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Sample records for regional cerebral perfusion

  1. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

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

    1996-03-15

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

  2. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    International Nuclear Information System (INIS)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S.; Lee, Kyung Han; Lee, Myung Chul

    1996-01-01

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

  3. Regional cerebral perfusion in cardiovascular reflex syncope

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  4. Double tracer autoradiographic method for sequential evaluation of regional cerebral perfusion

    International Nuclear Information System (INIS)

    Matsuda, H.; Tsuji, S.; Oba, H.; Kinuya, K.; Terada, H.; Sumiya, H.; Shiba, K.; Mori, H.; Hisada, K.; Maeda, T.

    1989-01-01

    A new double tracer autoradiographic method for the sequential evaluation of altered regional cerebral perfusion in the same animal is presented. This method is based on the sequential injection of two tracers, 99m Tc-hexamethylpropyleneamine oxime and N-isopropyl-( 125 I)p-iodoamphetamine. This method is validated in the assessment of brovincamine effects on regional cerebral perfusion in an experimental model of chronic brain ischemia in the rat. The drug enhanced perfusion recovery in low-flow areas, selectively in surrounding areas of infarction. The results suggest that this technique is of potential use in the study of neuropharmacological effects applied during the experiment

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

    International Nuclear Information System (INIS)

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

    1988-01-01

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

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

    International Nuclear Information System (INIS)

    Wang Peng; Ji Xunming

    2007-01-01

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

  7. Clinical application of cerebral dynamic perfusion studies

    International Nuclear Information System (INIS)

    DeLand, F.H.

    1975-01-01

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

  8. Gammagraphy of cerebral perfusion

    International Nuclear Information System (INIS)

    Vazquez, Silvia

    2003-01-01

    Important aspects of the gammagraphy of cerebral perfusion and the diverse clinical applications in the neurological diseases are comment in this article. We focus in the usefulness of the photon emission cerebral tomography (SPECT) and its capacity to cross the hemato encephalic barrier through the use of radiopharmacons like 99 mTc-H M-PAO and 99mTc-EDC, thus managing to offer functional data on the captantes neurons of the radiopharmacon. The clinical applications of SPECT are studied; cerebrovascular disease, transient ischemic attacks, dementias, Alzheimer disease, as well as other neurological diseases are referred. (The author)

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  10. Regional quantitative noninvasive assessment of cerebral perfusion and function with N-Isopropyl-[123I]p-iodoamphetamine

    International Nuclear Information System (INIS)

    von Schulthess, G.K.; Ketz, E.; Schubiger, P.A.; Bekier, A.

    1985-01-01

    Although several reports on the clinical usefulness of N-isopropyl-[ 123 I]p-iodoamphetamine (IMP) in the diagnosis of cerebral disease have appeared in the literature, quantitative, noninvasive measurements of regional cerebral blood flow with this method pose difficulties because cerebral IMP uptake not only depends on cerebral perfusion but also on cerebral function. Rather than trying to develop a method to measure cerebral perfusion with IMP, the authors have chosen to test a method to quantitatively evaluate planar and emission computed tomographic (ECT) studies by comparing the data obtained in patients with established pathology with the data obtained in a group of normal individuals. Using this method, absolute cerebral IMP uptake (counts/pixel/mCi/min) and planar anterior right-left ratios were obtained. Also measured were right-left ratios obtained from 12 paired regions in three ECT slices. The evaluation of the patients cerebral IMP uptake asymmetries relative to the normal standard values is a useful adjunct to qualitative image analysis in assessing the presence ans severity of disease, as qualitative analysis is prone to false-positive and negative results. Cerebral IMP uptake as measured in cts/pixel/mCi/min is abnormal only in severe cerebral disease and therefore generally a less helpful parameter

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

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  12. CT perfusion imaging on the disturbance of regional cerebral microcirculation in a pre-infarction period: an experimental study

    International Nuclear Information System (INIS)

    Gao Peiyi; Liang Chenyang; Lin Yan; Yuan Fang; Hu Ling

    2003-01-01

    Objective: To investigate the CT perfusion imaging and the pathological features on the disturbance of regional cerebral microcirculation in a pre-infarction period, and to evaluate the relationship between the astrocytes and regional cerebral microcirculation. Methods: Dynamic CT perfusion imaging of the models with regional cerebral hypoperfusion and astrocytic swelling in rats was performed to assess the presence or absence of the disturbance of regional cerebral microcirculation. Then, the histopathologic examination was made for both models, respectively. The ratios of side-to-side were measured at hypoperfusion areas in the models of regional cerebral ischemia. Results: Regional hypoperfusion was revealed by regional cerebral blood flow (rCBF) and mean transit time (MTT) maps in the group of hypoperfusion for 6 hours. Regional cerebral blood volume (rCBV) and time-to-peak (TTP) maps were normal in that group. The ratios of rCBF, rCBV, MTT and TTP were 0.39-0.55, 0.92-1.00, 1.20-1.50 and 1.00-1.00 respectively. Astrocytic swelling pressing the capillary wall was obvious and subtle neuronal reversible degeneration was occasionally found. TTC stain was normal. In the tACPD group of astrocytic swelling, the abnormal hemodynamic regions on rCBF and MTT maps were found. The rCBV maps of 3 rats in the tACPD group showed the area of reduced rCBV. In 2 rats of tACPD group, the areas of delayed TTP were also found. The ratios of rCBF, rCBV, MTT and TTP were 0.25-0.44, 0.70-1.01, 1.20-2.00 and 1.02-1.45 respectively. TTC stain was negative. Electron microscope study revealed remarkable swelling of astrocytes, especially endfoot processes of astrocytes around capillaries. The abnormal hemodynamic region on rCBF and MTT maps matched with abnormal extent on histopathologic examination. The rCBV and TTP maps appeared normal. Conclusion: The astrocytes can react in a way faster than the neurons in the pre-infarction period, viz. astrocytic swelling. The swelling of

  13. Regional cerebral perfusion for surgical correction of neonatal aortic arch obstruction.

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    Zhang, Hui; Cheng, Pei; Hou, Jia; Li, Lei; Liu, Hu; Liu, Ruifang; Ji, Bingyang; Luo, Yi

    2009-05-01

    One-stage repair of aortic arch obstruction and associated cardiac anomalies is a surgical challenge in infants.The purpose of the present study is to review the current outcome using regional cerebral perfusion (RCP) during a procedure correcting interrupted aortic arch (IAA) and also isolated aortic coarctation (CoA) and CoA combined with hypoplastic aortic arch (CoA-HyAA) in our center. Between January 2007 and July 2008, 24 infant patients with interrupted aortic arch (IAA) (n=3), isolated aortic coarctation (iCoA) (n=9) and aortic coarctation with hypoplastic aortic arch (CoA-HyAA) (n=12) underwent one-stage surgical correction in our hospital. End-to-end anastomosis was employed in 12 infants (IAA n=3 and iCoA n=9); for the other 12 patients with CoA-HyAA, an end-to-end extended anastomosis was used in 8 cases, end-to-side anastomosis in 2 cases, and composite heterologous pericardial patch in 2 cases. RCP with 40 mL/kg/min through the innominate artery during aortic arch reconstruction was employed for all pediatric patients. One single-dose histidine-ketoglutarate-tryptophan (HTK) solution was used for myocardial protection during CPB. Cardiopulmonary bypass time and aortic cross-clamp time were 165.6+/-32.4 min and 81.7+/-30.0 min, respectively. The mean regional cerebral perfusion time was 31.0+/-10.6 min; lowest nasopharyngeal temperature was 19.1+/-1.1 degrees C. Operative mortality rate in both groups was 8.3%. Mean follow-up was 10.5+/-4.8 months. There was no late mortality or postoperative neurologic, renal or hepatic complications. All patients are asymptomatic and are developing normally. One-stage total arch repair using the RCP technique is an excellent method that may minimize neurologic and renal complications. Our surgical strategy for arch anomaly has a low rate of residual and recurrent coarctation when performed in these infants.

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

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    Tomoyasu Takahiro

    2008-10-01

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

  15. Neurodevelopmental Outcomes Following Regional Cerebral Perfusion with Neuromonitoring for Neonatal Aortic Arch Reconstruction

    Science.gov (United States)

    Andropoulos, Dean B.; Easley, R. Blaine; Brady, Ken; McKenzie, E. Dean; Heinle, Jeffrey S.; Dickerson, Heather A.; Shekerdemian, Lara S.; Meador, Marcie; Eisenman, Carol; Hunter, Jill V.; Turcich, Marie; Voigt, Robert G.; Fraser, Charles D.

    2013-01-01

    Background In this study we report magnetic resonance imaging (MRI) brain injury, and 12 month neurodevelopmental outcomes, when regional cerebral perfusion (RCP) is utilized for neonatal aortic arch reconstruction. Methods Fifty seven neonates receiving RCP during aortic arch reconstruction were enrolled in a prospective outcome study. RCP flows were determined by near-infrared spectroscopy and transcranial Doppler monitoring. Brain MRI were performed preoperatively and 7 days postoperatively. Bayley Scales of Infant Development III was performed at 12 months. Results Mean RCP time was 71 ± 28 minutes (range 5–121), mean flow 56.6 ± 10.6 ml/kg/min. New postoperative MRI brain injury was seen in 40% of patients. For 35 RCP patients at age 12 months, mean Bayley III composite standard scores were: Cognitive = 100.1 ± 14.6,(range 75–125); Language = 87.2 ± 15.0, (range 62–132); Motor = 87.9 ± 16.8, (range 58–121).Increasing duration of RCP was not associated with adverse neurodevelopmental outcomes. Conclusions Neonatal aortic arch repair with RCP utilizing a neuromonitoring strategy results in 12-month cognitive outcomes that are at reference population norms; language and motor outcomes are lower than the reference population norms by 0.8–0.9 standard deviation. This largest RCP group with neurodevelopmental outcomes published to date demonstrates that this technique is effective and safe in supporting the brain during neonatal aortic arch reconstruction. PMID:22766302

  16. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

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

    2014-01-01

    dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...... the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... cardiac output brain perfusion becomes jeopardized. Whether, in patients with cardiovascular disease and/or defect, cerebral blood flow cerebral control HV-induced hypocapnia elicits cerebral hypoperfusion, leading to TLOC, remains to be established....

  17. 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

  18. Neurodevelopmental outcomes after regional cerebral perfusion with neuromonitoring for neonatal aortic arch reconstruction.

    Science.gov (United States)

    Andropoulos, Dean B; Easley, R Blaine; Brady, Ken; McKenzie, E Dean; Heinle, Jeffrey S; Dickerson, Heather A; Shekerdemian, Lara S; Meador, Marcie; Eisenman, Carol; Hunter, Jill V; Turcich, Marie; Voigt, Robert G; Fraser, Charles D

    2013-02-01

    In this study we report magnetic resonance imaging (MRI) brain injury and 12-month neurodevelopmental outcomes when regional cerebral perfusion (RCP) is used for neonatal aortic arch reconstruction. Fifty-seven neonates receiving RCP during aortic arch reconstruction were enrolled in a prospective outcome study. RCP flows were determined by near-infrared spectroscopy and transcranial Doppler monitoring. Brain MRI was performed preoperatively and 7 days postoperatively. Bayley Scales of Infant Development III was performed at 12 months. Mean RCP time was 71 ± 28 minutes (range, 5 to 121 minutes) and mean flow was 56.6 ± 10.6 mL/kg/min. New postoperative MRI brain injury was seen in 40% of patients. For 35 RCP patients at age 12 months, mean Bayley Scales III Composite standard scores were: Cognitive, 100.1 ± 14.6 (range, 75 to 125); Language, 87.2 ± 15.0 (range, 62 to 132); and Motor, 87.9 ± 16.8 (range, 58 to 121). Increasing duration of RCP was not associated with adverse neurodevelopmental outcomes. Neonatal aortic arch repair with RCP using a neuromonitoring strategy results in 12-month cognitive outcomes that are at reference population norms. Language and motor outcomes are lower than the reference population norms by 0.8 to 0.9 standard deviations. The neurodevelopmental outcomes in this RCP cohort demonstrate that this technique is effective and safe in supporting the brain during neonatal aortic arch reconstruction. Copyright © 2013 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

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    Carmen Ghisleni

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

    Acetylcholine may contribute to the increase in regional cerebral blood flow (rCBF) during cerebral activation since glycopyrrolate, a potent inhibitor of acetylcholine, abolishes the exercise-induced increase in middle cerebral artery mean flow velocity. We tested the hypothesis that cholinergic...... vasodilatation is important for the increase in rCBF during cerebral activation. The subjects were 11 young healthy males at an age of 24 ± 3 years (mean ± SD). We used arterial spin labeling and blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI) to evaluate rCBF with and without...... intravenous glycopyrrolate during a handgrip motor task and visual stimulation. Glycopyrrolate increased heart rate from 56 ± 9 to 114 ± 14 beats/min (mean ± SD; p

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

    Science.gov (United States)

    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.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

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

    International Nuclear Information System (INIS)

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

    2003-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Gláucio Furlanetto

    2009-12-01

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

  6. Regional cerebral perfusion measurements: a comparative study of xenon-enhanced CT and C15O2 build-up using dynamic PET

    International Nuclear Information System (INIS)

    St Lawrence, K.S.; Bews, J.; Dunscombe, P.B.

    1992-01-01

    Regional cerebral perfusion can be determined by monitoring the uptake of a diffusable tracer concurrently in cerebral tissue and arterial blood. Two techniques based on this methodology are xenon-enhanced computed tomography (Xe CT) and C 15 O 2 build-up using dynamic positron emission tomography (C 15 O 2 PET). Serial images are used by both Xe CT and C 15 O 2 PET to characterize the uptake of the tracer in cerebral tissue. The noise present in these images will reduce the precision of the perfusion measurements obtained by either technique. Using Monte Carlo type computer simulations, the precision of the two techniques as a function of image noise has been examined. On the basis of their results, they conclude that the precision of the Xe CT technique is comparable to the precision of C 15 O 2 PET when realistic clinical protocols are employed for both. (author)

  7. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Reza Nemati

    2014-01-01

    Full Text Available Landau-Kleffner syndrome (LKS is a rare childhood disorder characterized by acquired aphasia and epilepsy. 99mTc-ECD SPECT imaging was performed in two right-handed children with LKS. A relative decrease in perfusion was found in the left frontal-temporal cortices of both patients as well as in the left and right parietal cortices of one patient with aphasia, without clinical epilepsy. The degree of regional cerebral perfusion impairment did not correlate with the severity of the clinical and EEG abnormalities, but the area of hypoperfusion was compatible with the speech area of the brain. Overall, although asymmetrical temporoparietal perfusion appears as a common finding in LKS, SPECT findings in LKS alone cannot elucidate the pathogenic features of the disorder in the brain. Here, we present two cases of LKS in which we investigated SPECT perfusion scans.

  8. Basic and clinical evaluation of regional cerebral perfusion scintigraphy of 99mTc-HM-PAO

    International Nuclear Information System (INIS)

    Tsukatani, Yasushi; Nakamura, Kayoko; Fujii, Hiroshi

    1988-01-01

    Radiochemical purity of 99m Tc-HM-PAO decreased rapidly after preparation. 99m Tc activity of the whole brain increased rapidly after venous injection, and changed very little after 3 minutes later. 99m Tc-HM-PAO scintigram showed the wider abnormal perfusion area than CT scanning did. Hypoperfusion area found by IMP tended to be wider than that by HM-PAO. There were no side effects observed of all cases. (author)

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

    International Nuclear Information System (INIS)

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

    2001-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Bradley J MacIntosh

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

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

    Institute of Scientific and Technical Information of China (English)

    Cunli Xu; Wenhua Wu; Lingbin Kong

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    Cunli Xu; Wenhua Wu; Lingbin Kong

    2016-01-01

    Objective:To study the effects of regional cerebral blood flow(r CBF)perfusion on learning and memory function in special brain areas and its molecular mechanism in rat.Methods:Sixty-four adult male healthy Sprague-Dawley(SD)rats were randomly divided into two groups:A false operation group and an operation group.The false operation group was randomly divided into four subgroups(A0,B0,C0,and D0)and the operation group was randomly divided into four subgroups(A,B,C,and D),with eight rats in each subgroup.The operation group underwent bilateral common carotid artery permanent ligation,while the other group only underwent a skin incision without the bilateral common carotid artery permanent ligation.Learning memory function of rats in each subgroup was measured using a Y-maze at 4 h,8 h,24 h,and 3 days after surgery.The r CBF in the right frontal lobe and hippocampus was detected using the Periflux PF model laser Doppler flowmetry and c-fos,c-jun,Bcl-2,and Bax protein expression in the right frontal lobe and hippocampus was measured using immunohistochemistry.Results:The r CBF in the right frontal lobule division and right hippocampus division was significantly lower in the operation group than in the false operation group(P<0.05).The error number(EN),time to reach the target,and total reaction time(TRT)for the learning index using the Y-type labyrinth test in the operation group were significantly higher than that in the false operation group(P<0.05);however,the active avoid rate in the operation group was significantly lower than that of the false operation group.Expression of c-fos and c-jun as well as the average absorbency in the right frontal lobule division and right hippocampus division in the operation group were significantly higher than those in the false operation group(P<0.05).The number of Bax and Bcl-2-positive cells was significantly higher in the operation group,and the expression ratio of Bax/Bcl-2 in the operation

  13. Cerebral perfution studies; Estudios de Perfusion Cerebral

    Energy Technology Data Exchange (ETDEWEB)

    Mut, Fernando [Universidad de la Republica, Montevideo (Uruguay). Centro de Medicina Nuclear

    1994-12-31

    For detecting in precocious form a coronary disease is necessary to aply a diagnostic techniques. The main considerations to be indicated in the present work are: physiological considerations, myocardial perfusion studies with radiotracers such as Talio 201, 99mTc, MIBI, 99mTc-Teboroxima, 99mTc-Fosfinas, instrumentation for obtain good images, proceedings protocols, studies interpretation, standards, SPECT, anomalies standards, coronary diseases.

  14. Cerebral perfusion imaging in HIV positive patients

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  15. Cerebral perfusion in homogeneity in normal volunteers

    International Nuclear Information System (INIS)

    Gruenwald, S.M.; Larcos, G.

    1998-01-01

    Full text: In the interpretation of cerebral perfusion scans, it is important to know the normal variation in perfusion which may occur between the cerebral hemispheres. For this reason 24 normal volunteers with no neurological or psychiatric history, and who were on no medications, had 99m Tc-HMPAO brain SPECT studies using a single headed gamma camera computer system. Oblique, coronal and sagittal images were reviewed separately by two experienced observers and any differences were resolved by consensus. Semi-quantitation was performed by summing two adjacent oblique slices and drawing right and left mirror image ROIs corresponding to the mid section level of anterior and posterior frontal lobes, anterior and posterior parietal lobes, temporal lobes and cerebellum. From the mean counts per pixel, right: left ROI ratios and ROI: cerebellar ratios were calculated. On qualitative review 6/24 subjects had mild asymmetry in tracer distribution between right and left cerebral lobes. Semi-quantitation revealed a 5-10% difference in counts between right and left ROIs in 12/24 subjects and an additional three subjects had 10-20% difference in counts between right and left temporal lobes. This study demonstrates the presence of mild asymmetry of cerebral perfusion in a significant minority of normal subjects

  16. Evaluation of ocular acupuncture on cerebral infarction with cerebral blood flow perfusion imaging

    International Nuclear Information System (INIS)

    Li Yuge; Gao Qinyi; Wang Shuang; Zhao Yong

    2008-01-01

    To evaluate the immediate effect of ocular acupuncture on patients, an method of SPECT image of cerebral blood flow daily stress test was established. 10 patients diagnosed as cerebral infarction by CT or MRI were tested. They all received 99 Tc m -ECD SPECT imaging at twice before and after ocular acupuncture. By means of image subtraction technique and semi-quantitative method of regional interesting area, the change of regional cerebral blood flow was observed between the two images. Under restful state perfusion of cerebral blood flow in 18 foci was low at the frontal lobe, the cerebellum, the basal ganglia and temporal lobe. After ocular acupuncture, the perfusions were obviously increased in 16 foci among them and the reactivity of the frontal lobe and the cerebellum to ocular acupuncture was higher, the average improvement rate of which was 55.15% and 53.06% respectively, lower in the basal ganglia and temporal lobe, the average improvement rate was 31.79% and 36.67% respectively. 99 Tc m -ECD SPECT cerebral perfusion image has some significant clinic value for evaluating the effect of ocular acupuncture to treating cerebral infarction. (authors)

  17. 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)

  18. A Means for the Scintigraphic Imaging of Regional Brain Dynamics. Regional Cerebral Blood Flow and Regional Cerebral Blood Volume

    Energy Technology Data Exchange (ETDEWEB)

    Potchen, E. J.; Bentley, R.; Gerth, W.; Hill, R. L.; Davis, D. O. [Washington University School Of Medicine, St. Louis, MO (United States)

    1969-05-15

    The use of freely diffusable inert radioactive gas as a washout indicator to measure regional cerebral blood flow has become a standardized kinetic procedure in many laboratories. Recent investigations with this technique have led us to conclude that we can reliably distinguish regional flow with perfusion against regional flow without perfusion from the early portion of the curve. Based on a detailed study of the early curve kinetics in patients with and without cerebral vascular disease we have defined the sampling duration necessary for application of the Anger gamma camera imaging process to regional changes in cerebral radioactivity. Using a standard camera and a small computer, a procedure has been developed and based upon entire field to determine the time of maximum height followed by analysis of the data in a matrix. This will permit a contour plot presentation of calculated regional cerebral blood flow in millilitres per 100 grams perfused brain per minute. In addition, we propose to augment this data by the display of regional non-perfusion blood flow versus regional cerebral flow with perfusion. Preliminary investigation on sampling duration, and Compton scattering were prerequisite to clinical scintigraphy of regional cerebral blood flow. In addition, the method of interface for the conventional Anger gamma camera to digital computers used in this procedure are discussed. Applications to further assess regional cerebral dynamics by scintigraphy are presented. (author)

  19. Assessment of cerebral perfusion with dynamic susceptibility contrast

    International Nuclear Information System (INIS)

    Takahashi, Kiyohiko; Naito, Isao; Nozokido, Takeshi; Sato, Takaaki; Takatama, Shin; Kimura, Tokunori

    2004-01-01

    Accurate measurements of arterial input function (AIF) are indispensable for the quantification of perfusion parameters such as mean transit time (MTT), cerebral blood volume (CBV), and cerebral blood flow (CBF). Quantification trials of cerebral perfusion using the disconsolation method with dynamic susceptibility contrast MRI (DSC-MRI) have been reported on. Accurately measuring AIF with DSC-MRI is difficult due to non-linearity and the limited dynamic range between ΔR 2 * and the concentration of contrast media. In this study, we assessed simple methods while using various parameters calculated by the tissue time intensity curve without measuring AIF. The parameters used were appearance time of contrast media (AT), 1'st moment (MT1), the full width at half maximum (FWHM), and up slope at maximum gradient (US). Difference of the appearance time (delta AT) and the CBFratio between the regions in question and the contralateral regions obtained by MT1, FWHM and US were assessed in 38 stroke patients. The CBF calculated by the linear scaling method using the signal of the ASL (ASL, CBF) was used as the standard for a correlation study. The delta AT in patients with middle cerebral artery occlusions supplied by retrograde flow indicated a significantly greater value as compared to patients with other lesions with antegrade flow. US CBF indicated the best correlation among the three CBFs obtained by MT1, FWHM and US. Both the ASL CBFratio and the US CBFratio correlated with delta AT, with the ASL CBFratio being predominant. The CBVratio-CBFratio map showed that the CBVratio tended to decrease when the CBFratio decreased. The map is useful in clinical analysis of cerebral perfusion due to its simplicity and ability to alleviate AIF dependent errors. The validity of the proposed method still needs to be examined by comparing it to the deconvolution method with DSC-MRI, since DSC-MRI can correct the effect of AIF. It might also be compared to Xenon CT, which is less

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

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Kawashima, Ryuta; Fukuda, Hiroshi; Ishii, Kiyoshi; Onuma, Takehide.

