical angina who had AMPI between Nov 02-Nov 03, were retrospectively analyzed. LBBB was diagnosed ECG wise if there is prolonged QRS complex i.e. 0.125sec or more in sinus/supraventricular rhythm, a QS or rS complex in lead 1, and an R-wave peak time of 0.06sec in leads 1, V5 or V6 with no Q wave in same lead. Pts with prior Myocardial Infarct / revasularisation, pacemaker induced LBBB were excluded. Single day 6 min. Adenosine infusion Stress-rest 99m Tc MIBI gated MPI was performed with a dual head variable angle Gamma Camera at 76-degree angle. Coronary Angiogram (CAG) correlation was available in 24 pts. Results: Myocardial perfusion SPECT images were assessed visually and by a 20-segment model. Location, extent and severity of the LV perfusion defects were evaluated. 6/29 pts (20.7%) had normal stress-rest perfusion in all LV segments.12 (41.4%) had isolated septal fixed defect with normal perfusion in rest of the segments.3 pts (10.3%)showed isolated reversible septal defects while 8(27.6%) had reversible septal defects with reversible defects in other LV segments also. Pts with fixed septal perfusion defect showed moderate to good septal wall thickening in gated SPECT images. While all pts with multiple reversible perfusion defects had angiographically proven coronary artery disease (i.e. 3pts had LAD lesion, 2 had Triple vessel and 3 showed double vessel lesions), 1 out of 3 pts with isolated

Arterial Retention of Remnant Lipoproteins Ex Vivo Is Increased in Insulin Resistance Because of Increased Arterial Biglycan and Production of Cholesterol-Rich Atherogenic Particles That Can Be Improved by Ezetimibe in the JCR:LA-cp Rat

Science.gov (United States)

Mangat, Rabban; Warnakula, Samantha; Borthwick, Faye; Hassanali, Zahra; Uwiera, Richard R.E.; Russell, James C.; Cheeseman, Christopher I.; Vine, Donna F.; Proctor, Spencer D

2012-01-01

Background Literature supports the “response-to-retention” hypothesis—that during insulin resistance, impaired metabolism of remnant lipoproteins can contribute to accelerated cardiovascular disease progression. We used the JCR:LA-cp rat model of metabolic syndrome (MetS) to determine the extent of arterial accumulation of intestinal-derived remnants ex vivo and potential mechanisms that contribute to exacerbated cholesterol deposition in insulin resistance. Methods and Results Arteries from control and MetS (insulin-resistant) JCR:LA-cp rats were perfused ex vivo with Cy5-labeled remnant lipoproteins, and their arterial retention was quantified by confocal microscopy. Arterial proteoglycans were isolated from control and MetS rats at 6, 12, and 32 weeks of age. There was a significant increase in the arterial retention of remnants and in associated cholesterol accumulation in MetS rats as compared to control rats. Mechanistic studies reveal that increased cholesterol deposition is a result of greater arterial biglycan content; longer glycosaminoglycans and increased production of cholesterol-rich intestinal-derived remnants, as compared to controls. Additionally, perfusion of vessels treated with ezetimibe, alone or in combination with simvastatin, with remnants isolated from the respective treatment group reduced ex vivo arterial retention of remnant-derived cholesterol ex vivo as compared to untreated controls. Conclusions Increased progression of atherosclerotic cardiovascular disease in MetS and type 2 diabetes mellitus might be explained in part by an increase in the arterial retention of cholesterol-rich remnants. Furthermore, ezetimibe alone or in combination treatment with simvastatin could be beneficial in ameliorating atherosclerotic cardiovascular disease in insulin resistance and MetS. PMID:23316299

Cavitation enhances coagulated size during pulsed high-intensity focussed ultrasound ablation in an isolated liver perfusion system.

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Zhao, Lu-Yan; Liu, Shan; Chen, Zong-Gui; Zou, Jian-Zhong; Wu, Feng

2016-11-24

To investigate whether cavitation enhances the degree of coagulation during pulsed high-intensity focussed ultrasound (HIFU) in an isolated liver perfusion system. Isolated liver was treated by pulsed HIFU or continuous-wave HIFU with different portal vein flow rates. The cavitation emission during exposure was recorded, and real-time ultrasound images were used to observe changes in the grey scale. The coagulation size was measured and calculated. HIFU treatment led to complete coagulation necrosis and total cell destruction in the target regions. Compared to exposure at a duty cycle (DC) of 100%, the mean volumes of lesions induced by 6 s exposure at DCs of 50% and 10% were significantly larger (P cavitation activity for the pulsed-HIFU (P > .05). For continuous-wave HIFU exposure, there was a significant decrease in the necrosis volume and cavitation activity for exposure times of 1, 2, 3, 4, and 6 s with increasing portal perfusion rates. Perfusion flow rates negatively influence cavitation activity and coagulation volume. Ablation is significantly enhanced during pulsed HIFU exposure compared with continuous-wave HIFU.

Arterio-venous anastomoses in isolated, perfused rat lungs.

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Conhaim, Robert L; Segal, Gilad S; Watson, Kal E

2016-11-01

Several studies have suggested that large-diameter (>25 μm) arterio-venous shunt pathways exist in the lungs of rats, dogs, and humans. We investigated the nature of these pathways by infusing specific-diameter fluorescent latex particles (4, 7, 15, 30, or 50 μm) into isolated, ventilated rat lungs perfused at constant pressure. All lungs received the same mass of latex (5 mg), which resulted in infused particle numbers that ranged from 1.7 × 10 7 4 μm particles to 7.5 × 10 4 50 μm particles. Particles were infused over 2 min. We used a flow cytometer to count particle appearances in venous effluent samples collected every 0.5 min for 12 min from the start of particle infusion. Cumulative percentages of infused particles that appeared in the samples averaged 3.17 ± 2.46% for 4 μm diameter particles, but ranged from 0.01% to 0.17% for larger particles. Appearances of 4 μm particles followed a rapid upslope beginning at 30 sec followed by a more gradual downslope that lasted for up to 12 min. All other particle diameters also began to appear at 30 sec, but followed highly irregular time courses. Infusion of 7 and 15 μm particles caused transient but significant perfusate flow reductions, while infusion of all other diameters caused insignificant reductions in flow. We conclude that small numbers of bypass vessels exist that can accommodate particle diameters of 7-to-50 μm. We further conclude that our 4 μm particle data are consistent with a well-developed network of serial and parallel perfusion pathways at the acinar level. Published 2016. This article is a U.S. Government work and is in the public domain in the USA. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

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

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

1990-08-01

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

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

International Nuclear Information System (INIS)

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

1990-01-01

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

Effects of lysosomal inhibitors on 125I-insulin and 125I-asialofetuin degradation by the isolated, perfused rat liver and isolated rat hepatocytes

International Nuclear Information System (INIS)

Ward, W.F.; Moss, A.L.

1985-01-01

To further evaluate the role of the lysosomal system in insulin degradation, the authors have compared the effects of inhibitors of lysosomal function on the degradation of 125 I-insulin with 125 I-asialofetuin, a lysosomally targeted molecule, by the intact, perfused rat liver and the isolated rat hepatocyte. The inhibitors employed were chloroquine ( 125 microM), NH 4 Cl (10 mM), and leupeptin (50 micrograms/ml). In the intact, perfused liver the observed inhibition of 125 I-asialofetuin degradation at 30 min was as follows: chloroquine, 38%; NH 4 Cl, 32%; and leupeptin, 86%. Chloroquine also inhibited 125 I-insulin degradation in the intact, perfused liver (29%), but NH 4 Cl and leupeptin had no effect. Using the isolated hepatocyte, the observed values for inhibition of 125I-asialofetuin at 60 min were: chloroquine, 85%; NH 4 Cl, 76%; and leupeptin, 81%. Chloroquine produced a 28% inhibition of 125I-insulin degradation, while NH 4 Cl and leupeptin had no effect. Chloroquine and NH 4 Cl decreased cell-associated radioactivity when isolated hepatocytes were incubated with 125I-asialofetuin (leupeptin had no effect), whereas chloroquine caused a 107% increase in cell-associated radioactivity when 125I-insulin was added to the incubation media (NH 4 Cl and leupeptin had no effect). These results indicate that the effects of chloroquine on insulin degradation are an extralysosomal action and that lysosomes appear not to be involved in the physiologic degradation of the insulin molecule

Thallium-201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease

International Nuclear Information System (INIS)

Bailey, I.K.; Griffith, L.S.C.; Rouleau, J.; Strauss, H.W.; Pitt, B.

1977-01-01

The sensitivity of myocardial perfusion imaging (MPI) using thallium-201 injected both at rest and during peak exercise was compared to simultaneously recorded 12 lead electrocardiography (ECG) for the detection of transient ischemia in 20 normal subjects and 63 patients with coronary artery disease (CAD). No significant perfusion defects or ECG changes were seen on either the rest or exercise studies in any of the normal subjects. Fifty-six percent of patients with CAD developed new perfusion defects with exercise compared to 38 percent who developed ischemic ST-segment depression (P < 0.02). However, when chest pain and/or ST depression were considered indices of ischemia, the sensitivity of exercise testing and thallium-201 MPI was similar. The increased sensitivity of MPI compared to ST-segment depression on the ECG was due to patients with baseline ECG abnormalities and those who failed to achieve 85 percent of predicted maximum heart rate with exercise. Analysis of the exercise results according to the extent of coronary artery disease revealed a progressive increase in both positive ECGs and MPI with the number of vessels involved. In patients with single vessel disease the MPI was more sensitive than the ECG (P < 0.02). The combination of the rest and exercise ECG, MPI and chest pain during exercise failed to identify 11 percent of patients with CAD. Exercise thallium-201 MPI is a useful adjunct to conventional exercise testing particularly when evaluating patients with abnormal resting ECGs, those who develop ventricular conduction defects or arrhythmias during exercise, and those who fail to achieve their predicted heart rate because of fatigue or breathlessness

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

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

2016-02-01

The objective of this study was to observe the change in blood perfusion of liver cancer following argon-helium knife treatment with functional computer tomography perfusion imaging. Twenty-seven patients with primary liver cancer treated with argon-helium knife and were included in this study. Plain computer tomography (CT) and computer tomography perfusion (CTP) imaging were conducted in all patients before and after treatment. Perfusion parameters including blood flows, blood volume, hepatic artery perfusion fraction, hepatic artery perfusion, and hepatic portal venous perfusion were used for evaluating therapeutic effect. All parameters in liver cancer were significantly decreased after argon-helium knife treatment (p knife therapy. Therefore, CTP imaging would play an important role for liver cancer management followed argon-helium knife therapy. © The Author(s) 2014.

Prevention of reperfusion lung injury by lidocaine in isolated rat lung ventilated with higher oxygen levels.

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Das K

2003-01-01

Full Text Available BACKGROUND: Lidocaine, an antiarrhythmic drug has been shown to be effective against post-ischaemic reperfusion injury in heart. However, its effect on pulmonary reperfusion injury has not been investigated. AIMS: We investigated the effects of lidocaine on a postischaemic reperfused rat lung model. MATERIALS AND METHODS: Lungs were isolated and perfused at constant flow with Krebs-Henseilet buffer containing 4% bovine serum albumin, and ventilated with 95% oxygen mixed with 5% CO2. Lungs were subjected to ischaemia by stopping perfusion for 60 minutes followed by reperfusion for 10 minutes. Ischaemia was induced in normothermic conditions. RESULTS: Postischaemic reperfusion caused significant (p < 0.0001 higher wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure compared to control lungs. Lidocaine, at a dose of 5mg/Kg b.w. was found to significantly (p < 0.0001 attenuate the increase in the wet-to-dry lung weight ratio, pulmonary arterial pressure and peak airway pressure observed in post-ischaemic lungs. CONCLUSION: Lidocaine is effective in preventing post-ischaemic reperfusion injury in isolated, perfused rat lung.

Design and rationale of the MR-INFORM study: stress perfusion cardiovascular magnetic resonance imaging to guide the management of patients with stable coronary artery disease

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Hussain Shazia T

2012-09-01

Full Text Available Abstract Background In patients with stable coronary artery disease (CAD, decisions regarding revascularisation are primarily driven by the severity and extent of coronary luminal stenoses as determined by invasive coronary angiography. More recently, revascularisation decisions based on invasive fractional flow reserve (FFR have shown improved event free survival. Cardiovascular magnetic resonance (CMR perfusion imaging has been shown to be non-inferior to nuclear perfusion imaging in a multi-centre setting and superior in a single centre trial. In addition, it is similar to invasively determined FFR and therefore has the potential to become the non-invasive test of choice to determine need for revascularisation. Trial design The MR-INFORM study is a prospective, multi-centre, randomised controlled non-inferiority, outcome trial. The objective is to compare the efficacy of two investigative strategies for the management of patients with suspected CAD. Patients presenting with stable angina are randomised into two groups: 1 The FFR-INFORMED group has subsequent management decisions guided by coronary angiography and fractional flow reserve measurements. 2 The MR-INFORMED group has decisions guided by stress perfusion CMR. The primary end-point will be the occurrence of major adverse cardiac events (death, myocardial infarction and repeat revascularisation at one year. Clinical trials.gov identifier NCT01236807. Conclusion MR INFORM will assess whether an initial strategy of CMR perfusion is non-inferior to invasive angiography supplemented by FFR measurements to guide the management of patients with stable coronary artery disease. Non-inferiority of CMR perfusion imaging to the current invasive reference standard (FFR would establish CMR perfusion imaging as an attractive non-invasive alternative to current diagnostic pathways.

Consideration of Normal Variation of Perfusion Measurements in the Quantitative Analysis of Myocardial Perfusion SPECT: Usefulness in Assessment of Viable Myocardium

International Nuclear Information System (INIS)

Paeng, Jin Chul; Lim, Il Han; Kim, Ki Bong; Lee, Dong Soo

2008-01-01

Although automatic quantification software of myocardial perfusion SPECT provides highly objective and reproducible quantitative measurements, there is still some limitation in the direct use of quantitative measurements. In this study we derived parameters using normal variation of perfusion measurements, and tried to test the usefulness of these parameters. In order to calculate normal variation of perfusion measurements on myocardial perfusion SPECT, 55 patients (M:F=28:27) of low-likelihood for coronary artery disease were enrolled and 201 Tl rest / 99m Tc-MIBI stress SPECT studies were performed. Using 20-segment model, mean (m) and standard deviation (SD) of perfusion were calculated in each segment. As a myocardial viability assessment group, another 48 patients with known coronary artery disease, who underwent coronary artery bypass graft surgery (CABG) were enrolled. 201 Tl rest / 99m Tc-MIBI stress / 201 Tl 24-hr delayed SPECT was performed before CABG and SPECT was followed up 3 months after CABG. From the preoperative 24-hr delayed SPECT, Q delay (perfusion measurement), Δ delay (Q delay .m) and Z delay ((Q delay .m)/SD) were defined and diagnostic performances of them for myocardial viability were evaluated using area under curve (AUC) on receiver operating characteristic (ROC) curve analysis. Segmental perfusion measurements showed considerable normal variations among segments. In men, the lowest segmental perfusion measurement was 51.8±6.5 and the highest segmental perfusion was 87.0±5.9, and they are 58.7±8.1 and 87.3±6.0, respectively in women. In the viability assessment, Q delay showed AUC of 0.633, while those for Δ delay and Z delay were 0.735 and 0.716, respectively. The AUCs of Δ delay and Z delay were significantly higher than that of Q delay (p=0.001 and 0.018, respectively). The diagnostic performance of Δ delay , which showed highest AUC, was 85% of sensitivity and 53% of specificity at the optimal cutoff of -24.7. On automatic

Discrepancy between microsphere and diffusible tracer estimates of perfusion to ischemic myocardium

International Nuclear Information System (INIS)

Yoshida, S.; Akizuki, S.; Gowski, D.; Downey, J.M.

1985-01-01

This study critically tests the ability of microspheres to accurately measure perfusion to ischemic myocardium. The left anterior descending coronary artery was cannulated and perfused with arterial blood. The perfusion line was clamped, and a sidearm between the clamp and the cannula was opened to the atmosphere, allowing blood to flow retrograde from the distal segment of the artery. Measurement of regional blood flow during retrograde flow diversion with 15-micron microspheres revealed essentially zero flow to the perfused segment (0.005 ml X min-1 X g-1). Measurements under the same conditions by either 86 Rb uptake or 133 Xe washout revealed that an appreciable perfusion of the tissue persisted during retrograde flow diversion (0.043 and 0.11 ml X min-1 X g-1, respectively, for the 2 methods). Thus, the authors have identified a condition during which microspheres indicate zero flow to the tissue but diffusible tracers can both be washed in and washed out at a brisk rate. They conclude that with simple occlusion there is a hidden component of perfusion to an ischemic zone that cannot be measured by microspheres, causing them to underestimate flow by about 25% in that condition

Nuclear magnetic resonance of perfused tissue

International Nuclear Information System (INIS)

Harpen, M.D.; Allison, R.C.

1986-01-01

The effect of perfusion on the NMR signal observed in NMR imaging is studied in a phantom and in two isolated perfused canine lungs. It is observed that perfusion in tissue has little effect on longitudinal relaxation times. Transverse relaxation rates are observed to correlate linearly with rates of perfusion, in accordance with a model presented. (author)

The influence of Poly-Vinyl-Chloride tubing on the isolated perfused rat´s heart.

NARCIS (Netherlands)

Meijler, F.L.; Durrer, D.

1950-01-01

There are types of poly-vinyl-chloride tubing sold and used for medical and biological purposes which deteriorate heart action in a few minutes. A simple method for testing P.V.C. tubing can be found in the isolated rat's he art perfused according to Langendorff.

Perfusion lung scintigraphy in primary pulmonary hypertension

International Nuclear Information System (INIS)

Ogawa, Y.; Hayashida, K.; Uehara, T.; Shimonagata, T.; Nishimura, T.; Osaka Univ., Suita

1993-01-01

15 cases of primary pulmonary hypertension were classified into two groups by patterns of perfusion lung scintigraphy. Perfusion scintigrams showed multiple, small, ill-defined defects (mottled + ve) pattern in eight cases, and the remaining seven cases had a normal (mottled - ve) pattern. The mean pulmonary arterial pressure in patients with a mottled pattern (54 ± 10 mmHg) was higher than in those with a normal pattern (42 ± 9 mmHg, p < 0.05). There were no significant differences between the two groups in right ventricular ejection fraction, partial pressures of oxygen in the arterial blood or alveolo-arterial oxygen difference. All the patients with a mottled pattern died within 2 years following the lung scintigraphy. There was a significant difference in the survival curves between the two groups. (author)

The accuracy of myocardial perfusion SPECT imaging in the evaluation of coronary artery disease in women and men

International Nuclear Information System (INIS)

Kaminek, M.; Myslivecek, M.; Huyak, V.; Koranda, P.; Skvarilova, M.; Ostransky, J.

2001-01-01

The purpose of this study is to compare sensitivity, specificity and accuracy of myocardial perfusion SPECT for the detection of coronary artery disease (CAD) in women and men. 588 patients (455 males and 133 females, 273 after a previous myocardial infarction) underwent stress myocardial perfusion SPECT. The accuracy of myocardial perfusion SPECT was proved by coronary angiography (stenosis >50% was considered as a CAD). The sensitivity of SPECT was slightly higher, but statistically not significant, in men than in women (94% versus 91%, p > 0.05). The specificity was higher in women than in men (93% versus 82%), but this difference was not statistically significant either (p > 0.05). The accuracy of SPECT was the same for both sexes (92%). In angiographically verified group of patients the selection bias was obvious - patients with CAD dominated (74%) and the fraction of patients with CAD in men's group (83%) was significantly higher than in women's group (50%), p < 0.05. No significant difference was revealed in the accuracy of myocardial perfusion SPECT in men and women. Our results are in accordance with the prevailing opinion in literature that discovered differences in sensitivity, specificity and diagnostic accuracy are usually not statistically significant or that they can be explained by the selection bias of patients in angiographically verified groups (significantly higher fraction of patients with CAD in men's group). (author)

Myocardial perfusion assessment by dual-energy computed tomography in patients with intermediate to high likelihood of coronary artery disease

International Nuclear Information System (INIS)

De Zam, M.C.; Capunay, C.; Rodriguez Granillo, G.A.; Deviggiano, A.; Campisi, R.; Munain, M. López de; Vallejos, J.; Carrascosa, P.M.

2015-01-01

Objectives. We sought to explore the feasibility and diagnostic performance of dual-energy computed tomography (DECT) for the evaluation of myocardial perfusion in patients with intermediate to high likelihood of coronary artery disease (CAD), and to assess the impact of beam hardening artifacts (HAE). Methods. The present prospective study involved patients with known or suspected CAD referred for myocardial perfusion imaging by single-photon emission computed tomography (SPECT). Twenty patients were included in the study protocol, and scanned using DECT imaging (n = 20). The same pharmacological stress was used for DECT and SPECT scans. Results. A total of 680 left ventricular segments were evaluated by DECT and SPECT. The contrast to noise ratio was 8.8±2.9. The diagnostic performance of DECT was very good in identifying perfusion defects [area under ROC curve (AUC) of DECT 0.90 (0.86-0.94)] compared with SPECT, and remained unaffected when including only segments affected by beam hardening artifacts (BHA) [AUC= DECT 0.90 (0.84-0.96)]. Conclusions. In this pilot investigation, myocardial perfusion assessment by DECT imaging in patients with intermediate to high likelihood of CAD was feasible and remained unaffected by the presence of BHA. (authors) [es

Acute volume expansion attenuates hyperthermia-induced reductions in cerebral perfusion during simulated hemorrhage

DEFF Research Database (Denmark)

Schlader, Zachary J; Seifert, Thomas; Wilson, Thad E

2013-01-01

Hyperthermia reduces the capacity to withstand a simulated hemorrhagic challenge, but volume loading preserves this capacity. This study tested the hypotheses that acute volume expansion during hyperthermia increases cerebral perfusion and attenuates reductions in cerebral perfusion during...... infusion while hyperthermic. Primary dependent variables were mean middle cerebral artery blood velocity (MCAvmean), serving as an index of cerebral perfusion; mean arterial pressure (MAP); and cardiac output (thermodilution). During baseline, hyperthermia reduced MCAvmean (P = 0.001) by 12 ± 9% relative...