    1997-01-01

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

  1. Cerebral perfusion gammagraphy in neurology and neurosurgery

    International Nuclear Information System (INIS)

    Cardenas, Rene; Duran de Cardenas, Rosalia

    1998-01-01

    This paper describes six methods for measuring rCBF: 1) PET through 77 Kr, 15 O-water, 18 F-antipirine, 18 F-methane and 11 C-alcohols, 2) Wash measure of 133 Xe through SPECT or multidetectors, 3) CT contrasted through xenon, 4) planar gammagraphy or SPECT through 123 I-IMP or 123 I-HIPDM, 5) planar gammagraphy or radioisotopic tomography (SPECT) through 201 Tl-dietiltiocarbamate, and 6) planar gammagraphy or SPECT through 99m Tc lipofilics complex, 99m Tc-HMPAO and 99m Tc-ECD. They have been used for rCBF, , 133 Xe, 123 I-IMP 99m Tc-HMPAO studies, the two last ones are been used at the moment, the film performance is around 0.7 to 1.1 cm. The most useful radioisotopic techniques for gammagraphic study of cerebral perfusion have used HMPAO and 131 I-IMP labelled with 99m Tc

  2. 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...

  3. Cerebral perfusion in orthostatic hypotensive patients with and without symptoms

    International Nuclear Information System (INIS)

    Balan, K.; Parry-Jones, D.; Puliyel, M.M.; Set, P.; Solanki, C.; Campbell, G.A.

    2002-01-01

    Aim: Patients with orthostatic hypotension (OH) may be symptomatic or asymptomatic. This study was undertaken to determine whether postural response in cerebral perfusion plays any significant role in causing symptoms of OH. Materials and methods: 5 symptomatic OH patients and 5 asymptomatic OH patients were studied using 99mTc-HMPAO. Two dynamic studies were acquired within an interval of two days, with the patient injected either supine or erect. The brain perfusion index (BPI) was derived from Patlak-Rutland analysis of the aortic arch and the cerebral hemispheres. SPECT images were used to determine regional counts over frontal, temporal, occipital, cerebellar and basal ganglia regions. Paired t-test was used to compare the difference in the ratios between erect and supine studies and unpaired t-test for comparison between the two groups. Results: There was significant improvement in BPI in asymptomatic patients on assuming supine position (10.1±1.9 vs. 11.9±3.2), but not in the symptomatic group (12.9±4.5 vs. 13.1±2.8). No significant difference was noted between the two groups. In the SPECT studies, two areas of difference between the asymptomatic and symptomatic groups were identified: L temporal (0.038±0.018 vs. -0.004±0.025) and L basal ganglia (-0.02±0.043 vs. 0.044±0.035). However, these mean differences were comparable to those of other subsets. Paired t-tests between the erect and supine ratios identified: R frontal in the asymptomatic group (0.884±0.067 vs. 0.918±0.078), L basal ganglia in the symptomatic group (0.946±0.093 vs. 0.990±0.102). Again, these differences were small and only slightly greater than those found in other subsets. Conclusions: 1. Posture-related alterations in global or regional cerebral perfusion do not appear to play a causative role in symptoms of OH and 2. Future studies including larger number of patients may be required for further evaluation

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

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-08-15

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

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

    Directory of Open Access Journals (Sweden)

    Andreas Habertheuer

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  8. The regulation of cerebral perfusion in patients with Alzheimer's disease.

    NARCIS (Netherlands)

    Beek, H.E.A. van

    2010-01-01

    This thesis aimed at investigating whether the regulation of cerebral perfusion is impaired in patients with Alzheimer’s disease and whether this regulation is altered by treatment with cholinesterase inhibitors. This aim has first been translated in two literature studies on the clinical and

  9. The preliminary study of CT cerebral perfusion imaging in transient ischemic attacks

    International Nuclear Information System (INIS)

    Lu Jie; Li Kuncheng; Du Xiangying

    2002-01-01

    Objective: To probe the application of CT cerebral perfusion imaging on transient ischemic attacks (TIA). Methods: Conventional CT and CT cerebral perfusion imaging were performed on 5 normal adults and 20 patients with clinically diagnosed TIA. After regular CT examination, dynamic scans of 40 seconds were performed on selected slice (usually on the basal ganglia slice), while 40 ml non-ionic contrast material were bolus injected through antecubital vein with. These dynamic images were processed with the 'Perfusion CT' software package on a PC based workstation. Cerebral blood flow (CBF) and time to peak (TP) enhancement were measured within specific regions of the brain on CT perfusion images. Quantitative analysis was performed for these images. Results: A gradient of perfusion between gray matter and white matter was showed on cT perfusion images in normal adults and TIA patients. CBF and TP for normal cortical and white matter were 378.2 ml·min -1 ·L -1 , 7.8 s and 112.5 ml·min -1 ·L -1 , 9.9 s, respectively. In 20 cases with TIA, persisting abnormal perfusion changes corresponding to clinical symptoms were found in 15 cases with prolonged TP. Other 5 cases showed normal results. TP of affected side (11.8 +- 4.4) s compared with that of the contralateral side (9.1 +- 3.1) s was significantly prolonged (t = 5.277, P -1 · -1 ] and contralateral side [(229.1 +- 41.4) ml·min -1 ·L -1 ]. Conclusion: Perfusion CT provides valuable hemodynamic information and shows the extent of perfusion disturbances for patients with TIA

  10. 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...

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

    Science.gov (United States)

    2011-01-01

    Background This study aims to evaluate relationship between three different clinical conditions: Major Depressive Disorders (MDD), Hashimoto Thyroiditis (HT) and reduction in regional Cerebral Blood Flow (rCBF) in order to explore the possibility that patients with HT and MDD have specific pattern(s) of cerebral perfusion. Methods Design: Analysis of data derived from two separate data banks. Sample: 54 subjects, 32 with HT (29 women, mean age 38.8 ± 13.9); 22 without HT (19 women, mean age 36.5 ± 12.25). Assessment: Psychiatric diagnosis was carried out by Simplified Composite International Diagnostic Interview (CIDIS) using DSM-IV categories; cerebral perfusion was measured by 99 mTc-ECD SPECT. Statistical analysis was done through logistic regression. Results MDD appears to be associated with left frontal hypoperfusion, left temporal hypoperfusion, diffuse hypoperfusion and parietal perfusion asymmetry. A statistically significant association between parietal perfusion asymmetry and MDD was found only in the HT group. Conclusion In HT, MDD is characterized by a parietal flow asymmetry. However, the specificity of rCBF in MDD with HT should be confirmed in a control sample with consideration for other health conditions. Moreover, this should be investigated with a longitudinally designed study in order to determine a possible pathogenic cause. Future studies with a much larger sample size should clarify whether a particular perfusion pattern is associated with a specific course or symptom cluster of MDD. PMID:21910915

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-03-01

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

  13. Repeatability of Bolus Kinetics Ultrasound Perfusion Imaging for the Quantification of Cerebral Blood Flow

    NARCIS (Netherlands)

    Vinke, Elisabeth J.; Eyding, Jens; de Korte, Chris L.; Slump, Cornelis H.; van der Hoeven, Johannes G.; Hoedemaekers, Cornelia W.E.

    2017-01-01

    Ultrasound perfusion imaging (UPI) can be used for the quantification of cerebral perfusion. In a neuro-intensive care setting, repeated measurements are required to evaluate changes in cerebral perfusion and monitor therapy. The aim of this study was to determine the repeatability of UPI in

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

  15. Safety of adenosine in stress cerebral perfusion imaging

    International Nuclear Information System (INIS)

    Hu Pengcheng; Gu Yushen; Liu Wenguan; Xiu Yan; Zhu Weimin; Chen Shuguang; Shi Hongcheng

    2009-01-01

    Objective: To evaluate the safety of adenosine as pharmacological stress agents in stress cerebral perfusion imaging. Methods: Eighty patients under investigation for suspected cerebral vessel disease were recruited. Each had a resting scan and a stress scan on different days. The adenosine stress protocol was as same as the protocol used in adenosine stress myocardial perfusion imaging. Subjective and objective side-effects were investigated during pharmacological stress procedure. Results: All patients completed the 6 min infusion protocol without premature termination on safety criteria or due to intolerable symptoms. 46 patients had mild side effects. 20 patients (25%) had dizziness, 12 patients (15%) had palpitation, 1 patient (1%) was hypotensive, 7 patients (9%) had dyspnoea, 4 patients (5%) felt hot, 3 patients (4%) had sweat, 4 patients (5%) had nausea, 6 patients (8%) had flushing, 19 patients (24%) had chest pain, 6 patients (8%) had abdomen pain, 3 patients (4%) had abnormal taste and 1 patient (1%) were thirsty. Transient ST change occurred in only 1 patient. Conclusion: Adenosine stress cerebral perfusion imaging is a safe diagnostic method with mild side effects. (authors)

  16. Specific cerebral perfusion patterns in three schizophrenia symptom dimensions.

    Science.gov (United States)

    Stegmayer, Katharina; Strik, Werner; Federspiel, Andrea; Wiest, Roland; Bohlhalter, Stephan; Walther, Sebastian

    2017-12-01

    Dimensional concepts such as the Research Domain Criteria initiative have been proposed to disentangle the heterogeneity of schizophrenia. One model introduced three neurobiologically informed behavioral dimensions: language, affectivity and motor behavior. To study the brain-behavior associations of these three dimensions, we investigated whether current behavioral alterations were linked to resting state perfusion in distinct brain circuits in schizophrenia. In total, 47 patients with schizophrenia spectrum disorders and 44 healthy controls were included. Psychopathology was assessed with the Positive And Negative Syndrome Scale and the Bern Psychopathology scale (BPS). The BPS provides severity ratings of three behavioral dimensions (language, affectivity and motor). Patients were classified according to the severity of alterations (severe, mild, no) in each dimension. Whole brain resting state cerebral blood flow (CBF) was compared between patient subgroups and controls. Two symptom dimensions were associated with distinct CBF changes. Behavioral alterations in the language dimension were linked to increased CBF in Heschl's gyrus. Altered affectivity was related to increased CBF in amygdala. The ratings of motor behavior instead were not specifically associated with CBF. Investigating behavioral alterations in three schizophrenia symptom dimensions identified distinct regional CBF changes in the language and limbic brain circuits. The results demonstrate a hitherto unknown segregation of pathophysiological pathways underlying a limited number of specific symptom dimensions in schizophrenia. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Interleaving cerebral CT perfusion with neck CT angiography. Pt. I. Proof of concept and accuracy of cerebral perfusion values

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Marcel T.H.; Meijer, Frederick J.A.; Woude, Willem-Jan van der; Smit, Ewoud J.; Ginneken, Bram van; Prokop, Mathias; Manniesing, Rashindra [Radboud University Medical Center, Department of Radiology and Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands)

    2017-06-15

    We present a novel One-Step-Stroke protocol for wide-detector CT scanners that interleaves cerebral CTP with volumetric neck CTA (vCTA). We evaluate whether the resulting time gap in CTP affects the accuracy of CTP values. Cerebral CTP maps were retrospectively obtained from 20 patients with suspicion of acute ischemic stroke and served as the reference standard. To simulate a 4 s gap for interleaving CTP with vCTA, we eliminated one acquisition at various time points of CTP starting from the bolus-arrival-time(BAT). Optimal timing of the vCTA was evaluated. At the time point with least errors, we evaluated elimination of a second time point (6 s gap). Mean absolute percentage errors of all perfusion values remained below 10 % in all patients when eliminating any one time point in the CTP sequence starting from the BAT. Acquiring the vCTA 2 s after reaching a threshold of 70HU resulted in the lowest errors (mean <3.0 %). Eliminating a second time point still resulted in mean errors <3.5 %. CBF/CBV showed no significant differences in perfusion values except MTT. However, the percentage errors were always below 10 % compared to the original protocol. Interleaving cerebral CTP with neck CTA is feasible with minor effects on the perfusion values. (orig.)

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-12-15

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

  20. 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.

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

    International Nuclear Information System (INIS)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A.

    1998-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-06-01

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

  3. Scaling of cerebral blood perfusion in primates and marsupials.

    Science.gov (United States)

    Seymour, Roger S; Angove, Sophie E; Snelling, Edward P; Cassey, Phillip

    2015-08-01

    The evolution of primates involved increasing body size, brain size and presumably cognitive ability. Cognition is related to neural activity, metabolic rate and rate of blood flow to the cerebral cortex. These parameters are difficult to quantify in living animals. This study shows that it is possible to determine the rate of cortical brain perfusion from the size of the internal carotid artery foramina in skulls of certain mammals, including haplorrhine primates and diprotodont marsupials. We quantify combined blood flow rate in both internal carotid arteries as a proxy of brain metabolism in 34 species of haplorrhine primates (0.116-145 kg body mass) and compare it to the same analysis for 19 species of diprotodont marsupials (0.014-46 kg). Brain volume is related to body mass by essentially the same exponent of 0.70 in both groups. Flow rate increases with haplorrhine brain volume to the 0.95 power, which is significantly higher than the exponent (0.75) expected for most organs according to 'Kleiber's Law'. By comparison, the exponent is 0.73 in marsupials. Thus, the brain perfusion rate increases with body size and brain size much faster in primates than in marsupials. The trajectory of cerebral perfusion in primates is set by the phylogenetically older groups (New and Old World monkeys, lesser apes) and the phylogenetically younger groups (great apes, including humans) fall near the line, with the highest perfusion. This may be associated with disproportionate increases in cortical surface area and mental capacity in the highly social, larger primates. © 2015. Published by The Company of Biologists Ltd.

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

    Energy Technology Data Exchange (ETDEWEB)

    Claus, J J [Dept. of Neurology, Univ. Hospital, Rotterdam (Netherlands) Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Harskamp, F van [Dept. of Neurology, Univ. Hospital, Rotterdam (Netherlands); Breteler, M M.B. [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Krenning, E P [Dept. of Nuclear Medicine, Univ. Hospital, Rotterdam (Netherlands); Cammen, T.J.M. van der (Dept. of Geriatric Medicine, Univ. Hospital, Rotterdam (Netherlands)); Hofman, A [Dept. of Epidemiology and Biostatistics, Erasmus Univ. Medical School, Rotterdam (Netherlands); Hasan, D [Dept. of Neurology, Univ. Hospital, Rotterdam (Netherlands)

    1994-10-01

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

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

    International Nuclear Information System (INIS)

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

    1994-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Claus, J.J.; Walstra, G.J.M.; Hijdra, A.; Gool, W.A. van [Department of Neurology, Academic Medical Center, University of Amsterdam, Amsterdam (Netherlands); Royen, E.A. van [Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam (Netherlands); Verbeeten, B. Jr. [Department of Radiology, Academic Medical Center, University of Amsterdam (Netherlands)

    1999-03-01

    We determined the relationship between regional cerebral blood flow (rCBF) measured with single-photon emission tomography (SPET) and decline in cognitive function and survival in Alzheimer`s disease. In a prospective follow-up study, 69 consecutively referred patients with early probable Alzheimer`s disease (NINCDS/ADRDA criteria) underwent SPET performed at the time of initial diagnosis using technetium-99m-labelled hexamethylpropylene amine oxime. Neuropsychological function was assessed at baseline and after 6 months and survival data were available on all patients, extending to 5.5 years of follow-up. Lower left temporal (P<0.01) and lower left parietal (P<0.01) rCBF were statistically significantly related to decline in language function after 6 months. The association between left temporal rCBF and survival was also statistically significant (P<0.05) using Cox proportional hazards regression analysis. Performing analysis with quartiles of the distribution, we found a threshold effect for low left temporal rCBF (rCBF<73.7%, P<0.01) and high risk of mortality. In this lowest quartile, median survival time was 2.7 years (follow-up to 5.2 years), compared with 4.4 years in the other quartiles (follow-up to 5.5 years). Kaplan-Meier survival curves showed statistically significant (P<0.05, log rank test) survival curves for the lowest versus other quartiles of left temporal rCBF. All results were unaffected by adjustment for age, sex, dementia severity, duration of symptoms, education and ratings of local cortical atrophy. We conclude that left temporal rCBF predicts decline in language function and survival in patients with early probable Alzheimer`s disease, with a threshold effect of low rCBF and high risk of mortality. (orig.) With 3 figs., 3 tabs., 44 refs.

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

    International Nuclear Information System (INIS)

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

    1999-01-01

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

  8. External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery.

    Science.gov (United States)

    Grocott, Hilary P; Ambrose, Emma; Moon, Mike

    2016-10-01

    Selective antegrade cerebral perfusion (SACP) involving cannulation of either the axillary or innominate artery is a commonly used technique for maintaining cerebral blood flow (CBF) during the use of hypothermic cardiac arrest (HCA) for operations on the aortic arch. Nevertheless, asymmetrical CBF with hypoperfusion of the left cerebral hemisphere is a common occurrence during SACP. The purpose of this report is to describe an adjunctive maneuver to improve left hemispheric CBF during SACP by applying extrinsic compression to the left carotid artery. A 77-yr-old male patient with a history of aortic valve replacement presented for emergent surgical repair of an acute type A aortic dissection of a previously known ascending aortic aneurysm. His intraoperative course included cannulation of the right axillary artery, which was used as the aortic inflow during cardiopulmonary bypass and also allowed for subsequent SACP during HCA. After the onset of HCA, the innominate artery was clamped at its origin to allow for SACP. Shortly thereafter, however, the left-sided cerebral oxygen saturation (SrO2) began to decrease. Augmenting the PaO2, PaCO2 and both SACP pressure and flow failed to increase left hemispheric SrO2. Following the use of ultrasound guidance to confirm the absence of atherosclerotic disease in the carotid artery, external pressure was applied partially compressing the artery. With the carotid compression, the left cerebral saturation abruptly increased, suggesting pressurization of the left cerebral hemispheric circulation and augmentation of CBF. Direct ultrasound visualization and cautious partial compression of the left carotid artery may address asymmetrical CBF that occurs with SACP during HCA for aortic arch surgery. This strategy may lead to improved symmetry of CBF and corresponding cerebral oximetry measurements during aortic arch surgery.

  9. Glycopyrrolate abolishes the exercise-induced increase in cerebral perfusion in humans

    DEFF Research Database (Denmark)

    Seifert, Thomas; Fisher, James P; Young, Colin N

    2010-01-01

    Brain blood vessels contain muscarinic receptors that are important for cerebral blood flow (CBF) regulation, but whether a cholinergic receptor mechanism is involved in the exercise-induced increase in cerebral perfusion or affects cerebral metabolism remains unknown. We evaluated CBF and cerebral......(mean) during ergometer cycling (n = 8). Separate, randomized and counterbalanced trials were performed in control (no drug) conditions and following muscarinic cholinergic receptor blockade by glycopyrrolate. Glycopyrrolate increased resting heart rate from approximately 60 to approximately 110 beats min(-1...... abolished by glycopyrrolate (P important for the exercise-induced increase in cerebral perfusion without affecting the cerebral metabolic rate for oxygen....

  10. Acute cerebral stroke imaging and brain perfusion with the use of high-concentration contrast media

    Energy Technology Data Exchange (ETDEWEB)

    Miles, K.A. [Wesley Research Inst., The Wesley Hospital, Brisbane (Australia); Brighton and Sussex Medical School, Univ. of Sussex, Falmer, Brighton (United Kingdom)

    2003-12-01

    Acute cerebral stroke remains a major cause of death among adults and the emergence of new therapies has created a need for early and rapid imaging at a time when conventional CT is either normal or demonstrates subtle abnormalities that are easy to misinterpret. Perfusion CT uses the temporal changes in cerebral and blood attenuation during a rapid series of images acquired without table movement following an intravenous bolus of contrast medium to generate images of mean transit time (MTT) cerebral blood volume (CBV) and perfusion. Reduced perfusion with preserved CBV is indicative of reversible ischaemia, whereas a matched reduction in perfusion and CBV implies infarction. The CT perfusion imaging can positively identify patients with non-haemorrhagic stroke in the presence of a normal conventional CT, provide an indication as to prognosis and potentially select those patients for whom thrombolysis is appropriate. Perfusion CT offers a powerful adjunct to MDCT based imaging of cerebrovascular disease, but further clinical validation is required. (orig.)

  11. Determination of cerebral perfusion using magnetic resonance imaging

    International Nuclear Information System (INIS)

    Ropele, S.

    1997-01-01

    This thesis deals with various magnetic resonance imaging methods to quantify cerebral blood flow. Special attention has been drawn to noninvasive methods. A new method based on the T1-shortening due to perfusion was developed using a multipoint inversion recovery sequence with alternating slice selective and non selective preparation. To study the influence of errors arising from partial volume effects with cerebrospinal fluid and from brain motion, numerous investigations have been performed on a clinical 1.5 Tesla scanner. In a second approach, the IVIM-method, which treats isotropic movement in the capillary network like diffusion, has been investigated. Since artifacts in phase encoding direction caused by brain motion are a common problem to most diffusion imaging techniques, a significant improvement has been achieved by the development and optimization of a single shot STEAM-sequence. This sequence proved to be less sensitive for motion artifacts, although a high signal to noise ratio has been preserved. (author)

  12. Arterial blood gas management in retrograde cerebral perfusion: the importance of carbon dioxide.

    Science.gov (United States)

    Ueno, K; Takamoto, S; Miyairi, T; Morota, T; Shibata, K; Murakami, A; Kotsuka, Y

    2001-11-01

    Many interventional physiological assessments for retrograde cerebral perfusion (RCP) have been explored. However, the appropriate arterial gas management of carbon dioxide (CO2) remains controversial. The aim of this study is to determine whether alpha-stat or pH-stat could be used for effective brain protection under RCP in terms of cortical cerebral blood flow (CBF), cerebral metabolic rate for oxygen (CMRO2), and distribution of regional cerebral blood flow. Fifteen anesthetized dogs (25.1+/-1.1 kg) on cardiopulmonary bypass (CPB) were cooled to 18 degrees C under alpha-stat management and had RCP for 90 min under: (1), alpha-stat; (2), pH-stat; or (3), deep hypothermic (18 degrees C) antegrade CPB (antegrade). RCP flow was regulated for a sagittal sinus pressure of around 25 mmHg. CBF was monitored by a laser tissue flowmeter. Serial analyses of blood gas were made. The regional cerebral blood flow was measured with colored microspheres before discontinuation of RCP. CBF and CMRO2 were evaluated as the percentage of the baseline level (%CBF, %CMRO2). The oxygen content of arterial inflow and oxygen extraction was not significantly different between the RCP groups. The %CBF and %CMRO2 were significantly higher for pH-stat RCP than for alpha-stat RCP. The regional cerebral blood flow, measured with colored microspheres, tended to be higher for pH-stat RCP than for alpha-stat RCP, at every site in the brain. Irrespective of CO2 management, regional differences were not significant among any site in the brain. CO2 management is crucial for brain protection under deep hypothermic RCP. This study revealed that pH-stat was considered to be better than alpha-stat in terms of CBF and oxygen metabolism in the brain. The regional blood flow distribution was considered to be unchanged irrespective of CO2 management.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-07-01

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

  14. Continuous determination of optimal cerebral perfusion pressure in traumatic brain injury

    NARCIS (Netherlands)

    Aries, M.J.H.; Czosnyka, Marek; Budohoski, Karol P.; Steiner, Luzius A.; Lavinio, Andrea; Kolias, Angelos G.; Hutchinson, Peter J.; Brady, Ken M.; Menon, David K.; Pickard, John D.; Smielewski, Peter

    Objectives: We have sought to develop an automated methodology for the continuous updating of optimal cerebral perfusion pressure (CPPopt) for patients after severe traumatic head injury, using continuous monitoring of cerebrovascular pressure reactivity. We then validated the CPPopt algorithm by

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  16. Comparative clinical study between retrograde cerebral perfusion and selective cerebral perfusion in surgery for acute type A aortic dissection.

    Science.gov (United States)

    Usui, A; Yasuura, K; Watanabe, T; Maseki, T

    1999-05-01

    Selection of a brain protection method is a primary concern for aortic arch surgery. We performed a retrospective study to compare the respective advantages and disadvantages of retrograde cerebral perfusion (RCP) and selective cerebral perfusion (SCP) in patients who underwent surgery for acute type A aortic dissection. The study reviewed 166 patients who underwent surgery at Nagoya University or its eight branch hospitals between January 1990 and August 1996. There were 91 patients who received SCP and 75 patients who underwent RCP. Results for these two groups were compared. There were no significant differences in age, gender, Marfan syndrome rate, DeBakey classification, or emergency operation rate. Rates of various preoperative complications were similar except for aortic valve regurgitation. Arch replacement was performed more often in SCP than in RCP patients (49% vs. 27%, P = 0.0028). There were no significant differences between groups in cardiac ischemic time or visceral organ ischemic time. However, RCP group showed shorter cardio-pulmonary bypass time (297+/-99 vs. 269+/-112 min, P = 0.013) and lower the lowest core temperature (21.6+/-3.1 degrees C vs. 18.7+/-2.1 degrees C, P = 0.0001). SCP duration was longer than RCP duration (103+/-56 vs. 54+/-24 min, P RCP patients were not significantly different from SCP patients with regard to any postoperative complication, neurological dysfunction (16 vs. 19%), or operative mortality (all deaths within the hospitalization; 24 vs. 21%). Regarding neurologic dysfunction, there were six cases of coma, six of motor paralysis, two of paraplegia and one of visual loss among SCP patients, and eight cases of coma, three of motor paralysis, and three of convulsion in the RCP group. The incidence of motor paralysis was higher in the SCP group, while the incidence of coma was higher in the RCP group. RCP can be performed without clamping or cannulation of the cervical arteries, which is an advantage in reducing the

  17. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul

    2000-01-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.=20

  18. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2000-06-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.

  19. Sequential assessment of regional cerebral blood flow, regional cerebral blood volume, and blood-brain barrier in focal cerebral ischemia: a case report

    International Nuclear Information System (INIS)

    Di Piero, V.; Perani, D.; Savi, A.; Gerundini, P.; Lenzi, G.L.; Fazio, F.

    1986-01-01

    Regional CBF (rCBF) and regional cerebral blood volume (rCBV) were evaluated by N,N,N'-trimethyl-N'-(2)-hydroxy-3-methyl-5-[123I]iodobenzyl-1, 3-propanediamine-2 HCl- and /sup 99m/TC-labeled red blood cells, respectively, and single-photon emission computerized tomography (SPECT) in a patient with focal cerebral ischemia. Sequential transmission computerized tomography (TCT) and SPECT functional data were compared with clinical findings to monitor the pathophysiological events occurring in stroke. A lack of correlation between rCBF-rCBV distributions and blood-brain barrier (BBB) breakdown was found in the acute phase. In the face of more prolonged alteration of BBB, as seen by TCT enhancement, a rapid evolution of transient phenomena such as luxury perfusion was shown by SPECT studies. Follow-up of the patient demonstrated a correlation between the neurological recovery and a parallel relative improvement of the cerebral perfusion

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-04-15

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

  1. Cerebral blood volume imaging by flat detector computed tomography in comparison to conventional multislice perfusion CT

    International Nuclear Information System (INIS)

    Struffert, Tobias; Kloska, Stephan; Engelhorn, Tobias; Doerfler, Arnd; Deuerling-Zheng, Yu; Boese, Jan; Zellerhoff, Michael; Schwab, Stefan

    2011-01-01

    We tested the hypothesis that Flat Detector computed tomography (FD-CT) with intravenous contrast medium would allow the calculation of whole brain cerebral blood volume (CBV) mapping (FD-CBV) and would correlate with multislice Perfusion CT (PCT). Twenty five patients were investigated with FD-CBV and PCT. Correlation of the CBV maps of both techniques was carried out with measurements from six anatomical regions from both sides of the brain. Mean values of each region and the correlation coefficient were calculated. Bland-Altman analysis was performed to compare the two different imaging techniques. The image and data quality of both PCT and FD-CBV were suitable for evaluation in all patients. The mean CBV values of FD-CBV and PCT showed only minimal differences with overlapping standard deviation. The correlation coefficient was 0.79 (p < 0.01). Bland-Altman analysis showed a mean difference of -0.077 ± 0.48 ml/100 g between FD-CBV and PCT CBV measurements, indicating that FD-CBV values were only slightly lower than those of PCT. CBV mapping with intravenous contrast medium using Flat Detector CT compared favourably with multislice PCT. The ability to assess cerebral perfusion within the angiographic suite may improve the management of ischaemic stroke and evaluation of the efficacy of dedicated therapies. (orig.)

  2. Aβ degradation or cerebral perfusion? Divergent effects of multifunctional enzymes.

    Science.gov (United States)

    Miners, J Scott; Palmer, Jennifer C; Tayler, Hannah; Palmer, Laura E; Ashby, Emma; Kehoe, Patrick G; Love, Seth

    2014-01-01

    There is increasing evidence that deficient clearance of β-amyloid (Aβ) contributes to its accumulation in late-onset Alzheimer disease (AD). Several Aβ-degrading enzymes, including neprilysin (NEP), endothelin-converting enzyme (ECE), and angiotensin-converting enzyme (ACE) reduce Aβ levels and protect against cognitive impairment in mouse models of AD. In post-mortem human brain tissue we have found that the activity of these Aβ-degrading enzymes rise with age and increases still further in AD, perhaps as a physiological response that helps to minimize the build-up of Aβ. ECE-1/-2 and ACE are also rate-limiting enzymes in the production of endothelin-1 (ET-1) and angiotensin II (Ang II), two potent vasoconstrictors, increases in the levels of which are likely to contribute to reduced blood flow in AD. This review considers the possible interdependence between Aβ-degrading enzymes, ischemia and Aβ in AD: ischemia has been shown to increase Aβ production both in vitro and in vivo, whereas increased Aβ probably enhances ischemia by vasoconstriction, mediated at least in part by increased ECE and ACE activity. In contrast, NEP activity may help to maintain cerebral perfusion, by reducing the accumulation of Aβ in cerebral blood vessels and lessening its toxicity to vascular smooth muscle cells. In assessing the role of Aβ-degrading proteases in the pathogenesis of AD and, particularly, their potential as therapeutic agents, it is important to bear in mind the multifunctional nature of these enzymes and to consider their effects on other substrates and pathways.

  3. Stress test with adenosine in cerebral perfusion imaging for the diagnosis of ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Yuan Gengbiao; Kuang Anren; Chen Xuehong; Li Xihuan; Feng Jianzhong

    2004-01-01

    Objective: This study purpose is to evaluate cerebrovascular response and reserve capacity (CVR, CVRC) by stress test with adenosine in cerebral perfusion imaging for the diagnosis of ischemic cerebrovascular diseases. Methods There were 25 patients suffered from transient ischemia attack and 16 patients suffered from occlusive cerebral artery in this study. The rest cerebral perfusion imaging was obtained 30 minutes post-injection of 99mTC-ethylene cysteinate dimmer. After 2-5 days, adenosine stress tests were performed. Adenosine (0.14 mg/kg min) was administered intravenously 3 minutes pre-injection of 99mTC-ECD.Under same condition, the rest and stress tests of cerebral perfusion imaging were performed. By visual and semiquantitative analysis, the results of the rest/stress imaging were divided into the following four patterns: A: The stress imaging showed an expand areas of hypoperfusion, asymmetry index (AI) was decreased; B: Rest imaging was normal but new hypoperfused areas appeared with AI index declining in stress test; C: The hypoperfused areas were decreased or disappeared in size with AI index increasing in stress test; D: No changes showed in cerebral perfusion imaging patterns and Al index between rest and stress tests. AI index was ratio of radio account of interest regions than average radio account of cerebella. Results It was found that A, B, C and D type were 24%,12%,56% and 8% respectively in the group of transient ischemia attack patients, and 31%,44%, 19% and 6% respectively in the group of occlusive cerebrovascular patients. In rest test, of 41 patients of cerebrovascular disease, there were 28 cases decreased of radio uptake, moreover in stress test, there were 38 case decreased of radio uptake, positive rate were 68.29% and 92.68% respectively. Compared to X±SD of AI index of rest/stress test, it is found to increasing and being significant statistics (p<0.01, Spass 8.0 statistics software). Conclusion: Adenosinal-induced vasodilatation

  4. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    International Nuclear Information System (INIS)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui

    2007-01-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr ∼ 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1∼9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI

  5. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr {approx} 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1{approx}9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-05-15

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

  7. Moyamoya disease and its effect on cerebral perfusion

    International Nuclear Information System (INIS)

    Turner, James K.

    2009-01-01

    Full text: Objective: Moyamoya disease is a rare progressive occlusive disorder which affects the vasculature of the brain. It results in stroke like systems and can cause death due to haemorrhage. This poster follows the clinical case of a 12 year old South Korean Female diagnosed with Moyamoya disease in January 2004 and the role nuclear medicine played in her management. Methods: The clinical history of the patient was examined closely, with all previous medical imaging reports and nursing entries collated. An extensive literature review of Moyamoya disease was then performed using a range of resources. Results: The patient's clinical work-up involved a range of medical imaging procedures the results of which did not provide a clear pathway for clinical management. A Nuclear Medicine Cerebral Perfusion Diamox Challenge study was subsequently performed providing a critical result. The results of this study were indicative of no change in vascular reserve both pre and post Diamox infusion. Ultimately the patient's physicians then delayed the need for anastmosis surgery, with alternate methods of treatment required. Conclusion: Overall this case highlights the need for functional imaging and the importance of drug therapies including Diamox in nuclear medicine procedures. This study ensured the patients quality of life was maintained and eliminated any risk involved in performing further surgery.

  8. Perfusion and diffusion MR imaging in enhancing malignant cerebral tumors

    International Nuclear Information System (INIS)

    Calli, Cem; Kitis, Omer; Yunten, Nilgun; Yurtseven, Taskin; Islekel, Sertac; Akalin, Taner

    2006-01-01

    Objective: Common contrast-enhancing malignant tumors of the brain are glioblastoma multiforme (GBMs), anaplastic astrocytomas (AAs), metastases, and lymphomas, all of which have sometimes similar conventional MRI findings. Our aim was to evaluate the role of perfusion MR imaging (PWI) and diffusion-weighted imaging (DWI) in the differentiation of these contrast-enhancing malignant cerebral tumors. Materials and methods: Forty-eight patients with contrast-enhancing and histologically proven brain tumors, 14 AAs, 17 GBMs, nine metastases, and eight lymphomas, were included in the study. All patients have undergone routine MR examination where DWI and PWI were performed in the same session. DWI was performed with b values of 0, 500, and 1000 mm 2 /s. Minimum ADC values (ADC min ) of each tumor was later calculated from ADC map images. PWI was applied using dynamic susceptibility contrast technique and maximum relative cerebral blood volume (rCBV max ) was calculated from each tumor, given in ratio with contralateral normal white matter. Comparisons of ADC min and rCBV max values with the histological types of the enhancing tumors were made with a one-way analysis of variance and Bonferroni test. A P value less than 0.05 indicated a statistically significant difference. Results: The ADC min values (mean ± S.D.) in GBMs, AAs, lymphomas, and metastases were 0.79 ± 0.21 (x10 -3 mm 2 /s), 0.75 ± 0.21 (x10 -3 mm 2 /s), 0.51 ± 0.09 (x10 -3 mm 2 /s), and 0.68 ± 0.11 (x10 -3 mm 2 /s), respectively. The difference in ADC min values were statistically significant between lymphomas and GBMs (P max ratio (mean ± S.D.) in GBMs were 6.33 ± 2.03, whereas it was 3.66 ± 1.79 in AAs, 2.33 ± 0.68 in lymphomas, and 4.45 ± 1.87 in metastases. These values were statistically different between GBMs and AAs (P min and rCBV max calculations, may aid routine MR imaging in the differentiation of common cerebral contrast-enhancing malignant tumors

  9. Altered cerebral perfusion in executive, affective, and motor networks during adolescent depression.

    Science.gov (United States)

    Ho, Tiffany C; Wu, Jing; Shin, David D; Liu, Thomas T; Tapert, Susan F; Yang, Guang; Connolly, Colm G; Frank, Guido K W; Max, Jeffrey E; Wolkowitz, Owen; Eisendrath, Stuart; Hoeft, Fumiko; Banerjee, Dipavo; Hood, Korey; Hendren, Robert L; Paulus, Martin P; Simmons, Alan N; Yang, Tony T

    2013-10-01

    Although substantial literature has reported regional cerebral blood flow (rCBF) abnormalities in adults with depression, these studies commonly necessitated the injection of radioisotopes into subjects. The recent development of arterial spin labeling (ASL), however, allows noninvasive measurements of rCBF. Currently, no published ASL studies have examined cerebral perfusion in adolescents with depression. Thus, the aim of the present study was to examine baseline cerebral perfusion in adolescent depression using a newly developed ASL technique: pseudocontinuous arterial spin labeling (PCASL). A total of 25 medication-naive adolescents (13-17 years of age) diagnosed with major depressive disorder (MDD) and 26 well-matched control subjects underwent functional magnetic resonance imaging. Baseline rCBF was measured via a novel PCASL method that optimizes tagging efficiency. Voxel-based whole brain analyses revealed significant frontal, limbic, paralimbic, and cingulate hypoperfusion in the group with depression (p region-of-interest analyses revealed amygdalar and insular hypoperfusion in the group with depression, as well as hyperperfusion in the putamen and superior insula (p networks. Dysfunction in these regions may contribute to the cognitive, emotional, and psychomotor symptoms commonly present in adolescent depression. These findings point to possible biomarkers for adolescent depression that could inform early interventions and treatments, and establishes a methodology for using PCASL to noninvasively measure rCBF in clinical and healthy adolescent populations. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Chien Hung Chang

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

  12. Cerebral blood perfusion after treatment with zolpidem and flumazenil in the baboon.

    Science.gov (United States)

    Clauss, Ralf P; Dormehl, Irene C; Kilian, Elmaré; Louw, Werner K A; Nel, Wally H; Oliver, Douglas W

    2002-01-01

    Previous studies have shown that zolpidem (CAS 82626-48-0) can lead to improved perfusion in damaged brain tissue. Zolpidem belongs to the imidazopyridine chemical class and it illicits its pharmacological action via the gamma-aminobutyric acid (GABA) receptor system through stimulation of particularly the omega 1 receptors and to a lesser extent omega 2 receptors. Previously it was reported that no cerebral blood flow effects were observed in normal baboons after treatment with zolpidem, whereas an asymmetric regional increase in cerebral blood flow was observed in a neurologically abnormal baboon. In this study, the effect of a combination of the benzodiazepine receptor antagonist flumazenil (CAS 78755-81-4) and zolpidem on brain perfusion was examined by the 99mTc-hexamethyl-propylene amine oxime (99mTc-HMPAO) split dose brain single photon emission computed tomography (SPECT). Four normal baboons and the neurologically abnormal baboon from the previous zolpidem study were examined. In the current study the asymmetric changes observed after zolpidem--only treatment in the abnormal baboon was attenuated by flumazenil intervention. A decreased brain blood flow was observed after combination treatment of zolpidem and flumazenil in the normal baboons. The involvement of the omega receptors is suggested by these results. Up- or down-regulation of omega receptors may also contribute to the observed responses in the abnormal baboon and a brain injured patient.

  13. Methodological NMR imaging developments to measure cerebral perfusion

    International Nuclear Information System (INIS)

    Pannetier, N.

    2010-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  15. Perfusion-weighted magnetic resonance imaging detects recurrent isolated vertigo caused by cerebral hypoperfusion.

    Science.gov (United States)

    Xu, Xiaowei; Jiang, Li; Luo, Man; Li, Jiaoxing; Li, Weidong; Sheng, Wenli

    2015-06-01

    The etiology of isolated vertigo has been a substantial diagnostic challenge for both neurologists and otolaryngologists. This study was designed to detect recurrent isolated vertigo due to cerebral hypoperfusion using perfusion-weighted magnetic resonance imaging (PWI). We recruited isolated vertigo patients whose clinical condition was suspected to be caused by hypodynamics of the brain; these individuals formed the case group. We generated two additional groups: a negative group composed of vertigo patients whose symptoms were caused by problems associated with the ear and a healthy control group. Each subject underwent PWI, and seven regions of interest (ROIs) were chosen. The relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), and mean transit time (MTT) were obtained from each ROI. We further calculated the absolute difference of relative parameter values between two mirrored ROIs. The significant difference in the relative MTT from the mirrored cerebellar ROI (|rMTTleft-right|) of the case group was larger than those from the negative and healthy control groups (p = 0.026 and p = 0.038, respectively). Signal differences in |rrCBVleft-right| and |rrCBFleft-right| were not found among the three groups. In summary, disequilibrium in the rMTT of the bilateral cerebellum in the case group implied that hypoperfusion of the posterior circulation could trigger recurrent isolated vertigo and could be shown efficiently using PWI.

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

    International Nuclear Information System (INIS)

    Hou Min; Liu Xingdang; Wang Kaiyan

    2004-01-01

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

  17. In vivo tomographic study of cerebral blood perfusion with SPECT in hemiparkinsonian monkeys

    International Nuclear Information System (INIS)

    Chen Shengdi; Xu Delong

    1994-01-01

    The authors present data on the utility of functional brain imaging with 99m Tc-ECD and SPECT in the study of MPTP induced hemiparkinsonism in monkeys. Injection of MPTP into the right common carotid artery of 10 rhesus monkeys produced hemiparkinsonism in the contralateral limbs which responded to antiparkinsonian medication. The unilateral neurotoxicity of the MPTP treated side was confirmed biochemically by marked reduction of DA contents in the nigrostriatum and histologically by selective neuronal loss in the substantia nigra. These monkeys with hemiparkinsonism were studied with SPECT using 99m Tc-ECD as perfusion marker. The results of brain scanning showed that the cerebral blood perfusion of MPTP treated side was significantly depleted 20∼90 days after MPTP intoxication, and returned to normal 8 months after perfusion. The experiment indicates that abnormal cerebral blood perfusion is involved in the course of parkinsonian pathophysiology

  18. Intracranial CT angiography obtained from a cerebral CT perfusion examination

    International Nuclear Information System (INIS)

    Gratama van Andel, H. A. F.; Venema, H. W.; Majoie, C. B.; Den Heeten, G. J.; Grimbergen, C. A.; Streekstra, G. J.

    2009-01-01

    CT perfusion (CTP) examinations of the brain are performed increasingly for the evaluation of cerebral blood flow in patients with stroke and vasospasm after subarachnoid hemorrhage. Of the same patient often also a CT angiography (CTA) examination is performed. This study investigates the possibility to obtain CTA images from the CTP examination, thereby possibly obviating the CTA examination. This would save the patient exposure to radiation, contrast, and time. Each CTP frame is a CTA image with a varying amount of contrast enhancement and with high noise. To improve the contrast-to-noise ratio (CNR) we combined all 3D images into one 3D image after registration to correct for patient motion between time frames. Image combination consists of weighted averaging in which the weighting factor of each frame is proportional to the arterial contrast. It can be shown that the arterial CNR is maximized in this procedure. An additional advantage of the use of the time series of CTP images is that automatic differentiation between arteries and veins is possible. This feature was used to mask veins in the resulting 3D images to enhance visibility of arteries in maximum intensity projection (MIP) images. With a Philips Brilliance 64 CT scanner (64x0.625 mm) CTP examinations of eight patients were performed on 80 mm of brain using the toggling table technique. The CTP examination consisted of a time series of 15 3D images (2x64x0.625 mm; 80 kV; 150 mAs each) with an interval of 4 s. The authors measured the CNR in images obtained with weighted averaging, images obtained with plain averaging, and images with maximal arterial enhancement. The authors also compared CNR and quality of the images with that of regular CTA examinations and examined the effectiveness of automatic vein masking in MIP images. The CNR of the weighted averaged images is, on the average, 1.73 times the CNR of an image at maximal arterial enhancement in the CTP series, where the use of plain averaging

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2003-07-01

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

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

    Science.gov (United States)

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

    2017-04-01

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

  1. Invos Cerebral Oximeter compared with the transcranial Doppler for monitoring adequacy of cerebral perfusion in patients undergoing carotid endarterectomy.

    Science.gov (United States)

    Fassiadis, N; Zayed, H; Rashid, H; Green, D W

    2006-12-01

    The aim of this prospective study was to assess the correlation between signals obtained during carotid endarterectomy (CEA) under local (LA) or general anesthesia from the Somanetics Invos cerebral oximeter (CO) and transcranial Doppler (TCD). Forty patients were enrolled in the study. The percentages fall in TCD mean flow velocity (FVm) and CO regional oxygen saturation (rSO2) on the ipsilateral side following clamping were recorded and the correlation coefficient and Spearman's coefficient of rank correlation were calculated. Fourteen patients were not included in the statistical analysis because either no TCD window or reliable TCD signal was obtained. The remaining 26 patients had a fall in either FVm, rSO2 or both during carotid clamping. There was a highly statistically significant correlation between the percentage fall in FVm and rSO2 with a correlation coefficient of 0.73, P<0.0001, with a 95% confidence interval (CI) for r=0.48 to 0.87; Spearman's coefficient of rank correlation (rho) =0.67, P=0.0008, with a 95% CI for rho=0.384 to 0.84. A significant decline in both TCD and rSO2 was noted in 3 patients under LA out of which 2 required shunts for alteration in conscious level. In 2 LA patients there was a significant decline in TCD but not in rSO2 and the endarterectomy was completed without a shunt. Regional oxygen saturation correlates well with FVm during carotid clamping. However, the inability to obtain reliable TCD FVm readings in 35% of patients is a serious disadvantage for this monitor. It appears that CO is a satisfactory and possibly superior device for monitoring adequacy of cerebral perfusion and oxygenation during CEA in comparison with the TCD.