Can dual-energy CT replace perfusion CT for the functional evaluation of advanced hepatocellular carcinoma?

Science.gov (United States)

Mulé, Sébastien; Pigneur, Frédéric; Quelever, Ronan; Tenenhaus, Arthur; Baranes, Laurence; Richard, Philippe; Tacher, Vania; Herin, Edouard; Pasquier, Hugo; Ronot, Maxime; Rahmouni, Alain; Vilgrain, Valérie; Luciani, Alain

2018-05-01

To determine the degree of relationship between iodine concentrations derived from dual-energy CT (DECT) and perfusion CT parameters in patients with advanced HCC under treatment. In this single-centre IRB approved study, 16 patients with advanced HCC treated with sorafenib or radioembolization who underwent concurrent dynamic perfusion CT and multiphase DECT using a single source, fast kV switching DECT scanner were included. Written informed consent was obtained for all patients. HCC late-arterial and portal iodine concentrations, blood flow (BF)-related and blood volume (BV)-related perfusion parameters maps were calculated. Mixed-effects models of the relationship between iodine concentrations and perfusion parameters were computed. An adjusted p value (Bonferroni method) statistic (F)=28.52, padvanced HCC lesions, DECT-derived late-arterial iodine concentration is strongly related to both aBF and BV, while portal iodine concentration mainly reflects BV, offering DECT the ability to evaluate both morphological and perfusion changes. • Late-arterial iodine concentration is highly related to arterial BF and BV. • Portal iodine concentration mainly reflects tumour blood volume. • Dual-energy CT offers significantly decreased radiation dose compared with perfusion CT.

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.)

Acute Effects of Lateral Thigh Foam Rolling on Arterial Tissue Perfusion Determined by Spectral Doppler and Power Doppler Ultrasound.

Science.gov (United States)

Hotfiel, Thilo; Swoboda, Bernd; Krinner, Sebastian; Grim, Casper; Engelhardt, Martin; Uder, Michael; Heiss, Rafael U

2017-04-01

Hotfiel, T, Swoboda, B, Krinner, S, Grim, C, Engelhardt, M, Uder, M, and Heiss, R. Acute effects of lateral thigh foam rolling on arterial tissue perfusion determined by spectral Doppler and power Doppler ultrasound. J Strength Cond Res 31(4): 893-900, 2017-Foam rolling has been developed as a popular intervention in training and rehabilitation. However, evidence on its effects on the cellular and physiological level is lacking. The aim of this study was to assess the effect of foam rolling on arterial blood flow of the lateral thigh. Twenty-one healthy participants (age, 25 ± 2 years; height, 177 ± 9 cm; body weight, 74 ± 9 kg) were recruited from the medical and sports faculty. Arterial tissue perfusion was determined by spectral Doppler and power Doppler ultrasound, represented as peak flow (Vmax), time average velocity maximum (TAMx), time average velocity mean (TAMn), and resistive index (RI), and with semiquantitative grading that was assessed by 4 blindfolded investigators. Measurement values were assessed under resting conditions and twice after foam rolling exercises of the lateral thigh (0 and 30 minutes after intervention). The trochanteric region, mid portion, and distal tibial insertion of the lateral thigh were representative for data analysis. Arterial blood flow of the lateral thigh increased significantly after foam rolling exercises compared with baseline (p ≤ 0.05). We detected a relative increase in Vmax of 73.6% (0 minutes) and 52.7% (30 minutes) (p power Doppler scores at all portions revealed increased average grading of 1.96 after intervention and 2.04 after 30 minutes compared with 0.75 at baseline. Our results may contribute to the understanding of local physiological reactions to self-myofascial release.

In-vivo quantitative evaluation of perfusion zones and perfusion gradient in the deep inferior epigastric artery perforator flap

Science.gov (United States)

Saint-Cyr, Michel; Lakhiani, Chrisovalantis; Cheng, Angela; Mangum, Michael; Liang, Jinyang; Teotia, Sumeet; Livingston, Edward H.; Zuzak, Karel J.

2013-03-01

The selection of well-vascularized tissue during DIEP flap harvest remains controversial. While several studies have elucidated cross-midline perfusion, further characterization of perfusion to the ipsilateral hemiabdomen is necessary for minimizing rates of fat necrosis or partial fat necrosis in bilateral DIEP flaps. Eighteen patients (29 flaps) underwent DIEP flap harvest using a prospectively designed protocol. Perforators were marked and imaged with a novel system for quantitatively measuring tissue oxygenation, the Digital Light Hyperspectral Imager. Images were then analyzed to determine if perforator selection influenced ipsilateral flap perfusion. Flaps based on a single lateral row perforator (SLRP) were found to have a higher level of hemoglobin oxygenation in Zone I (mean %HbO2 = 76.1) compared to single medial row perforator (SMRP) flaps (%HbO2 = 71.6). Perfusion of Zone III relative to Zone I was similar between SLRP and SMRP flaps (97.4% vs. 97.9%, respectively). These differences were not statistically significant (p>0.05). Perfusion to the lateral edge of the flap was slightly greater for SLRP flaps compared SMRP flaps (92.1% vs. 89.5%, respectively). SMRP flaps had superior perfusion travelling inferiorly compared to SLRP flaps (88.8% vs. 83.9%, respectively). Overall, it was observed that flaps were better perfused in the lateral direction than inferiorly. Significant differences in perfusion gradients directed inferiorly or laterally were observed, and perforator selection influenced perfusion in the most distal or inferior aspects of the flap. This suggests broader clinical implications for flap design that merit further investigation.

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

International Nuclear Information System (INIS)

Talakic, Emina; Schoellnast, Helmut; Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut; Stauber, Rudolf; Quehenberger, Franz

2017-01-01

To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p < 0.05) between SAF and HVPG, and -0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. (orig.)

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

Energy Technology Data Exchange (ETDEWEB)

Talakic, Emina; Schoellnast, Helmut [Medical University of Graz, Division of General Radiology, Department of Radiology, Graz (Austria); Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut [Medical University of Graz, Department of Surgery, Division of Transplantation Surgery, Graz (Austria); Stauber, Rudolf [Medical University of Graz, Department of Internal Medicine, Division of Gastoenterology and Hepatology, Graz (Austria); Quehenberger, Franz [Medical University of Graz, Institute for Medical Informatics, Statistics and Documentation, Graz (Austria)

2017-10-15

To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p < 0.05) between SAF and HVPG, and -0.68 (p < 0.01) between HVPG and SCL. Using a cut-off value of 125 ml/min/100 ml for SCL, sensitivity for detection of a HVPG of ≥12 mmHg was 94%, and specificity 100%. There was no significant correlation between hepatic perfusion parameters and HVPG. CT perfusion in patients with cirrhosis showed a strong correlation between SCL and HVPG and may be used for detection of severe portal hypertension. (orig.)

Myocardial perfusion magnetic resonance imaging using sliding-window conjugate-gradient HYPR methods in canine with stenotic coronary arteries.

Science.gov (United States)

Ge, Lan; Kino, Aya; Lee, Daniel; Dharmakumar, Rohan; Carr, James C; Li, Debiao

2010-01-01

First-pass perfusion magnetic resonance imaging (MRI) is a promising technique for detecting ischemic heart disease. However, the diagnostic value of the method is limited by the low spatial coverage, resolution, signal-to-noise ratio (SNR), and cardiac motion-related image artifacts. A combination of sliding window and conjugate-gradient HighlY constrained back-PRojection reconstruction (SW-CG-HYPR) method has been proposed in healthy volunteer studies to reduce the acquisition window for each slice while maintaining the temporal resolution of 1 frame per heartbeat in myocardial perfusion MRI. This method allows for improved spatial coverage, resolution, and SNR. In this study, we use a controlled animal model to test whether the myocardial territory supplied by a stenotic coronary artery can be detected accurately by SW-CG-HYPR perfusion method under pharmacological stress. Results from 6 mongrel dogs (15-25 kg) studies demonstrate the feasibility of SW-CG-HYPR to detect regional perfusion defects. Using this method, the acquisition time per cardiac cycle was reduced by a factor of 4, and the spatial coverage was increased from 2 to 3 slices to 6 slices as compared with the conventional techniques including both turbo-Fast Low Angle Short (FLASH) and echoplanar imaging (EPI). The SNR of the healthy myocardium at peak enhancement with SW-CG-HYPR (12.68 ± 2.46) is significantly higher (P < 0.01) than the turbo-FLASH (8.65 ± 1.93) and EPI (5.48 ± 1.24). The spatial resolution of SW-CG-HYPR images is 1.2 × 1.2 × 8.0 mm, which is better than the turbo-FLASH (1.8 × 1.8 × 8.0 mm) and EPI (2.0 × 1.8 × 8.0 mm). Sliding-window CG-HYPR is a promising technique for myocardial perfusion MRI. This technique provides higher image quality with respect to significantly improved SNR and spatial resolution of the myocardial perfusion images, which might improve myocardial perfusion imaging in a clinical setting.

Perfusion-induced changes in cardiac contractility depend on capillary perfusion.

Science.gov (United States)

Dijkman, M A; Heslinga, J W; Sipkema, P; Westerhof, N

1998-02-01

The perfusion-induced increase in cardiac contractility (Gregg phenomenon) is especially found in heart preparations that lack adequate coronary autoregulation and thus protection of changes in capillary pressure. We determined in the isolated perfused papillary muscle of the rat whether cardiac muscle contractility is related to capillary perfusion. Oxygen availability of this muscle is independent of internal perfusion, and perfusion may be varied or even stopped without loss of function. Muscles contracted isometrically at 27 degrees C (n = 7). During the control state stepwise increases in perfusion pressure resulted in all muscles in a significant increase in active tension. Muscle diameter always increased with increased perfusion pressure, but muscle segment length was unaffected. Capillary perfusion was then obstructed by plastic microspheres (15 microns). Flow, at a perfusion pressure of 66.6 +/- 26.2 cmH2O, reduced from 17.6 +/- 5.4 microliters/min in the control state to 3.2 +/- 1.3 microliters/min after microspheres. Active tension developed by the muscle in the unperfused condition before microspheres and after microspheres did not differ significantly (-12.8 +/- 29.4% change). After microspheres similar perfusion pressure steps as in control never resulted in an increase in active tension. Even at the two highest perfusion pressures (89.1 +/- 28.4 and 106.5 +/- 31.7 cmH2O) that were applied a significant decrease in active tension was found. We conclude that the Gregg phenomenon is related to capillary perfusion.

Percutaneous transluminal angioplasty combining intraarterial drug perfusion for the treatment of chronic lower limb ischemia

International Nuclear Information System (INIS)

Liu Yuan; He Chunshui; Liao Huaqiang; Zeng Wei; Zhang Hongwei; Liu Yang; Mu Yan; Liao Huaqiang; Guan Yongsong

2008-01-01

Objective: To evaluate the clinical effects of balloon angioplasty in combination with intraarterial perfusion of vasoactive drugs in the treatment of chronic lower limb ischemia. Methods: A total of 21 patients were treated with percutaneous transfemoral or transaxillary approach of balloon dilatation of the occlusive arterial segments, and then followed by perfusion of urokinase, Lipo prostaglandin E 1 and ginkgo leaf injection, respectively, into the responsible arteries via the catheter. Postoperatively, some of the patients with tibioperoneal arteries occlusion were perfused with the same drugs into their diseased arterial segments, one time per day altogether 5-7 times, through the ipsilateral femoral arterial sheath reserved temporarily, and then followed by observation for improvement of ischemia, superficial ulceration and gangrenous change. Results: Of the 21 patients, 20 were successfully treated with percutaneous transluminal balloon dilation and arterial perfusion with a technical successful rate of 95.2% (20/21). Five of the total 20 were additionally treated with the same drugs perfusion 5-7 days through the retained sheath, showing well patency. No serious complications occurred and ischemic symptoms of limbs improved, such as rest pain, claudication and dermo temperature. During 2-7 months follow-up, healing of skin ulcer occurred in 4 patients and breakoff of necrotic digits in 2 with the surface wound healed. Necrotic toes in all patients were dehydrated with stopping of necrosis and without any amputation. Conclusions: Percutaneous transluminal angioplasty combining intraarterial drug perfusion is safe and effective for promoting blood circulation with healing of ulceration and ceasing the development of lesions; with furthermore of maintaining the arterial patency through the retained vascular sheath for sustaining the drug plerfusion. (authors)

Uterine artery embolization for leiomyomas. Examination of correlation between degree of leiomyoma perfusion determined by enhanced MR i-Drive method and leiomyoma volume change on MR image

International Nuclear Information System (INIS)

Arimoto, Hiroshi; Yamamoto, Kazuhiro; Yamaguchi, Hiroyuki; Terai, Yoshito; Ohmichi, Masahide; Narabayashi, Isamu

2007-01-01

The objective of this study was to evaluate the correlations of leiomyoma volume reduction with the perfusion pattern of leiomyomas and signal intensity on T2-weighted images. Magnetic resonance (MR) imaging was performed on 11 patients with 35 symptomatic uterine leiomyomas before and 3 and 6 months after uterine artery embolization (UAE). The correlation between leiomyoma perfusion pattern and percent leiomyoma volume reduction was assessed. The mean percent leiomyoma volume reductions were 41.1% 3 months and 58.4% 6 months after UAE. The mean percent volume reductions of highly perfused leiomyomas were 58.6% 3 months and 85.7% 6 months after UAE. The reduction rates of poorly perfused leiomyomas were 37.9% 3 months and 49.1% 6 months after UAE. Well-perfused leiomyomas are more likely to reduce in leiomyoma volume. It is thought that a patient with a well-perfusion myoma is a good candidate for UAE. (author)

The value of regional wall motion abnormalities on gated mycardiac perfusion imaging in perfusion imaging in predicting angiographic stenoses of coronary artery

International Nuclear Information System (INIS)

Yao Lixin; Liu Binbin

2007-01-01

Objective: To determine the possible level of angiographic stenoses of coronary artery at which reversible regional wall motion abnormalities (RWMA) are present on 99m Tc-sestamibi ( 99m Tc-MIBI)-gated myocardial perfusion imaging (MPI). Methods: ninty patients undergoing coronary angiography MPI within two weeks were recruited. A five grades and nine segments marking system was introduced to assess the RWMA and thickening of left ventricles. Results: The sensitivity of reversible RWMA for detecting ≥75% angiographic stenoses was 64%,with a specificity of 95% and positive predictive value of 97%. The presence of reversible RWMA was able to stratify patients with severe angiographic stenoses of 75% or more from those less than 75% with high positive predictive value. A good correlation was noted between the presence of reversible RWMA and the coronary artery jeopardy score. Multivariate analysis showed that the post-stress RWMA and reversible RWMA scores and positive dipyridamole-stress exercise electrocardiogram(ECG) were significant predictors of angiographic severity. Conclusions: Reversible RWMA, as shown by dipyridamole stress 99m Tc-MIBI MPI, is a significant predictor of angiographic disease with very high specificity and adds incremental value to MPI for the assessment of angiographic severity. (authors)

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

International Nuclear Information System (INIS)

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

2003-01-01

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

Isolated Unilateral Absent Branch Pulmonary Artery with Peripheral Pulmonary Stenosis and Coronary Artery Disease

Directory of Open Access Journals (Sweden)

Sunil Abhishek B

2017-09-01

Full Text Available Isolated Unilateral Absent Pulmonary Artery (UAPA is a rare congenital anomaly. It is usually associated with congenital heart defects. A 45 year old male patient presented with complaints of fever with cough and expectoration for 15 days and retrosternal chest discomfort for the previous 2 days. ECG showed diffuse ST segment depression with T wave inversion in the inferior and lateral leads. Coronary Angiogram done through the right femoral approach revealed diffusely diseased Left Anterior Descending (LAD artery that was totally cut off at the mid segment. The Left Circumflex (LCx artery was providing blood supply to the right middle and lower lung areas. There was another collateral arising from the Left Subclavian Artery supplying the right middle and lower lung areas. The left pulmonary artery was normal, but branches supplying the middle and lower lobes of the right lung were absent and the upper lobe branch had pulmonary stenosis. UAPA is a rare clinical entity; collaterals from coronaries are extremely rare in this condition and till now there has not been any case report of unilateral absent branch pulmonary artery with peripheral stenosis of other branches, on the affected side and associated coronary artery disease.

Tc-99m macroaggregate albumin perfusion studies in the therapeutically embolized liver

International Nuclear Information System (INIS)

Hall, J.T.; Kim, E.E.; Charnsangavej, C.; Haynie, T.P.; Wallace, S.

1988-01-01

This paper discusses the authors' study of 15 patients who underwent 21 hepatic arterial chemoembolizations and hepatic arterial chemotherapy infusions. The arteriograms and the hepatic perfusion studies using Tc-99m macroaggregates of human serum albumin (MAA) particles were reviewed and correlated. Early perfusion studies (within 4 hours of embolization) often revealed flow reversal or MAA reflux into an undesirable location. Scans obtained at 24 hours revealed restoration of flow to the embolized lobe, confirming the proper position of the catheter for hepatic arterial chemotherapy infusion

Exercise promotes collateral artery growth mediated by monocytic nitric oxide.

Science.gov (United States)

Schirmer, Stephan H; Millenaar, Dominic N; Werner, Christian; Schuh, Lisa; Degen, Achim; Bettink, Stephanie I; Lipp, Peter; van Rooijen, Nico; Meyer, Tim; Böhm, Michael; Laufs, Ulrich

2015-08-01

Collateral artery growth (arteriogenesis) is an important adaptive response to hampered arterial perfusion. It is unknown whether preventive physical exercise before limb ischemia can improve arteriogenesis and modulate mononuclear cell function. This study aimed at investigating the effects of endurance exercise before arterial occlusion on MNC function and collateral artery growth. After 3 weeks of voluntary treadmill exercise, ligation of the right femoral artery was performed in mice. Hindlimb perfusion immediately after surgery did not differ from sedentary mice. However, previous exercise improved perfusion restoration ≤7 days after femoral artery ligation, also when exercise was stopped at ligation. This was accompanied by an accumulation of peri-collateral macrophages and increased expression of endothelial nitric oxide synthase and inducible nitric oxide synthase (iNOS) in hindlimb collateral and in MNC of blood and spleen. Systemic monocyte and macrophage depletion by liposomal clodronate but not splenectomy attenuated exercise-induced perfusion restoration, collateral artery growth, peri-collateral macrophage accumulation, and upregulation of iNOS. iNOS-deficient mice did not show exercise-induced perfusion restoration. Transplantation of bone marrow-derived MNC from iNOS-deficient mice into wild-type animals inhibited exercise-induced collateral artery growth. In contrast to sedentary controls, thrice weekly aerobic exercise training for 6 months in humans increased peripheral blood MNC iNOS expression. Circulating mononuclear cell-derived inducible nitric oxide is an important mediator of exercise-induced collateral artery growth. © 2015 American Heart Association, Inc.

Fatty acid metabolism in symptomatic patients with mitral valve prolapse but without coronary artery disease - comparison with 201Tl myocardial perfusion scintigraphy

International Nuclear Information System (INIS)

Voth, E.; Schicha, H.; Neumann, P.; Emrich, D.; Tebbe, U.

1987-01-01

Using 123 I-ω-heptadecanoic acid (HDA) and 201 Tl, respectively, myocardial fatty acid metabolism and perfusion were studied in 51 symptomatic patients with mitral valve prolapse (MVP) as diagnosed by ventriculography, and no evidence of coronary artery disease. Twelve subjects with normal coronary arteries and normal ventriculogram served as a control group for the evaluation of elimination kinetics of HDA. In the control group, the mean elimination half-life was 26.1±3.6 min, whereas the patients with MVP had a mean value of 25.0±6.4 min. In patients with MVP, a high incidence concerning abnormalities of accumulation and/or elimination of HDA occurred, namely accumulation defects in 31% and both prolonged and shortened elimination half-lives in 16% and 29%, respectively. Myocardial perfusion scintigraphy using 201 Tl showed abnormalities in 76%. Correlations were found between decreased uptake of HDA and prolonged elimination half-life as well as defects by 201 Tl, presumably due to ischemia based on small-vessel disease or abnormalities of cellular metabolism. (orig.) [de

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. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

Clinical indications for Thallium-201 myocardial perfusion scanning

International Nuclear Information System (INIS)

Dunn, R.J.; Kelly, D.T.

1982-01-01

Thallium-201 myocardial perfusion scanning can assess regional myocardial perfusion non-invasively. As it is both time-consuming and expensive its use should be restricted to specific diagnostic problems. The clinical indications in known or suspected coronary artery disease are reviewed. In suspected coronary artery disease thallium scanning is most useful in patients with chest pain when the exercise ECG is uninterpretable, in men with probable angina but a negative exercise ECG, or conversely a positive exercise ECG without typical angina, and in women with probable angina and either a positive or a negative exercise ECG. In known coronary artery disease, thallium scanning may help determine the functional significance of a coronary obstruction found at angiography and may determine the site of myocardial ischaemia when multiple obstructions are present

Renal MR angiography and perfusion in the pig using hyperpolarized water.

Science.gov (United States)

Wigh Lipsø, Kasper; Hansen, Esben Søvsø Szocska; Tougaard, Rasmus Stilling; Laustsen, Christoffer; Ardenkjaer-Larsen, Jan Henrik

2017-09-01

To study hyperpolarized water as an angiography and perfusion tracer in a large animal model. Protons dissolved in deuterium oxide (D 2 O) were hyperpolarized in a SPINlab dissolution dynamic nuclear polarization (dDNP) polarizer and subsequently investigated in vivo in a pig model at 3 Tesla (T). Approximately 15 mL of hyperpolarized water was injected in the renal artery by hand over 4-5 s. A liquid state polarization of 5.3 ± 0.9% of 3.8 M protons in 15 mL of deuterium oxide was achieved with a T 1 of 24 ± 1 s. This allowed injection through an arterial catheter into the renal artery and subsequently high-contrast imaging of the entire kidney parenchyma over several seconds. The dynamic images allow quantification of tissue perfusion, with a mean cortical perfusion of 504 ± 123 mL/100 mL/min. Hyperpolarized water MR imaging was successfully demonstrated as a renal angiography and perfusion method. Quantitative perfusion maps of the kidney were obtained in agreement with literature and control experiments with gadolinium contrast. Magn Reson Med 78:1131-1135, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

Initial isolated Takayasu's arteritis of the right pulmonary artery: MR appearance

International Nuclear Information System (INIS)

Ferretti, G.; Defaye, P.; Thony, F.; Ranchoup, Y.; Coulomb, M.

1996-01-01

Takayasu's arteritis involves the pulmonary artery tree in more than 50 % of the cases. Initial isolated involvement of the pulmonary artery by Takayasu's arteritis, however, is very rare. We report the case of a 34-year-old white woman who presented a clinical and radiographic pattern that mimicked an acute pulmonary embolism with pulmonary infarction. Pulmonary angiography showed stenosis lesions and occlusion of the right pulmonary artery tree. Magnetic resonance imaging demonstrated thickening of the pulmonary artery wall leading to the correct diagnosis. (orig.). With 3 figs

Inhibition of mirtazapine metabolism by Ecstasy (MDMA) in isolated perfused rat liver model.

Science.gov (United States)

Jamshidfar, Sanaz; Ardakani, Yalda H; Lavasani, Hoda; Rouini, Mohammadreza

2017-06-28

Nowadays MDMA (3,4-methylendioxymethamphetamine), known as ecstasy, is widely abused among the youth because of euphoria induction in acute exposure. However, abusers are predisposed to depression in chronic consumption of this illicit compound. Mirtazapine (MRZ), an antidepressant agent, may be prescribed in MDMA-induced depression. MRZ is extensively metabolized in liver by CYP450 isoenzymes. 8-hydroxymirtazapine (8-OH) is mainly produced by CYP2D6. N-desmethylmirtazapine (NDES) is generated by CYP3A4. MDMA is also metabolized by the mentioned isoenzymes and demonstrates mechanism-based inhibition (MBI) in association with CYP2D6. Several studies revealed that MDMA showed inhibitory effects on CYP3A4. In the present study, our aim was to evaluate the impact of MDMA on the metabolism of MRZ in liver. Therefore, isolated perfused rat liver model was applied as our model of choice in this assessment. The subjects of the study were categorized into two experimental groups. Rats in the control group received MRZ-containing Krebs-Henselit buffer (1 μg/ml). Rats in the treatment group received aqueous solution of 1 mg/ml MDMA (3 mg/kg) intraperitoneally 1 hour before receiving MRZ. Perfusate samples were analyzed by HPLC. Analyses of perfusate samples showed 80% increase in the parent drug concentrations and 50% decrease in the concentrations of both metabolites in our treatment group compared to the control group. In the treatment group compared to the control group, AUC (0-120) of the parent drug demonstrated 50% increase and AUC (0-120) of 8-OH and NDES showed 70% and 60% decrease, respectively. Observed decrease in metabolic ratios were 83% and 79% for 8-OH and NDES in treatment group compared to control group, respectively. Hepatic clearance (CL h ) and intrinsic clearance (Cl int ) showed 20% and 60% decrease in treatment group compared to control group. All findings prove the inhibitory effects of ecstasy on both CYP2D6 and CYP3A4 hepatic isoenzymes. In

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

Science.gov (United States)

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

2016-04-01

To determine the feasibility and accuracy of a protocol for calculating whole-organ renal perfusion (renal blood flow [RBF]) and regional perfusion on the basis of biphasic computed tomography (CT), with concurrent dynamic contrast material-enhanced (DCE) CT perfusion serving as the reference standard. This prospective study was approved by the institutional review board, and written informed consent was obtained from all patients. Biphasic CT of the kidneys, including precontrast and arterial phase imaging, was integrated with a first-pass dynamic volume CT protocol and performed and analyzed in 23 patients suspected of having renal artery stenosis. The perfusion value derived from biphasic CT was calculated as CT number enhancement divided by the area under the arterial input function and compared with the DCE CT perfusion data by using the paired t test, correlation analysis, and Bland-Altman plots. Correlation analysis was made between the RBF and the extent of renal artery stenosis. All postprocessing was independently performed by two observers and then averaged as the final result. Mean ± standard deviation biphasic and DCE CT perfusion data for RBF were 425.62 mL/min ± 124.74 and 419.81 mL/min ± 121.13, respectively (P = .53), and for regional perfusion they were 271.15 mL/min per 100 mL ± 82.21 and 266.33 mL/min per 100 mL ± 74.40, respectively (P = .31). Good correlation and agreement were shown between biphasic and DCE CT perfusion for RBF (r = 0.93; ±10% variation from mean perfusion data [P < .001]) and for regional perfusion (r = 0.90; ±13% variation from mean perfusion data [P < .001]). The extent of renal artery stenosis was negatively correlated with RBF with biphasic CT perfusion (r = -0.81, P = .012). Biphasic CT perfusion is clinically feasible and provides perfusion data comparable to DCE CT perfusion data at both global and regional levels in the kidney. Online supplemental material is available for this article.

Chamber-specific effects of hypokalaemia on ventricular arrhythmogenicity in isolated, perfused guinea-pig heart

DEFF Research Database (Denmark)

Osadchii, Oleg E; Bentzen, Bo Hjorth; Olesen, Søren-Peter

2009-01-01

of hypokalaemic perfusion (2.5 mm K(+) for 30 min) were assessed in isolated guinea-pig heart preparations using simultaneous recordings of volume-conducted electrocardiogram and monophasic action potentials from six ventricular epicardial sites. Effective refractory periods, ventricular fibrillation thresholds...... for re-entrant tachyarrhythmias. Taken together, these findings suggest that proarrhythmic effects of hypokalaemia are mostly attributed to increased LV arrhythmogenicity in the guinea-pig heart....

Myocardial imaging by direct injection of thallium-201 into coronary artery

International Nuclear Information System (INIS)

Sugihara, Hiroki; Inagaki, Suetsugu; Kubota, Yasushi

1988-01-01

Myocardial perfusion images were evaluated by direct injection of Thallium (Tl)-201 into coronary artery. Approximately 0.5 - 1 mCi of Tl-201 were instilled into the right coronary artery and/or the left coronary artery after coronary arteriography. Three images were obtained in the anterior, left anterior oblique and left lateral projections. Myocardial perfusion images of single photon emission computed tomography were also acquired in some patients. An image of supreme quality could be obtained in spite of small dose of Tl-201 since there was a lack of interference from background activity. Myocardial perfusion images corresponded to areas which were supplied by left or right coronary artery respectively. And the regional myocardial blood flow distribution of a coronary artery bypass graft could be revealed by instilling Tl-201 into the graft. Further, contribution of collateral channels to myocardial perfusion was showed. Not only left ventricle but also right ventricle was clearly visualized by injection of Tl-201 into right coronary artery. But in a case with arrhythmogenic right ventricular dysplasia, there was an area of decreased tracer uptake in the apex of the right ventricle which was identified as the site of dysplasia by electrophysiologic study. We conclude that direct injection of Tl-201 into coronary artery is an useful method to clarify the correlation between coronary anatomical findings and coronary perfusion and contribution of collaterals to myocardial perfusion, and also to detect the right ventricular myopathic site. (author)

Clinical application of lower extremity CTA and lower extremity perfusion CT as a method of diagnostic for lower extremity atherosclerotic obliterans

Energy Technology Data Exchange (ETDEWEB)

Moon, Il Bong; Dong, Kyung Rae [Dept. Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Goo, Eun Hoe [Dept. Radiological Science, Cheongju University, Cheongju (Korea, Republic of)

2016-11-15

The purpose of this study was to assess clinical application of lower extremity CTA and lower extremity perfusion CT as a method of diagnostic for lower extremity atherosclerotic obliterans. From January to July 2016, 30 patients (mean age, 68) were studied with lower extremity CTA and lower extremity perfusion CT. 128 channel multi-detector row CT scans were acquired with a CT scanner (SOMATOM Definition Flash, Siemens medical solution, Germany) of lower extremity perfusion CT and lower extremity CTA. Acquired images were reconstructed with 3D workstation (Leonardo, Siemens, Germany). Site of lower extremity arterial occlusive and stenosis lesions were detected superficial femoral artery 36.6%, popliteal artery 23.4%, external iliac artery 16.7%, common femoral artery 13.3%, peroneal artery 10%. The mean total DLP comparison of lower extremity perfusion CT and lower extremity CTA, 650 mGy-cm and 675 mGy-cm, respectively. Lower extremity perfusion CT and lower extremity CTA were realized that were never be two examination that were exactly the same legions. Future through the development of lower extremity perfusion CT soft ware programs suggest possible clinical applications.

Release of galanin from isolated perfused porcine adrenal glands

DEFF Research Database (Denmark)

Holst, J J; Ehrhart-Bornstein, M; Messell, T

1991-01-01

We found a high concentration of galanin in extracts of porcine adrenal glands (114 pmol/g). By immunohistochemistry, galanin was localized to groups of medullary cells previously shown to produce norepinephrine. To study mechanisms for the release of galanin, we developed the following in vitro...... model: isolated perfused porcine adrenals with intact splanchnic nerve supply. When the nerves were electrically stimulated, epinephrine and norepinephrine secretion increased 276- and 291-fold, respectively, and galanin release increased up to 1,300-fold. Acetylcholine at 10(-6) M stimulated galanin...... release, and hexamethonium almost abolished the response to nerve stimulation. Galanin infusions had no effect on epinephrine and norepinephrine secretion in concentrations of 10(-8) and 10(-7) M, but increased both cortisol and aldosterone secretion (P less than 0.05). Splanchnic nerve stimulation...

Kidney in potassium depletion. II. K+ handling by the isolated perfused rat kidney

International Nuclear Information System (INIS)

Hayashi, M.; Katz, A.I.

1987-01-01

In a companion paper the authors reported a large increment in Na + -K + -ATPase activity and [ 3 H]ouabain binding the inner stripe of outer medullary collecting tubules from K-depleted rats. To test the hypothesis that the increased number of Na + -K + pumps in these animals may be involved in potassium reabsorption they examined the effect of ouabain on K excretion by isolated, perfused kidneys from rats fed a K-free diet for 3 wk. Kidneys from K-depleted rats retain potassium avidly, both the fractional (FE/sub K/) and absolute K excretion being approximately fivefold lower than in control kidneys. Ouabain (5 mM) increased FE/sub K/ in kidneys from each K-depleted rat; similar results were obtained when kidneys were perfused with low and high potassium concentrations. In contrast, ouabain produced a variable effect in control kidneys, that depended on the perfusate potassium concentration. In K-depleted rats amiloride did not significantly alter K excretion and did not block the ouabain-induced kaliuresis, suggesting that the latter is not due to enhanced secretion secondary to increased distal fluid delivery. These results provide evidence for ouabain-sensitive potassium reabsorption in kidneys of chronically K-depleted rats, and suggest an explanation for the increased Na + -K + -ATPase observed in such animals

Gray matter perfusion correlates with disease severity in ALS.

Science.gov (United States)

Rule, Randall R; Schuff, Norbert; Miller, Robert G; Weiner, Michael W

2010-03-09

The goal of this study is to determine if regional brain perfusion, as measured by arterial spin labeling (ASL) MRI, is correlated with clinical measures of amyotrophic lateral sclerosis (ALS) disease severity. The presence of such a relationship would indicate a possible role for ASL perfusion as a marker of disease severity and upper motor neuron involvement in ALS. Disease severity was assessed in 16 subjects with ALS (age 54 +/- 11) using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS) and the pulmonary function measure, forced vital capacity (FVC). Upper motor neuron involvement was assessed by testing rapid tapping of the fingers and feet. Magnetic resonance perfusion images were coregistered with structural T1-weighted MRI, corrected for partial volume effects using the structural images and normalized to a study-specific atlas. Correlations between perfusion and ALS disease severity were analyzed, using statistical parametric mapping, and including age as a factor. Analyses were adjusted for multiple clusters. ALS severity, as measured by the ALSFRS and FVC, was correlated with gray matter perfusion. This correlation was predominantly observed in the hemisphere contralateral to the more affected limbs. ALSFRS scores correlated with perfusion in the contralateral frontal and parietal lobe (p frontal lobe (p frontal lobe (p Upper motor neuron involvement, as measured by rapid finger tapping, correlated bilaterally with perfusion in the middle cingulate gyrus (p < 0.001). Amyotrophic lateral sclerosis (ALS) severity is correlated with brain perfusion as measured by arterial spin labeling (ASL) perfusion. This correlation appears to be independent of brain atrophy. ASL perfusion may be a useful tool for monitoring disease progression and assessing treatment effects in ALS.

Distribution of coronary arterial capacitance in a canine model.

Science.gov (United States)

Lader, A S; Smith, R S; Phillips, G C; McNamee, J E; Abel, F L

1998-03-01

The capacitative properties of the major left coronary arteries, left main (LM), left anterior descending (LAD), and left circumflex (LCX), were studied in 19 open-chest isolated dog hearts. Capacitance was determined by using ramp perfusion and a left ventricular-to-coronary shunt diastolic decay method; both methods gave similar results, indicating a minimal systolic capacitative component. Increased pericardial pressure (PCP), 25 mmHg, was used to experimentally alter transmural wall pressure. The response to increased PCP was different in the LAD vs. LCX; increasing PCP decreased capacitance in the LCX but increased capacitance in the LAD. This may have been due to the different intramural vs. epicardial volume distribution of these vessels and a decrease in intramural tension during increased PCP. Increased PCP decreased LCX capacitance by approximately 13%, but no changes in conductance or zero flow pressure intercept occurred in any of the three vessels, i. e., evidence against the waterfall theory of vascular collapse at these levels of PCP. Coronary arterial capacitance was also linearly related to perfusion pressure.

CT perfusion imaging of the liver and the spleen in patients with cirrhosis: Is there a correlation between perfusion and portal venous hypertension?

Science.gov (United States)

Talakić, Emina; Schaffellner, Silvia; Kniepeiss, Daniela; Mueller, Helmut; Stauber, Rudolf; Quehenberger, Franz; Schoellnast, Helmut

2017-10-01

To correlate hepatic and splenic CT perfusion parameters with hepatic venous pressure gradient (HVPG) measurements in patients with cirrhosis. Twenty-one patients with cirrhosis (males, 17; females, 4; mean ± SD age, 57 ± 7 years) underwent hepatic and splenic perfusion CT on a 320-detector row volume scanner as well as invasive measurement of HVPG. Different CT perfusion algorithms (maximum slope analysis and Patlak plot) were used to measure hepatic arterial flow (HAF), portal venous flow (PVF), hepatic perfusion index (HPI), splenic arterial flow (SAF), splenic blood volume (SBV) and splenic clearance (SCL). Hepatic and splenic perfusion parameters were correlated with HVPG, and sensitivity and specificity for detection of severe portal hypertension (≥12 mmHg) were calculated. The Spearman correlation coefficient was -0.53 (p portal hypertension. • SAF and SCL are statistically significantly correlated with HVPG • SCL showed stronger correlation with HVPG than SAF • 125 ml/min/100 ml SCL-cut-off yielded 94 % sensitivity, 100 % specificity for severe PH • HAF, PVF and HPI showed no statistically significant correlation with HVPG.

Myocardial perfusion as an indicator of graft patency after coronary artery bypass surgery

International Nuclear Information System (INIS)

Kolibash, A.J.; Call, T.D.; Bush, C.A.; Tetalman, M.R.; Lewis, R.P.

1980-01-01

Stress and resting myocardial perfusion were assessed in 38 patients who received 96 grafts. Stress perfusion was evaluated with thallium-201 and resting myocardial blood flow distribution with radiolabeled particles. When both stress and rest perfusion were normal, graft patency was 82% (51 of 62 grafts). Graft patency was also high (81%, 13 of 16) in areas where stress perfusion abnormalities resolved or become less apparent at rest. However, when stress perfusion defects remained unchanged at rest, the graf was likely to be occuluded (73%, 11 of 15). Maintenance of normal rest perfusion or improvement of rest perfusion postoperatively was also associated with a high graft patency rate (80%, 35 of 44), whereas the development of new rest perfusion defects postoperatively implied graft occlusion

Active Oxygen Metabolites and Thromboxane in Phorbol Myristate Acetate Toxicity to the Isolated, Perfused Rat Lung.

Science.gov (United States)

Carpenter, Laurie Jean

When administered intravenously or intratracheally to rats, rabbits and sheep, phorbol myristate acetate (PMA) produces changes in lung morphology and function are similar to those seen in humans with the adult respiratory distress syndrome (ARDS). Therefore, it is thought that information about the mechanism of ARDS development can be gained from experiments using PMA-treated animals. Currently, the mechanisms by which PMA causes pneumotoxicity are unknown. Results from other studies in rabbits and in isolated, perfused rabbit lungs suggest that PMA-induced lung injury is mediated by active oxygen species from neutrophils (PMN), whereas studies in sheep and rats suggest that PMN are not required for the toxic response. The role of PMN, active oxygen metabolites and thromboxane (TxA_2) in PMA-induced injury to isolated, perfused rat lungs (IPLs) was examined in this thesis. To determine whether PMN were required for PMA to produce toxicity to the IPL, lungs were perfused for 30 min with buffer containing various concentrations of PMA (in the presence or absence of PMN). When concentrations >=q57 ng/ml were added to medium devoid of added PMN, perfusion pressure and lung weight increased. When a concentration of PMA (14-28 ng/ml) that did not by itself cause lungs to accumulate fluid was added to the perfusion medium containing PMN (1 x 10 ^8), perfusion pressure increased, and lungs accumulated fluid. These results indicate that high concentrations of PMA produce lung injury which is independent of PMN, whereas injury induced by lower concentrations is PMN-dependent. To examine whether active oxygen species were involved in mediating lung injury induced by PMA and PMN, lungs were coperfused with the oxygen radical scavengers SOD and/or catalase. Coperfusion with either or both of these enzymes totally protected lungs against injury caused by PMN and PMA. These results suggest that active oxygen species (the hydroxyl radical in particular), mediate lung injury in

Increased sinusoidal volume and solute extraction during retrograde liver perfusion

International Nuclear Information System (INIS)

Bass, N.M.; Manning, J.A.; Weisiger, R.A.

1989-01-01

Retrograde isolated liver perfusion has been used to probe acinar functional heterogeneity, but the hemodynamic effects of backward flow have not been characterized. In this study, extraction of a long-chain fatty acid derivative, 12-N-methyl-7-nitrobenzo-2-oxa-1,3-diazol-amino stearate (12-NBDS), was greater during retrograde than during anterograde perfusion of isolated rat liver. To determine whether hemodynamic differences between anterograde and retrograde perfused livers could account for this finding, the hepatic extracellular space was measured for both directions of flow by means of [ 14 C]sucrose washout during perfusion as well as by direct measurement of [ 14 C]sucrose entrapped during perfusion. A three- to fourfold enlargement of the total hepatic extracellular space was found during retrograde perfusion by both approaches. Examination of perfusion-fixed livers by light microscopy and morphometry revealed that marked distension of the sinusoids occurred during retrograde perfusion and that this accounts for the observed increase in the [ 14 C]sucrose space. These findings support the hypothesis that maximum resistance to perfusate flow in the isolated perfused rat liver is located at the presinusoidal level. In addition, increased transit time of perfusate through the liver and greater sinusoidal surface area resulting from sinusoidal distension may account for the higher extraction of 12-NBDS and possibly other compounds by retrograde perfused liver

Distribution and Determinants of Myocardial Perfusion Grade Following Late Mechanical Recanalization of Occluded Infarct-Related Arteries Postmyocardial Infarction: A Report From the Occluded Artery Trial

Science.gov (United States)

Jorapur, Vinod; Steigen, Terje K.; Buller, Christopher E.; Dẑavík, Vladimír; Webb, John G.; Strauss, Bradley H.; Yeoh, Eunice E.S.; Kurray, Peter; Sokalski, Leszek; Machado, Mauricio C.; Kronsberg, Shari S.; Lamas, Gervasio A.; Hochman, Judith S.; John Mancini, G.B.