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

    NARCIS (Netherlands)

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

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

  3. Surgical thromboendarterectomy for chronic thromboembolic pulmonary hypertension using circulatory arrest with selective antegrade cerebral perfusion

    NARCIS (Netherlands)

    Zeebregts, CJAM; Dossche, KM; Morshuis, WJ; Knaepen, PJ; Schepens, MAAM

    The use of circulatory arrest with selective antegrade cerebral perfusion is described in a 59-year-old man who underwent thrombendarterectomy for chronic thromboembolic pulmonary hypertension. The postoperative course was uneventful. The described surgical technique may prevent the patient from

  4. Dynamic Susceptibility Contrast Perfusion Magnetic Resonance Imaging Demonstrates Reduced Periventricular Cerebral Blood Flow in Dogs with Ventriculomegaly

    Directory of Open Access Journals (Sweden)

    Martin J. Schmidt

    2017-08-01

    Full Text Available The nature of ventriculomegaly in dogs is still a matter of debate. Signs of increased intraventricular pressure and atrophy of the cerebral white matter have been found in dogs with ventriculomegaly, which would imply increased intraventricular pressure and, therefore, a pathological condition, i.e., to some extent. Reduced periventricular blood flow was found in people with high elevated intraventricular pressure. The aim of this study was to compare periventricular brain perfusion in dogs with and without ventriculomegaly using perfusion weighted-magnetic-resonance-imaging to clarify as to whether ventriculomegaly might be associated with an increase in intraventricular pressure. Perfusion was measured in 32 Cavalier King Charles spaniels (CKCS with ventriculomegaly, 10 CKCSs were examined as a control group. Cerebral blood flow (CBF was measured using free-hand regions of interest (ROI in five brain regions: periventricular white matter, caudate nucleus, parietal cortex, hippocampus, and thalamus. CBF was significantly lower in the periventricular white matter of the dogs with ventriculomegaly (p = 0.0029 but not in the other ROIs. Reduction of periventricular CBF might imply increase of intraventricular pressure in ventriculomegaly.

  5. A brain stress test: Cerebral perfusion during memory encoding in mild cognitive impairment.

    Science.gov (United States)

    Xie, Long; Dolui, Sudipto; Das, Sandhitsu R; Stockbower, Grace E; Daffner, Molly; Rao, Hengyi; Yushkevich, Paul A; Detre, John A; Wolk, David A

    2016-01-01

    Arterial spin labeled perfusion magnetic resonance imaging (ASL MRI) provides non-invasive quantification of cerebral blood flow, which can be used as a biomarker of brain function due to the tight coupling between cerebral blood flow (CBF) and brain metabolism. A growing body of literature suggests that regional CBF is altered in neurodegenerative diseases. Here we examined ASL MRI CBF in subjects with amnestic mild cognitive impairment (n = 65) and cognitively normal healthy controls (n = 62), both at rest and during performance of a memory-encoding task. As compared to rest, task-enhanced ASL MRI improved group discrimination, which supports the notion that physiologic measures during a cognitive challenge, or "stress test", may increase the ability to detect subtle functional changes in early disease stages. Further, logistic regression analysis demonstrated that ASL MRI and concomitantly acquired structural MRI provide complementary information of disease status. The current findings support the potential utility of task-enhanced ASL MRI as a biomarker in early Alzheimer's disease.

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Timothy C. Durazzo

    2015-07-01

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

  8. Fast Doppler as a novel bedside measure of cerebral perfusion in preterm infants.

    Science.gov (United States)

    Peeples, Eric S; Mehic, Edin; Mourad, Pierre D; Juul, Sandra E

    2016-02-01

    Altered cerebral perfusion from impaired autoregulation may contribute to the morbidity and mortality associated with premature birth. We hypothesized that fast Doppler imaging could provide a reproducible bedside estimation of cerebral perfusion and autoregulation in preterm infants. This is a prospective pilot study using fast Doppler ultrasound to assess blood flow velocity in the basal ganglia of 19 subjects born at 26-32 wk gestation. Intraclass correlation provided a measure of test-retest reliability, and linear regression of cerebral blood flow velocity and heart rate or blood pressure allowed for estimations of autoregulatory ability. The intraclass correlation when imaging in the first 48 h of life was 0.634. We found significant and independent correlations between the systolic blood flow velocity and both systolic blood pressure and heart rate (P = 0.015 and 0.012 respectively) only in the 26-28 wk gestational age infants in the first 48 h of life. Our results suggest that fast Doppler provides reliable bedside measurements of cerebral blood flow velocity at the tissue level in premature infants, acting as a proxy for cerebral tissue perfusion. Additionally, autoregulation appears to be impaired in the extremely preterm infants, even within a normal range of blood pressures.

  9. MRI evaluation of cerebral perfusion changes in patients with MELAS syndrome

    International Nuclear Information System (INIS)

    Xie Sheng; Qi Zhaoyue; Xiao Jiangxi; Jiang Xuexiang; Yang Yanling

    2008-01-01

    Objective: To detect the changes of cerebral perfusion in patients with MELAS syndrome by using MR perfusion technique. Methods: Thirteen patients with MELAS syndrome and 13 controls with normal neurological conditions were scanned with the sequence of flow-sensitive alternating inversion recovery exempting separate T 1 measurement (FAIREST). Their rCBF values were obtained in regions of bilateral basilar nuclei and thalami, as well as bilateral temporal lobes and occipital lobes. Regression analysis was carried out to determine the effect of location and side on the measurement of rCBF in controls. One-way ANOVA was conducted to compare rCBF values among the control group, the lesion ROIs and normal ROIs of the MELAS syndrome group. Results: The values of rCBF were 0.83 ± 0.23, 1.17± 0.30, 0.93 ± 0.28, and 1.11 ± 0.25 for the left basilar ganglia, thalamus, temporal lobe, and occipital lobe respectively, while they were 0.77 ± 0.15, 1.03 ± 0.34, 1.06 ± 0.23, and 1.09 ± 0.23 for the right basilar ganglia, thalamus, temporal lobe, and occipital lobe respectively. Regression analysis revealed no effect of location and side on the rCBF (P>0.05). The rCBF value for control group was 1.00 + 0. 28, while it was 1.01 ± 0.31 for the normal ROIs and 1.95 ± 0.43 for the lesion ROIs in the MELAS syndrome group (F=54.99, P<0.01). The rCBF of the lesion ROIs in the MELAS syndrome group was significantly higher than the normal ROIs and the control group. Conclusion: CBF maps can reveal changes of cerebral blood flow in patients with ictal MELAS, which suggests increased perfusion in the stroke-like lesions. (authors)

  10. Differences in cerebral perfusion deficits in mild traumatic brain injury and depression using single photon emission computed tomography

    Directory of Open Access Journals (Sweden)

    Kristoffer eRomero

    2014-08-01

    Full Text Available Background: Numerous studies have shown decreased perfusion in the prefrontal cortex following mild traumatic brain injury (mTBI. However, similar hypoperfusion can also be observed in depression. Given the high prevalence of depressive symptoms following mTBI, it is unclear to what extent depression influences hypoperfusion in TBI.Methods: Mild TBI patients without depressive symptoms (mTBI-noD, n = 39, TBI patients with depressive symptoms (mTBI-D, n = 13, and 15 patients with major depressive disorder, but no TBI (MDD were given 99-m T-ECD SPECT scans within 2 weeks of injury. All subjects completed tests of information processing speed, complex attention, and executive functioning, and a self-report questionnaire measuring symptoms of psychological distress. Between group comparisons of quantified SPECT perfusion were undertaken, using univariate and multivariate (partial least squares analyses.Results: mTBI-D and mTBI-noD groups did not differ in terms of cerebral perfusion. However, patients with MDD showed hypoperfusion in several frontal (orbitofrontal, middle frontal, and superior frontal cortex, superior temporal, and posterior cingulate regions. The mTBI-D group showed poorer performance on a measure of complex attention and working memory, compared to both the mTBI-noD and MDD groups.Conclusions: These results suggest that depressive symptoms do not affect SPECT perfusion in the sub-acute phase following a mild TBI. Conversely, MDD is associated with hypoperfusion primarily in frontal regions.

  11. 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...

  12. Cerebral peritumoral oedema study: Does a single dynamic MR sequence assessing perfusion and permeability can help to differentiate glioblastoma from metastasis?

    International Nuclear Information System (INIS)

    Lehmann, Pierre; Saliou, Guillaume; Marco, Giovanni de; Monet, Pauline; Souraya, Stoquart-Elsankari; Bruniau, Alexis; Vallée, Jean Noel; Ducreux, Denis

    2012-01-01

    Our purpose was to differentiate glioblastoma from metastasis using a single dynamic MR sequence to assess perfusion and permeability parameters. 24 patients with glioblastoma or cerebral metastasis with peritumoral oedema were recruited and explored with a 3 T MR unit. Post processing used DPTools software. Regions of interest were drawn around contrast enhancement to assess relative cerebral blood volume and permeability parameters. Around the contrast enhancement Glioblastoma present high rCBV with modification of the permeability, metastasis present slight modified rCBV without modification of permeability. In conclusion, peritumoral T2 hypersignal exploration associating morphological MR and functional MR parameters can help to differentiate cerebral metastasis from glioblastoma.

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

    Directory of Open Access Journals (Sweden)

    Yu. A. Churlyaev

    2008-01-01

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

  14. Interventional model establishment and computed tomography perfusion imaging for early diagnosis of acute cerebral infarction in dogs

    International Nuclear Information System (INIS)

    Shi Haibin; Liu Sheng; Ji Libiao; Li Lingsun; Huang Jun

    2005-01-01

    Objective: To establish interventionally a new canine model of focal cerebral infarction suitable to the study of imaging diagnosis and thrombolytic therapy, and to evaluate the application of computed tomography perfusion (CTP) in super acute ischemic cerebrovascular disease. Methods: Ten beagle adult dogs with self white thrombi of venous blood, injected into the left internal carotid arteries through 4F headhunter catheter selectively were created under fluoroscopic guidance. The cerebral angiography was performed before and after the embolization and the patency of the occluded cerebral arteries was observed with angiography at 1, 2 and 5 hours after the procedure. The CTP was performed at 2 hours after embolization. These dogs were sacrificed and their cerebra were taken out for pathologic study at 24th hour. Results: The occlusions of middle cerebral artery were shown angiographically in all 10 dogs with additional other cerebral arteries occlusion in 4. All occluded arteries were not recanalized at 2 hours after embolization, but the occluded arteries of 2 canines were partly recanalized at 5 hours. The regional cerebral blood flow (rCBF) was decreased to 48.3% ± 13.2% (33.7%-69.2%) in CTP of 9 canines showing no significant difference between digital subtraction angiography (DSA) and CTP (P>0.05). All dogs were survived at 24 hours without any severe complications. The cerebral infarction was found in deep part of cerebrum of all dogs. Conclusions: The establishment of acute cerebral infarction model in dogs with interventional technique is simple, micro invasive and reliable, for investigating CTP as a fast, accurate and no invasive method in evaluating the canine super acute ischemic cerebrovascular disease. (authors)

  15. Bernoulli's Principle Applied to Brain Fluids: Intracranial Pressure Does Not Drive Cerebral Perfusion or CSF Flow.

    Science.gov (United States)

    Schmidt, Eric; Ros, Maxime; Moyse, Emmanuel; Lorthois, Sylvie; Swider, Pascal

    2016-01-01

    In line with the first law of thermodynamics, Bernoulli's principle states that the total energy in a fluid is the same at all points. We applied Bernoulli's principle to understand the relationship between intracranial pressure (ICP) and intracranial fluids. We analyzed simple fluid physics along a tube to describe the interplay between pressure and velocity. Bernoulli's equation demonstrates that a fluid does not flow along a gradient of pressure or velocity; a fluid flows along a gradient of energy from a high-energy region to a low-energy region. A fluid can even flow against a pressure gradient or a velocity gradient. Pressure and velocity represent part of the total energy. Cerebral blood perfusion is not driven by pressure but by energy: the blood flows from high-energy to lower-energy regions. Hydrocephalus is related to increased cerebrospinal fluid (CSF) resistance (i.e., energy transfer) at various points. Identification of the energy transfer within the CSF circuit is important in understanding and treating CSF-related disorders. Bernoulli's principle is not an abstract concept far from clinical practice. We should be aware that pressure is easy to measure, but it does not induce resumption of fluid flow. Even at the bedside, energy is the key to understanding ICP and fluid dynamics.

  16. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  17. Clinical indicators to monitor patients with risk for ineffective cerebral tissue perfusion

    Directory of Open Access Journals (Sweden)

    Miriam de Abreu Almeida

    2015-04-01

    Full Text Available Objective. Select and validate the clinical indicators to monitor patients on risk for ineffective cerebral tissue perfusion, according to the Nursing Outcomes Classification (NOC. Methodology. Validation study carried out between November 2012 and August 2013, in a Brazilian hospital. Seventeen judges nurses evaluated the clinical indicators of Nursing Outcomes, according to NOC for patients on risk for ineffective cerebral tissue perfusion. In the first stage, were selected the nursing results for the assessment of the studied diagnosis and, in the second nurses assessment the importance of the indicators of the validated results in the previous step through a five points Likert scale (1 = not important to 5 = extremely important. Were used the content validity index (CVI that corresponds to the calculation of weighted averages of them marks awarded for each indicator, as it considered the following weights: 1=0.00, 2=0.25, 3=0.50; 4=0.75; 5=1.00. For categorization, the CVI considered as critical = ≥0.80; supplementary =≥0.50 to 0.79 and were disposed results <0.50. Results. Of the 9 nursing results, only the cerebral tissue perfusion obtained a 100% consensus. The CVI of the 18 indicators of this result showed that five were validated as critical (impaired neurological reflexes, systolic blood pressure, diastolic blood pressure, reduced level of consciousness and mean arterial pressure, 12 were validated as supplementary (Agitation, Impaired cognition, Intracranial pressure, Syncope, Vomiting, Findings of cerebral angiography, Headache, Restlessness, Fever, Unexplained anxiety, listlessness and Hiccughs and one was disposed (carotid bruit. Conclusions. The validation of information about the conditions of risk may allow early intervention to minimize the consequences of ineffective cerebral tissue perfusion.

  18. Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Hyoung; Chung, Yong An; Seo, Ye Young; Yoo, Ik Dong; Na, Sae Jung; Jung, Hyun Suk; Kim, Ki Jun [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-04-15

    The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4 weeks (male: 7, female: 5, age range: 19approx52 years, average age: 29.3+-9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19approx53 years, average age: 31.4+-9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated

  19. Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder

    International Nuclear Information System (INIS)

    Lee, Won Hyoung; Chung, Yong An; Seo, Ye Young; Yoo, Ik Dong; Na, Sae Jung; Jung, Hyun Suk; Kim, Ki Jun

    2009-01-01

    The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for > 4 weeks (male: 7, female: 5, age range: 19∼52 years, average age: 29.3±9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19∼53 years, average age: 31.4±9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated

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

    DEFF Research Database (Denmark)

    Immink, R.V.; Truijen, J.; Secher, Niels H.

    2009-01-01

    In the upright position, cerebral blood flow is reduced, maybe because arterial carbon dioxide partial pressure (Pa(CO(2))) decreases. We evaluated the time-dependent influence of a reduction in Pa(CO(2)), as indicated by the end-tidal Pco(2) tension (Pet(CO(2))), on cerebral perfusion during head......-up tilt. Mean arterial pressure, cardiac output, middle cerebral artery mean flow velocity (MCA V(mean)), and dynamic cerebral autoregulation at supine rest and 70 degrees head-up tilt were determined during free breathing and with Pet(CO(2)) clamped to the supine level. The postural changes in central...... hemodynamic variables were equivalent, and the cerebrovascular autoregulatory capacity was not significantly affected by tilt or by clamping Pet(CO(2)). In the first minute of tilt, the decline in MCA V(mean) (10 +/- 4 vs. 3 +/- 4 cm/s; mean +/- SE; P

  1. Simplified quantitative determination of cerebral perfusion reserve with H215O PET and acetazolamide

    International Nuclear Information System (INIS)

    Arigoni, M.; Kneifel, S.; Burger, C.; Buck, A.; Fandino, J.; Khan, N.

    2000-01-01

    The measurement of regional cerebral blood from (rCBF) and perfusion reserve (PR) with H 2 15 O positron emission tomography (PET) and acetazolamide challenge is of importance in evaluating patients with cerebrovascular disease and is thought to be useful in selecting patients for possible vascular surgery. Full quantitative assessment of rCBF with PET requires arterial blood sampling, which is inconvenient in a clinical setting. In this work, we present a simple non-invasive method with which to quantitatively evaluate PR in one PET session lasting no more than 30 min. In ten patients with cerebrovascular disease, rCBF was measured with H 2 15 O PET under the baseline condition and after administration of 1 g acetazolamide using a standard technique involving arterial blood sampling. The activity accumulated over 60 s was normalized to injected activity per kilogram body weight (nAA) and compared with rCBF in eight different brain regions. A high linear correlation was found for PR based on nAA (PR nAA ) and rCBF (PR rCBF ) (PR nAA =0.843 PR rCBF + 0.092, r=0.83, Pearson's correlation coefficient). Bland-Altman analyses further confirmed that PR nAA reflects PR in a quantitative manner. These results demonstrate that the method based on normalized counts allows the quantitative assessment of PR without blood sampling. (orig.)

  2. Presurgical evaluation of cerebral perfusion reserve in patients for cardiovascular surgery using {sup 99m}Tc-ECD SPECT with diamox enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kaname; Nakashima, Hiromichi; Tanaka, Kuniyoshi; Kitano, Tokio; Murashima, Shuichi; Takeda, Kan; Yuasa, Hiroshi; Yada, Isao; Nakagawa, Tsuyoshi [Mie Univ., Tsu (Japan). School of Medicine

    1996-03-01

    Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative {sup 99m}Tc-ethyl cysteinate dimer (ECD) SPECT and acetazolamide (diamox) enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox (1 g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures. (author).

  3. Cerebellar malformations alter regional cerebral development.

    Science.gov (United States)

    Bolduc, Marie-Eve; Du Plessis, Adre J; Evans, Alan; Guizard, Nicolas; Zhang, Xun; Robertson, Richard L; Limperopoulos, Catherine

    2011-12-01

    The aim of this study was to compare total and regional cerebral volumes in children with isolated cerebellar malformations (CBMs) with those in typically developing children, and to examine the extent to which cerebellar volumetric reductions are associated with total and regional cerebral volumes. This is a case-control study of children diagnosed with isolated CBMs. Each child was matched on age and sex to two typically developing children. Using advanced three-dimensional volumetric magnetic resonance imaging, the cerebrum was segmented into tissue classes and partitioned into eight regions. Analysis of variance was used to compare cerebral volumes between children with CBMs and control children, and linear regressions to examine the impact of cerebellar volume reduction on cerebral volumes. Magnetic resonance imaging was performed at a mean age of 27 months in 20 children (10 males, 10 females) with CBMs and 40 typically developing children. Children with CBMs showed significantly smaller deep grey matter nuclei (p developing children. Greater cerebellar volumetric reduction in children with CBMs was associated with decreased total cerebral volume and deep grey matter nuclei (p = 0.02), subgenual white/grey matter (p = 0.001), midtemporal white (p = 0.02) and grey matter (p = 0.01), and parieto-occipital grey matter (p = 0.004). CBMs are associated with impaired regional cerebral growth, suggesting deactivation of principal cerebello-cerebral pathways. © The Authors. Developmental Medicine & Child Neurology © 2011 Mac Keith Press.

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

    International Nuclear Information System (INIS)

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

    1989-01-01

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

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

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

    OpenAIRE

    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...

  8. Cerebral Perfusion and the Risk of Dementia: A Population-Based Study.

    Science.gov (United States)

    Wolters, Frank J; Zonneveld, Hazel I; Hofman, Albert; van der Lugt, Aad; Koudstaal, Peter J; Vernooij, Meike W; Ikram, M Arfan

    2017-08-22

    Cerebral hypoperfusion has previously been associated with mild cognitive impairment and dementia in various cross-sectional studies, but whether hypoperfusion precedes neurodegeneration is unknown. We prospectively determined the association of cerebral perfusion with subsequent cognitive decline and development of dementia. Between 2005 and 2012, we measured cerebral blood flow by 2-dimensional phase-contrast magnetic resonance imaging in participants of the population-based Rotterdam Study without dementia. We determined the association of cerebral perfusion (mL/100mL/min) with risk of dementia (until 2015) using a Cox model, adjusting for age, sex, demographics, cardiovascular risk factors, and apolipoprotein E genotype. We repeated analyses for Alzheimer disease and accounting for stroke. We used linear regression to determine change in cognitive performance during 2 consecutive examination rounds in relation to perfusion. Finally, we investigated whether associations were modified by baseline severity of white matter hyperintensities. Of 4759 participants (median age 61.3 years, 55.2% women) with a median follow-up of 6.9 years, 123 participants developed dementia (97 Alzheimer disease). Lower cerebral perfusion was associated with higher risk of dementia (adjusted hazard ratio, 1.31; 95% confidence interval per standard deviation decrease, 1.07-1.61), similar for Alzheimer disease only, and unaltered by accounting for stroke. Risk of dementia with hypoperfusion was higher with increasing severity of white matter hyperintensities (with severe white matter hyperintensities; hazard ratio, 1.54; 95% confidence interval, 1.11-2.14). At cognitive reexamination after on average 5.7 years, lower baseline perfusion was associated with accelerated decline in cognition (global cognition: β=-0.029, P =0.003), which was similar after excluding those with incident dementia, and again most profound in individuals with higher volume of white matter hyperintensities ( P

  9. Global cerebral blood flow changes measured by brain perfusion SPECT immediately after whole brain irradiation

    International Nuclear Information System (INIS)

    Ohtawa, Nobuyuki; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Takahashi, Takeo

    2003-01-01

    Whole brain irradiation (WBI) is still a major treatment option for patients with metastatic brain tumor despite recent advances in chemotherapy and newer techniques of radiation therapy. Cerebral blood flow (CBF) of changes induced by whole brain radiation is not fully investigated, and the aim of the study was to measure CBF changes non-invasively with brain perfusion SPECT to correlate with treatment effect or prognosis. Total of 106 patients underwent WBI during April 1998 to March 2002. Both brain MRI and brain perfusion SPECT could be performed before (less than 1 week before or less than 10 Gy of WBI) and immediately after (between 1 week before and 2 weeks after the completion of WBI) the therapy in 17 of these patients. They, 10 men and 7 women, all had metastatic brain tumor with age range of 45 to 87 (mean of 61.4) years. Tc-99m brain perfusion agent (HMPAO in 4, ECD in 13) was rapidly administered in a 740-MBq dose to measure global and regional CBF according to Matsuda's method, which based on both Patlak plot and Lassens' linearity correction. Brain MRI was used to measure therapeutic response according to World Health Organization (WHO) classification as complete remission (CR), partial response (PR), no change (NC), and progressive disease (PD). Survival period was measured from the completion of WBI. Mean global CBF was 40.6 and 41.5 ml/100 g/min before and immediately after the WBI, respectively. Four patients increased (greater than 10%) their global mean CBF, 10 unchanged (less than 10% increase or decrease), and 3 decreased after the WBI. The WBI achieved CR in none, PR in 8, NC in 6, and PD in 3 on brain MRI. Change in global mean CBF (mean±SD) was significantly larger in PR (4.3±2.0 ml/100 g/min, p=0.002) and in NC (-0.1±4.5) than in PD (-3.9±6.4, P=0.002, P=0.016, respectively). Survival was not significantly (p>0.05) different among the patients with CR (20 weeks), NC (48 weeks), and PD (21 weeks). Change in global CBF and survival was

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

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2003-01-01

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

  11. Interleaving cerebral CT perfusion with neck CT angiography. Pt. II. Clinical implementation and image quality

    Energy Technology Data Exchange (ETDEWEB)

    Oei, Marcel T.H.; Meijer, Frederick J.A.; Woude, Willem-Jan van der; Smit, Ewoud J.; Ginneken, Bram van; Manniesing, Rashindra; Prokop, Mathias [Radboud University Medical Centre, Department of Radiology and Nuclear Medicine, P.O. Box 9101, Nijmegen (Netherlands)

    2017-06-15

    Feasibility evaluation of the One-Step Stroke Protocol, which is an interleaved cerebral computed tomography perfusion (CTP) and neck volumetric computed tomography angiography (vCTA) scanning technique using wide-detector computed tomography, and to assess the image quality of vCTA. Twenty patients with suspicion of acute ischaemic stroke were prospectively scanned and evaluated with a head and neck CTA and with the One-Step Stroke Protocol. Arterial enhancement and contrast-to-noise ratio (CNR) in the carotid arteries was assessed. Three observers scored artefacts and image quality of the cervical arteries. The total z-coverage was evaluated. Mean enhancement in the carotid bifurcation was rated higher in the vCTA (595 ± 164 HU) than CTA (441 ± 117 HU). CNR was rated higher in vCTA. Image quality scores showed no significant difference in the region of the carotid bifurcation between vCTA and CTA. Lower neck image quality scores were slightly lower for vCTA due to artefacts, although not rated as diagnostically relevant. In ten patients, the origin of the left common carotid artery was missed by 1.6 ± 0.8 cm. Mean patient height was 1.8 ± 0.09 m. Carotid bifurcation and origin of vertebral arteries were covered in all patients. The One-Step Stroke Protocol is feasible with good diagnostic image quality of vCTA, although full z-coverage is limited in tall patients. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Euclides Timóteo da Rocha

    2011-01-01

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

  13. A study of whole brain perfusion CT and CT angiography in hyperacute and acute cerebral infarction

    International Nuclear Information System (INIS)

    Zhang Yonghai; Bai Junhu; Zhang Ming; Yang Guocai; Tang Guibo; Fang Jun; Shi Wei; Li Xinghua; Liu Suping; Lu Qing; Tang Jun

    2005-01-01

    Objective: To evaluate the diagnostic value of whole-brain perfusion blood volume-weighted CT imaging (PWCT) and simultaneous CT angiography (CTA) on early stage of cerebral ischemic infarction. Methods: Non-contrast CT (NCCT), CT perfusion-weighted imaging (PWCT) and delayed CT (DCT) were conducted on 20 cases of early ischemic infarction of whose onset time ranged from 2 to 24 hours. All cases were reexamined with CT or MRI one week to one month later. CT values and perfusion blood volume (PBV) of central and peripheral low perfusion areas as well as those of collateral side were measured. CTA was reconstructed with PWCT as source images to evaluate occlusion or stenosis of blood vessel, and DCT was used to detect the collateral circulation. Results: Of the 20 cases, NCCT, PWCT and CTA were negative in 10 cases in which 6 were confirmed as Transient Ischemic Attack (TIA) on reexamined CT and clinical features, and the other 4 were confirmed as lacunar infarction. For the remaining 10 cases, a comparison was made with ANOVA between low perfusion area (central, peripheral inside and outside) and collateral side. The difference was significant (P<0.01). However, no significant difference was revealed in the central, peripheral inside and outside areas. PBV values were significant in low perfusion area and collateral side (P<0.05). The area of the final infarction was larger than that of the low perfusion area, and the percentage of enlargement exhibited medium negative correlation to the time of ischemia. CTA indicated that 2 cases suffered from left middle cerebral artery occlusion, meanwhile anterior and middle branches of MCA in the other 3 cases were not identified. The sensitivity of NCCT, PWCT and CTA were 28.5%, 71.4% and 35.7% respectively. DCT indicated that 5 cases had asymmetrical blood vessels. Conclusion: The whole-brain perfusion-weighted CT imaging and simultaneous CT angiography (CTA) is p roved to be a simple, timesaving and effective method for the

  14. Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease. Comparison with dynamic susceptibility contrast-perfusion MR imaging

    International Nuclear Information System (INIS)

    Ida, Kentaro; Akaki, Shiro; Sei, Tetsuro; Kanazawa, Susumu; Tsunoda, Masatoshi

    2006-01-01

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

  15. Functional MRI of CO2 induced increase in cerebral perfusion

    DEFF Research Database (Denmark)

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

    1994-01-01

    The sensitivity of MR gradient echo imaging towards CO2 induced changes in cerebral blood flow was investigated in 10 normal subjects. The subjects were inhaling 5% and 7% CO2 and the experiments were carried out at 1.5 T (n = 6) and 2.0 T (n = 5), allowing a comparison of field strengths....... Additional experiments were carried out using a higher spatial resolution. The largest signal increases were noted in areas corresponding to larger vessels, but significant changes were also conspicuous in deeper cortical and central grey matter. The changes appeared linearly related to the arterial CO2...... tension, within the range of PaCO2 studied. In white matter, the changes were not statistically significant....

  16. Time Course of Changes in Extravascular Lung Water Index, Intracranial and Cerebral Perfusion Pressures in Acute Cerebral Circulatory Disorders

    Directory of Open Access Journals (Sweden)

    Yu. A. Churlyaev

    2009-01-01

    Full Text Available Objective: to study the time course of changes in extravascular lung water index (ELWI and intracranial and cerebral perfusion pressures (ICP and CPP and to determine their possible relationships in acute cerebral circulatory disorders (ACCD. Subject and methods. ELWI, pulmonary vascular permeability index (PVPI, ICP, CPP, and central hemodynamics were studied by transpulmonary thermodilution and current X-ray studies were conducted in 18 patients on days 1, 3, 5, and 7 of ACCD. Results. Examinations revealed a supratentorial dislocation of the brain in 6 persons; its subtento-rial dislocation was found in 1 case; supra- and subtentorial dislocations were seen in 6. In patients, ELWI and PVPI increased from days 1 and 5, respectively. The high baseline ICP increased over time. CPP remained unchanged. Preserved left ventricular contractility, enhanced myocardial one, a significant direct correlation between ELWI and PVPI, as well as their increase confirmed that the noncardiogenic genesis was responsible for increased ELWI. A direct significant correlation was found between ICP and ELWI, ICP and PVPI. Against this background, acute respiratory distress syndrome developed in 14 patients with pneumonia evolving in its presence in 7 patients. Conclusion. In ACCD, ELWI increases in the first 24 hours of the acute period. One of its causes is, along with others, primary and/or secondary damage to the brainstem structures with elevated ICP and progressive brain dislocation. The determination of ICP, unlike CPP, is crucial in the diagnosis and treatment of primary/secondary brain injuries and in prognosis. Key words: acute cerebral circulatory disorder, extravascular lung fluid, pulmonary vascular permeability, intracranial pressure, cerebral perfusion pressure, acute respiratory distress syndrome.

  17. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  18. 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.)

  19. 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.)

  20. Post Traumatic Cerebral Oedema in Severe Head Injury is Related to Intracranial Pressure and Cerebral Perfusion Pressure but not to Cerebral Compliance

    Directory of Open Access Journals (Sweden)

    U Nujaimin

    2009-07-01

    Full Text Available This was a prospective cohort study, carried out in the Neuro Intensive Care Unit, Department of Neurosciences, Hospital Universiti Sains Malaysia, Kubang Kerian Kelantan. The study was approved by the local ethics committee and was conducted between November 2005 and September 2007 with a total of 30 patients included in the study. In our study, univariate analysis showed a statistically significant relationship between mean intracranial pressure (ICP as well as cerebral perfusion pressure (CPP with both states of basal cistern and the degree of diffuse injury and oedema based on the Marshall classification system. The ICP was higher while CPP and compliance were lower whenever the basal cisterns were effaced in cases of cerebral oedema with Marshall III and IV. In comparison, the study revealed lower ICP, higher mean CPP and better mean cerebral compliance if the basal cisterns were opened or the post operative CT brain scan showed Marshall I and II. These findings suggested the surgical evacuation of clots to reduce the mass volume and restoration of brain anatomy may reduce vascular engorgement and cerebral oedema, therefore preventing intracranial hypertension, and improving cerebral perfusion pressure and cerebral compliance. Nevertheless the study did not find any significant relationship between midline shifts and mean ICP, CPP or cerebral compliance even though lower ICP, higher CPP and compliance were frequently observed when the midline shift was less than 0.5 cm. As the majority of our patients had multiple and diffuse brain injuries, the absence of midline shift did not necessarily mean lower ICP as the pathology was bilateral and even when after excluding the multiple lesions, the result remained insignificant. We assumed that the CT brain scan obtained after evacuation of the mass lesion to assess the state basal cistern and classify the diffuse oedema may prognosticate the intracranial pressure and cerebral perfusion pressure

  1. Elimination of extracranial blood flow during dynamic cerebral perfusion studies using diffusible and non-diffusible radioisotope

    International Nuclear Information System (INIS)

    Ahonen, A.; Koivula, A.; Kallanranta, T.; Kuikka, J.

    1981-01-01

    The extracranial blood flow seriously complicates the interpretation of dynamic cerebral studies. To eliminate this, we used a blood pressure cuff placed around the head in 50 patients with no evidence of cerebrovascular disease. The pressure in the headband was increased to 30 mmHg above the patient's systolic pressure, and the first 60 sec static scintigram was taken exactly 3 min after the injection of sup(99m)Tc-pertechnetate. A second 60 sec static scintigram was taken without pressure in the headband at 6 min after injection. After correction for diffusion of tracer into extravascular compartments we could still show 13% reduction in counting rates over the hemispheric regions and 30% over the convexity regions during application of the pressure headband. With the Xenon method, the application of the headband appears to have insignificant influence on the results of cerebral perfusion. We thus recommend that a headband should be used for dynamic sup(99m)Tc-isotope cerebral circulation studies. (author)

  2. Differences in cerebral perfusion deficits in mild traumatic brain injury and depression using single-photon emission computed tomography.

    Science.gov (United States)

    Romero, Kristoffer; Black, Sandra E; Feinstein, Anthony

    2014-01-01

    Numerous studies have shown decreased perfusion in the prefrontal cortex following mild traumatic brain injury (mTBI). However, similar hypoperfusion can also be observed in depression. Given the high prevalence of depressive symptoms following mTBI, it is unclear to what extent depression influences hypoperfusion in TBI. Mild TBI patients without depressive symptoms (mTBI-noD, n = 39), TBI patients with depressive symptoms (mTBI-D, n = 13), and 15 patients with major depressive disorder (MDD), but no TBI were given 99m T-ECD single-photon emission computed tomography (SPECT) scans within 2 weeks of injury. All subjects completed tests of information processing speed, complex attention, and executive functioning, and a self-report questionnaire measuring symptoms of psychological distress. Between-group comparisons of quantified SPECT perfusion were undertaken using univariate and multivariate (partial least squares) analyses. mTBI-D and mTBI-noD groups did not differ in terms of cerebral perfusion. However, patients with MDD showed hypoperfusion compared to both TBI groups in several frontal (orbitofrontal, middle frontal, and superior frontal cortex), superior temporal, and posterior cingulate regions. The mTBI-D group showed poorer performance on a measure of complex attention and working memory compared to both the mTBI-noD and MDD groups. These results suggest that depressive symptoms do not affect SPECT perfusion in the sub-acute phase following a mild TBI. Conversely, MDD is associated with hypoperfusion primarily in frontal regions.

  3. Preliminary studies of regional cerebral blood flow changes in patients with leukoaraiosis

    International Nuclear Information System (INIS)

    Li Yaming; Ren Yan; He Qiu

    1997-01-01

    PURPOSE: To investigate changes of regional cerebral blood flow (rCBF) in leukoaraiosis (LA) lesion and cortical regions and analyse the relation between rCBF changes and dementia. METHODS: Regional cerebral blood flow perfusion imaging with SPECT was performed in 49 patients with subcortical multiple cerebral infarction, including 24 cases company LA [LA(+)], 25 cases not company LA[LA(-)] and 10 normal subjects. The relative analysis was made between rCBF changes and cognitive scores. RESULTS: Compared the LA(+) with control, the rCBFs in frontal, parietal, temporal cortexes and LA lesion significantly decreased (P<0.05). The rCBF of frontal, parietal cortexes and LA lesions was also significantly decreased (P<0.05) compared with LA(-) groups. The cognitive scores were significantly related with rCBF changes in frontal cortex and LA lesion (r = 0.765, P<0.01 and r = 0.439, P<0.05). CONCLUSION: In patients with subcortical multiple cerebral infarction company LA lesion, there were extensive ischemic hypoperfusion changes in the cortical regions and LA lesion, which may response to decreased cerebral function and had certain relationship with dementia. The examination with SPECT cerebral blood flow perfusion imaging had unique advantage and value

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

    Directory of Open Access Journals (Sweden)

    D'Souza Olympio

    2010-02-01

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

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

    International Nuclear Information System (INIS)

    Sinnatamby, R.; Antoun, N.A.; Freer, C.E.L.; Miles, K.A.; Hodges, J.R.

    1996-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1996-04-01

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

  7. Hypothermia and Selective Antegrade Cerebral Perfusion Is Safe for Arch Repair in Type A Dissection.

    Science.gov (United States)

    Keeling, W Brent; Leshnower, Bradley G; Hunting, John C; Binongo, Jose; Chen, Edward P

    2017-09-01

    Unilateral selective antegrade cerebral perfusion with moderate hypothermic circulatory arrest has been shown to be a safe and effective method of cerebral protection during surgery for acute type A dissection. This study evaluates the impact of this cerebral protection strategy on clinical outcomes after extended aortic arch reconstruction in patients undergoing emergent repair of acute type A dissection. A retrospective review from 2004 to 2016 at a US academic center of patients undergoing surgery for acute type A dissections using moderate hypothermic circulatory arrest and selective antegrade cerebral perfusion was performed. Patient data were abstracted from The Society of Thoracic Surgeons (STS) institutional database and patient charts. Cohorts were established based on extent of arch replacement: a hemiarch group and a transverse arch group were created. Owing to a dearth of events, a risk score was estimated using a logistic regression model with 30-day mortality as outcome and preoperative variables as predictors, including non-STS variables such as malperfusion. Postoperative outcomes were then adjusted in subsequent regression analyses for the estimated risk score. In all, 342 patients met inclusion criteria and were included for analysis (299 hemiarch, 43 transverse arch). The mean age was 55.4 years and not different between groups (p = 0.79). Preoperative comorbidities, including prior stroke, diabetes mellitus, and renal failure, were also similar between groups (p > 0.2). Inhospital mortality was 11.7% for the entire cohort (11.7% hemiarch, 9.3% transverse arch; p = 0.60), and the permanent stroke rate was 7.3% (7.7% hemiarch, 4.3% transverse arch; p = 0.47). Median circulatory arrest time was 38.9 ± 19.2 minutes (35.0 ± 13.2 hemiarch, 65.1 ± 30.1 transverse arch; p optimal strategy for cerebral protection in this acute setting. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    de la Torre, Jack C

    2016-09-01

    Cardiovascular and cerebrovascular diseases are major risk factors in the development of cognitive impairment and Alzheimer's disease (AD). These cardio-cerebral disorders promote a variety of vascular risk factors which in the presence of advancing age are prone to markedly reduce cerebral perfusion and create a neuronal energy crisis. Long-term hypoperfusion of the brain evolves mainly from cardiac structural pathology and brain vascular insufficiency. Brain hypoperfusion in the elderly is strongly associated with the development of mild cognitive impairment (MCI) and both conditions are presumed to be precursors of Alzheimer dementia. A therapeutic target to prevent or treat MCI and consequently reduce the incidence of AD aims to elevate cerebral perfusion using novel pharmacological agents. As reviewed here, the experimental pharmaca include the use of Rho kinase inhibitors, neurometabolic energy boosters, sirtuins and vascular growth factors. In addition, a compelling new technique in laser medicine called photobiomodulation is reviewed. Photobiomodulation is based on the use of low level laser therapy to stimulate mitochondrial energy production non-invasively in nerve cells. The use of novel pharmaca and photobiomodulation may become important tools in the treatment or prevention of cognitive decline that can lead to dementia. © 2016 International Society of Neuropathology.

  9. Cerebral vasoreactivity to carbon dioxide during cardiopulmonary perfusion at normothermia and hypothermia

    International Nuclear Information System (INIS)

    Johnsson, P.; Messeter, K.; Ryding, E.; Kugelberg, J.; Stahl, E.

    1989-01-01

    With the pH-stat acid-base regulation strategy during hypothermic cardiopulmonary bypass (CPB), carbon dioxide (CO 2 ) is generally administered to maintain the partial pressure of arterial CO 2 at a higher level than with the alpha-stat method. With preserved CO 2 vasoreactivity during CPB, this induction of respiratory acidosis can lead to a much higher cerebral blood flow level than is motivated metabolically. To evaluate CO 2 vasoreactivity, cerebral blood flow was measured using a xenon 133 washout technique before, during, and after CPB at different CO 2 levels in patients who were undergoing coronary artery bypass grafting with perfusion at either hypothermia or normothermia. The overall CO 2 reactivity was 1.2 mL/100 g/min/mm Hg. There was no difference between the groups. The CO 2 reactivity was not affected by temperature or CPB. The induced hemodilution resulted in higher cerebral blood flow levels during CPB, although this was counteracted by the temperature-dependent decrease in the hypothermia group. After CPB, a transient increase in cerebral blood flow was noted in the hypothermia group, the reason for which remains unclear. The study shows that manipulation of the CO 2 level at different temperatures results in similar changes in cerebral blood flow irrespective of the estimated metabolic demand. This finding further elucidates the question of whether alpha-stat or pH-stat is the most physiological way to regulate the acid-base balance during hypothermic CPB

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

    International Nuclear Information System (INIS)

    Kato, Toru; Nanbu, Ichiro; Tohyama, Junko; Ohba, Satoru

    1995-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-01-01

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

  12. 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.)

  13. Regional cerebral blood flow in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, J.; Ohta, Y.; Nakane, Y.; Mori, H.; Hirota, N.; Yonekura, M.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of /sup 133/X in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., hypofrontality); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms.

  14. Regional cerebral blood flow in schizophrenics

    International Nuclear Information System (INIS)

    Uchino, Jun; Ohta, Yasuyuki; Nakane, Yoshibumi; Mori, Hiroyuki; Hirota, Noriyoshi; Yonekura, Masahiro.

    1987-01-01

    The present study on schizophrenics dealt with the relationship of regional cerebral blood flow (rCBF) to age, disease duration, and treatment length with chlorpromazine hydrochloride (CPZ). Regional cerebral blood flow in 28 cerebral regions of interest was measured by iv injection of X-133 in 54 schizophrenic patients and 39 healthy volunteers. Neither age nor dosage of CPZ significantly influenced rCBF. All patients, including 11 treated for a short period of time (6 months or less), were characterized by having a decreased rCBF over the whole cerebrum. Thirty-four patients treated for a long period of time (2 years or more) had a varied rCBF distribution in the left hemisphere, with the most predominant feature being the decrease in rCBF in the frontal lobe (i.e., ''hypofrontality''); however, there was no linear correlation between rCBF and disease duration. A decreased rCBE in the right occipital region was seen in patients with paranoid schizophrenia, suggesting that manifestations of symptoms may depend on disturbed regions. These results suggest that cerebral dysfunction in schizophrenic patients may not be restricted to the frontal lobe, but cover the whole cerebrum, and that nonuniform dysfunction in various regions of the cerebrum, including the frontal lobe, may be involved in manifestations of symptoms. (Namekawa, K.)

  15. Cerebral perfusion computed tomography deconvolution via structure tensor total variation regularization

    Energy Technology Data Exchange (ETDEWEB)

    Zeng, Dong; Zhang, Xinyu; Bian, Zhaoying, E-mail: zybian@smu.edu.cn, E-mail: jhma@smu.edu.cn; Huang, Jing; Zhang, Hua; Lu, Lijun; Lyu, Wenbing; Feng, Qianjin; Chen, Wufan; Ma, Jianhua, E-mail: zybian@smu.edu.cn, E-mail: jhma@smu.edu.cn [Department of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong 510515, China and Guangdong Provincial Key Laboratory of Medical Image Processing, Southern Medical University, Guangzhou, Guangdong 510515 (China); Zhang, Jing [Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052 (China)

    2016-05-15

    Purpose: Cerebral perfusion computed tomography (PCT) imaging as an accurate and fast acute ischemic stroke examination has been widely used in clinic. Meanwhile, a major drawback of PCT imaging is the high radiation dose due to its dynamic scan protocol. The purpose of this work is to develop a robust perfusion deconvolution approach via structure tensor total variation (STV) regularization (PD-STV) for estimating an accurate residue function in PCT imaging with the low-milliampere-seconds (low-mAs) data acquisition. Methods: Besides modeling the spatio-temporal structure information of PCT data, the STV regularization of the present PD-STV approach can utilize the higher order derivatives of the residue function to enhance denoising performance. To minimize the objective function, the authors propose an effective iterative algorithm with a shrinkage/thresholding scheme. A simulation study on a digital brain perfusion phantom and a clinical study on an old infarction patient were conducted to validate and evaluate the performance of the present PD-STV approach. Results: In the digital phantom study, visual inspection and quantitative metrics (i.e., the normalized mean square error, the peak signal-to-noise ratio, and the universal quality index) assessments demonstrated that the PD-STV approach outperformed other existing approaches in terms of the performance of noise-induced artifacts reduction and accurate perfusion hemodynamic maps (PHM) estimation. In the patient data study, the present PD-STV approach could yield accurate PHM estimation with several noticeable gains over other existing approaches in terms of visual inspection and correlation analysis. Conclusions: This study demonstrated the feasibility and efficacy of the present PD-STV approach in utilizing STV regularization to improve the accuracy of residue function estimation of cerebral PCT imaging in the case of low-mAs.

  16. Evaluation of optimal scan duration and end time in cerebral CT perfusion study

    International Nuclear Information System (INIS)

    Hirata, Masaaki; Sugawara, Yoshifumi; Miki, Hitoshi; Mochizuki, Teruhito; Murase, Kenya

    2005-01-01

    The purpose of this study was to evaluate the optimal end time of scanning and the influence of varying the number of source images adopted for calculation of the parameter values in computerized tomography (CT) perfusion. Nineteen CT perfusion studies in 14 patients with cerebrovascular disease were retrospectively analyzed. CT perfusion scanning was performed using continuous scans of 1 sec/rotation x 60 sec with 5-mm-thick sections. To determine the appropriate end time of scanning, the time-density curves (TDCs) of the anterior cerebral artery (ACA), superior sagittal sinus (SSS), and basal ganglia were analyzed. The functional maps of cerebral blood flow (CBF), cerebral blood volume (CBV), and mean transit time (MTT) were retrospectively generated from various numbers (30, 35, 40, 45, 50, 55, and 60) of source images. Defining the values calculated from the number of source images equal to the end time of the first pass as standard values, the percentage difference between the standard values and the values generated from various numbers of sources were evaluated. The TDCs of SSS showed the latest end time of the first pass (mean, 38.6±5.2 sec; range, 32 to 48 sec). Therefore, the values calculated from the number of source images equal to the end time of the first pass of SSS were defined as standard values. Increase and decrease of the number of source images for calculation resulted in increase of the percentage difference in every parameter value. The percentage differences ranged up to 49.6% for CBF, 48.0% for CBV, and 20.0% for MTT. Scanning until the end time of the first pass of SSS is necessary and sufficient for reliable measurement. Variable scan time based on the TDC of the SSS may be of better utility than use of fixed scan time. Further, the radiation dose could be minimized in many cases by reducing the scan time. (author)

  17. Effect of intranasally administered insulin on cerebral blood flow and perfusion

    DEFF Research Database (Denmark)

    Akintola, Abimbola A.; van Opstal, Anna M.; Westendorp, Rudi G.