2010-01-01

Objective To evaluate the distribution and determinants of myocardial perfusion grade (MPG) following late recanalization of persistently occluded infarct-related arteries (IRA). Background MPG reflects microvascular integrity. It is an independent prognostic factor following myocardial infarction, but has been studied mainly in the setting of early reperfusion. The occluded artery trial (OAT) enrolled stable patients with persistently occluded IRAs beyond 24 hr and up to 28 days post-MI. Methods Myocardial blush was assessed using TIMI MPG grading in 261 patients with TIMI 3 epicardial flow following IRA PCI. Patients demonstrating impaired (0–1) versus preserved (2–3) MPG were compared with regard to baseline clinical and pre-PCI angiographic characteristics. Results Impaired MPG was observed in 60 of 261 patients (23%). By univariate analysis, impaired MPG was associated with failed fibrinolytic therapy, higher heart rate, lower systolic blood pressure, lower ejection fraction, LAD occlusion, absence of collaterals (P < 0.01) and ST elevation MI, lower diastolic blood pressure, and higher systolic sphericity index (P < 0.05). By multivariable analysis, higher heart rate, LAD occlusion, absence of collaterals and higher systolic sphericity index (P < 0.01), and lower systolic blood pressure (P < 0.05) were independently associated with impaired MPG. Conclusion Preserved microvascular integrity was present in a high proportion of patients following late recanalization of occluded IRAs post-MI. Presence of collaterals was independently associated with preserved MPG and likely accounted for the high frequency of preserved myocardial perfusion in this clinical setting. Impaired MPG was associated with baseline clinical and angiographic features consistent with larger infarct size. PMID:18798327

Isolated lung perfusion with gemcitabine for the treatment of pulmonary metastases : Experimental study in a rat model

NARCIS (Netherlands)

Putte, B.P. van

2003-01-01

Isolated lung perfusion is an experimental surgical technique for the treatment of pulmonary metastases in order to improve the current 5-year survival of approximately 40 % after surgical resection of manually palpable metastases. Several drugs have been tested in animals models and five phase I

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

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Irmina Sefić Pašić

2015-08-01

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

Hybrid Endovascular Aortic Aneurysm Repair: Preservation of Pelvic Perfusion with External to Internal Iliac Artery Bypass.

Science.gov (United States)

Mansukhani, Neel A; Havelka, George E; Helenowski, Irene B; Rodriguez, Heron E; Hoel, Andrew W; Eskandari, Mark K

2017-07-01

Diminished pelvic arterial flow as a result of intentional coverage/embolization of internal iliac arteries (IIA) during isolated endovascular common iliac artery aneurysm (CIAA) repair or endovascular repair of abdominal aortic aneurysms (EVAR) may result in symptomatic pelvic ischemia. Although generally well tolerated, in severe cases, pelvic ischemia may manifest as recalcitrant buttock claudication, vasculogenic impotence, or perineal, vesicle, rectal, and/or spinal cord ischemia. Branched graft technology has recently become available; however, many patients are not candidates for endovascular repair with these devices. Therefore, techniques to preserve pelvic arterial flow are needed. We reviewed our outcomes of isolated endovascular CIAA repair or EVAR in conjunction with unilateral external-internal iliac artery bypass. Single-center, retrospective review of 10 consecutive patients who underwent hybrid endovascular abdominal aortic aneurysm (AAA) or CIAA repair with concomitant external-internal iliac artery bypass between 2006 and 2015. Demographics, index procedural details, postoperative symptoms, hospital length of stay (LOS), follow-up imaging, and bypass patency were recorded. The cohort of 10 patients was all men with a mean age of 71 years (range: 56-84). Hybrid repair consisted of contralateral IIA coil embolization followed by EVAR with external iliac artery-internal iliac artery (EIA-IIA) bypass. All EIA-IIA bypasses were performed via a standard lower quadrant retroperitoneal approach with a prosthetic bypass graft. Technical success was 100%, and there were no perioperative deaths. One patient developed transient paraplegia, 1 patient had buttock claudication on the side of his hypogastric embolization contralateral to his iliac bypass, and 1 developed postoperative impotence. 20% of patients sustained long-term complications (buttock claudication and postoperative impotence). Mean LOS was 2.8 days (range: 1-9 days). Postoperative imaging

Improvement of myocardial perfusion detected by 201Tl scintigraphy on cardiac rehabilitation for patients with coronary artery disease

International Nuclear Information System (INIS)

Li, Linxue; Nohara, Ryuji; Makita, Shigeru

1996-01-01

The effect of cardiac rehabilitation (mean 70±48 months) on myocardial perfusion was assessed using thallium-201 ( 201 Tl) exercise study in 63 patients with coronary artery disease (CAD). Subjects were those in a rehabilitation group (Rh=42) participating in supervised sports training two to three times per week and the control group (Ct=21) not taking active daily exercise. The interval between two 201 Tl SPECT studies was 19±16 months. After physical training, total duration of the exercise test increased from 443±112 to 536±121 seconds (+19%) in the Rh group, and from 484±129 to 432±115 seconds in the Ct group (-10.7%) (p 2 to 269.8±58 x 10 2 in the Rh group and decreased from 218.7±40 x 10 2 to 216.6±76 x 10 2 (p 201 Tl myocardial perfusion defect on exercise improved more in 54.8% (stress 59.5%, rest 35.7%) in the Rh group than in the Ct group (9.5%, p 201 Tl perfusion defect decreased from 68 (23.1%) to 49 regions (16.7%) of 294 total myocardial regions in the Rh group on exercise. However. it increased from 39 (26.5%) to 44 (29.9%) regions of 147 regions in the Ct group (p<0.01). Thus, cardiac rehabilitation increases exercise tolerance with improvement of myocardial perfusion. suggesting that cardiac rehabilitation is an advisable and effective treatment for patients with ischemic heart disease. (author)

Combined anatomical and functional imaging using coronary CT angiography and myocardial perfusion SPECT in symptomatic adults with abnormal origin of a coronary artery.

Science.gov (United States)

Uebleis, C; Groebner, M; von Ziegler, F; Becker, A; Rischpler, C; Tegtmeyer, R; Becker, C; Lehner, S; Haug, A R; Cumming, P; Bartenstein, P; Franz, W M; Hacker, M

2012-10-01

There has been a lack of standardized workup guidelines for patients with congenital abnormal origin of a coronary artery from the opposite sinus (ACAOS). We aimed to evaluate the use of cardiac hybrid imaging using multi-detector row CT (MDCT) for coronary CT angiography (Coronary CTA) and stress-rest myocardial perfusion SPECT (MPS) for comprehensive diagnosis of symptomatic adult patients with ACAOS. Seventeen symptomatic patients (12 men; 54 ± 13 years) presenting with ACAOS underwent coronary CTA and MPS. Imaging data were analyzed by conventional means, and with additional use of 3D image fusion to allocate stress induced perfusion defects (PD) to their supplying coronary arteries. An anomalous RCA arose from the left anterior sinus in eight patients, an abnormal origin from the right sinus was detected in nine patients (5 left coronary arteries, LCA and 4 LCx). Five of the 17 patients (29%) demonstrated a reversible PD in MPS. There was no correlation between the anatomical variants of ACAOS and the presence of myocardial ischemia. Image fusion enabled the allocation of reversible PD to the anomalous vessel in three patients (two cases in the RCA and the other in the LCA territory); PD in two patients were allocated to the territory of artery giving rise to the anomalies, rather than the anomalies themselves. In a small cohort of adult symptomatic patients with ACAOS anomaly there was no relation found between the specific anatomical variant and the appearance of stress induced myocardial ischemia using cardiac hybrid imaging.

Prognostic value of abnormal exercise myocardial perfusion imaging and its types in patients with coronary artery disease

International Nuclear Information System (INIS)

Zhu Mei; Pan Zhongyun; Lin JInghui; Zhang Chunli; Nie Tao; Wang Yanfu

1998-01-01

Purpose: To evaluate the prognostic value of abnormal exercise myocardial perfusion imaging and its types in patients with coronary artery disease (CAD). Methods: 69 patients with CAD underwent exercise myocardial perfusing imaging and exercise ECG test. The images of all of them were abnormal. 45 patients were angiographically proved CAD. Follow-up period ranged from 6∼110 months and even longer than 12 months for patients with no cardiac events (CE). Results: CE occurred in 15 patients during the follow-up period. The CE incidence was 8.7% per year. Cox regression analysis revealed that there was a good correlation between the number of myocardial segments with reversible defects and future CE. Comparing the results of 13 patients with small extent irreversible defects with the data obtained from normal subjects reported previously, there was no significant difference between two no-CE rates (x 2 = 0.09, P>0.05). Conclusions: Normal myocardial images and irreversible defects involving rather small areas predicted an excellent prognosis. The better predictor of future CE is the quantity of myocardial segments with reversible defect

Diagnosis of severe and extensive coronary artery disease using gated myocardial perfusion SPECT

Energy Technology Data Exchange (ETDEWEB)

Cho, Ihn Ho; Lee, Hyoung Woo; Won, Kyu Chang; Park, Jong Sun; Sin, Dog Gu; Kim, Young Jo; Shim, Bong Sub [College of Medicine, Yeungnam Univ., Taegu (Korea, Republic of)

1999-07-01

Left ventricular volumes and ejection fractions constitute important informations in the diagnosis and prognosis of cardiac disease. Aim of the study is to verify if the assessment of left ventricular function and perfusion together by gated myocardial perfusion SPECT is useful for diagnosing severe and extensive CAD. We examined 27 consecutive patients (17 males and 10 females, mean age : 60.1 years) who underwent two day rest/stress Tc-99m MIBI gated SPECT. Stress was done with adenosine. Post-stress gated SPECT was done at 1 hour after an injection of Tc-99m MIBI (740 MBq). All patients underwent coronary angiography after gated SPECT within 1 month. We divided them three groups with single vessel disease, double vessel disease and triple vessel disease or severe proximal left coronary artery stenosis. Extent of Defect (ED), Reversibility of Extent (RE), Severity of Defect (SD) and Severity of Reversibility (SR) were calculated by CEqual program. Post-stress LVEF, Rest LVEF, End-diastolic volume(EDV), End-systolic volume(ESV), Transient Ischemic Dilation (TID) of left ventricle (Post-stress EDV/Rest EDV) were calculated using gated SPECT quantification program. Left ventricle is divided with 18 segments and wall motion was scored (normal=0, mild hypokinesia =1, severe hypokinesia =2, akinesia =3 and dyskinesia =4), and then post-stress summed wall motion score was calculated. Post-stress summed wall motion score and post-stress LVEF were significant differences between three groups ( P <0.01). Extent of defect, Extent of reversibility, Severity of defect and severity of reversibility in Polar map were significant differences between three groups ( P <0.01). Post-stress Transient left ventricular dilatation and test LVEF were not significant differences between three groups ( P > 0.05). The gated SPECT pattern (low post-stress LVEF and post-stress summed wall motion score) add important diagnostic information over ungated perfusion data (high ED, ER and SR and

Inflammatory processes during arteriogenesis : the contribution of the innate immune system to collateral artery growth

NARCIS (Netherlands)

de Groot, D.

2011-01-01

The central theme of the work presented in the thesis is restoration of tissue perfusion by collateral artery growth. During collateral artery growth, or arteriogenesis, unused pre-existing vascular anastomoses remodel into functional arteries. These arteries are able to take over the perfusion of

Anionic and cationic drug secretion in the isolated perfused rat kidney after neonatal surgical induction of ureteric obstruction.

NARCIS (Netherlands)

Gier, R.P.E. de; Feitz, W.F.J.; Masereeuw, R.; Wouterse, A.C.; Smits, D.; Russel, F.G.M.

2003-01-01

OBJECTIVE: To study the pathophysiological changes of renal tubular drug transport mechanisms in congenital renal obstruction, by developing a model for perfusing the isolated kidney (IPK) after neonatal surgical induction of partial ureteric obstruction in Hanover Wistar rats. MATERIAL AND METHODS:

An open-source framework of neural networks for diagnosis of coronary artery disease from myocardial perfusion SPECT.

Science.gov (United States)

Guner, Levent A; Karabacak, Nese Ilgin; Akdemir, Ozgur U; Karagoz, Pinar Senkul; Kocaman, Sinan A; Cengel, Atiye; Unlu, Mustafa

2010-06-01

The purpose of this study is to develop and analyze an open-source artificial intelligence program built on artificial neural networks that can participate in and support the decision making of nuclear medicine physicians in detecting coronary artery disease from myocardial perfusion SPECT (MPS). Two hundred and forty-three patients, who had MPS and coronary angiography within three months, were selected to train neural networks. Six nuclear medicine residents, one experienced nuclear medicine physician, and neural networks evaluated images of 65 patients for presence of coronary artery stenosis. Area under the curve (AUC) of receiver operating characteristics analysis for networks and expert was .74 and .84, respectively. The AUC of the other physicians ranged from .67 to .80. There were no significant differences between expert, neural networks, and standard quantitative values, summed stress score and total stress defect extent. The open-source neural networks developed in this study may provide a framework for further testing, development, and integration of artificial intelligence into nuclear cardiology environment.

[Myocardial perfusion imaging by digital subtraction angiography].

Science.gov (United States)

Kadowaki, H; Ishikawa, K; Ogai, T; Katori, R

1986-03-01

Several methods of digital subtraction angiography (DSA) were compared to determine which could better visualize regional myocardial perfusion using coronary angiography in seven patients with myocardial infarction, two with angina pectoris and five with normal coronary arteries. Satisfactory DSA was judged to be achieved if the shape of the heart on the mask film was identical to that on the live film and if both films were exactly superimposed. To obtain an identical mask film in the shape of each live film, both films were selected from the following three phases of the cardiac cycle; at the R wave of the electrocardiogram, 100 msec before the R wave, and 200 msec before the R wave. The last two were superior for obtaining mask and live films which were similar in shape, because the cardiac motion in these phases was relatively small. Using these mask and live films, DSA was performed either with the continuous image mode (CI mode) or the time interval difference mode (TID mode). The overall perfusion of contrast medium through the artery to the vein was adequately visualized using the CI mode. Passage of contrast medium through the artery, capillary and vein was visualized at each phase using TID mode. Subtracted images were displayed and photographed, and the density of the contrast medium was adequate to display contour lines as in a relief map. Using this DSA, it was found that regional perfusion of the contrast medium was not always uniform in normal subjects, depending on the typography of the coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of an isotope washout technique to measure skin vascular resistance and skin perfusion pressure: influence of age, site and arterial surgery

International Nuclear Information System (INIS)

Duncan, H.J.; Faris, I.B.

1986-01-01

1. A simplified isotope (sup(99m)Tc) washout technique has been devised to calculate the skin perfusion pressure (SPP) and skin vascular resistance (SVR). This test is simple, requires inexpensive equipment and is well tolerated by patients. 2. SPP and SVR were calculated in 20 patients 30 years of age and in 15 patients with peripheral vascular disease (PVD). With increasing age the SPP and SVP were increased. The SPP was similar to the mean arterial pressure in normal individuals but was decreased in patients with PVD. The SPP is a useful indicator of the severity of the PVD. 3. The SPP and SVR were higher in the calf than in the foot. This is probably related to the decrease in pressure in the distal arterial tree. 4. SPP was increased by 110% and skin blood flow by 190% by arterial reconstructive surgery. This test may be of use in assessing the effectiveness of arterial surgery. (author)

Nuclear medicine and coronary artery disease: evaluation of tracers of myocardial perfusion and vulnerable atherosclerotic plaque

International Nuclear Information System (INIS)

Broisat, A.

2005-04-01

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

Compartment analysis of 125I-labelled albumin washout from coronary vessels of isolated perfused hearts

International Nuclear Information System (INIS)

Cheng Eap Ng; Seh-Hoon Song

1978-01-01

Albumin labelled with 125 I was used as a tracer to investigate the washout kinetics of plasma from the coronary circulation of isolated perfused feline hearts. Compartmentalization with experimental results showed at least two compartments. The model was compared with a three-compartment model found previously for red blood cells. The results indicate that there is a separation of plasma and RBC in the coronary microcirculation. (author)

Prognostic value of Tc-99m tetrofosmin myocardial perfusion gated SPECT in patients with diabetes mellitus and suspected coronary artery disease

International Nuclear Information System (INIS)

Santos, Marcia Maria Sales dos; Pantoja, Mauricio da Rocha; Cwajg, Eduardo

2008-01-01

Background: The cardiovascular disease is the main cause of death among diabetic patients, which makes it crucial to identify the individuals at higher risk of cardiovascular events. Objective: To evaluate the prognostic value of scintigraphy with gated single photon emission computed tomography (SPECT) in patients with diabetes mellitus (DM) and suspected coronary artery disease. Methods: Retrospective study with 232 diabetic patients submitted to scintigraphy with gated SPECT. Perfusion Gated SPECT (scores and number of altered segments) as well as ventricular function parameters (ejection fraction, left ventricle volume and contractility) were evaluated. Cardiac death, acute ischemic coronary syndrome, revascularization procedures or encephalic vascular accident were considered future cardiovascular events. The uni- and multivariate analyses were carried out by the multiple logistic regression model (p< 0.05). Results: At the univariate analysis, age (p=0.02), chest angina (p=0.01), insulin therapy (p=0.02), myocardial perfusion abnormalities (p<0.0001), the number of segments involved (p=0.0001), the perfusion scores (p=0.0001), the ejection fraction (p=0.004), the final systolic volume (p=0.03) and the finding of segmental alteration at the LV contractility (p<0.0001) were associated with future events at the univariate analysis. At the multivariate analysis, the male sex (p=0.007), age (p=0.03), angina (p=0.001), insulin therapy (p=0.007) and the SDS ≥ 3 (p=0.0001), and the number of altered segments ≥ 3 (p=0.0001) were predictors of cardiovascular events. Conclusion: The myocardial scintigraphy with gated SPECT adds independent information to the stratification of the risk of future cardiovascular events in patients with DM and suspected coronary artery disease. (author)

Prognostic value of Tc-99m tetrofosmin myocardial perfusion gated SPECT in patients with diabetes mellitus and suspected coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Santos, Marcia Maria Sales dos; Pantoja, Mauricio da Rocha; Cwajg, Eduardo [Universidade Federal do Rio de Janeiro (UFRJ), RJ (Brazil); CINTILAB, Rio de Janeiro, RJ (Brazil); E-mail: mmsales@oi.com.br

2008-01-15

Background: The cardiovascular disease is the main cause of death among diabetic patients, which makes it crucial to identify the individuals at higher risk of cardiovascular events. Objective: To evaluate the prognostic value of scintigraphy with gated single photon emission computed tomography (SPECT) in patients with diabetes mellitus (DM) and suspected coronary artery disease. Methods: Retrospective study with 232 diabetic patients submitted to scintigraphy with gated SPECT. Perfusion Gated SPECT (scores and number of altered segments) as well as ventricular function parameters (ejection fraction, left ventricle volume and contractility) were evaluated. Cardiac death, acute ischemic coronary syndrome, revascularization procedures or encephalic vascular accident were considered future cardiovascular events. The uni- and multivariate analyses were carried out by the multiple logistic regression model (p< 0.05). Results: At the univariate analysis, age (p=0.02), chest angina (p=0.01), insulin therapy (p=0.02), myocardial perfusion abnormalities (p<0.0001), the number of segments involved (p=0.0001), the perfusion scores (p=0.0001), the ejection fraction (p=0.004), the final systolic volume (p=0.03) and the finding of segmental alteration at the LV contractility (p<0.0001) were associated with future events at the univariate analysis. At the multivariate analysis, the male sex (p=0.007), age (p=0.03), angina (p=0.001), insulin therapy (p=0.007) and the SDS {>=} 3 (p=0.0001), and the number of altered segments {>=} 3 (p=0.0001) were predictors of cardiovascular events. Conclusion: The myocardial scintigraphy with gated SPECT adds independent information to the stratification of the risk of future cardiovascular events in patients with DM and suspected coronary artery disease. (author)

Non-contrast MRI perfusion angiosome in diabetic feet

Energy Technology Data Exchange (ETDEWEB)

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

2015-01-15

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

Non-contrast MRI perfusion angiosome in diabetic feet

International Nuclear Information System (INIS)

Zheng, Jie; Hastings, Mary K.; Mueller, Michael J.; Muccigross, David; Hildebolt, Charles F.; Fan, Zhaoyang; Gao, Fabao; Curci, John

2015-01-01

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

Isolated unilateral pulmonary artery hypoplasia with accompanying pulmonary parenchymal findings on CT: A case report

Energy Technology Data Exchange (ETDEWEB)

Park, Surin; Cha, Yoon Ki; Kim, Jeung Sook; Kwon, Jae Hyun; Jeong, Yun Jeong [Dongguk University Ilsan Hospital, Dongguk University College of Medicine, Goyang (Korea, Republic of); Kim, Seon Jeong [Dept. of Radiology, Myongji Hospital, Goyang (Korea, Republic of)

2017-05-15

Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia.

Isolated unilateral pulmonary artery hypoplasia with accompanying pulmonary parenchymal findings on CT: A case report

International Nuclear Information System (INIS)

Park, Surin; Cha, Yoon Ki; Kim, Jeung Sook; Kwon, Jae Hyun; Jeong, Yun Jeong; Kim, Seon Jeong

2017-01-01

Unilateral pulmonary artery hypoplasia or agenesis without congenital cardiovascular anomalies is rare in adults. We report a case of a 36-year-old man with isolated left unilateral pulmonary artery hypoplasia with recurrent hemoptysis. On computed tomography (CT), the left pulmonary artery showed hypoplasia with multiple collateral vessels seen in the mediastinum and the left hemithorax. Also, parenchymal bands and peripheral linear opacities were seen in the affected lung, which were probably due to chronic infarction induced by unilateral pulmonary artery hypoplasia. There are only a few reports focusing on the radiologic findings in the pulmonary parenchyma induced by unilateral pulmonary artery hypoplasia, such as parenchymal bands and peripheral linear opacities. Therefore we report this case, which focused on the CT findings in the pulmonary parenchyma due to isolated unilateral pulmonary artery hypoplasia

Perfusion CT in acute stroke

International Nuclear Information System (INIS)

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

2015-01-01

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

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

International Nuclear Information System (INIS)

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

1977-01-01

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

Normal Values of Tissue-Muscle Perfusion Indexes of Lower Limbs Obtained with a Scintigraphic Method.

Science.gov (United States)

Manevska, Nevena; Stojanoski, Sinisa; Pop Gjorceva, Daniela; Todorovska, Lidija; Miladinova, Daniela; Zafirova, Beti

2017-09-01

Introduction Muscle perfusion is a physiologic process that can undergo quantitative assessment and thus define the range of normal values of perfusion indexes and perfusion reserve. The investigation of the microcirculation has a crucial role in determining the muscle perfusion. Materials and method The study included 30 examinees, 24-74 years of age, without a history of confirmed peripheral artery disease and all had normal findings on Doppler ultrasonography and pedo-brachial index of lower extremity (PBI). 99mTc-MIBI tissue muscle perfusion scintigraphy of lower limbs evaluates tissue perfusion in resting condition "rest study" and after workload "stress study", through quantitative parameters: Inter-extremity index (for both studies), left thigh/right thigh (LT/RT) left calf/right calf (LC/RC) and perfusion reserve (PR) for both thighs and calves. Results In our investigated group we assessed the normal values of quantitative parameters of perfusion indexes. Indexes ranged for LT/RT in rest study 0.91-1.05, in stress study 0.92-1.04. LC/RC in rest 0.93-1.07 and in stress study 0.93-1.09. The examinees older than 50 years had insignificantly lower perfusion reserve of these parameters compared with those younger than 50, LC (p=0.98), and RC (p=0.6). Conclusion This non-invasive scintigraphic method allows in individuals without peripheral artery disease to determine the range of normal values of muscle perfusion at rest and stress condition and to clinically implement them in evaluation of patients with peripheral artery disease for differentiating patients with normal from those with impaired lower limbs circulation.

Arterio-venous anastomoses in mice affect perfusion measurements with dynamic contrast enhanced CT

International Nuclear Information System (INIS)

Gabra, Peter; Lee, Ting-Yim; Shen, Gang; Xuan, Jim

2010-01-01

Accurate measurement of perfusion with dynamic contrast enhanced CT requires an arterial input curve (AIC) uncontaminated by venous sources. Arterio-venous anastomoses (AVAs) are sources of contamination if contrast is injected intravenously. We seek to identify AVAs in mice and associated errors in perfusion measurements. Six transgenic mice with spontaneous prostate tumor were scanned with a micro-CT scanner (GE Healthcare (GE)) using a high resolution anatomical and a lower resolution perfusion protocol. For the anatomical protocol, a CT scan was performed during injection of an iodinated contrast agent (Hypaque) into a tail vein. Images covering the thoracic, abdominal and pelvic regions at an isotropic resolution of 175 µm were reconstructed and rendered in 3D to show the arterial and venous tree (Advantage Window, GE). For the perfusion protocol, each mouse was continuously scanned for 40 s and the contrast agent (Hypaque) was injected via a tail vein 5 s into scanning. Tumor images were reconstructed every second. Tumor blood flow (BF) and volume (BV) maps were calculated with CT perfusion software (GE) using AIC measured either from abdominal aorta (AA) or tail (caudal) artery (TA). In all mice, there was an AVA from the bifurcation of the inferior vena cava to the tail artery shunting venous blood and portion of the contrast agent injected into the tail vein into the TA. Contrast arrival time at the TA preceded that at the AA by 3.3 ± 0.5 s (P < 0.05). Mean tumor BV and BF values calculated with AA versus TA were 10.0 ± 1.8 versus 4.8 ± 2.1 ml (100 g) −1 (P < 0.05) and 108.8 ± 26.5 versus 33.0 ± 8.5 ml min −1 100 g −1 (P < 0.05), respectively. AVA in the murine pelvic region can result in inaccurate and more variable measurements of pelvic organ/tissue perfusion when the tail artery is used as the AIC

Pulmonary arterial hypertension secondary to chronic thromboemboli

International Nuclear Information System (INIS)

Crysikopoulos, H.; Forrest, J.V.; Olson, L.K.; Roberts, A.C.

1989-01-01

The authors report their experience in 150 patients with pulmonary arterial hypertension secondary to chronic pulmonary embolism (CPE). Plain film findings are variable, commonly nonspecific. Occasionally nonuniformity of pulmonary perfusion or truncation of central pulmonary arteries suggest CPE. Multiple, large, unmatched perfusion defects are the most common scintigraphic observations. CT can exclude conditions mimicking CPE, particularly fibrosing mediastinitis. Pulmonary arteriography depicts the location and distribution of emboli. CPE is becoming an increasingly important entity to recognize because of available surgical treatment. Thromboendarterectomy may improve functional status and survival. The diagnosis should be considered in any patient with pulmonary arterial hypertension

Perfusion lung scanning: differentiation of primary from thromboembolic pulmonary hypertension

International Nuclear Information System (INIS)

Lisbona, R.; Kreisman, H.; Novales-Diaz, J.; Derbekyan, V.

1985-01-01

Of eight patients with pulmonary arterial hypertension, final diagnosis established by autopsy or angiography, four had primary hypertension and four hypertension from thromboembolism. The perfusion lung scan was distinctly different in the two groups. The lung scan in primary pulmonary hypertension was associated with nonsegmental, patchy defects of perfusion, while in thromboembolic hypertensives it was characterized by segmental and/or lobar defects of perfusion with or without subsegmental defects. The perfusion lung scan is a valuable, noninvasive study in the evaluation of the patient with pulmonary hypertension of undetermined cause and in the exclusion of occult large-vessel pulmonary thromboembolism

Isolated aneurysms of the iliac arteries

International Nuclear Information System (INIS)

Eckmann, A.; Schild, H.; Schmiedt, W.; Groenninger, J.

1988-01-01

Isolated aneurysms of the iliac arteries are rare. They must be considered as a disease pattern of their own as against aneurysms of the abdominal aorta because of the specific anatomical conditions in the pelvis. The clinical symptomatology is determinated by their localisation and topographical relationships within teh pelvis; this can give rise to problems in differential diagnosis primary urological, neurological or gastrointestinal diseases. The prognosis is decisively determined early and correct diagnosis because of the danger of rupture. Sonography, computed tomography and angiography are indispensable aids in preoperative planning. (orig.) [de

Resting cardiointegram: correlation with stress thallium perfusion studies

International Nuclear Information System (INIS)

Gould, L.A.; Betzu, R.; Judge, D.; Lee, J.; Taddeo, M.; Yang, D.

1988-01-01

The cardiointegram is a noninvasive technique for the analysis of the electrical signals of the heart obtained by a transformation of the voltage versus time format by a series of integrations. The stress thallium perfusion study is a widely used test for the detection of coronary artery disease. In order to evaluate the correlation between the resting cardiointegram and the stress thallium 201 perfusion study, 20 patients with normal resting electrocardiograms underwent stress thallium tests and resting cardiointegrams. The cardiointegram was determined on two resting complexes of leads I, II, V4, V5, and V6 and called abnormal if five of ten complexes deviated outside a normalized template. There was concordance of the cardiointegram and the thallium study in 16 of 20 patients (80%). The sensitivity for the detection of coronary artery disease was 71%, and the specificity was 80%. The overall accuracy was 74%. Thus in patients with normal electrocardiograms, the cardiointegram is a useful noninvasive test for the detection of coronary artery disease

Comparison of single-dose and double-dose thallium-201 myocardial perfusion scintigraphy for the detection of coronary artery disease and prior myocardial infarction

International Nuclear Information System (INIS)

Blood, D.K.; McCarthy, D.M.; Sciacca, R.R.; Cannon, P.J.

1978-01-01

Thallium-201 myocardial perfusion scintigraphy was performed after exercise, 4 hours after exercise (redistribution) and after a separate rest injection in 87 patients undergoing coronary arteriography. Significant coronary lesions were present in 62 of the patients. Interpretation of the rest and redistribution scintiscans was the same in 69 patients, 45 of whom had coronary artery disease (CAD). In 16 of the 17 patients with CAD and differing interpretations, defects were present on redistribution scintiscans but not on rest scintiscans; 11 of these patients had evidence of prior transmural myocardial infarction and the other five had an occluded coronary artery supplying the region of the defect. Redistribution scintiscans were more sensitive than rest scintiscans for the detection of prior myocardial infarction (93% vs 54%; P < 0.01). The increased sensitivity was confined to the detection of prior inferior myocardial infarctions. In 36 of 38 patients with persistent perfusion defects on 4-hour redistribution scintiscans, either a prior infarction or an occluded coronary vessel was present. These data demonstrate that redistribution thallium-201 scintiscans may be substituted for conventional rest scintiscans, resulting in reduced cost and radiation exposure to the patients

Influence of the prevalence of coronary artery disease in patients with normal myocardial perfusion SPECT imaging. Cooperative study in South America

International Nuclear Information System (INIS)

Balestrini, V.R.; Arja, V.J.; Sandrin, A.L.; Sala, J.P.; Joekes, S.; Bier, G.; Precoma, D.; Yamada, A.

2002-01-01

An important feature of myocardial perfusion imaging is the ability to predict prognosis and identify high- and low-risk patients for coronary events. According to Bayes' theorem, the significance of test's results, relates not only the sensitivity and specificity of a test but also the prevalence of disease in the population under study. Aim: evaluate the relationship between pretest likelihood (PTL) and coronary events (CE) in patients with normal myocardial perfusion SPECT imaging during a long period of time. Material and Methods: The population included 709 patients (411 men and 298 women, mean age 58 years old) who underwent stress/rest myocardial perfusion SPECT imaging at nuclear cardiology laboratories in Argentina and Brazil, with scintigraphic images interpreted as normal. Analyzed variables: clinical, EKG and stress test. Perfusion agents: Tc-99m-tetrofosmin: 36.5%, Tc99m-sestamibi 5.8% and Tl-201 57.7%. Mean follow up: 919 days. CE: soft (unstable angina and need for revascularization) and hard (AMI and cardiac death). Results: Stress test: exercise stress test 72.2%, dipyridamole 25%, adenosine 1.7%, dobutamine 1.1%. PTL [ 9' (M/F): 59/11% (p 78%] 31 vs. 50%. Conclusions: 1) There was a relationship between PTL, events rate and time to event. 2) We found a low hard events rate (0.85%). 3) The results in this group of patients with normal myocardial perfusion SPECT imaging may suggest a guarantee period of low risk of coronary events between 2-3 years. 4) In spite of there is a low event rate in total population with normal myocardial perfusion imaging, patients with highest prevalence of coronary artery disease have more statistical probabilities of coronary events and therefore they have to be watched closely

HYPERTHERMIC ISOLATED REGIONAL PERFUSION WITH CISPLATIN IN THE LOCAL TREATMENT OF SPONTANEOUS CANINE OSTEOSARCOMA - ASSESSMENT OF SHORT-TERM EFFECTS

NARCIS (Netherlands)

VANGINKEL, RJ; HOEKSTRA, HJ; MEUTSTEGE, FJ; OOSTERHUIS, JW; UGES, DRA; KOOPS, HS

To increase the effect of cisplatin on locoregional osteosarcoma, the short-term effect of hyperthermic isolated regional perfusion (HIRP) with cisplatin (30 mg/L extremity volume) was studied in 28 dogs with spontaneous osteogenic sarcoma, using clinical, radiological, and histological parameters.

Hepatic blood perfusion estimated by dynamic contrast-enhanced computed tomography in pigs

DEFF Research Database (Denmark)

Winterdahl, Michael; Sørensen, Michael; Keiding, Inger Susanne

2012-01-01

The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates.......The aim of this study was to determine whether dynamic contrast-enhanced computed tomography (DCE-CT) and the slope method can provide absolute measures of hepatic blood perfusion from the hepatic artery (HA) and portal vein (PV) at experimentally varied blood flow rates....

Hyperpolarized Water Perfusion in the Porcine Brain – a Pilot Study

DEFF Research Database (Denmark)

Søvsø Szocska Hansen, Esben; Lipsø, Hans Kasper Wigh; Tougaard, Rasmus Stilling

2017-01-01

Dynamic Contrast-Enhanced MR (DCE-MR) perfusion assessment with gadolinium contrast agents is currently the most widely used cerebral perfusion MR method. Hyperpolarized water has recently been shown to succeed 13C probes as angiography probe. In this study, we demonstrate the feasibility...... of hyperpolarized water for visualizing the brain vasculature of a large animal in a clinically relevant setting. In detail, reference perfusion values were obtained and large to small arteries could be identified....

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

DEFF Research Database (Denmark)

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

2006-01-01

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

Isolated hepatic perfusion as a treatment for uveal melanoma liver metastases (the SCANDIUM trial)

DEFF Research Database (Denmark)

Olofsson, Roger; Ny, Lars; Eilard, Malin Sternby

2014-01-01

for patients with liver metastases is between 6 and 12 months, and no treatment has in randomized trials ever been shown to prolong survival. A previous phase II trial using isolated hepatic perfusion (IHP) has suggested a 14-month increase in overall survival compared with a historic control group consisting...... of the longest surviving patients in Sweden during the same time period (26 versus 12 months). METHODS/DESIGN: This is the protocol for a multicenter phase III trial randomizing patients with isolated liver metastases of uveal melanoma to IHP or best alternative care (BAC). Inclusion criteria include liver....... The planned sample size is 78 patients throughout five years. DISCUSSION: Patients with isolated liver metastases of uveal melanoma origin have a short expected survival and no standard treatment option exists. This is the first randomized clinical trial to evaluate IHP as a treatment option with overall...

Magnetic resonance perfusion imaging without contrast media

International Nuclear Information System (INIS)

Martirosian, Petros; Graf, Hansjoerg; Schick, Fritz; Boss, Andreas; Schraml, Christina; Schwenzer, Nina F.; Claussen, Claus D.

2010-01-01

Principles of magnetic resonance imaging techniques providing perfusion-related contrast weighting without administration of contrast media are reported and analysed systematically. Especially common approaches to arterial spin labelling (ASL) perfusion imaging allowing quantitative assessment of specific perfusion rates are described in detail. The potential of ASL for perfusion imaging was tested in several types of tissue. After a systematic comparison of technical aspects of continuous and pulsed ASL techniques the standard kinetic model and tissue properties of influence to quantitative measurements of perfusion are reported. For the applications demonstrated in this paper a flow-sensitive alternating inversion recovery (FAIR) ASL perfusion preparation approach followed by true fast imaging with steady precession (true FISP) data recording was developed and implemented on whole-body scanners operating at 0.2, 1.5 and 3 T for quantitative perfusion measurement in various types of tissue. ASL imaging provides a non-invasive tool for assessment of tissue perfusion rates in vivo. Images recorded from kidney, lung, brain, salivary gland and thyroid gland provide a spatial resolution of a few millimetres and sufficient signal to noise ratio in perfusion maps after 2-5 min of examination time. Newly developed ASL techniques provide especially high image quality and quantitative perfusion maps in tissues with relatively high perfusion rates (as also present in many tumours). Averaging of acquisitions and image subtraction procedures are mandatory, leading to the necessity of synchronization of data recording to breathing in abdominal and thoracic organs. (orig.)

Counteracting negative venous line pressures to avoid arterial air bubbles: an experimental study comparing two different types of miniaturized extracorporeal perfusion systems.

Science.gov (United States)

Aboud, Anas; Mederos-Dahms, Hendrikje; Liebing, Kai; Zittermann, Armin; Schubert, Harald; Murray, Edward; Renner, Andre; Gummert, Jan; Börgermann, Jochen

2015-05-29

Because of its low rate of clinical complications, miniaturized extracorporeal perfusion systems (MEPS) are frequently used in heart centers worldwide. However, many recent studies refer to the higher probability of gaseous microemboli formation by MEPS, caused by subzero pressure values. This is the main reason why various de-airing devices were developed for today's perfusion systems. In the present study, we investigated the potential benefits of a simple one-way-valve connected to a volume replacement reservoir (OVR) for volume and pressure compensation. In an experimental study on 26 pigs, we compared MEPS (n = 13) with MEPS plus OVR (n = 13). Except OVR, perfusion equipment was identical in both groups. Primary endpoints were pressure values in the venous line and the right atrium as well as the number and volume of air bubbles. Secondary endpoints were biochemical parameters of systemic inflammatory response, ischemia, hemodilution and hemolysis. One animal was lost in the MEPS + OVR group. In the MEPS + OVR group no pressure values below -150 mmHg in the venous line and no values under -100 mmHg in right atrium were noticed. On the contrary, nearly 20% of venous pressure values in the MEPS group were below -150 and approximately 10% of right atrial pressure values were below -100 mmHg. Compared with the MEPS group, the bubble counter device showed lower numbers of arterial air bubbles in the MEPS + OVR group (mean ± SD: 13444 ± 5709 vs. 1 ± 2, respectively; p pressures and to reduce the number and volume of arterial air bubbles. This approach may lead to a lower rate of neurological complications.

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

Science.gov (United States)

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

2016-01-01

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

TNFa-based isolated limb perfusion in the rat : development of a model and analysis of efficacy determining factors

NARCIS (Netherlands)

E.R. Manusama (Eric)

1998-01-01

textabstractIsolated limb perfusion (lLP) with high dose TNFa in combination with IFNr and melphalan in patients with melanoma in transit metastases confined to the limb has recently been reported to result in much higher complete tumor response rates than after the standard therapy of ILP with

Improved calculation of the equilibrium magnetization of arterial blood in arterial spin labeling

DEFF Research Database (Denmark)

Ahlgren, André; Wirestam, Ronnie; Knutsson, Linda

2018-01-01

PURPOSE: To propose and assess an improved method for calculating the equilibrium magnetization of arterial blood ( M0a), used for calibration of perfusion estimates in arterial spin labeling. METHODS: Whereas standard M0a calculation is based on dividing a proton density-weighted image by an ave...

The effect of age on outcomes after isolated limb perfusion for advanced extremity malignancies.

Science.gov (United States)

Smith, H G; Wilkinson, M J; Smith, M J F; Strauss, D C; Hayes, A J

2018-06-22

Isolated limb perfusion (ILP) is a well-established treatment for patients with advanced extremity malignancies unsuitable for limb-conserving surgery. However, little is known about the outcomes of this treatment in elderly patients. We sought to determine the effects of age on the tolerability and efficacy of ILP for advanced extremity malignancy. Patients undergoing ILP at our institution between January 2005 and January 2018 were identified from a prospectively maintained database. Patients were stratified by pathology (melanoma, soft-tissue sarcoma, other) and age (<75 years and ≥75 years). Outcomes of interest were perioperative morbidity and mortality, locoregional toxicities, response rates and oncological outcomes. During the study period, a total of 189 perfusions were attempted. Successful perfusions were performed in 179 patients, giving a technical success rate of 94.7%. No difference in perfusion success rates, severe locoregional toxicity and perioperative morbidity or mortality was noted between those aged <75 years and ≥75 years. The overall response rate in melanoma was 82.4%, and no difference in response rates or oncological outcomes between age groups was noted in these patients. The overall response rate in soft-tissue sarcoma was 63.5%, with no difference in response rates noted between age groups. However, patients aged <75 years with soft-tissue sarcoma had prolonged local recurrence-free survival compared with older patients (13 versus 6 months), possibly due to the prevalence of chemosensitive subtypes in the younger age group. ILP is an effective treatment for advanced extremity malignancies in the elderly, with comparable response rates and toxicities to younger patients. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Measurement of pulmonary vascular resistance of Fontan candidates with pulmonary arterial distortion by means of pulmonary perfusion imaging

International Nuclear Information System (INIS)

Park, In-Sam; Mizukami, Ayumi; Tomimatsu, Hirofumi; Kondou, Chisato; Nakanishi, Toshio; Nakazawa, Makoto; Momma, Kazuo

1998-01-01

We measured the distribution of blood flow to the right (R) and left lung (L) by means of pulmonary perfusion imaging and calculated pulmonary vascular resistance (Rp) in 13 patients, whose right and left pulmonary artery pressures were different by 2 to 9 mmHg due to pulmonary arterial distortion (5 interruption, 8 stenosis). The right lung/left lung blood flow ratio was determined and from the ratio and the total pulmonary blood flow, which was determined using the Fick's principle, the absolute values of right and left pulmonary blood flow were calculated. Using the right and left pulmonary blood flow and the right and left pulmonary arterial pressures, right and left pulmonary vascular resistance were calculated, separately. Vascular resistance of the whole lung (Rp) was then calculated using the following equation. 1/(Rp of total lung)=1/(Rp of right lung)+1/(Rp of left lung). Rp calculated from this equation was 1.8+/-0.8 U·m 2 and all values were less than 3 U·m 2 (range 0.3-2.8). Rp estimated from the conventional method using the total pulmonary blood flow and pulmonary arterial pressures, without using the right/left blood flow ratio, ranging from 0.4 to 3.8 U·m 2 and 5 of 13 patients showed Rp>3 U·m 2 . All patients underwent Fontan operation successfully. These data indicated that this method is useful to estimate Rp and to determine the indication of Fontan operation in patients with pulmonary arterial distortions. (author)

Perfusion lung scintigraphy in primary pulmonary hypertension

International Nuclear Information System (INIS)

Ogawa, Yoji; Nishimura, Tsunehiko; Kumita, Shin-ichirou; Hayashida, Kohei; Uehara, Toshiisa; Shimonagata, Tsuyoshi; Ohno, Akira

1991-01-01

Fifteen cases with primary pulmonary hypertension (PPH) were classified into two groups by using the perfusion lung scan pattern. Eight cases had multiple, small, ill-defined defects (mottled pattern), and remaining seven cases had no mottled pattern. These two groups were compared with mean pulmonary arterial pressure (mean PAP), right ventricular ejection fraction (RVEF), blood gas at room air (PaO 2 ), and alveolar-arterial O 2 difference (A-aDo 2 ). The cases with mottled pattern showed a significant increase in mean PAP. There were no significant differences in RVEF, PaO 2 , and A-aDo 2 , between the groups. The survival rate of the patients with mottled pattern was significantly lower than that without mottled pattern (p<0.05). We concluded that perfusion lung scan is very useful for evaluation of the prognosis in primary pulmonary hypertension. (author)

Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease

Energy Technology Data Exchange (ETDEWEB)

Bisdas, Sotirios [JWG University Hospital, Department of Diagnostic and Interventional Radiology, Frankfurt (Germany); Nemitz, Ole; Becker, Hartmut; Donnerstag, Frank [Hannover Medical School, Department of Neuroradiology, Hannover (Germany); Berding, Georg [Hannover Medical School, Department of Nuclear Medicine, Hannover (Germany); Weissenborn, Karin; Ahl, Bjoern [Hannover Medical School, Department of Neurology, Hannover (Germany)

2006-10-15

Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [{sup 15}O]H{sub 2}O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics. (orig.)