    2017-01-01

    Insulin, a vasoactive modulator regulating peripheral and cerebral blood flow, has been consistently linked to aging and longevity. In this proof of principle study, using a randomized, double-blinded, placebo-controlled crossover design, we explored the effects of intranasally administered insulin...... labelling. Total flow through the major cerebropetal arteries was unchanged in both young and old. In the older participants, intranasal insulin compared to placebo increased perfusion through the occipital gray matter (65.2±11.0 mL/100g/min vs 61.2±10.1 mL/100g/min, P=0.001), and in the thalamus (68...

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-10-15

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

  19. Influence of antihypertensive therapy on cerebral perfusion in patients with metabolic syndrome: relationship with cognitive function and 24-h arterial blood pressure monitoring.

    Science.gov (United States)

    Efimova, Nataliya Y; Chernov, Vladimir I; Efimova, Irina Y; Lishmanov, Yuri B

    2015-08-01

    To investigate the regional cerebral blood flow, cognitive function, and parameters of 24-h arterial blood pressure monitoring in patients with metabolic syndrome before and after combination antihypertensive therapy. The study involved 54 patients with metabolic syndrome (MetS) investigated by brain single-photon emission computed tomography, 24-h blood pressure monitoring (ABPM), and comprehensive neuropsychological testing before and after 24 weeks of combination antihypertensive therapy. Patients with metabolic syndrome had significantly poorer regional cerebral blood flow compared with control group: by 7% (P = 0.003) in right anterior parietal cortex, by 6% (P = 0.028) in left anterior parietal cortex, by 8% (P = 0.007) in right superior frontal lobe, and by 10% (P = 0.00002) and 7% (P = 0.006) in right and left temporal brain regions, correspondingly. The results of neuropsychological testing showed 11% decrease in mentation (P = 0.002), and 19% (P = 0.011) and 20% (P = 0.009) decrease in immediate verbal and visual memory in patients with MetS as compared with control group. Relationships between the indices of ABPM, cerebral perfusion, and cognitive function were found. Data showed an improvement of regional cerebral blood flow, ABPM parameters, and indicators of cognitive functions after 6 months of antihypertensive therapy in patients with MetS. The study showed the presence of diffuse disturbances in cerebral perfusion is associated with cognitive disorders in patients with metabolic syndrome. Combination antihypertensive treatment exerts beneficial effects on the 24-h blood pressure profile, increases cerebral blood flow, and improves cognitive function in patients with MetS. © 2015 John Wiley & Sons Ltd.

  20. [How can we determine the best cerebral perfusion pressure in pediatric traumatic brain injury?].

    Science.gov (United States)

    Vuillaume, C; Mrozek, S; Fourcade, O; Geeraerts, T

    2013-12-01

    The management of cerebral perfusion pressure (CPP) is the one of the main preoccupation for the care of paediatric traumatic brain injury (TBI). The physiology of cerebral autoregulation, CO2 vasoreactivity, cerebral metabolism changes with age as well as the brain compliance. Low CPP leads to high morbidity and mortality in pediatric TBI. The recent guidelines for the management of CPP for the paediatric TBI indicate a CPP threshold 40-50 mmHg (infants for the lower and adolescent for the upper). But we must consider the importance of age-related differences in the arterial pressure and CPP. The best CPP is the one that allows to avoid cerebral ischaemia and oedema. In this way, the adaptation of optimal CPP must be individual. To assess this objective, interesting tools are available. Transcranial Doppler can be used to determine the best level of CPP. Other indicators can predict the impairment of autoregulation like pressure reactivity index (PRx) taking into consideration the respective changes in ICP and CPP. Measurement of brain tissue oxygen partial pressure is an other tool that can be used to determine the optimal CPP. Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  1. Measurement of cerebral perfusion after zolpidem administration in the baboon model.

    Science.gov (United States)

    Clauss, R P; Dormehl, I C; Oliver, D W; Nel, W H; Kilian, E; Louw, W K

    2001-01-01

    A recent report showed that zolpidem (CAS 82626-48-0) can lead to the arousal of a semi-comatosed patient. Zolpidem is clinically used for the treatment of insomnia. It belongs to the imidazopyridine chemical class and is a non benzodiazepine drug. It illicits its pharmacological action via the GABA receptor system through stimulation of particularly the omega 1 receptors. In this study, the effect of zolpidem on brain perfusion was examined by 99mTc hexamethyl-propylene amine oxime (HMPAO) split dose brain SPECT on four normal baboons and in one baboon with abnormal neurological behaviour. The global and regional brain perfusion was not significantly affected in the normal brains. In some regions of the abnormal baboon brain, however, there was a disproportionate increase in perfusion after zolpidem.

  2. Postradiation regional cerebral blood flow in primates

    International Nuclear Information System (INIS)

    Cockerham, L.G.; Cerveny, T.J.; Hampton, J.D.

    1986-01-01

    Early transient incapacitation (ETI) is the complete cessation of performance during the first 30 min after radiation exposure and performance decrement (PD) is a reduction in performance at the same time. Supralethal doses of radiation have been shown to produce a marked decrease in regional cerebral blood flow in primates concurrent with hypotension and a dramatic release of mast cell histamine. In an attempt to elucidate mechanisms underlying the radiation-induced ETI/PD phenomenon and the postradiation decrease in cerebral blood flow, primates were exposed to 100 Gy (1 Gy = 100 rads), whole-body, gamma radiation. Pontine and cortical blood flows were measured by hydrogen clearance, before and after radiation exposure. Systemic blood pressures were determined simultaneously. Systemic arterial histamine levels were determined preradiation and postradiation. Data obtained indicated that radiated animals showed a decrease in blood flow of 63% in the motor cortex and 51% in the pons by 10 min postradiation. Regional cerebral blood flow of radiated animals showed a slight recovery 20 min postradiation, followed by a fall to the 10 min nadir by 60 min postradiation. Immediately, postradiation systemic blood pressure fell 67% and remained at that level for the remainder of the experiment. Histamine levels in the radiated animals increased a hundredfold 2 min postradiation. This study indicates that regional cerebral blood flow decreases postradiation with the development of hypotension and may be associated temporally with the postradiation release of histamine

  3. The Transcranial Doppler Sonography for Optimal Monitoring and Optimization of Cerebral Perfusion in Aortic Arch Surgery: A Case Series.

    Science.gov (United States)

    Ghazy, Tamer; Darwisch, Ayham; Schmidt, Torsten; Nguyen, Phong; Elmihy, Sohaila; Fajfrova, Zuzana; Zickmüller, Claudia; Matschke, Klaus; Kappert, Utz

    2017-06-16

    To analyze the feasibility and advantages of transcranial doppler sonography (TCD) for monitoring and optimization of selective cerebral perfusion (SCP) in aortic arch surgery. From April 2013 to April 2014, nine patients with extensive aortic pathology underwent surgery under moderate hypothermic cardiac arrest with unilateral antegrade SCP under TCD monitoring in our institution. Adequate sonographic window and visualization of circle of Willis were to be confirmed. Intraoperatively, a cerebral cross-filling of the contralateral cerebral arteries on the unilateral SCP was to be confirmed with TCD. If no cross-filling was confirmed, an optimization of the SCP was performed via increasing cerebral flow and increasing PCO2. If not successful, the SCP was to be switched to bilateral perfusion. Air bubble hits were recorded at the termination of SCP. A sonographic window was confirmed in all patients. Procedural success was 100%. The mean operative time was 298 ± 89 minutes. Adequate cross-filling was confirmed in 8 patients. In 1 patient, inadequate cross-filling was detected by TCD and an optimization of cerebral flow was necessary, which was successfully confirmed by TCD. There was no conversion to bilateral perfusion. Extensive air bubble hits were confirmed in 1 patient, who suffered a postoperative stroke. The 30-day mortality rate was 0. Conclusion: The TCD is feasible for cerebral perfusion monitoring in aortic surgery. It enables a confirmation of adequacy of cerebral perfusion strategy or the need for its optimization. Documentation of calcific or air-bubble hits might add insight into patients suffering postoperative neurological deficits.

  4. Radiation dose reduction in cerebral CT perfusion imaging using iterative reconstruction

    International Nuclear Information System (INIS)

    Niesten, Joris M.; Schaaf, Irene C. van der; Riordan, Alan J.; Jong, Hugo W.A.M. de; Eijspaart, Daniel; Smit, Ewoud J.; Mali, Willem P.T.M.; Velthuis, Birgitta K.; Horsch, Alexander D.

    2014-01-01

    To investigate whether iterative reconstruction (IR) in cerebral CT perfusion (CTP) allows for 50 % dose reduction while maintaining image quality (IQ). A total of 48 CTP examinations were reconstructed into a standard dose (150 mAs) with filtered back projection (FBP) and half-dose (75 mAs) with two strengths of IR (middle and high). Objective IQ (quantitative perfusion values, contrast-to-noise ratio (CNR), penumbra, infarct area and penumbra/infarct (P/I) index) and subjective IQ (diagnostic IQ on a four-point Likert scale and overall IQ binomial) were compared among the reconstructions. Half-dose CTP with high IR level had, compared with standard dose with FBP, similar objective (grey matter cerebral blood volume (CBV) 4.4 versus 4.3 mL/100 g, CNR 1.59 versus 1.64 and P/I index 0.74 versus 0.73, respectively) and subjective diagnostic IQ (mean Likert scale 1.42 versus 1.49, respectively). The overall IQ in half-dose with high IR level was scored lower in 26-31 %. Half-dose with FBP and with the middle IR level were inferior to standard dose with FBP. With the use of IR in CTP imaging it is possible to examine patients with a half dose without significantly altering the objective and diagnostic IQ. The standard dose with FBP is still preferable in terms of subjective overall IQ in about one quarter of patients. (orig.)

  5. Cerebral perfusion disorders in patients after craniocerebral injury with clinical temporal conus syndrome

    International Nuclear Information System (INIS)

    Prasek, J.; Smrcka, M.; Maca, K.; Juran, V.; Vidlak, M.; Smrcka, V.

    2002-01-01

    Aim: to evaluate the changes of cerebral perfusion in patients after craniocerebral injury with clinical temporal conus syndrome. Material and methods: We present a group of 14 head injured patients admitted to neurosurgery with the syndrome of temporal herniation (Glasgow coma scale 3 - 5, homorateral dilated pupil and disturbed vital functions). There were 7 epidural, 6 subdural and one intracerebral hematomas. Mean age was 42, 7. All patients had urgent surgery and then continuous monitoring of vital functions. Results: Two postoperative CT and SPECT examinations were performed in each patient. Only 2 patients had visible ischemia on the first postoperative CT scan, both diet. 11 patients had ischemia in both the first post-operative and the follow up SPECT. 7 patients had improvement on the follow up SPECT compared to the first one, 6 of them were good results, one died. Conclusions: SPECT is very sensitive to impaired cerebral perfusion and may be helpful as a serial study. This is very mainly in the patients with reversible ischemia which may be influenced therapeutically with good results

  6. Cerebral cross-perfusion and the Circle of Willis: does physiology trump anatomy?

    Directory of Open Access Journals (Sweden)

    Musicki K

    2017-07-01

    Full Text Available Korana Musicki,1 Katherine Victoria Hurst,1,2 Zoltán Molnár,3 Elizabeth Hardy,4 Ashok Handa,1,2 1Department of Vascular Surgery, John Radcliffe Hospital, 2Nuffield Department of Surgical Sciences, 3Department of Physiology, Anatomy and Genetics, University of Oxford, 4Vascular Studies Unit, John Radcliffe Hospital, Oxford, UK Introduction: Cerebral cross-perfusion is essential for ipsilateral brain viability during unilateral insult. Aortic arch and great vessel procedures depend on its function for safe practice, unless adjuncts like shunts are used. This paper assesses the contribution of cerebrovascular anatomy against physiology in determining requisite hemispheric perfusion during carotid endarterectomy (CEA.Materials and methods: A review of shunting requirements for CEAs under locoregional anesthesia (LA at the John Radcliffe Hospital during 1999–2013 was performed. A PubMed search for “Circle of Willis” was screened for all original articles defining cerebrovascular anatomy by postmortem or angiography.Results: Over 14 years, 1137 CEAs were performed under cervical plexus block; during this period, the departmental standard of practice evolved from exclusively general anesthesia to predominantly LA. CEAs performed under LA during the early phase (1999–2003 had a shunt rate of 15.1%, compared to 20% as predicted by stump pressures alone. However, shunting decreased as higher perioperative systolic pressures were routinely practiced; shunt rates were 8.0% during the intermediate (2004–2007 and 6.4% during the later (2008–2013 phase. By comparison, 25 articles characterizing 6414 brains report an intact circle of Willis in 33–35% of people, with a complete hemi-circle anteriorly (77% seen more commonly than posteriorly (42%, and 11–16% deficient in both hemi-circles with no cross-flow.Conclusion: Cerebral cross-perfusion is fundamental for safe CEA. Anatomy of the circle of Willis alone does not itself determine adequacy

  7. Measurement of cerebral white matter perfusion using pseudocontinuous arterial spin labeling 3T magnetic resonance imaging--an experimental and theoretical investigation of feasibility.

    Directory of Open Access Journals (Sweden)

    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.

  8. Prospective comparative study of brain protection in total aortic arch replacement: deep hypothermic circulatory arrest with retrograde cerebral perfusion or selective antegrade cerebral perfusion.

    Science.gov (United States)

    Okita, Y; Minatoya, K; Tagusari, O; Ando, M; Nagatsuka, K; Kitamura, S

    2001-07-01

    The purpose of this study was to compare the results of total aortic arch replacement using two different methods of brain protection, particularly with respect to neurologic outcome. From June 1997, 60 consecutive patients who underwent total arch replacement through a midsternotomy were alternately allocated to one of two methods of brain protection: deep hypothermic circulatory arrest with retrograde cerebral perfusion (RCP: 30 patients) or with selective antegrade cerebral perfusion (SCP: 30 patients). Preoperative and postoperative (3 weeks) brain CT scan, neurological examination, and cognitive function tests were performed. Serum 100b protein was assayed before and after the cardiopulmonary bypass, as well as 24 hours and 48 hours after the operation. Hospital mortality occurred in 2 patients in the RCP group (6.6%) and 2 in the SCP group (6.6%). New strokes occurred in 1 (3.3%) of the RCP group and in 2 (6.6%) of the SCP group (p = 0.6). The incidence of transient brain dysfunction was significantly higher in the RCP group than in the SCP group (10, 33.3% vs 4, 13.3%, p = 0.05). Except in patients with strokes, S-100b values showed no significant differences in the two groups (RCP: SCP, prebypass 0.01+/-0.04: 0.05+/-0.16, postbypass 2.17+/-0.94: 1.97+/-1.00, 24 hours 0.61+/-0.36: 0.60+/-0.37, 48 hours 0.36+/-0.45: 0.46+/-0.40 microg/L, p = 0.7). There were no intergroup differences in the scores of memory decline (RCP 0.74+/-0.99; SCP 0.55+/-1.19, p = 0.6), orientation (RCP 1.11+/-1.29; SCP 0.50+/-0.76, p = 0.08), or intellectual function (RCP 1.21+/-1.27; SCP 1.05+/-1.15, p = 0.7). Both methods of brain protection for patients undergoing total arch replacement resulted in acceptable levels of mortality and morbidity. However, the prevalence of transient brain dysfunction was significantly higher in patients with the RCP.

  9. 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.

  10. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-09-15

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

  12. Neuro-functional alteration in disorders of the encourage they cause with conducts self-mutilations study of cerebral regional perfusion starting from the technique of Neuro-SPECT Tc99-HMPAO

    International Nuclear Information System (INIS)

    Mena, Ismael; Correa, Rodrigo; Nader, Armando

    2007-01-01

    We report NeuroSPECT findings in mood disorders, including bipolar disorder, major depression and self-mutilation. We compare results in 29 patients with bipolar disorder complicated by self-mutilation, a group of 20 patients with bipolar disorder uncomplicated and 22 patients with mayor depression uncomplicated by self-mutilation. Among the NeuroSPECT findings we report the association of mood disorders and self-mutilation with hyper perfusion of the anterior-dorsal-ventral segment of both thalami concomitant with hypoperfusion in perilimbic cortex, namely areas 32, 24 (anterior cingulate gyrus) and 23 of Brodmann. Multiple reports in the literature relate both, in animals and man, self-mutilation with phenomena of hypoalghesia, anesthesia, or dysestesias and are the basis for our hypothesis linking dysfunction of limbic-thalamic circuits, associated with nocioceptive fibers, somato-psychic consciousness and self-mutilation phenomena

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

    International Nuclear Information System (INIS)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G.; Zauner, H.

    2009-01-01

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

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

    Science.gov (United States)

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

    2015-08-01

    Despite the advancement in the postoperative care of neonates with congenital heart disease (CHD), there is little information on preoperative management of systemic and regional hemodynamics, which may be related to outcomes. We aimed to determine the preoperative effect of milrinone, a phosphodiesterase III inhibitor, on cardiac output and splanchnic and cerebral perfusion in neonates with CHD. Neonates with CHD requiring cardiac surgery were enrolled in a prospective, single-blinded study once a clinical decision of starting milrinone (0.75 μg/kg per minute intravenously) using institutional criteria was made. Demographic and clinical variables and outcomes were recorded. Combined cardiac output and measures of splanchnic (superior mesenteric and celiac arteries) and cerebral (anterior and middle cerebral arteries) perfusion were determined by Doppler studies at 0, 6, 24, and 48 h after milrinone infusion. Investigators were unaware of intervention time points and patients in analyzing blood flow measurements. Seventeen term (39.2 ± 1.3 weeks) neonates were included with hypoplastic left-sided heart syndrome (78.5%) as the most common diagnosis. Combined cardiac output increased by 28% within 48 h (613 ± 154 vs. 479 ± 147 mL/kg per minute at baseline, P milrinone infusion (P milrinone infusion (P milrinone infusion. Milrinone increases cardiac output with concurrent effects on splanchnic and cerebral blood flows during the short-term preoperative use in neonates with CHD.

  15. Cerebral perfusion studies using Au-195: Investigations into their clinical usefulness and comparisons with the xenon-133 inhalation method

    International Nuclear Information System (INIS)

    Draws, J.

    1989-01-01

    Au-195m cerebral perfusion studies in the diagnosis of blood supply disorders of the brain have only recently leaped into currency. Au-195m is not capable of diffusing. This particular property permits first-pass times of vascular transfer to be determined for cerebral tissues that correlate with the degree of cerebral circulation. In the study described here, attempts were made to shed more light on the clinical usefulness of the method. For this purpose, the record sheets of two cohorts of patients were analysed on a retrospective basis. 1. In 23 patients, where the cerebrovascular disorders were strictly confined to the cerebral hemispheres, the blood supply of the brain was examined on the basis of both Au-195m cerebral perfusion studies and the xenon-133 inhalation method. In the evaluation of the findings based on the Au-195m study the investigator was blinded to the neurological manifestations of the disease and the results from other studies. In 82% of the patients the perfusion mapping using Au-195m was consistent with the clinical symptoms. 2. In a second group of patients, the probable results of the Au-195m perfusion study were forecasted on the basis of the medical history, clinical symptoms and preliminary diagnosis and subsequently compared to those actually obtained. Expected and actual results were found to be in agreement for 88% of cases. The results provided evidence of the suitability of Au-195m cerebral perfusion studies to examine the blood suply of the brain. In view of the fact that the examinations and measurements are relatively uncomplicated, this newly developed method is most likely to be used on a broader basis in the future. (orig./MG) [de

  16. Perfusion study in the pulmonary hilar region by SPECT

    International Nuclear Information System (INIS)

    Satoh, Katashi; Tanabe, Masatada; Kawase, Yoshiro

    1990-01-01

    Alveoli in the hilar region comprise the peripheral area containing daughter branches from subsegmental or one more divisional peripheral bronchi. Pulmonary perfusion in hilar region was examined by SPECT (single photon emission CT) in ten normal volunteers. ROI (region of interest) in the axial images were set in the hilar region, the upper, middle and lower lung fields with 10.8 mm thickness. Counts/one pixel (C/P) were calculated in these ROI. There was a tendency of C/P increase from upper to lower lung field. And there were no significant differences in C/P increase between hilar region and other axial fields. In the chronic obstructive pulmonary diseases, however, ventilation studies in the previous reports using Xe dynamic CT or PET (positron emission tomography) showed differences between outer region and hilar region. This method will be expected to evaluate the pulmonary perfusion not only in the whole lung but in different lung areas, including the hilar region in the chronic obstructive pulmonary diseases. (author)

  17. New possibilities for quantitative measurements of regional cerebral blood flow with gold-195m

    International Nuclear Information System (INIS)

    Lindner, P.; Nickel, O.

    1985-01-01

    A previously reported theory for quantitative cerebral blood flow measurement for nondiffusible radiotracers has been applied to patients after stroke and to volunteers undergoing a mental stimulation exercise. The energy spectrum of gold-195m shows two strong photon peaks, one at an energy level of 68 keV and a second at an energy-level of 262 keV. The low energy peak is suitable for perfusion studies in lateral views of the hemispheres; no look-through effect is seen. The high energy level is good for studies in posterior-anterior positions. Parametric images for quantitative regional cerebral blood flow can be generated. The area of occluded vessels in the case of stroke can be detected. Quantitative activation patterns of cerebral blood flow during mental stimulation can be generated. The results prove that, not only with freely diffusible indicators like xenon but also with nondiffusible indicators, it is possible to measure quantitatively cerebral blood flow patterns

  18. Regional cerebral flows in hypertensive patients

    International Nuclear Information System (INIS)

    Britton, K.E.; Granowska, M.; Lee, T.Y.; Nimmon, C.C.; Rutland, M.

    1978-01-01

    The aim of this study is to develop a method for assessing the natural history of cerebrovascular disease in patients with hypertension in order that the effects of controlling hypertension may be judged. By developing a quantitative noninvasive method for measuring regional cerebral flow and internal carotid appearance times it is hoped that drugs intended to inhibit the continued formation of atheroma and drugs intended to aid the dissolution of atheroma, may be objectively evaluated. (Auth.)

  19. Regional cerebral blood flow in Angelman syndrome

    International Nuclear Information System (INIS)

    Guecueyener, K.; Goekcora, N.; Ilgin, N.; Buyan, N.; Sayli, A.

    1993-01-01

    A patient with typical features of Angelman syndrome - a genetically inherited disorder involving developmental delay, ataxia, episodes of paroxysmal laughter and brachiocephaly - was studied with single-photon emission tomography. Hyperfusion found in the left frontal and left temporoparietal regions can provide insights into the functional cerebral pathology, which may be due to a disturbance of the developmental process related to a chromosomal abnormality. (orig.)