Correlative assessment of cerebral blood flow obtained with perfusion CT and positron emission tomography in symptomatic stenotic carotid disease

International Nuclear Information System (INIS)

Bisdas, Sotirios; Nemitz, Ole; Becker, Hartmut; Donnerstag, Frank; Berding, Georg; Weissenborn, Karin; Ahl, Bjoern

2006-01-01

Twelve patients with ICA stenosis underwent dynamic perfusion computed tomography (CT) and positron emission tomography (PET) studies at rest and after acetazolamide challenge. Cerebral blood flow (CBF) maps on perfusion CT resulted from a deconvolution of parenchymal time-concentration curves by an arterial input function (AIF) in the anterior cerebral artery as well as in both anterior choroidal arteries. CBF was measured by [ 15 O]H 2 O PET using multilinear least-squares minimization procedure based on the one-compartment model. In corresponding transaxial PET scans, CBF values were extracted using standardized ROIs. The baseline perfusion CT-CBF values were lower in perfusion CT than in PET (P>0.05). CBF values obtained by perfusion CT were significantly correlated with those measured by PET before (P<0.05) and after (P<0.01) acetazolamide challenge. Nevertheless, the cerebrovascular reserve capacity was overestimated (P=0.05) using perfusion CT measurements. The AIF selection relative to the side of carotid stenosis did not significantly affect calculated perfusion CT-CBF values. In conclusion, the perfusion CT-CBF measurements correlate significantly with the PET-CBF measurements in chronic carotid stenotic disease and contribute useful information to the evaluation of the altered cerebral hemodynamics. (orig.)

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

International Nuclear Information System (INIS)

Koehli, M.; Monbaron, D.; Gaillard, R.C.; Ruiz, J.; Prior, J.O.; Bischof Delaloye, A.; Calcagni, M.L.; Fivaz-Arbane, M.; Stauffer, J.C.

2006-01-01

Aim: To determine the long-term prognostic value of SPECT myocardial perfusion imaging (MPI) for the occurrence of cardiovascular events in diabetic patients. Patients, methods: SPECT MPI of 210 consecutive Caucasian diabetic patients were analysed using Kaplan-Meier event-free survival curve and independent predictors were determined by Cox multivariate analyses. Results: Follow-up was complete in 200 (95%) patients with a median period of 3.0 years (0.8-5.0). The population was composed of 114 (57%) men, age 65 ± 10 years, 181 (90.5%) type 2 diabetes mellitus, 50 (25%) with a history of coronary artery disease (CAD) and 98 (49%) presenting chest pain prior to MPI. The prevalence of abnormal MPI was 58%. Patients with a normal MPI had neither cardiac death, nor myocardial infarction, independently of a history of coronary artery disease or chest pain. Among the independent predictors of cardiac death and myocardial infarction, the strongest was abnormal MPI (p 5-fold increase in cardiovascular events. This emphasizes the value of SPECT MPI in predicting and risk-stratifying cardiovascular events in diabetic patients. (orig.)

Diagnostic and Prognostic Impact of pc-ASPECTS Applied to Perfusion CT in the Basilar Artery International Cooperation Study.

Science.gov (United States)

Pallesen, Lars-Peder; Gerber, Johannes; Dzialowski, Imanuel; van der Hoeven, Erik J R J; Michel, Patrik; Pfefferkorn, Thomas; Ozdoba, Christoph; Kappelle, L Jaap; Wiedemann, Baerbel; Khomenko, Andrei; Algra, Ale; Hill, Michael D; von Kummer, Ruediger; Demchuk, Andrew M; Schonewille, Wouter J; Puetz, Volker

2015-01-01

The posterior circulation Acute Stroke Prognosis Early CT Score (pc-APECTS) applied to CT angiography source images (CTA-SI) predicts the functional outcome of patients in the Basilar Artery International Cooperation Study (BASICS). We assessed the diagnostic and prognostic impact of pc-ASPECTS applied to perfusion CT (CTP) in the BASICS registry population. We applied pc-ASPECTS to CTA-SI and cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) parameter maps of BASICS patients with CTA and CTP studies performed. Hypoattenuation on CTA-SI, relative reduction in CBV or CBF, or relative increase in MTT were rated as abnormal. CTA and CTP were available in 27/592 BASICS patients (4.6%). The proportion of patients with any perfusion abnormality was highest for MTT (93%; 95% confidence interval [CI], 76%-99%), compared with 78% (58%-91%) for CTA-SI and CBF, and 46% (27%-67%) for CBV (P < .001). All 3 patients with a CBV pc-ASPECTS < 8 compared to 6/23 patients with a CBV pc-ASPECTS ≥ 8 had died at 1 month (RR 3.8; 95% CI, 1.9-7.6). CTP was performed in a minority of the BASICS registry population. Perfusion disturbances in the posterior circulation were most pronounced on MTT parameter maps. CBV pc-ASPECTS < 8 may indicate patients with high case fatality. Copyright © 2014 by the American Society of Neuroimaging.

Revascularization of the internal carotid artery for isolated, stenotic, and symptomatic kinking.

Science.gov (United States)

Illuminati, Giulio; Calió, Francesco G; Papaspyropoulos, Vassilios; Montesano, Giuseppe; D'Urso, Antonio

2003-02-01

The operation for isolated, stenotic, and symptomatic kinking of the internal carotid artery is safe and effective in preventing stroke and relieving the symptoms of cerebral ischemia. A consecutive sample clinical study with a mean follow-up of 44 months. The surgical department of an academic tertiary care center and an affiliated secondary care center. Fifty-four patients with a mean age of 67 years underwent 55 revascularizations of the internal carotid artery. The surgical procedures consisted of the following: shortening and reimplantation in the common carotid artery in 36 cases, bypass grafting in 15 cases, and transposition into the external carotid artery in 4 cases. Cumulative survival, primary patency, and stroke-free and neurologic symptom-free rates expressed by standard life-table analysis. No patients died in the postoperative period. The postoperative stroke rate was 1.8%. The cumulative rates (SEs) at 5 years were as follows: survival, 70% (10.2%); primary patency, 89% (7.8%); overall stroke free, 92% (6.8%); ipsilateral stroke free, 96% (5.3%); neurologic symptom free, 90% (7.5%); and ipsilateral symptom free, 93% (6.5%). Revascularization of the internal carotid artery for the treatment of isolated, stenotic, and symptomatic kinking is safe and effective in preventing stroke and relieving symptoms of cerebrovascular insufficiency.

Myocardial perfusion magnetic resonance imaging using sliding-window conjugate-gradient highly constrained back-projection reconstruction for detection of coronary artery disease.

Science.gov (United States)

Ma, Heng; Yang, Jun; Liu, Jing; Ge, Lan; An, Jing; Tang, Qing; Li, Han; Zhang, Yu; Chen, David; Wang, Yong; Liu, Jiabin; Liang, Zhigang; Lin, Kai; Jin, Lixin; Bi, Xiaoming; Li, Kuncheng; Li, Debiao

2012-04-15

Myocardial perfusion magnetic resonance imaging (MRI) with sliding-window conjugate-gradient highly constrained back-projection reconstruction (SW-CG-HYPR) allows whole left ventricular coverage, improved temporal and spatial resolution and signal/noise ratio, and reduced cardiac motion-related image artifacts. The accuracy of this technique for detecting coronary artery disease (CAD) has not been determined in a large number of patients. We prospectively evaluated the diagnostic performance of myocardial perfusion MRI with SW-CG-HYPR in patients with suspected CAD. A total of 50 consecutive patients who were scheduled for coronary angiography with suspected CAD underwent myocardial perfusion MRI with SW-CG-HYPR at 3.0 T. The perfusion defects were interpreted qualitatively by 2 blinded observers and were correlated with x-ray angiographic stenoses ≥50%. The prevalence of CAD was 56%. In the per-patient analysis, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of SW-CG-HYPR was 96% (95% confidence interval 82% to 100%), 82% (95% confidence interval 60% to 95%), 87% (95% confidence interval 70% to 96%), 95% (95% confidence interval 74% to100%), and 90% (95% confidence interval 82% to 98%), respectively. In the per-vessel analysis, the corresponding values were 98% (95% confidence interval 91% to 100%), 89% (95% confidence interval 80% to 94%), 86% (95% confidence interval 76% to 93%), 99% (95% confidence interval 93% to 100%), and 93% (95% confidence interval 89% to 97%), respectively. In conclusion, myocardial perfusion MRI using SW-CG-HYPR allows whole left ventricular coverage and high resolution and has high diagnostic accuracy in patients with suspected CAD. Copyright © 2012 Elsevier Inc. All rights reserved.

Sensitivity and specificity of thallium-201 perfusion scintigrams under exercise in the diagnosis of coronary artery disease

International Nuclear Information System (INIS)

Verani, M.S.; Marcus, M.L.; Razzak, M.A.; Ehrhardt, J.C.

1978-01-01

The specificity and sensitivity of thallium-201 myocardial perfusion imaging (MPI), under exercise, in patients with suspected coronary-obstructive disease was compared with graded exercise ECG tests (GTX) in patients with angiographically normal (N = 34) and obstructed (N = 48) coronary arteries. Of the 34 patients with normal coronaries, only one had a perfusion defect on the MPI (specificity 97%). Of the 48 patients with coronary obstructive disease (>50% obstruction of at least one coronary vessel), MPI was positive in 38 (sensitivity 79%). In contrast, the GTX had a specificity of 62% and sensitivity of 88% if nondiagnostic GTX tests are excluded. When the MPI and the GTX were used in combination, however, the sensitivity of detecting patients with coronary obstructive disease was increased to 94% (p < 0.01). The MPI was particularly useful in the evaluation of the 26 patients with nondiagnostic GTX. In this group, 24 of the 26 patients were correctly identified by the MPI with respect to the presence or absence of coronary-obstructive disease. In the 14 patients with a history of classical angina but with normal coronaries, the MPI was negative in 13 and positive in one, thus suggesting that in the majority of these patients transient transmural myocardial ischemia probably does not occur during exercise. The presence or absence of angiographically demonstrable coronary collateral vessels did not seem to influence the exercise MPI in patients with coronary-obstructive disease. Thus, although the MPI does not correctly identify all patients with either coronary-obstructive disease or normal coronary arteries, it is helpful in patients who have a nondiagnostic GTX. Furthermore, when used in combination with the GTX, the MPI significantly increases the likelihood that significant coronary-obstructive disease is present when both tests are positive, and that coronary disease is absent when both tests are negative

CT hepatic perfusion measurement: Comparison of three analytic methods

International Nuclear Information System (INIS)

Kanda, Tomonori; Yoshikawa, Takeshi; Ohno, Yoshiharu; Kanata, Naoki; Koyama, Hisanobu; Takenaka, Daisuke; Sugimura, Kazuro

2012-01-01

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

Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease

Energy Technology Data Exchange (ETDEWEB)

Meyer, Mathias [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim–Heidelberg University, Mannheim (Germany); Nance, John W. [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC (United States); Moscariello, Antonio [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Bioimaging and Radiological Sciences, Catholic University of Sacred Heart, “A. Gemelli” Hospital, Rome (Italy); Weininger, Markus; Rowe, Garrett W.; Ruzsics, Balazs [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Kang, Doo Kyoung [Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston, SC (United States); Department of Radiology, Ajou University School of Medicine, Suwon (Korea, Republic of); Chiaramida, Salvatore A. [Department of Medicine, Division of Cardiology, Medical University of South Carolina, Charleston, SC (United States); Schoenberg, Stefan O.; Fink, Christian [Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim–Heidelberg University, Mannheim (Germany); and others

2012-12-15

Purpose: We compared cost-effectiveness and potential lifetime benefits of using dual-energy computed tomography (DECT) for myocardial perfusion assessment instead of single photon emission computed tomography (SPECT) for the workup of coronary artery disease (CAD). Materials and methods: A decision and simulation model was developed to estimate cost and health effects of using DECT myocardial perfusion imaging instead of SPECT for identifying patients in need of invasive imaging and possible revascularization. The model was based on the performance indices of stress/rest DECT compared with stress/rest SPECT for detecting myocardial perfusion deficits in 50 patients (mean age 61 ± 10 years) with CAD. Stress/rest perfusion and delayed enhancement cardiac MRI served as reference standard. For DECT a reimbursement of US$1700 was assumed but costs of cardiac MRI were not included in the model. All other actual healthcare costs in these patients were derived from MUSC's hospital billing system. Results: Compared with cardiac MRI, DECT (versus SPECT) had 90% (85%) sensitivity and 71% (58%) specificity for identifying patients with obstructive CAD. Compared with the no imaging and no treatment strategy, routine SPECT gained 13.49 quality-adjusted life-years (QALYs) with an incremental cost-effectiveness ratio (ICER) of US$3557 (in 2010) per QALY. In comparison, DECT ICER was lower (US$3.191 per QALY, p = 0.0002) and an additional 0.64 QALYs was obtained (total of 14.13 QALYs) if compared with the SPECT strategy as well as the no imaging and no treatment strategy. Conclusion: Using DECT as the first-line imaging test for myocardial perfusion for the workup of patients with CAD has the potential to provide gains in QALYs, while lowering costs if compared to routine myocardial perfusion SPECT.

Cost-effectiveness of substituting dual-energy CT for SPECT in the assessment of myocardial perfusion for the workup of coronary artery disease

International Nuclear Information System (INIS)

Meyer, Mathias; Nance, John W.; Schoepf, U. Joseph; Moscariello, Antonio; Weininger, Markus; Rowe, Garrett W.; Ruzsics, Balazs; Kang, Doo Kyoung; Chiaramida, Salvatore A.; Schoenberg, Stefan O.; Fink, Christian

2012-01-01

Purpose: We compared cost-effectiveness and potential lifetime benefits of using dual-energy computed tomography (DECT) for myocardial perfusion assessment instead of single photon emission computed tomography (SPECT) for the workup of coronary artery disease (CAD). Materials and methods: A decision and simulation model was developed to estimate cost and health effects of using DECT myocardial perfusion imaging instead of SPECT for identifying patients in need of invasive imaging and possible revascularization. The model was based on the performance indices of stress/rest DECT compared with stress/rest SPECT for detecting myocardial perfusion deficits in 50 patients (mean age 61 ± 10 years) with CAD. Stress/rest perfusion and delayed enhancement cardiac MRI served as reference standard. For DECT a reimbursement of US$1700 was assumed but costs of cardiac MRI were not included in the model. All other actual healthcare costs in these patients were derived from MUSC's hospital billing system. Results: Compared with cardiac MRI, DECT (versus SPECT) had 90% (85%) sensitivity and 71% (58%) specificity for identifying patients with obstructive CAD. Compared with the no imaging and no treatment strategy, routine SPECT gained 13.49 quality-adjusted life-years (QALYs) with an incremental cost-effectiveness ratio (ICER) of US$3557 (in 2010) per QALY. In comparison, DECT ICER was lower (US$3.191 per QALY, p = 0.0002) and an additional 0.64 QALYs was obtained (total of 14.13 QALYs) if compared with the SPECT strategy as well as the no imaging and no treatment strategy. Conclusion: Using DECT as the first-line imaging test for myocardial perfusion for the workup of patients with CAD has the potential to provide gains in QALYs, while lowering costs if compared to routine myocardial perfusion SPECT.

Isolated unilateral absence of the right pulmonary artery in two cats visualized by computed tomography angiography

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Tyler JM Jordan

2016-10-01

Full Text Available Case series summary Two cats were evaluated for progressive exercise intolerance, dyspnea and unilateral infiltrate of the left lung. Computed tomography angiography (CTA revealed absence of the right pulmonary artery in both cats with systemic arterial collateral vessels perfusing the right segmental pulmonary arteries. In one case, the collateral vessels arose from the esophageal artery, while in the other case they derived off the right costocervical trunk. One cat was diagnosed with pulmonary hypertension and was euthanized owing to progressive respiratory distress despite medical management with sildenafil, pimobendan, clopidogrel and furosemide. The other cat, without echocardiographic evidence of pulmonary hypertension, was successfully managed with furosemide and enalapril for more than 4 years. Relevance and novel information CTA allowed visualization of a rare congenital heart malformation, unilateral absence of the right pulmonary artery, in two cats and accurately characterized the source of collateral blood supply to the affected lung. Severe pulmonary hypertension may be a negative prognostic factor in cats with this condition as medical therapy in the cat without evidence of pulmonary hypertension resolved clinical signs, while the cat with severe pulmonary hypertension died from the disease.

[Cytostatic hyperthermic isolated limb perfusion (HILP) in VFN (General Faculty Hospital in Prague)].

Science.gov (United States)

Spacek, M; Mitás, P; Lacina, L; Krajsová, I; Hodková, G; Salmay, M; Spunda, R; Brlicová, L; Lindner, J

2011-01-01

Hyperthermic isolated limb perfusion (HILP) is a standardized method of treatment in selected patients with in-transient locoregional recurrence/methastasis of melanoma or, some other soft tissue tumors (incl. sarcoma etc.) Authors present history and current status of this treatment modality in General University Hospital in Prague. During one year period (7/2009-6/2010) 10 patients were indicated for this procedure. We performed 13 procedures (3x redo), 11 in lower extremity and 2 in upper extremity. There was no serious complication in this cohort of patiens. Multidisciplinar approach is indicated in melanoma patients care.

Comparison between angiographic and arterial duplex ultrasound assessment of tibial arteries in patients with peripheral arterial disease: on behalf of the Joint Endovascular and Non-Invasive Assessment of LImb Perfusion (JENALI) Group.

Science.gov (United States)

Mustapha, Jihad A; Saab, Fadi; Diaz-Sandoval, Larry; Karenko, Barbara; McGoff, Theresa; Heaney, Carmen; Sevensma, Matthew

2013-11-01

Endovascular treatment of peripheral arterial disease (PAD) involving the tibial arteries is becoming an increasingly important part of revascularization. The current anatomical description of vessel patency in tibial arteries does not contribute effectively to therapeutic strategies. The Joint Endovascular and Non-Invasive Assessment of Limb Perfusion (JENALI) score, is a novel scoring system developed to further assess patency of tibial arteries, via both angiography and arterial duplex ultrasonography. A comparison was made between the JENALI score obtained by ultrasound and by angiography. Angiography is currently considered the gold standard of tibial artery imaging. This prospective single-center study involved 49 patients undergoing peripheral angiography for evaluation of PAD, between November 2011 and November 2012. All patients underwent a detailed ultrasound assessment of the tibial arteries ± 7 days from diagnostic angiography. Eligible patients had a Rutherford score ≥ III or abnormal ankle-brachial index values. Angiography and ultrasound were evaluated in a blinded fashion. Average age of patients was 69.8 years. A total of 846 segments were assessed by both angiography and ultrasound. We found that 648 segments (76.6%) were deemed to be patent by angiography compared to 723 (85.5%) by ultrasound. Critical limb ischemia (CLI; Rutherford score ≥ 4) was described in 26 patients (53%). Average JENALI score for the right lower extremity was 7.0 by angiogram vs 7.7 by ultrasound. The average JENALI score of the left leg was 6.7 by angiogram vs 7.7 by ultrasound. A total of 94 lower extremities were assigned a JENALI score. Ultrasound was accurate in detecting tibial artery patency or occlusion in 80% of segments. The overall sensitivity/specificity of ultrasound detecting tibial artery patency was calculated at 93% and 40% (P<.05), respectively. Detection of patency via ultrasound was highest for the anterior tibial artery and the lowest for the

The anterior cerebral artery is an appropriate arterial input function for perfusion-CT processing in patients with acute stroke

International Nuclear Information System (INIS)

Wintermark, Max; Lau, Benison C.; Chien, Jeffrey; Arora, Sandeep

2008-01-01

Dynamic perfusion-CT (PCT) with deconvolution requires an arterial input function (AIF) for postprocessing. In clinical settings, the anterior cerebral artery (ACA) is often chosen for simplicity. The goals of this study were to determine how the AIF selection influences PCT results in acute stroke patients and whether the ACA is an appropriate default AIF. We retrospectively identified consecutive patients suspected of hemispheric stroke of less than 48 h duration who were evaluated on admission by PCT. PCT datasets were postprocessed using multiple AIF, and cerebral blood volume (CBV) and flow (CBF), and mean transit time (MTT) values were measured in the corresponding territories. Results from corresponding territories in the same patients were compared using paired t-tests. The volumes of infarct core and tissue at risk obtained with different AIFs were compared to the final infarct volume. Of 113 patients who met the inclusion criteria, 55 with stroke were considered for analysis. The MTT values obtained with an ''ischemic'' AIF tended to be shorter (P=0.055) and the CBF values higher (P=0.108) than those obtained using a ''nonischemic'' AIF. CBV values were not influenced by the selection of the AIF. No statistically significant difference was observed between the size of the PCT infarct core (P=0.121) and tissue at risk (P=0.178), regardless of AIF selection. In acute stroke patients, the selection of the AIF has no statistically significant impact of the PCT results; standardization of the PCT postprocessing using the ACA as the default AIF is adequate. (orig.)

Reversible defects on myocardial perfusion imaging early after coronary stent implantation: a predictor of late restenosis

International Nuclear Information System (INIS)

Kim, D. E.; Park, S. A.; Kim, C. K.; Chang, J. A.; Jeong, J. W.; Oh, S. G.; Lee, C.

2007-01-01

It appears logical that myocardial perfusion should be fixed and not reversible, in the territory supplied by a dilated coronary artery. However, several studies have demonstrated reversible perfusion in the territory supplied by a coronary artery with an optimally implanted stent. The main objective of this study was to evaluate the incidence of reversible defects detected by M-SPECT early after optimal PTCA with stent implantation. Its second objective was to determine the predictive value of detecting reversible defects after stent implantation for late restenosis. Sixty-six patients that underwent M-SPECT within 24 hours of successful PTCA with stent implantation were included. All patients were followed up clinically and angiographically. The incidence of reversible perfusion defects on M-SPECT and the rate of late restenosis in target coronary arteries were evaluated retrospectively. Reversible perfusion defects on M-SPECT were observed in 26% of the patients and in 36% of lesions following successful PTCA with stent implantation. The incidence of late restenosis was significantly higher in patients and lesions with reversible perfusion defects (47% vs. 18%). According to binary logistic regression analysis, the presence of a reversible perfusion defects was the only independent predictor of late restenosis. This study shows that the predictive value of reversible perfusion defects on M-SPECT early after stent implantation with respect to the incidence of late restenosis was 47% in patients with a reversible defect, and 18% in those without it

Quantitative evaluation of muscle perfusion with CEUS and with MR

International Nuclear Information System (INIS)

Weber, Marc-Andre; Delorme, Stefan; Krix, Martin

2007-01-01

Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases. (orig.)

Quantitative evaluation of muscle perfusion with CEUS and with MR

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Weber, Marc-Andre; Delorme, Stefan [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Krix, Martin [German Cancer Research Centre, Department of Radiology, Heidelberg (Germany); Bracco ALTANA Pharma GmbH, Konstanz (Germany)

2007-10-15

Functional imaging might increase the role of imaging in muscular diseases, since alterations of muscle morphology alone are not specific for a particular disease. Perfusion, i.e., the blood flow per tissue and time unit including capillary flow, is an important functional parameter. Pathological changes of skeletal muscle perfusion can be found in various clinical conditions, such as degenerative or inflammatory myopathies or peripheral arterial occlusive disease. This article reviews the theoretical basics of functional radiological techniques for assessing skeletal muscle perfusion and focuses on contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) techniques. Also, the applications of microvascular imaging, such as in detection of myositis and for discriminating myositis from other myopathies or evaluating peripheral arterial occlusive disease, are presented, and possible clinical indications are discussed. In conclusion, dedicated MR and CEUS methods are now available that visualize and quantify (patho-)physiologic information about microcirculation within skeletal muscles in vivo and hence establish a useful diagnostic tool for muscular diseases. (orig.)

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

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Sundaram P

2009-01-01

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

Right sided single coronary artery origin: surgical interventions without clinical consequences.

Science.gov (United States)

Hamid, Tahir; Rose, Samman; Horner, Simon

2011-11-01

Congenital coronary anomalies are uncommon and are usually diagnosed incidentally during coronary angiogram or autopsy. Isolated coronary artery anomalies and the anomalous origin of left main stem (LMS) from the proximal portion of the right coronary artery or from the right sinus of valsalva are extremely rare. A 68 years old woman with atypical chest pains was referred for risk assessment for the general anaesthesia. A stress exercise treadmill test and myocardial perfusion scan revealed evidence of mild myocardial ischemia. Her coronary angiography revealed her left coronary artery to have a single origin with the right coronary artery. There were no flowlimiting lesions. A CT aortography confirmed a retro-aortic course of the left coronary artery. She successfully underwent multiple surgical procedures under general anaesthesia including total abdominal hysterectomy, Burch colposuspension (twice) for stress incontinence, intravesical botox injection for urge incontinence and haemorrhoidectomy for recurrent rectal mucosal prolapse. Various anaesthetic agents including halothane, thiopentone, suxamethonium, pancuronium, enflurane, fentanyl, propofol and isoflurane were used without any adverse clinical consequences. She remained well on 48 months follow-up.

Testing the biocompatibility of a glutathione-containing intra-ocular irrigation solution by using an isolated perfused bovine retina organ culture model - an alternative to animal testing.

Science.gov (United States)

Januschowski, Kai; Zhour, Ahmad; Lee, Albert; Maddani, Ramin; Mueller, Sebastien; Spitzer, Martin S; Schnichels, Sven; Schultheiss, Maximilian; Doycheva, Deshka; Bartz-Schmidt, Karl-Ulrich; Szurman, Peter

2012-03-01

The effects of a glutathione-containing intra-ocular irrigation solution, BSS Plus©, on retinal function and on the survival of ganglion cells in whole-mount retinal explants were studied. Evidence is provided that the perfused ex vivo bovine retina can serve as an alternative to in vivo animal testing. Isolated bovine retinas were prepared and perfused with an oxygen-saturated standard irrigation solution, and an electroretinogram was recorded to assess retinal function. After stable b-waves were detected, the isolated retinas were perfused with BSS Plus for 45 minutes. To investigate the effects of BSS Plus on photoreceptor function, 1mM aspartate was added to the irrigation solution in order to obtain a-waves, and the ERG trace was monitored for 75 minutes. For histological analysis, isolated whole retinal mounts were stored for 24 hours at 4°C, in the dark. The percentages of cell death in the retinal ganglion cell layer and in the outer and inner nuclear layers were estimated by using an ethidium homodimer-1 stain and the TUNEL assay. General swelling of the retina was examined with high-resolution optical coherence tomography. During perfusion with BSS Plus, no significant changes in a-wave and b-wave amplitudes were recorded. Retinas stored for 24 hours in BSS Plus showed a statistically significant smaller percentage (52.6%, standard deviation [SD] = 16.1%) of cell death in the retinal ganglion cell layer compared to the control group (69.6%, SD = 3.9, p = 0.0031). BSS Plus did not seem to affect short-term retinal function, and had a beneficial effect on the survival of retinal ganglion cells. This method for analysing the isolated perfused retina represents a valuable alternative for testing substances for their retinal biocompatibility and toxicity. 2012 FRAME.

Tc-99m DTPA perfusion scintigraphy and color coded duplex sonography in the evaluation of minimal renal allograft perfusion

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Bair, H.J.; Platsch, G.; Wolf, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Nuclear Medicine; Guenter, E.; Becker, D. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 1; Rupprecht, H.; Neumayer, H.H. [Erlangen-Nuernberg Univ., Erlangen (Germany). Dept. of Internal Medicine 4

1997-08-01

Aim: The clinical impact of perfusion scintigraphy versus color coded Duplex sonography was evaluated, with respect to their potential in assessing minimal allograft perfusion in vitally threatened kidney transplants, i.e. oligoanuric allografts suspected to have either severe rejection or thrombosis of the renal vein or artery. Methods: From July 1990 to August 1994 the grafts of 15 out of a total of 315 patients were vitally threatened. Technetium-99m DTPA scintigraphy and color coded Duplex sonography were performed in all patients. For scintigraphic evaluation of transplant perfusion analog scans up to 60 min postinjection, and time-activity curves over the first 60 sec after injection of 370-440 MBq Tc-99m diethylenetriaminepentaacetate acid (DTPA) were used and classified by a perfusion score, the time between renal and iliac artery peaks (TDiff) and the washout of the renogram curve. Additionally, evaluation of excretion function and assessment of vascular or urinary leaks were performed. By color coded Duplex sonography the perfusion in all sections of the graft as well as the vascular anastomoses were examined and the maximal blood flow velocity (Vmax) and the resistive index (RI) in the renal artery were determined by means of the pulsed Doppler device. Pathologic-anatomical diagnosis was achieved by either biopsy or post-explant histology in all grafts. Results: Scintigraphy and color coded Duplex sonography could reliably differentiate minimal (8/15) and not perfused (7/15) renal allografts. The results were confirmed either by angiography in digital subtraction technique (DSA) or the clinical follow up. Conclusion: In summary, perfusion scintigraphy and color coded Duplex sonography are comparable modalities to assess kidney graft perfusion. In clinical practice scintigraphy and colorcoded Doppler sonography can replace digital subtraction angiography in the evaluation of minimal allograft perfusion. (orig.) [Deutsch] Ziel der Studie war es, das

Single-photon emission computed tomography for the assessment of ventricular perfusion and function

International Nuclear Information System (INIS)

Gonzalez, Patricio; Dussaillant, Gaston; Gutierrez, Daniela; Berrocal, Isabel; Alay, Rita; Otarola, Sonia

2013-01-01

Background: Single-photon emission computed tomography (SPECT) can be used as a non-invasive tool for the assessment of coronary perfusion. Aim: To assess ventricular perfusion and function by SPECT in patients with single vessel coronary artery disease. Material and Methods: Among patients with indications for a coronary artery angiography, those with significant lesions in one vessel, were selected for the study. Within 24 hours, cardiac SPECT examinations on basal conditions and after high doses of dipyridamole, were performed. SPECT data from 38 patients with a low probability of coronary artery disease was used for comparisons. Results:Ten patients aged 61 ± 8 years (seven men) were studied. Visual analysis of SPECT revealed signs suggestive of ischemia in eight patients. The remaining two patients did not have perfusion disturbances. SPECT detected eight of ten abnormal vessels reported in the coronary artery angiography. There were two false negative results Summed stress, summed rest and summed difference scores were 9.78 ± 6.51, 3.22 ± 5.07 and 6.33 ± 4.97, respectively. The ejection fractions under stress and at rest were 53 ± 11.7% and 61 ± 15.7% respectively (p ≤ 0.01). The figures for the control group were 69.1 ± 13.5% and 75.2 ± 12.04% respectively (significantly different from patients). Two patients had a summed motion score above 14.9. Likewise, two patients had a summed thickening score above 10.9. Conclusions: SPECT detected 80% of coronary lesions found during coronary artery angiography. Visual analysis of perfusion is highly reliable for diagnosis. Quantitative parameters must be considered only as reference parameters

Thallium-201 myocardial imaging in young adults with anomalous left coronary artery arising from the pulmonary artery

International Nuclear Information System (INIS)

Moodie, D.S.; Cook, S.A.; Gill, C.C.; Napoli, C.A.

1980-01-01

Anomalous origin of the left coronary artery from the pulmonary artery (Bland-Garland-White syndrome) may produce myocardial ischemia, infarction, and frequently death in infancy. Some patients, however, develop satisfactory coronary artery collaterals and are relatively asymptomatic into adulthood. Very little is known about their myocardial perfusion patterns. We studied three young adults with this condition using stress thallium-201 myocardial imaging. Electrocardiograms in two patients demonstrated old arterolateral myocardial infarctions. Preoperative stress exercise tests were positive in all three patients. Marked perfusion abnormalities were found in the proximal anterolateral wall in all patients, and one patient also had a posterolateral defect. Postoperatively, all stress tests returned to normal. Thallium imaging demonstrated improvement in ischemic areas, but old scars persisted

Comparison of selective arterial spin labeling using 1D and 2D tagging RF pulses

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Konstandin, Simon; Heiler, Patrick M.; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine; Scharf, Johann [Heidelberg Univ., Mannheim (Germany). Dept. of Neuroradiology

2011-07-01

Generic arterial spin labeling (ASL) techniques label all brain feeding arteries. In this work, we used two different selective ASL (SASL) methods to show the perfusion of one single artery. A slice selective inversion of an area including the desired vessel was compared to a multidimensional RF pulse with Gaussian profile to label only the artery of interest. Perfusion images with a resolution of 2 x 2 x 5 mm{sup 3} are shown that were acquired after tagging only the internal carotid artery of healthy volunteers. In addition, both techniques were applied to a patient with an extra-intracranial bypass to illustrate its perfusion territory. These perfusion images are consistent with a standard angiography. SASL imaging with a resolution of 2 x 2 x 5 mm{sup 3} is possible in a total scan time of 5 min. The presented MR techniques may in part replace the assessment of revascularization success by conventional angiography. (orig.)

Comparison of selective arterial spin labeling using 1D and 2D tagging RF pulses

International Nuclear Information System (INIS)

Konstandin, Simon; Heiler, Patrick M.; Schad, Lothar R.; Scharf, Johann

2011-01-01

Generic arterial spin labeling (ASL) techniques label all brain feeding arteries. In this work, we used two different selective ASL (SASL) methods to show the perfusion of one single artery. A slice selective inversion of an area including the desired vessel was compared to a multidimensional RF pulse with Gaussian profile to label only the artery of interest. Perfusion images with a resolution of 2 x 2 x 5 mm 3 are shown that were acquired after tagging only the internal carotid artery of healthy volunteers. In addition, both techniques were applied to a patient with an extra-intracranial bypass to illustrate its perfusion territory. These perfusion images are consistent with a standard angiography. SASL imaging with a resolution of 2 x 2 x 5 mm 3 is possible in a total scan time of 5 min. The presented MR techniques may in part replace the assessment of revascularization success by conventional angiography. (orig.)

The future of collateral artery research

NARCIS (Netherlands)

Hakimzadeh, Nazanin; Verberne, Hein J.; Siebes, Maria; Piek, Jan J.

2014-01-01

In the event of obstructive coronary artery disease, collateral arteries have been deemed an alternative blood source to preserve myocardial tissue perfusion and function. Monocytes play an important role in modulating this process, by local secretion of growth factors and extracellular matrix

Perfusion computed tomography for detection of hepatocellular carcinoma in patients with liver cirrhosis

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Fischer, Michael A.; Kartalis, Nikolaos; Grigoriadis, Aristeidis; Loizou, Louiza; Leidner, Bertil; Aspelin, Peter; Brismar, Torkel B. [Karolinska Institute, Department of Clinical Science, Intervention and Technology, Division of Medical Imaging and Technology, Stockholm (Sweden); Karolinska University Hospital, Department of Radiology, Stockholm (Sweden); Staal, Per [Karolinska University Hospital, Department of Hepatology, Stockholm (Sweden)

2015-11-15

To evaluate the diagnostic performance of dynamic perfusion CT (P-CT) for detection of hepatocellular carcinoma (HCC) in the cirrhotic liver. Twenty-six cirrhotic patients (19 men, aged 69 ± 10 years) with suspicion of HCC prospectively underwent P-CT of the liver using the 4D spiral-mode (100/80 kV; 150/175mAs/rot) of a dual-source system. Two readers assessed: (1) arterial liver-perfusion (ALP), portal-venous liver-perfusion (PLP) and hepatic perfusion-index (HPI) maps alone; and (2) side-by-side with maximum-intensity-projections of arterial time-points (art-MIP) for detection of HCC using histopathology and imaging follow-up as standard of reference. Another reader quantitatively assessed perfusion maps of detected lesions. A total of 48 HCCs in 21/26 (81 %) patients with a mean size of 20 ± 10 mm were detected by histopathology (9/48, 19 %) or imaging follow-up (39/48, 81 %). Detection rates (Reader1/Reader2) of HPI maps and side-by-side analysis of HPI combined with arterial MIP were 92/88 % and 98/96 %, respectively. Positive-predictive values were 63/63 % and 68/71 %, respectively. A cut-off value of ≥85 % HPI and ≥99 % HPI yielded a sensitivity and specificity of 100 %, respectively, for detection of HCC. P-CT shows a high sensitivity for detection of HCC in the cirrhotic liver. Quantitative assessment has the potential to reduce false-positive findings improving the specificity of HCC diagnosis. (orig.)

Synergism of diabetic and inflammatory culture conditions on reactivity of isolated small arteries

DEFF Research Database (Denmark)

Blædel, Martin Mads; Boonen, Harrie C.M.; Sams Nielsen, Anette

Background: Cardiovascular disease (CVD) is the manifestation of atherosclerosis, which has been linked to obesity, the metabolic syndrome (MS) and overt type 2 diabetes (T2DM). Vascular dysfunction has been proposed to precede atherosclerosis, and in addition, a correlation between vascular...... isolated from 8 week old male SD rats were cultured for 21 hours in Endothelial Basal Medium (EBM-2) in petri dishes and in the absence or presence of either 30 mM D-glucose, 100 nM insulin, 100 ng/mL TNFa or any combination of these. Contractile reactivity of normalised arteries was then determined...... by wire myography as a response to cumulatively increasing concentrations of noradrenaline (NA). Results: 21 hour culture of isolated mesenteric arteries significantly reduced the arteries maximal high potassium-induced contractile reactivity and increased the contractility to noradrenaline slightly...

Isolated Deep Infarcts: Which Size Indicates Single Penetrating Artery Disease?

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Nilüfer Yeşilot

2007-06-01

Full Text Available OBJECTIVE: The relationship between infarction size determined in the acute stage and the probability of the presence of large artery stenosis or cardiac source of emboli in patients with isolated deep infarcts was evaluated. METHODS: Maximum transverse diameters of the infarcts seen in 59 consecutive patients’ T2 weighted MRI scans were prospectively recorded. Receiver operating characteristic curves were generated to analyze the optimal size that discriminate IDI with and without underlying large artery stenosis or cardiac source of emboli (LAS/CSE. RESULTS: Twenty-six IDI were in the medial cerebral artery (MCA territory, 24 in pons and 9 in thalamus. Optimal infarct diameter for MCA IDIs was 25 mm. One of the 10 cases with small (2-14 mm and half of the 14 cases (50% with large (17-25 mm pontine infarcts had LAS/CSE, but only 2 patients, one in each group had severe (≥70% basilar artery stenosis. None had major CSE. None of the 9 cases with thalamic infarcts (8-20 mm had LAS/CSE. CONCLUSION: : IDIs in different anatomical locations should be assessed separately. Middle cerebral artery territory IDIs with a maximum diameter of less than 25 mm are rarely associated with LAS/CSE and possibly develop due to occlusion of single lenticulostriate artery. Large unilateral pontine infarcts are usually not associated with severe basilar artery stenosis or major CSE and are probably caused by basilar artery atheromatous branch occlusion

Application of Arterial Spin Labelling in Detecting Retinal Ischemia

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Ehsan Vaghefi

2017-12-01

Full Text Available Purpose: Here, we have tried to quantify the chorioretinal blood perfusion in patients who are clinically identified to be suffering from retinal ischemia using arterial spin labelling (ASL MRI. Method: Four participants, diagnosed with retinal ischemia based on their structural OCT and angiography test, were then scanned using anatomical MRI as well as ASL. We optimized MR parameters to maximize resolution and target fixation, blinking, and breathing ques to minimize motion artifacts. Results: Participants had a maximum of ∼50 mL/100 mL/min of blood perfusion, which is below the normal values of ∼200 mL/100 mL/min. It also appeared that thinning of the choroid contributes more to the measured decreased chorioretinal perfusion, compared to slowed arterial filling time. Conclusion: Decreased chorioretinal perfusion is a multifactorial event and has been implicated in several posterior eye pathologies. Based on our current results, it seems that ischemia of the eye could be due to anatomy (tissue volume and/or functionality (arterial flow.

The Hepatoprotective Effects of Corn Silk against Dose-induced Injury of Ecstasy (MDMA Using Isolated Rat Liver Perfusion System

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Mohammad Karami

2016-07-01

Full Text Available Background: Corn silk (CS is widely used in Iranian traditional medicine. The aim of this study was to investigate hepatoprotective activity of CS by Isolated Rat Liver Perfusion System (IRLP. Methods: Hydro-alcoholic extract of corn silk (10, 20, 40, and 100 mg kg-1 was evaluated for its hepatoprotective activity by IRLP. Phenol and flavonoid contents of the extract were determined as gallic acid and quercetin equivalents from a calibration curve, respectively. IRLP system is ideal for studying biochemical alterations of chemicals with minimum neuro-hormonal effects. In this study, the liver was perfused with Kerbs-Henseleit buffer, containing different concentration of hydro-alcoholic extract of corn silk (10, 20, 40, 50,100mg/kg, added to the buffer, and perfused for 2 hours. During the perfusion, many factors, including amino-transferees activities and the level of GSH, were assessed as indicators of liver viability. Consequently, sections of liver tissues were examined for any histopathological changes. Results: Histopathological changes in liver tissues were related to hydro-alcoholic extract of corn silk concentrations in a dose-dependent manner. Also, 50 and 100mg/kg doses caused significant (P<0.05 histopathological changes. Level of GSH in samples perfused with hydro-alcoholic extract increased compared to the control group. Conclusion: Hepatoprotective effect of CS is due to decreased lipid peroxidation, although other mechanisms might also be involved.

Postoperative peri-axillary seroma following axillary artery cannulation for surgical treatment of acute type A aortic dissection

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Katsanos Konstantinos

2010-05-01

Full Text Available Abstract The arterial cannulation site for optimal tissue perfusion and cerebral protection during cardiopulmonary bypass (CPB for surgical treatment of acute type A aortic dissection remains controversial. Right axillary artery cannulation confers significant advantages, because it provides antegrade arterial perfusion during cardiopulmonary bypass, and allows continuous antegrade cerebral perfusion during hypothermic circulatory arrest, thereby minimizing global cerebral ischemia. However, right axillary artery cannulation has been associated with serious complications, including problems with systemic perfusion during cardiopulmonary bypass, problems with postoperative patency of the artery due to stenosis, thrombosis or dissection, and brachial plexus injury. We herein present the case of a 36-year-old Caucasian man with known Marfan syndrome and acute type A aortic dissection, who had direct right axillary artery cannulation for surgery of the ascending aorta. Postoperatively, the patient developed an axillary perigraft seroma. As this complication has, not, to our knowledge, been reported before in cardiothoracic surgery, we describe this unusual complication and discuss conservative and surgical treatment options.