  20. Regional cerebral blood flow in Angelman syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Guecueyener, K [Dept. of Pediatric Neurology, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Goekcora, N [Dept. of Nuclear Medicine, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Ilgin, N [Dept. of Nuclear Medicine, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Buyan, N [Dept. of Pediatric Neurology, Faculty of Medicine, Gazi Univ., Ankara (Turkey); Sayli, A [Dept. of Molecular Biology and Genetics, Faculty of Medicine, Gazi Univ., Ankara (Turkey)

    1993-07-01

    A patient with typical features of Angelman syndrome - a genetically inherited disorder involving developmental delay, ataxia, episodes of paroxysmal laughter and brachiocephaly - was studied with single-photon emission tomography. Hyperfusion found in the left frontal and left temporoparietal regions can provide insights into the functional cerebral pathology, which may be due to a disturbance of the developmental process related to a chromosomal abnormality. (orig.)

  1. Correlation between cerebral hemodynamic and perfusion pressure changes in non-human primates

    Science.gov (United States)

    Ruesch, A.; Smith, M. A.; Wollstein, G.; Sigal, I. A.; Nelson, S.; Kainerstorfer, J. M.

    2017-02-01

    The mechanism that maintains a stable blood flow in the brain despite changes in cerebral perfusion pressure (CPP), and therefore guaranties a constant supply of oxygen and nutrients to the neurons, is known as cerebral auto-regulation (CA). In a certain range of CPP, blood flow is mediated by a vasomotor adjustment in vascular resistance through dilation of blood vessels. CA is known to be impaired in diseases like traumatic brain injury, Parkinson's disease, stroke, hydrocephalus and others. If CA is impaired, blood flow and pressure changes are coupled and thee oxygen supply might be unstable. Lassen's blood flow auto-regulation curve describes this mechanism, where a plateau of stable blood flow in a specific range of CPP corresponds to intact auto-regulation. Knowing the limits of this plateau and maintaining CPP within these limits can improve patient outcome. Since CPP is influenced by both intracranial pressure and arterial blood pressure, long term changes in either can lead to auto-regulation impairment. Non-invasive methods for monitoring blood flow auto-regulation are therefore needed. We propose too use Near infrared spectroscopy (NIRS) too fill this need. NIRS is an optical technique, which measures microvascular changes in cerebral hemoglobin concentration. We performed experiments on non-human primates during exsanguination to demonstrate that thee limits of blood flow auto-regulation can be accessed with NIRS.

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

    International Nuclear Information System (INIS)

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

    2000-01-01

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

  3. Analysis of Regional Cerebral Blood Flow Using 99mTc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    International Nuclear Information System (INIS)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In

    1988-01-01

    99m Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, 99m Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

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

    Energy Technology Data Exchange (ETDEWEB)

    Pannetier, N.

    2010-12-15

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

  5. White Matter Hyperintensity Volume and Cerebral Perfusion in Older Individuals with Hypertension Using Arterial Spin-Labeling

    NARCIS (Netherlands)

    van Dalen, J. W.; Mutsaerts, H. J. M. M.; Nederveen, A. J.; Vrenken, H.; Steenwijk, M. D.; Caan, M. W. A.; Majoie, C. B. L. M.; van Gool, W. A.; Richard, E.

    2016-01-01

    BACKGROUND AND PURPOSE: White matter hyperintensities of presumed vascular origin in elderly patients with hypertension may be part of a general cerebral perfusion deficit, involving not only the white matter hyperintensities but also the surrounding normal-appearing white matter and gray matter. We

  6. Perfusion magnetic resonance imaging and magnetic resonance spectroscopy of cerebral gliomas showing imperceptible contrast enhancement on conventional magnetic resonance imaging

    International Nuclear Information System (INIS)

    Batra, A.; Tripathi, R.P.; Singh, A.K.

    2004-01-01

    The purpose of the present paper was to evaluate the utility of perfusion MRI in cerebral gliomas showing imperceptible contrast enhancement on conventional MRI, and to evaluate the relationships of perfusion MRI and magnetic resonance (MR) spectroscopic results in these tumours. Twenty-two patients with histopathologically proven cerebral gliomas and showing insignificant contrast enhancement on conventional MR were included in the present study. All patients underwent perfusion MRI and MR spectroscopy on a 1.5-T MR system. Significant differences of the relative cerebral blood volume (rCBV) values and the choline : creatine ratios were noted between low-grade and anaplastic gliomas (P < 0.01). Good correlation was found between the rCBV values and the choline : creatine values (y = 0. 532x + 1.5643; r = 0.67). Perfusion MRI can be a useful tool in assessing the histopathological grade of non-contrast-enhancing cerebral gliomas. Along with MR spectroscopic imaging it can serve as an important technique for preoperative characterization of such gliomas, so that accurate targeting by stereotactic biopsies is possible. Copyright (2004) Blackwell Science Pty Ltd

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

    International Nuclear Information System (INIS)

    Claus, J.J.; Breteler, M.M.B.; Hasan, D.; Krenning, E.P.; Bots, M.L.; Grobbee, D.E.; Swieten, J.C. van; Harskamp, F. van; Hofman, A.

    1996-01-01

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

  8. The influence of norepinephrine and phenylephrine on cerebral perfusion and oxygenation during propofol-remifentanil and propofol-remifentanil-dexmedetomidine anaesthesia in piglets

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Rasmussen, Rune

    2018-01-01

    of dexmedetomidine. Cerebral perfusion measured by laser speckle contrast imaging was related to cerebral oxygenation as measured by an intracerebral Licox probe (partial pressure of oxygen) and transcranial near infrared spectroscopy technology (NIRS) (cerebral oxygen saturation). Results During propofol......–remifentanil anaesthesia, increases in blood pressure by norepinephrine and phenylephrine did not change cerebral perfusion significantly, but cerebral partial pressure of oxygen (Licox) increased following vasopressors in both groups and increases following norepinephrine were significant (NBP: P = 0.04, LBP: P = 0......–remifentanil–dexmedetomidine anaesthesia was not followed by significant changes in cerebral perfusion. Licox measures increased significantly following both vasopressors in both groups, whereas the decreases in NIRS measures were only significant in the NBP group. Conclusions Cerebral partial pressure of oxygen measured by Licox...

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

    International Nuclear Information System (INIS)

    Jeong, Y. J.; Park, M. J.; Cha, J. G.; Kim, S. H.; Kim, J. W.; Kang, D. Y.

    2005-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-07-01

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

  11. Regional cerebral blood flow in schizophrenia

    International Nuclear Information System (INIS)

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions

  12. Regional cerebral blood flow in schizophrenia

    Energy Technology Data Exchange (ETDEWEB)

    Mathew, R.J.; Duncan, G.C.; Weinman, M.L.; Barr, D.L.

    1982-10-01

    Regional cerebral blood flow (rCBF) was measured via xenon133 inhalation technique in 23 patients with schizophrenia and 18 age- and sex-matched controls. The mean blood flow to both hemispheres was found to be lower for the patients. The patients and their controls did not differ on interhemispheric differences in blood flow. There were no differences in rCBF between medicated and unmedicated, subchronic and chronic, and paranoid and nonparanoid patients. Hallucinations were associated with reduced blood flow to several postcentral regions.

  13. Effect of epinephrine on cerebral and myocardial perfusion in an infant animal preparation of cardiopulmonary resuscitation.

    Science.gov (United States)

    Schleien, C L; Dean, J M; Koehler, R C; Michael, J R; Chantarojanasiri, T; Traystman, R; Rogers, M C

    1986-04-01

    We assessed the efficacy of conventional cardiopulmonary resuscitation (CPR) in 2-week-old piglets. We determined intrathoracic vascular pressures, cerebral (CBF) and myocardial blood flows (MBF), and cerebral oxygen uptake during conventional CPR in this infant animal preparation and contrasted these results with those of previous work on adult animals. We further examined the effects of the infusion of epinephrine on these pressures and flows and on cerebral oxygen uptake, which has not been previously evaluated in adult preparations. Conventional CPR was performed on pentobarbital-anesthetized piglets with a 20% sternal displacement with the use of a pneumatic piston compressor. Chest recoil was incomplete, leading to an 18% to 27% reduction in anteroposterior diameter during the relaxation phase. Aortic and right atrial pressures in excess of 80 mm Hg were generated. These pressures are greater than those generally obtained in adult animals with similar percent pulsatile displacements. CBF and MBF were also initially greater than those reported in adult animals undergoing conventional CPR. However, when CPR was prolonged beyond 20 min, aortic pressure fell and CBF and MBF declined to the near-zero levels seen in adult preparations. At 5 min of CPR, CBF and MBF were 24 +/- 7 and 27 +/- 7 ml . min-1 x 100 g-1 (50% and 17% of the values during cardiac arrest), respectively. With the continuous infusion of epinephrine (4 micrograms/kg/min) in another group of animals, MBF was significantly greater at 20 min of CPR and CBF and cerebral O2 uptake were greater at 35 min of CPR as a result of higher perfusion pressures.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Optimizing Cardiac Out-Put to Increase Cerebral Penumbral Perfusion in Large Middle Cerebral Artery Ischemic Lesion—OPTIMAL Study

    Directory of Open Access Journals (Sweden)

    Hannah Fuhrer

    2017-08-01

    Full Text Available IntroductionIn unsuccessful vessel recanalization, clinical outcome of acute stroke patients depends on early improvement of penumbral perfusion. So far, mean arterial blood pressure (MAP is the target hemodynamic parameter. However, the correlations of MAP to cardiac output (CO and cerebral perfusion are volume state dependent. In severe subarachnoid hemorrhage, optimizing CO leads to a reduction of delayed ischemic neurological deficits and improvement of clinical outcome. This study aims to investigate the effect of standard versus advanced cardiac monitoring with optimization of CO on the clinical outcome in patients with large ischemic stroke.Methods and analysisThe OPTIMAL study is a prospective, multicenter, open, into two arms (1:1 randomized, controlled trial. Sample size estimate: sample sizes of 150 for each treatment group (300 in total ensure an 80% power to detect a difference of 16% of a dichotomized level of functional clinical outcome at 3 months at a significance level of 0.05. Study outcomes: the primary endpoint is the functional outcome at 3 months. The secondary endpoints include functional outcome at 6 months follow-up, and complications related to hemodynamic monitoring and therapies.DiscussionThe results of this trial will provide data on the safety and efficacy of advanced hemodynamic monitoring on clinical outcome.Ethics and disseminationThe trial was approved by the leading ethics committee of Freiburg University, Germany (438/14, 2015 and the local ethics committees of the participating centers. The study is performed in accordance with the Declaration of Helsinki and the guidelines of Good Clinical Practice. It is registered in the German Clinical Trial register (DRKS; DRKS00007805. Dissemination will include submission to peer-reviewed professional journals and presentation at congresses. Hemodynamic monitoring may be altered in a specific stroke patient cohort if the study shows that advanced monitoring is

  15. Cerebral perfusion study using 99mTc-HMPAO-ECT: Particular aspects regarding uptake and evaluation

    International Nuclear Information System (INIS)

    Spitz, J.; Clemenz, N.

    1988-01-01

    From the performance of about 250 99m Tc-HMPAO-SPECT studies for clarification of cerebro-vascular diseases, five essential problem groups have emerged: 1. Positioning of the patient's head and hence resulting rotation radius of the camera head. 2. Choice of the slice level for documentation and demonstration of the ECT study. 3. Standardization and colour codation of the single slice images. 4. Localization and identification of single slices in different slice levels. 5. Quantification of the distribution pattern. Whether nuclear medical cerebral perfusion study for diagnosis of cerebro-vascular diseases using 99m Tc-HMPAO may be an equivalent to DSA und TCT in future, should at least partially depend upon an adequate answer to the presented problems. (orig.) [de

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    .4±4.2 mmHg when standing up (Phydrostatic pressure gradient with reference just below the heart, likely reflecting the venous hydrostatic...... indifference point. When upright, the decrease in ICP was attenuated, corresponding to formation of a separate hydrostatic gradient with reference to the base of the skull, likely reflecting the site of venous collapse. ICP therefore seems to be governed by pressure in the draining veins and collapse of neck......We evaluated postural effects on intracranial pressure (ICP) and cerebral perfusion pressure (CPP: mean arterial pressure (MAP) - ICP) in neurosurgical patients undergoing 24-hour ICP monitoring as part of their diagnostic workup. We identified 9 patients (5 women, age 44±20 yrs.; mean±SD) who were...

  17. Compromised Global and Regional Cerebral Blood Flow in Congestive Heart Failure

    Energy Technology Data Exchange (ETDEWEB)

    Kim, J. S.; Kim, J. J.; Im, K. C.; Moon, D. H. [College of Medicine, Univ. of Ulsan, Seoul (Korea, Republic of)

    2003-07-01

    It has been known that cerebral perfusion is maintained in patients with congestive heart failure (CHF) by a complex series of compensatory mechanisms. However cognitive impairment is a common problem experienced by patients with CHF and may result from deranged cerebral perfusion. We prospectively investigated the global and regional CBF of patients with CHF and compared the results with that of normal controls. Thirty two patients (M/F: 22/10, 4211 yr) with CHF (LVEF=218.1%) and 10 healthy controls (M/F: 6/4, 398 yr) were prospectively studied. No patients had cerebrovascular disease or other disease affecting cognitive function. All patients and normal controls underwent radionuclide angiography including cerebral hemispheres and aortic arch, and brain perfusion SPECT using Tc-99m ECD. Global CBF was measured non-invasively by the application of Patlak plot graphical analysis. Quantitative rCBF images were obtained from SPECT image using global CBF values, regional/global count ratios, and Lassen's linearization correction algorithm. Difference of regional CBF between CHF and normal control were assessed using a SPM99 without global count normalization (uncorrected p<0.0001, extent threshold>100 voxels). Global CBF (41.54.7 ml/min/100g) of the patients with CHF were significantly lower than those (49.15.7 ml/min/100g) of controls (p<0.001). Regional CBF was significantly decreased in frontal, temporal and parietal neocortex of both cerebral hemispheres compared to normal controls. Regional rCBF of basal ganglia, thalamus, and brain stem were preserved, even though global CBF was variably compromised. Our study show that global CBF is significantly decreased in CHF and regional CBF of frontal, parietal and temporal neocortex is compromised preferentially. Further studies would be needed to investigate the relationship of rCBF change and cognitive impairment in patients with CHF.

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

    Science.gov (United States)

    Cremers, Charlotte H P; Dankbaar, Jan Willem; Vergouwen, Mervyn D I; Vos, Pieter C; Bennink, Edwin; Rinkel, Gabriel J E; Velthuis, Birgitta K; van der Schaaf, Irene C

    2015-05-01

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

  19. Characteristic pattern of cerebral perfusion in patients with the early stage of subcortical vascular dementia compared with Alzheimer's disease

    International Nuclear Information System (INIS)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Cheon, Sang Myung; Kim, Jong Kuk; Kim, Jae Woo

    2004-01-01

    Brain perfusion SPECT has been commonly used to evaluate several different types of dementia. The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVD (mean age; 68.0±7.0 years, educational period; 6.3±5.6 years, CDR; 0.80±0.26). 46 AD (mean age; 69.9±7.4 years, educational period; 5.4±4.7 years, CDR; 0.86±0.23) and 12 normal control subjects (mean age; 67.1±7.7 years, educational period; 6.2±4.2 years) participated in this study. We included the patients with SVD and AD according to NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for probable or possible VD. They were all matched for age, education and clinical dementia scale scores. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and right thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyral regions in patients with SVD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in patients with AD compared with control subjects (uncorrected p<0.01). SVD patients revealed significant hypoperfusion in the right parahippocampal gyrus, right cingulated gyrus, left insula, and both frontal subgyral regions compared with AD patients (uncorrected p<0.01). SVD patients revealed significant hyperperfusion in right superior frontal gyrus, left pre- and postcentral gyri, left paracentral lobule, left precuneus and both medial frontal gyri compared with AD patients (uncorrected p<0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

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

    2010-05-01

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

  2. A National Trial on Differences in Cerebral Perfusion Pressure Values by Measurement Location.

    Science.gov (United States)

    McNett, Molly M; Bader, Mary Kay; Livesay, Sarah; Yeager, Susan; Moran, Cristina; Barnes, Arianna; Harrison, Kimberly R; Olson, DaiWai M

    2018-04-01

    Cerebral perfusion pressure (CPP) is a key parameter in management of brain injury with suspected impaired cerebral autoregulation. CPP is calculated by subtracting intracranial pressure (ICP) from mean arterial pressure (MAP). Despite consensus on importance of CPP monitoring, substantial variations exist on anatomical reference points used to measure arterial MAP when calculating CPP. This study aimed to identify differences in CPP values based on measurement location when using phlebostatic axis (PA) or tragus (Tg) as anatomical reference points. The secondary study aim was to determine impact of differences on patient outcomes at discharge. This was a prospective, repeated measures, multi-site national trial. Adult ICU patients with neurological injury necessitating ICP and CPP monitoring were consecutively enrolled from seven sites. Daily MAP/ICP/CPP values were gathered with the arterial transducer at the PA, followed by the Tg as anatomical reference points. A total of 136 subjects were enrolled, resulting in 324 paired observations. There were significant differences for CPP when comparing values obtained at PA and Tg reference points (p Differences remained significant in repeated measures model when controlling for clinical factors (mean CPP-PA = 80.77, mean CPP-Tg = 70.61, p identified as adequate with PA values, yet inadequate with CPP values measured at the Tg. Findings identify numerical differences for CPP based on anatomical reference location and highlight importance of a standard reference point for both clinical practice and future trials to limit practice variations and heterogeneity of findings.

  3. PET imaging of cerebral perfusion and oxygen consumption in acute ischemic stroke: Relation to outcome

    International Nuclear Information System (INIS)

    Marchal, G.; Serrati, C.; Rioux, P.; Petit-Taboue, M.C.; Viader, F.; Sayette, V. de la; Doze, F. le; Lonchon, P; Derlon, J.M.; Orgogozo, J.M.; Baron, J.C.

    1993-01-01

    The authors used positron emission tomography (PET) to assess the relation between combined imaging of cerebral blood flow and oxygen consumption 5-18 h after first middle cerebral artery (MCA) stroke and neurological outcome at 2 months. All 18 patients could be classified into three visually defined PET patterns of perfusion and oxygen consumption changes. Pattern 1 suggested extensive irreversible damage and was consistently associated with poor outcome. Pattern 2 suggested continuing ischemia and was associated with variable outcome. Pattern 3 with hyperperfusion and little or no metabolic alteration, was associated with excellent recovery, which suggests that early reperfusion is beneficial. This relation between PET and outcome was highly significant. The results suggest that within 5-18 h of stroke onset, PET is a good predictor of outcome in patterns 1 and 3, for which therapy seems limited. The absence of predictive value for pattern 2 suggests that it is due to a reversible ischemic state that is possibly amenable to therapy. These findings may have important implications for acute MCA stroke management and for patients' selection for therapeutic trials

  4. A noninvasive estimation of cerebral perfusion pressure using critical closing pressure.

    Science.gov (United States)

    Varsos, Georgios V; Kolias, Angelos G; Smielewski, Peter; Brady, Ken M; Varsos, Vassilis G; Hutchinson, Peter J; Pickard, John D; Czosnyka, Marek

    2015-09-01

    Cerebral blood flow is associated with cerebral perfusion pressure (CPP), which is clinically monitored through arterial blood pressure (ABP) and invasive measurements of intracranial pressure (ICP). Based on critical closing pressure (CrCP), the authors introduce a novel method for a noninvasive estimator of CPP (eCPP). Data from 280 head-injured patients with ABP, ICP, and transcranial Doppler ultrasonography measurements were retrospectively examined. CrCP was calculated with a noninvasive version of the cerebrovascular impedance method. The eCPP was refined with a predictive regression model of CrCP-based estimation of ICP from known ICP using data from 232 patients, and validated with data from the remaining 48 patients. Cohort analysis showed eCPP to be correlated with measured CPP (R = 0.851, p area under the curve of 0.913 (95% CI 0.883-0.944). When each recording session of a patient was assessed individually, eCPP could predict CPP with a 95% CI of the SD for estimating CPP between multiple recording sessions of 1.89-5.01 mm Hg. Overall, CrCP-based eCPP was strongly correlated with invasive CPP, with sensitivity and specificity for detection of low CPP that show promise for clinical use.

  5. Elevation of the correlation between cerebral blood volume and permeability surface from CT perfusion images with glioma grade

    International Nuclear Information System (INIS)

    Ding Bei; Ling Huawei; Zhang Huan; Song Qi; Dong Haipeng; Chen Kemin

    2007-01-01

    Objective: To evaluate the correlation between cerebral blood volume and permeability surface by using multislice CT perfusion imaging with glioma grade. Methods: Ninteen patients with gliomas underwent conventional MR and multislice CT perfusion imaging preoperatively. These patients were divided into low grade and high grade groups which were correspond to WHO II grade gliomas and WHO III or IV grade gliomas respectively. CT data were transferred to on-line working station and processed to obtain time-signal curves, color perfusion maps and calculated perfusion parameters, including cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTF) and permeability surfaces (PS) in tumoral parenchyma. Kruskal-Wallis test and correlation of CBV and PS was assessed by using SPSS 11.0 software. Results: The median of CBV and PS in low-grade and high-grade glioma were 2.7, 6.5 ml/100 g; 0.389, 12.810 ml·100 g -1 ·min -1 respectively, corresponding t value were 12.907 13.500 with P<0.05. Pearson correlations between CBV and PS were as follows: in low-grade group, r=-0.058, in high-grade group, r=0.648. Conclusion: Both CBV and PS have obvious correlation with glioma grade. The correlation between CBV and PS in low-grade glioma was weaker, probably because of the focal high vascularity in oligodendroglioma. (authors)

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

    International Nuclear Information System (INIS)

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

    1990-01-01

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

  7. The Risk of Neurological Dysfunctions after Deep Hypothermic Circulatory Arrest with Retrograde Cerebral Perfusion.

    Science.gov (United States)

    Gatti, Giuseppe; Benussi, Bernardo; Currò, Placido; Forti, Gabriella; Rauber, Elisabetta; Minati, Alessandro; Gabrielli, Marco; Tognolli, Umberto; Sinagra, Gianfranco; Pappalardo, Aniello

    2017-12-01

    Retrograde cerebral perfusion (RCP) is a brain protection technique that is adopted generally for anticipated short periods of deep hypothermic circulatory arrest (DHCA). However, the real impact of this technique on cerebral protection during DHCA remains a controversial issue. For 344 (59.5%) of 578 consecutive patients (mean age, 66.9 ± 10.9 years) who underwent cardiovascular surgery under DHCA at the present authors' institution (1999-2015), RCP was the sole technique of cerebral protection that was adopted in addition to deep hypothermia. Surgery of the thoracic aorta was performed in 95.9% of these RCP patients; in 92 cases there was an aortic arch involvement. Outcomes were reviewed retrospectively. The focus was on postoperative neurological dysfunctions. There were 33 (9.6%) in-hospital deaths. Thirty-one (9%) patients had permanent neurological dysfunctions and 66 (19.1%) transitory neurological dysfunctions alone. Age older than 74 years (odds ratio [OR], 1.88, P = .023), surgery for acute aortic dissection (OR, 2.57; P = .0009), and DHCA time longer than 25 minutes (OR, 2.44; P = .0021) were predictors of neurological dysfunctions. The 10-year nonparametric estimate of freedom from all-cause death was 61.8% (95% confidence interval, 57.8%-65.8%). Permanent postoperative neurological dysfunctions were risk factors for cardiac or cerebrovascular death (hazard ratio, 2.6; P = .039) even after an adjusted survival analysis (P RCP, in addition to deep hypothermia, combines with a low risk of neurological dysfunctions provided that DHCA length is 25 minutes or less. Permanent postoperative neurological dysfunctions are predictors of poor late survival. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  8. Regional cerebral blood flow in schizophrenic patients

    International Nuclear Information System (INIS)

    Sagawa, Katsuo; Sibuya, Isoo; Oiji, Arata; Kawakatsu, Sinobu; Morinobu, Shigeru; Totsuka, Shiro; Kinoshita, Osami; Yazaki, Mitsuyasu.