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

International Nuclear Information System (INIS)

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

1984-01-01

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

Brain perfusion CT in acute stroke: current status

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Koenig, Matthias E-mail: matthias.koenig@ruhr-uni-bochum.de

2003-03-01

Dynamic perfusion CT has become a widely accepted imaging modality for the diagnostic workup of acute stroke patients. Although compared with standard spiral CT the use of multislice CT has broadened the range from which perfusion data may be derived in a single scan run. The advent of multidetector row technology has not really overcome the limited 3D capability of this technique. Multidetector CT angiography (CTA) of the cerebral arteries may in part compensate for this by providing additional information about the cerebrovascular status. This article describes the basics of cerebral contrast bolus scanning with a special focus on optimization of contrast/noise in order to ensure high quality perfusion maps. Dedicated scan protocols including low tube voltage (80 kV) as well as the use of highly concentrated contrast media are amongst the requirements to achieve optimum contrast signal from the short bolus passage through the brain. Advanced pre and postprocessing algorithms may help reduce the noise level, which may become critical in unconscious stroke victims. Two theoretical concepts have been described for the calculation of tissue perfusion from contrast bolus studies, both of which can be equally employed for brain perfusion imaging. For each perfusion model there are some profound limitations regarding the validity of perfusion values derived from ischemic brain areas. This makes the use of absolute quantitative cerebral blood flow (CBF) values for the discrimination of the infarct core from periinfarct ischemia questionable. Multiparameter imaging using maps of CBF, cerebral blood volume (CBV), and a time parameter of the local bolus transit enables analyzing of the cerebral perfusion status in detail. Perfusion CT exceeds plain CT in depicting cerebral hypoperfusion at its earliest stage yielding a sensitivity of about 90% for the detection of embolic and hemodynamic lesions within cerebral hemispheres. Qualitative assessment of brain perfusion can be

The impact of short chain fatty acids on GLP-1 and PYY secretion from the isolated perfused rat colon

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Christiansen, Charlotte Bayer; Gabe, Maria Buur Nordskov; Svendsen, Berit

2018-01-01

chain fatty acids (SCFAs) produced by local bacterial fermentation are suggested to activate the colonic free fatty acid receptors FFAR2 (GPR43) and FFAR3 (GPR41), stimulating the colonic L-cells. We used the isolated perfused rat colon as a model of colonic endocrine secretion and studied the effects...

Renovascular hypertension due to insufficient collateral flow in segmental artery occulusion

International Nuclear Information System (INIS)

Park, Y. H.; Lee, S. Y.; Kim, S. H.; Sohn, H. S.; Chung, S. K.

2001-01-01

We report a case in which a 33-year-old woman with renovascular hypertension due to insufficient collateral flow in segmental renal artery occlusion demonstrated abnormality on captopril renal scintigram. Baseline renal scintigram with DTPA showed normal perfusion and excretion in left kidney and captopril renal scintigram with DTPA showed a focal area of decreased perfusion and delayed clearance in lower half of left kidney, suggesting segmental renal artery stenosis. Selective left renal arteriography showed complete obstruction in proximal portion of anterior segmental artery with multiple small collateral vessels from posterior segmental artery and capsular artery and delayed opacification in lower half of left kidney. These findings are suggestive of segmental hypoperfusion due to insufficient collateral blood flow resulting to positive captopril response. Patient's blood pressure have been controlled well with ACE (angiotensin converting enzyme) inhibitor and calcium channel blocker for 2 year. Follow-up baseline renal scintigram with MAG3 showed normal perfusion and excretion in left kidney and captopril renal scintigram with MAG3 showed a focal area of decreased perfusion and delayed clearance in lower lateral portion of left kidney, which was smaller size than that of previous renal scintigram. And captopril renal scintigram with DMSA demonstrated a small area of decreased DMSA uptake on this lesion compared to baseline DMSA scintigram

Diagnostic performance of dual-energy CT stress myocardial perfusion imaging: direct comparison with cardiovascular MRI.

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Ko, Sung Min; Song, Meong Gun; Chee, Hyun Kun; Hwang, Hweung Kon; Feuchtner, Gudrun Maria; Min, James K

2014-12-01

The purpose of this study was to assess the diagnostic performance of stress perfusion dual-energy CT (DECT) and its incremental value when used with coronary CT angiography (CTA) for identifying hemodynamically significant coronary artery disease. One hundred patients with suspected or known coronary artery disease without chronic myocardial infarction detected with coronary CTA underwent stress perfusion DECT, stress cardiovascular perfusion MRI, and invasive coronary angiography (ICA). Stress perfusion DECT and cardiovascular stress perfusion MR images were used for detecting perfusion defects. Coronary CTA and ICA were evaluated in the detection of ≥50% coronary stenosis. The diagnostic performance of coronary CTA for detecting hemo-dynamically significant stenosis was assessed before and after stress perfusion DECT on a per-vessel basis with ICA and cardiovascular stress perfusion MRI as the reference standard. The performance of stress perfusion DECT compared with cardiovascular stress perfusion MRI on a per-vessel basis in the detection of perfusion defects was sensitivity, 89%; specificity, 74%; positive predictive value, 73%; negative predictive value, 90%. Per segment, these values were sensitivity, 76%; specificity, 80%; positive predictive value, 63%; and negative predictive value, 88%. Compared with ICA and cardiovascular stress perfusion MRI per vessel territory the sensitivity, specificity, positive predictive value, and negative predictive value of coronary CTA were 95%, 61%, 61%, and 95%. The values for stress perfusion DECT were 92%, 72%, 68%, and 94%. The values for coronary CTA and stress perfusion DECT were 88%, 79%, 73%, and 91%. The ROC AUC increased from 0.78 to 0.84 (p=0.02) with the use of coronary CTA and stress perfusion DECT compared with coronary CTA alone. Stress perfusion DECT plays a complementary role in enhancing the accuracy of coronary CTA for identifying hemodynamically significant coronary stenosis.

Lung perfusion scintigraphy in the diagnosis of peripheral pulmonary stenosis in patients after repair of Fallot tetralogy

International Nuclear Information System (INIS)

Sabiniewicz, R.; Chojnicki, M.; Alszewicz-Baranowska, J.; Erecinski, J.; Romanowicz, G.; Lass, P.; Bandurski, T.

2002-01-01

The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The disturbances in lung perfusion (mostly in the left lung) were show by means of lung perfusion scintigraphy in 43 (49%) of patients. In 27 of them heart catheterisation has been performed. Angiography revealed stenosis of the lung artery branch in 15/43 (34.9%) patients with abnormal perfusion lung scan and in 4/44 (9%) in patients with normal perfusion lung scan. Intervention procedures were carried out on 10 patients. Lung perfusion scintigraphy may prove a valuable, non-invasive screening tool in the assessment of patients after TOF repair, although both false-negative and false positive results may happen. Therefore, it should play an auxiliary role together with other diagnostic modalities. (author)

Measurement of cerebral white matter perfusion using pseudocontinuous arterial spin labeling 3T magnetic resonance imaging--an experimental and theoretical investigation of feasibility.

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Wen-Chau Wu

Full Text Available PURPOSE: This study was aimed to experimentally and numerically investigate the feasibility of measuring cerebral white matter perfusion using pseudocontinuous arterial spin labeling (PCASL 3T magnetic resonance imaging (MRI at a relatively fine resolution to mitigate partial volume effect from gray matter. MATERIALS AND METHODS: The Institutional Research Ethics Committee approved this study. On a clinical 3T MR system, ten healthy volunteers (5 females, 5 males, age = 28 ± 3 years were scanned after providing written informed consent. PCASL imaging was performed with varied combinations of labeling duration (τ = 1000, 1500, 2000, and 2500 ms and post-labeling delay (PLD = 1000, 1400, 1800, and 2200 ms, at a spatial resolution (1.56 x 1.56 x 5 mm(3 finer than commonly used (3.5 x 3.5 mm(2, 5-8 mm in thickness. Computer simulations were performed to calculate the achievable perfusion-weighted signal-to-noise ratio at varied τ, PLD, and transit delay. RESULTS: Based on experimental and numerical data, the optimal τ and PLD were found to be 2000 ms and 1500-1800 ms, respectively, yielding adequate SNR (~2 to support perfusion measurement in the majority (~60% of white matter. The measurement variability was about 9% in a one-week interval. The measured white matter perfusion and perfusion ratio of gray matter to white matter were 15.8-27.5 ml/100ml/min and 1.8-4.0, respectively, depending on spatial resolution as well as the amount of deep white matter included. CONCLUSION: PCASL 3T MRI is able to measure perfusion in the majority of cerebral white matter at an adequate signal-to-noise ratio by using appropriate tagging duration and post-labeling delay. Although pixel-wise comparison may not be possible, region-of-interest based flow quantification is feasible.

Prognostic Value of Quantitative Stress Perfusion Cardiac Magnetic Resonance.

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Sammut, Eva C; Villa, Adriana D M; Di Giovine, Gabriella; Dancy, Luke; Bosio, Filippo; Gibbs, Thomas; Jeyabraba, Swarna; Schwenke, Susanne; Williams, Steven E; Marber, Michael; Alfakih, Khaled; Ismail, Tevfik F; Razavi, Reza; Chiribiri, Amedeo

2018-05-01

This study sought to evaluate the prognostic usefulness of visual and quantitative perfusion cardiac magnetic resonance (CMR) ischemic burden in an unselected group of patients and to assess the validity of consensus-based ischemic burden thresholds extrapolated from nuclear studies. There are limited data on the prognostic value of assessing myocardial ischemic burden by CMR, and there are none using quantitative perfusion analysis. Patients with suspected coronary artery disease referred for adenosine-stress perfusion CMR were included (n = 395; 70% male; age 58 ± 13 years). The primary endpoint was a composite of cardiovascular death, nonfatal myocardial infarction, aborted sudden death, and revascularization after 90 days. Perfusion scans were assessed visually and with quantitative analysis. Cross-validated Cox regression analysis and net reclassification improvement were used to assess the incremental prognostic value of visual or quantitative perfusion analysis over a baseline clinical model, initially as continuous covariates, then using accepted thresholds of ≥2 segments or ≥10% myocardium. After a median 460 days (interquartile range: 190 to 869 days) follow-up, 52 patients reached the primary endpoint. At 2 years, the addition of ischemic burden was found to increase prognostic value over a baseline model of age, sex, and late gadolinium enhancement (baseline model area under the curve [AUC]: 0.75; visual AUC: 0.84; quantitative AUC: 0.85). Dichotomized quantitative ischemic burden performed better than visual assessment (net reclassification improvement 0.043 vs. 0.003 against baseline model). This study was the first to address the prognostic benefit of quantitative analysis of perfusion CMR and to support the use of consensus-based ischemic burden thresholds by perfusion CMR for prognostic evaluation of patients with suspected coronary artery disease. Quantitative analysis provided incremental prognostic value to visual assessment and

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

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Meeder, J.G. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Blanksma, P.K. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Wall, E.E. van der [Department of Cardiology, University Hospital, Leiden (Netherlands); Anthonio, R.L. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Willemsen, A.T.M. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Pruim, J. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Vaalburg, W. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands); Lie, K.I. [Department of Cardiology and National Research PET Center, University Hospital, Groningen (Netherlands)

1996-11-01

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

Induced Human Decidual NK-Like Cells Improve Utero-Placental Perfusion in Mice.

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Ricardo C Cavalli

Full Text Available Decidual NK (dNK cells, a distinct type of NK cell, are thought to regulate uterine spiral artery remodeling, a process that allows for increased blood delivery to the fetal-placental unit. Impairment of uterine spiral artery remodeling is associated with decreased placental perfusion, increased uterine artery resistance, and obstetric complications such as preeclampsia and intrauterine growth restriction. Ex vivo manipulation of human peripheral blood NK (pNK cells by a combination of hypoxia, TGFß-1 and 5-aza-2'-deoxycytidine yields cells with phenotypic and in vitro functional similarities to dNK cells, called idNK cells. Here, gene expression profiling shows that CD56Bright idNK cells derived ex vivo from human pNK cells, and to a lesser extent CD56Dim idNK cells, are enriched in the gene expression signature that distinguishes dNK cells from pNK cells. When injected into immunocompromised pregnant mice with elevated uterine artery resistance, idNK cells homed to the uterus and reduced the uterine artery resistance index, suggesting improved placental perfusion.

Diagnostic value of early post-exercise 99Tcm-MIBI ECG-gated myocardial perfusion imaging in severe coronary artery disease

International Nuclear Information System (INIS)

Li Dianfu; Huang Jun; Feng Jianlin; Cheng Xu; Li Xinli; Cao Kejiang

2005-01-01

Objective: To study and compare the diagnostic value in severe coronary artery disease (CAD) of 99 Tc m -methoxyisobutylisonitrile (MIBI) electrocardiogram (ECG)-gated early post-exercise myocardial perfusion imaging (G-MPI) with that of non-ECG-gated myocardial perfusion imaging (NG-MPI). Methods: Two hundred and fifteen suspected CAD patients had undergone G-MPI and coronary artery angiography (CAG) within one month were enrolled and distributed into three-vessel and non-three-vessel CAD groups according to CAG results (≥70%); the diagnostic values in severe CAD of G-MPI and NG-MPI were gained and compared to determine which one of the two protocols would be superior in identification of severe three-vessel CAD. Results: When the ≥70% diameter stenosis CAG was the diagnostic standard of severe CAD, the sensitivity of G-MPI and NG-MPI in the diagnosis of severe CAD were 95.3% (143/150) and 90.7% (136/150, χ 2 =2.509, P=0.113), but when the comparison specifically pinpointed to severe three-vessel CAD, there was significant difference between G-MPI [100%(51/51)] and NG-MPI [92.2% (47/51), χ 2 =4.163, P=0.041]. Diagnostic specificity of G-MPI was 80.0% and that of NG-MPI was 72.3% (χ 2 =1.059, P=0.303). Conclusions: The incremental diagnostic sensitivity of G-MPI adding to the NG-MPI in the diagnosis of severe CAD was mainly from the three-vessel subgroup patients. Exercise stress G-MPI has better diagnostic value in severe three-vessel CAD patients than NG-MPI. (authors)

Skin Perfusion Pressure Measurement to Assess Improvement in Peripheral Circulation after Arterial Reconstruction for Critical Limb Ischemia

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Watanabe, Yoshiko; Onozuka, Atsuko; Obitsu, Yukio; Komai, Hiroyoshi; Koizumi, Nobusato; Saiki, Naozumi; Shigematsu, Hiroshi

2011-01-01

Aim: To assess the utility of skin perfusion pressure (SPP) measurement in evaluating the outcome of vascular constructions for critical limb ischemia (CLI) patients. Methods: We retrospectively studied 19 lower limbs in 18 patients who underwent arterial reconstruction for CLI from whom SPP measurements had been obtained pre- and postoperatively between 2008 and 2010. Six limbs whose ulcers had healed postoperatively were classified into group H, 7 limbs whose ulcers had not healed into group U, and 6 limbs without ulcers into group N. SPP values were compared among these groups. Results: The preoperative SPP values in all groups were <30 mmHg, without significant differences among the groups. The SPP values in groups H and N significantly improved after operation, and those in group U were significantly lower than those in the other groups. Conclusions: SPP measurement before and after arterial reconstruction is useful to assess improvement in tissue circulation and to predict the likelihood of wound healing. An SPP value ≥30 mmHg was considered necessary for wound healing, supporting the findings of the few reports in the literature on the usefulness of SPP for assessing vascular reconstruction effects on ulcer wound healing. PMID:23555459

Computed Tomography Perfusion Imaging for the Diagnosis of Hepatic Alveolar Echinococcosis

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Sade, Recep; Kantarci, Mecit; Genc, Berhan; Ogul, Hayri; Gundogdu, Betul; Yilmaz, Omer

2018-01-01

Objective: Alveolar echinococcosis (AE) is a rare life-threatening parasitic infection. Computed tomography perfusion (CTP) imaging has the potential to provide both quantitative and qualitative information about the tissue perfusion characteristics. The purpose of this study was the examination of the characteristic features and feasibility of CTP in AE liver lesions. Material and Methods: CTP scanning was performed in 25 patients who had a total of 35 lesions identified as AE of the liver. Blood flow (BF), blood volume (BV), portal venous perfusion (PVP), arterial liver perfusion (ALP), and hepatic perfusion indexes (HPI) were computed for background liver parenchyma and each AE lesion. Results: Significant differences were detected between perfusion values of the AE lesions and background liver tissue. The BV, BF, ALP, and PVP values for all components of the AE liver lesions were significantly lower than the normal liver parenchyma (p<0.01). Conclusions: We suggest that perfusion imaging can be used in AE of the liver. Thus, the quantitative knowledge of perfusion parameters are obtained via CT perfusion imaging. PMID:29531482

Detectable perfusion changes in MAG3 studies

International Nuclear Information System (INIS)

Shuter, B.; Bernar, A.; Roach, P.

1998-01-01

Full text: The use of 120 MBq 99m Tc-MAG 3 instead of 600 MBq 99m Tc-DTPA in renal imaging has degraded the images obtained during the perfusion phase. An increase of the minimum detectable change (MDC) in blood flow (BF) would also be expected. In transplant patients, renal BF is an important factor in patient management and the MDC should be small to allow early detection of reduced perfusion. We determined the mean and coefficient of variation (CoV: standard deviation/mean) of three renal perfusion indices as a function of counts in the time-activity curves (TACs). Transplant patients were given a dose of about 300 MBq of 99m Tc-MAG3 and images acquired at 8 fps for 60s. TACs made up from 8, 4, 2 or I images per second allowed calculation of renal perfusion indices as if doses of 300, 150, 75 and 38 MBq had been administered. Perfusion indices based on area under the TACs up to the arterial peak (API), the maximum slopes of the TACs (SPI) and the maximum slope of renal TAC and height of arterial TAC (BPI) were calculated by our routine renal software package. As the administered dose decreased, the CoV rose for all indices, least for BPI and most for API. BPI CoV increased from ∼10% at 300 MBq to 20% at 75 MBq, but API CoV rose from 6% to 46%. Mean BPI was stable over the dose range, but mean API showed a systematic increase of about 50% over the 300 MBq result. We conclude that at 120 MBq the MDC (expressed as 2*CoV) in BF is 30-60%, whereas at 600 MBq it may be as low as 10%, allowing earlier confident detection of a change in BF. The BPI was the preferred perfusion index as its mean value changed little and it had the least CoV at lower activities. The data also imply that relative kidney perfusion in the one individual will be much less accurate with 120 MBq of MAG 3

Longitudinal Assessment of Renal Perfusion and Oxygenation in Transplant Donor-Recipient Pairs Using Arterial Spin Labeling and Blood Oxygen Level-Dependent Magnetic Resonance Imaging.

Science.gov (United States)

Niles, David J; Artz, Nathan S; Djamali, Arjang; Sadowski, Elizabeth A; Grist, Thomas M; Fain, Sean B

2016-02-01

The aims of this study were to assess renal function in kidney transplant recipients and their respective donors over 2 years using arterial spin labeling (ASL) and blood oxygen level-dependent (BOLD) magnetic resonance imaging (MRI) and to prospectively evaluate the effect of losartan on functional MRI measures in recipients. The study included 15 matched pairs of renal transplant donors and recipients. Arterial spin labeling and BOLD MRI of the kidneys were performed on donors before transplant surgery (baseline) and on both donors and recipients at 3 months, 1 year, and 2 years after transplant. After 3 months, 7 of the 15 recipients were prescribed 25 to 50 mg/d losartan for the remainder of the study. A linear mixed-effects model was used to evaluate perfusion, R2*, estimated glomerular filtration rate, and fractional excretion of sodium for changes across time or associated with losartan treatment. In donors, cortical perfusion in the remaining kidney decreased by 50 ± 19 mL/min per 100 g (11.8%) between baseline and 2 years (P donors and to 14.6 ± 4.3 mL/min per 1.73 m (33.3%; P donors, and they indicate a potentially beneficial effect of losartan in recipients.

Study of Nicorandil stress perfusion MRI in diagnosing ischemic heart disease

International Nuclear Information System (INIS)

Tateishi, Toshiki; Iwai, Mitsuhiro; Takeda, Soji; Hayashi, Ryuji

2006-01-01

The excellent spatial resolution of myocardial stress perfusion magnetic resonance imaging is effective for the diagnosis of ischemic heart disease. When dipyridamole or adenosine triphosphate is used as a pharmacological stress in cardiac MRI, non-magnetic instruments are required for infusion of these drugs in a MRI room. We attempted to use nicorandil as a pharmacological stressor. Nicorandil exhibited KATP channel opening and nitrate effects, and could be infused without any special instruments. Based on the coronary artery stenosis assessed by coronary angiography, according to the criteria of the American Heart Association (AHA), the sensitivity, specificity and diagnostic accuracy of nicorandil perfusion MRI for the detection of coronary artery stenosis was 85%, 57% and 74.3%, respectively. No major side effects were observed, except for mild hypotension (mean 10 mmHg) after infusion of the drug. It was concluded that myocardial perfusion MRI examination using nicorandil could be performed non-invasively and safely for the evaluation of coronary vessel disease in patients. (author)

MRI and MRA of kidney transplants - evaluation of vessels and perfusion

International Nuclear Information System (INIS)

Wiesner, W.; Pfammatter, T.; Krestin, G.P.; Debatin, J.F.

1998-01-01