    1990-01-01

    Seventy-six schizophrenic patients were examined by a Xe-133 inhalation method to determine regional cerebral blood flow. A decreased blood flow was observed in the frontal lobe, especially in the right inferior part. In a study on the relationship between disease subtypes and regional cerebral blood flow, negative symptoms were found more predominantly associated with dissolution type than delusion type. In the group of dissolution type, a decreased blood flow was observed in both the right inferior frontal lobe and the right upper hemisphere, in comparison to the group of delution type. Patients presenting with auditory hallucination had a significantly higher incidence of both negative and positive symptoms, as compared with those not presenting with it. In such patients, a significantly decreased blood flow was also seen in the left upper frontal lobe and the bilateral parietal lobe. Xe-133 inhalation method should assist in evaluating brain function in schizophrenic patients, thus leading to the likelihood of developing a new treatment modality. (N.K.)

  9. Quantitative Analysis of Regional Cerebral Blood Flow using 99mTc-HMPAO SPECT in Parkinson's Disease

    International Nuclear Information System (INIS)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin; Lee, Myung Hae

    1992-01-01

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using 99m Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 ± 0.033 and 0.108 ± 0.062, respectively and PIA were -0.4 ± 0.7% and -0.7 ± 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  10. Quantitative Analysis of Regional Cerebral Blood Flow using {sup 99m}Tc-HMPAO SPECT in Parkinson's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Myung Hae [Asan Medical Center, Seoul (Korea, Republic of)

    1992-07-15

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using {sup 99m}Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 +- 0.033 and 0.108 +- 0.062, respectively and PIA were -0.4 +- 0.7% and -0.7 +- 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  11. Severe cerebral hypovolemia on perfusion CT and lower body weight are associated with parenchymal haemorrhage after thrombolysis

    Energy Technology Data Exchange (ETDEWEB)

    Tsetsou, S.; Eskandari, A.; Michel, P. [Centre Hospitalier Universitaire Vaudois and University of Lausanne CHUV, Department of Neurology, Lausanne (Switzerland); Amiguet, M. [Centre Hospitalier Universitaire Vaudois and University of Lausanne, Institute of Social and Preventive Medicine, Lausanne (Switzerland); Meuli, R.; Maeder, P. [Centre Hospitalier Universitaire Vaudois and University of Lausanne, Department of Radiology, Lausanne (Switzerland); Jiang, B.; Wintermark, M. [Stanford University and Medical Center, Department of Radiology, Neuroradiology Division, Stanford, CA (United States)

    2017-01-15

    Haemorrhagic transformation of acute ischemic stroke (AIS) and particularly parenchymal haemorrhage (PH) remains a feared complication of intravenous thrombolysis (IVT). We aimed to identify clinical and perfusion CT (PCT) variables which are independently associated with PHs. In this observational cohort study, based on the Acute Stroke Registry Analysis of Lausanne (ASTRAL) from 2003 to December 2013, we selected patients with AIS involving the middle cerebral artery (MCA) territory who were thrombolysed within 4.5 h of symptoms' onset and who had a good quality baseline PCT at the beginning of IVT. In addition to demographic, clinical, laboratory and non-contrast CT data, volumes of salvageable tissue and ischemic core on PCT, as well as absolute CBF and CBV values within the ischemic regions were compared in patients with and without PH in multivariate analysis. Of the 190 included patients, 24 (12.6%) presented a PH (11 had PH1 and 13 had PH2). In multivariate analysis of the clinical and radiological variables, the lowest CBV in the core and lower body weight was both significantly associated with PH (p = 0.009 and p = 0.024, respectively). In thrombolysed MCA strokes, maximal hypoperfusion severity depicted by lowest CBV values in the core region and lower body weight are independently correlated with PH. This information, if confirmed in other case series, may add to the stratification of revascularisation decisions in patients with a perceived high PH risk. (orig.)

  12. The effect of dexmedetomidine on cerebral perfusion and oxygenation in healthy piglets with normal and lowered blood pressure anaesthetized with propofol-remifentanil total intravenous anaesthesia

    DEFF Research Database (Denmark)

    Mikkelsen, Mai Louise Grandsgaard; Ambrus, Rikard; Rasmussen, Rune

    2017-01-01

    Background During anaesthesia and surgery, in particular neurosurgery, preservation of cerebral perfusion and oxygenation (CPO) is essential for normal postoperative brain function. The isolated effects on CPO of either individual anaesthetic drugs or entire anaesthetic protocols are of importance...

  13. Regional cerebral blood flow in diabetic patients

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Ono, Shinnichi; Nishikawa, Takushi

    1993-01-01

    N-isopropyl-p- 123 I-iodoamphetamine (IMP) was used to quantify the regional cerebral blood flow (r-CBF) in 11 diabetic patients (average age; 67.9 years) and 12 non-diabetic subjects (average age; 67.4 years), none of whom had (cerebrovascular disease (CVD) on CT studies. A reference sampling method by continuous arterial blood sampling was used to quantify r-CBF. There were no significant differences in physiological or laboratory data between diabetic and non-diabetic groups except for fasting plasma glucose and HbA 1c levels. The average of r-CBF in each region of cerebrum and cerebellum was significantly lower in diabetic group than that in the control group (p<0.01). These observations show that r-CBF of diabetic patients is reduced, even in the absence of findings of CVD on a CT study. (author)

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  15. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    Directory of Open Access Journals (Sweden)

    Gonzalez-Brito Manuel

    2008-02-01

    Full Text Available Abstract Background Assessment of cerebral blood flow (CBF by SPECT could be important in the management of patients with severe traumatic brain injury (TBI because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia, or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. Methods The focal effects of moderate traumatic brain injury (TBI on cerebral blood flow (CBF by SPECT cerebral blood perfusion (CBP imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM. Results A significant area of hypoperfusion (P Conclusion The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.

  16. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping.

    Science.gov (United States)

    McGoron, Anthony J; Capille, Michael; Georgiou, Michael F; Sanchez, Pablo; Solano, Juan; Gonzalez-Brito, Manuel; Kuluz, John W

    2008-02-29

    Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM). A significant area of hypoperfusion (P TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM. The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.

  17. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    International Nuclear Information System (INIS)

    McGoron, Anthony J; Capille, Michael; Georgiou, Michael F; Sanchez, Pablo; Solano, Juan; Gonzalez-Brito, Manuel; Kuluz, John W

    2008-01-01

    Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM). A significant area of hypoperfusion (P < 0.01) was found as a response to the TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM. The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques

  18. Regional cortical hyper perfusion on perfusion CT during postical motor deficit: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Hye Jin [Dept. of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan (Korea, Republic of)

    2013-08-15

    Postictal neurologic deficit is a well-known complication mimicking the manifestation of a stroke. We present a case of a patient with clinical evidence of Todd's paralysis correlating with reversible postictal parenchymal changes on perfusion CT and magnetic resonance (MR) imaging. In this case, perfusion CT and MR imaging were helpful in the differential diagnosis of stroke-mimicking conditions.

  19. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    Energy Technology Data Exchange (ETDEWEB)

    Clanet, M

    1987-06-18

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO/sub 2/), oxygen extraction (EO/sub 2/) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO/sub 2/ and often a decrease in CMRO/sub 2/, whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO/sub 2/, EO/sub 2/ and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis.

  20. Value of cerebral blood flow rate and regional oxygen consumption studies in cerebral ischaemia

    International Nuclear Information System (INIS)

    Clanet, M.

    1987-01-01

    Studies of experimentally-induced ischaemia have shown that the intensity of neuronal suffering is related to the fall in perfusion rate. Below a certain level, called functional threshold, cerebral function is reversibly altered, whereas at a lower level (tissue necrosis threshold) the damage inflicted on neurons is irreversible. Between these two thresholds lies a ''penumbra zone''. This concept of thresholds must be mitigated by 2 parameters: duration of ischaemia and selective vulnerability of the various structures affected. Variations in blood flow rate only indirectly affect the state of tissues. Techniques developed from positron emission tomography make it possible to evaluate the metabolic activity of brain tissue in vivo: oxygen consumption (CMRO 2 ), oxygen extraction (EO 2 ) and glucose consumption (CMRG) which are thus correlated to cerebral blood flow and cerebral blood volume, sometimes also to tissue pH. Normal relations between blood flow rate and metabolism may be altered. Misery perfusion reflects a fall in cerebral blood flow with an increase in EO 2 and often a decrease in CMRO 2 , whereas luxury perfusion reflects an increase in cerebral blood flow rate with reduction of CMRO 2 , EO 2 and CMRG. The type of alteration encountered in human ischaemia varies according to the nature of the accident: studies of transient accidents emphasize the different haemodynamic aspects of occlusion of the wider arteries. The metabolic and haemodynamic profiles of established ischaemic accidents vary according to their type and to the time of the study, reflecting the complexity of the physiopathological mechanisms involved; they are frequently associated with metabolic repercussions at a distance from the ischaemic focus, which supports the concept of diaschisis [fr

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

    DEFF Research Database (Denmark)

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

    2000-01-01

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

  2. Cerebral Perfusion Measurements in Elderly with Hypertension Using Arterial Spin Labeling

    DEFF Research Database (Denmark)

    Mutsaerts, H J M M; van Dalen, J W; Heijtel, D F R

    2015-01-01

    (CV) and physiological correlations with age and gender were compared between the three perfusion parameters. RESULTS: There was no difference in CV between CBFcrushed and CBFnon-crushed (15-24%, p>0.4) but the CV of ATT (4-9%) was much smaller. The total gray matter correlations with age and gender...... for group analyses in elderly with hypertension. The obtained flow territories provide knowledge on vascular anatomy of elderly with hypertension and can be used in future studies to investigate regional vascular effects....

  3. Intraoperative intracranial pressure and cerebral perfusion pressure for predicting surgical outcome in severe traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Tai-Hsin Tsai

    2013-10-01

    Full Text Available Intraoperative intracranial pressure (ICP and cerebral perfusion pressure (CPP were evaluated for use as prognostic indicators after surgery for severe traumatic brain injury (TBI, and threshold ICP and CPP values were determined to provide guidelines for patient management. This retrospective study reviewed data for 66 patients (20 females and 46 males aged 13–83 years (average age, 48 years who had received decompressive craniectomy and hematoma evacuation for severe TBI. The analysis of clinical characteristics included Glascow Coma Scale score, trauma mechanism, trauma severity, cerebral hemorrhage type, hematoma thickness observed on computed tomography scan, Glasgow Outcome Scale score, and mortality. Patients whose treatment included ICP monitoring had significantly better prognosis (p < 0.001 and significantly lower mortality (p = 0.016 compared to those who did not receive ICP monitoring. At all three major steps of the procedure, i.e., creation of the burr hole, evacuation of the hematoma, and closing of the wound, intraoperative ICP and CPP values significantly differed. The ICP and CPP values were also significantly associated with surgical outcome in the severe TBI patients. Between hematoma evacuation and wound closure, ICP and CPP values differed by 6.8 ± 4.5 and 6.5 ± 4.6 mmHg, respectively (mean difference, 6 mmHg. Intraoperative thresholds were 14 mmHg for ICP and 56mmH for CPP. Monitoring ICP and CPP during surgery improves management of severe TBI patients and provides an early prognostic indicator. During surgery for severe TBI, early detection of increased ICP is also crucial for enabling sufficiently early treatment to improve surgical outcome. However, further study is needed to determine the optimal intraoperative ICP and CPP thresholds before their use as subjective guidelines for managing severe TBI patients.

  4. Gender differences in regional cerebral blood flow

    International Nuclear Information System (INIS)

    Gur, R.E.; Gur, R.C.

    1990-01-01

    Gender differences have been noted in neurobehavioral studies. The 133xenon inhalation method for measuring regional cerebral blood flow (rCBF) can contribute to the understanding of the neural basis of gender differences in brain function. Few studies have examined gender differences in rCBF. In studies of normal subjects, women have higher rates of CBF than men, and this is related to age. Usually by the sixth decade men and women have similar flow rates. Fewer studies on rCBF in schizophrenia have examined sex differences. The pattern of higher flows for females maintains, but its correlates with gender differences in clinical as well as other parameters of brain function remain to be examined

  5. Perfusion Pressure Cerebral Infarct (PPCI) trial - the importance of mean arterial pressure during cardiopulmonary bypass to prevent cerebral complications after cardiac surgery

    DEFF Research Database (Denmark)

    Vedel, Anne G.; Holmgaard, Frederik; Rasmussen, Lars Simon

    2016-01-01

    Background: Debilitating brain injury occurs in 1.6–5 % of patients undergoing cardiac surgery with cardiopulmonary bypass. Diffusion-weighted magnetic resonance imaging studies have reported stroke-like lesions in up to 51 % of patients after cardiac surgery. The majority of the lesions seem...... to be caused by emboli, but inadequate blood flow caused by other mechanisms may increase ischaemia in the penumbra or cause watershed infarcts. During cardiopulmonary bypass, blood pressure can be below the lower limit of cerebral autoregulation. Although much debated, the constant blood flow provided...... by the cardiopulmonary bypass system is still considered by many as appropriate to avoid cerebral ischaemia despite the low blood pressure. Methods/design: The Perfusion Pressure Cerebral Infarct trial is a single-centre superiority trial with a blinded outcome assessment. The trial is randomising 210 patients...

  6. Regional cerebral blood flow in schizophrenia

    International Nuclear Information System (INIS)

    Kanoh, Masayuki

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured at rest using the 133 Xe inhalation technique in 40 DSM-III-diagnosed schizophrenics (22 males, 18 females: mean age 35.0 years, range 20-49 years) and 31 age-and sex-matched normal controls (16 males, 15 females: mean age 34.3 years, range 21-49 years). The absolute value (AV) and the percent value (PV) of the rCBF in schizophrenics were compared with those in controls. Correlations between rCBF and the Brief Psychiatric Rating Scale (BPRS) scores or the performance of Wisconsin Card Sorting Test (WCST) were examined in schizophrenics. Schizophrenics showed significantly lower AVs in all brain regions examined and a significantly lower PV in the left superior frontal region than controls. The hyperfrontal rCBF distribution which was found in both hemispheres in controls, was absent in the left hemisphere in schizophrenics. In schizophrenics, superior frontal blood flows were significantly negatively correlated with the negative symptom scores of the BPRS but not with the total scores and the positive symptom scores of the BPRS. In schizophrenics, inferior frontal blood flows were significantly correlated with the number of sorting categories achieved. These results indicate that rCBF in schizophrenia is reduced in the whole brain and especially in the left superior frontal region. These findings suggest a frontal lobe dysfunction in schizophrenia. (author)

  7. Regional MRI Perfusion Measures Predict Motor/Executive Function in Patients with Clinically Isolated Syndrome

    Directory of Open Access Journals (Sweden)

    Efrosini Z. Papadaki

    2014-01-01

    Full Text Available Background. Patients with clinically isolated syndrome (CIS demonstrate brain hemodynamic changes and also suffer from difficulties in processing speed, memory, and executive functions. Objective. To explore whether brain hemodynamic disturbances in CIS patients correlate with executive functions. Methods. Thirty CIS patients and forty-three healthy subjects, matched for age, gender, education level, and FSIQ, were administered tests of visuomotor learning and set shifting ability. Cerebral blood volume (CBV, cerebral blood flow (CBF, and mean transit time (MTT values were estimated in normal-appearing white matter (NAWM and normal-appearing deep gray Matter (NADGM structures, using a perfusion MRI technique. Results. CIS patients showed significantly elevated reaction time (RT on both tasks, while their CBV and MTT values were globally increased, probably due to inflammatory vasodilation. Significantly, positive correlation coefficients were found between error rates on the inhibition condition of the visuomotor learning task and CBV values in occipital, periventricular NAWM and both thalami. On the set shifting condition of the respective task significant, positive associations were found between error rates and CBV values in the semioval center and periventricular NAWM bilaterally. Conclusion. Impaired executive function in CIS patients correlated positively with elevated regional CBV values thought to reflect inflammatory processes.

  8. Assessing regional cerebral blood flow in depression using 320-slice computed tomography.

    Directory of Open Access Journals (Sweden)

    Yiming Wang

    Full Text Available While there is evidence that the development and course of major depressive disorder (MDD symptomatology is associated with vascular disease, and that there are changes in energy utilization in the disorder, the extent to which cerebral blood flow is changed in this condition is not clear. This study utilized a novel imaging technique previously used in coronary and stroke patients, 320-slice Computed-Tomography (CT, to assess regional cerebral blood flow (rCBF in those with MDD and examine the pattern of regional cerebral perfusion. Thirty nine participants with depressive symptoms (Hamilton Depression Rating Scale 24 (HAMD24 score > 20, and Self-Rating Depression Scale (SDS score > 53 and 41 healthy volunteers were studied. For all subjects, 3 ml of venous blood was collected to assess hematological parameters. Transcranial Doppler (TCD ultrasound was utilized to measure parameters of cerebral artery rCBFV and analyse the Pulsatility Index (PI. 16 subjects (8 =  MDD; 8 =  healthy also had rCBF measured in different cerebral artery regions using 320-slice CT. Differences among groups were analyzed using ANOVA and Pearson's tests were employed in our statistical analyses. Compared with the control group, whole blood viscosity (including high\\middle\\low shear rateand hematocrit (HCT were significantly increased in the MDD group. PI values in different cerebral artery regions and parameters of rCBFV in the cerebral arteries were decreased in depressive participants, and there was a positive relationship between rCBFV and the corresponding vascular rCBF in both gray and white matter. rCBF of the left gray matter was lower than that of the right in MDD. Major depression is characterized by a wide range of CBF impairments and prominent changes in gray matter blood flow. 320-slice CT appears to be a valid and promising tool for measuring rCBF, and could thus be employed in psychiatric settings for biomarker and treatment response purposes.

  9. Spatio-temporal cerebral blood flow perfusion patterns in cortical spreading depression

    Science.gov (United States)

    Verisokin, Andrey Yu.; Verveyko, Darya V.; Postnov, Dmitry E.

    2017-04-01

    Cortical spreading depression (CSD) is an example of one of the most common abnormalities in biophysical brain functioning. Despite the fact that there are many mathematical models describing the cortical spreading depression (CSD), most of them do not take into consideration the role of redistribution of cerebral blood flow (CBF), that results in the formation of spatio-temporal patterns. The paper presents a mathematical model, which successfully explains the CBD role in the CSD process. Numerical study of this model has revealed the formation of stationary dissipative structures, visually analogous to Turing structures. However, the mechanism of their formation is not diffusion. We show these structures occur due to another type of spatial coupling, that is related to tissue perfusion rate. The proposed model predicts that at similar state of neurons the distribution of blood flow and oxygenation may by different. Currently, this effect is not taken into account when the Blood oxygen-level dependent (BOLD) contrast imaging used in functional magnetic resonance imaging (fMRI). Thus, the diagnosis on the BOLD signal can be ambiguous. We believe that our results can be used in the future for a more correct interpretation of the data obtained with fMRI, NIRS and other similar methods for research of the brain activity.

  10. Is correction necessary when clinically determining quantitative cerebral perfusion parameters from multi-slice dynamic susceptibility contrast MR studies?

    International Nuclear Information System (INIS)

    Salluzzi, M; Frayne, R; Smith, M R

    2006-01-01

    Several groups have modified the standard singular value decomposition (SVD) algorithm to produce delay-insensitive cerebral blood flow (CBF) estimates from dynamic susceptibility contrast (DSC) perfusion studies. However, new dependences of CBF estimates on bolus arrival times and slice position in multi-slice studies have been recently recognized. These conflicting findings can be reconciled by accounting for several experimental and algorithmic factors. Using simulation and clinical studies, the non-simultaneous measurement of arterial and tissue concentration curves (relative slice position) in a multi-slice study is shown to affect time-related perfusion parameters, e.g. arterial-tissue-delay measurements. However, the current clinical impact of relative slice position on amplitude-related perfusion parameters, e.g. CBF, can be expected to be small unless any of the following conditions are present individually or in combination: (a) high concentration curve signal-to-noise ratios, (b) small tissue mean transit times, (c) narrow arterial input functions or (d) low temporal resolution of the DSC image sequence. Recent improvements in magnetic resonance (MR) technology can easily be expected to lead to scenarios where these effects become increasingly important sources of inaccuracy for all perfusion parameter estimates. We show that using Fourier interpolated (high temporal resolution) residue functions reduces the systematic error of the perfusion parameters obtained from multi-slice studies

  11. Dynamic assessment of acute blunt cerebral contusions and lacerations with CT perfusion: an experimental study

    International Nuclear Information System (INIS)

    Yuan Tao; Quan Guanmin; Liu Huaijun; Gao Guodong; Lei Jianming

    2009-01-01

    Objective: To explore the dynamic changes of blood perfusion in traumatic cerebral contusion and laceration of experimental model. Methods: Impact-acceleration head traumatic cerebral contusion and laceration models of 40 rabbits were established. CTP was made for all animals at 1, 3, 6, 12, 24, 48 and 72 h after head injury. The original images were transferred to workstation for postprocessing. Cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) of central area, peripheral area of contusion and laceration, and their mirror areas were measured on the section in which lesions were in their maximal area. The CTP parameters among different areas were compared with paired samples t test. The evolvement of CBF, CBV and MTT of cerebral contusion and laceration areas were recorded as well. Then, the histological abnormalities of central and peripheral areas were observed separately by referring to corresponding CTP maps. Results: Experimental models were successfully made in 35 rabbits. Abnormal signal intensity was detected on their T 2 WI and DWI images, which was consistent with brain contusion. For CTP parameters: (1) The CBF of central area of the lesions decreased markedly after trauma and reached its nadir at 12 h. Then the CBF of central area rose slowly from 24 h. The value of CBF of the central area at 1, 3, 6, 12, 24 and 72 h were (27.58±18.70), (20.64±6.50), (23.38± 7.53), (22.14±10.25), (25.08±11.01), (43.08±18.33) and (54.79± 14.63) ml·min -1 ·100 g -1 respectively. Whereas the CBF value of the corresponding mirror areas were (62.28±25.46), (60.67±16.19), (67.00±21.34), (74.46±20.11), (66.73±11.68), (81.63± 10.99) and 86.16±10.57) ml·min -1 ·100 g -1 respectively. There was significant difference of CBF between the central and the mirror areas (t=4.41, 5.57, 5.47, 6.02, 6.44, 4.81, 10.60 respectively, P 0.05). (2) The CBV of central area of the lesions also decreased obviously after trauma and reached its

  12. Regional cerebral blood flow changes in chronic polidrug abusers

    International Nuclear Information System (INIS)

    Quintana, J.C.; Olea, E.; Seijas, D.; Haydn, V.

    2002-01-01

    Chronic exposure to cocaine and other drugs are in clear association with a variety of medical complications, involving many organ systems. The Central Nervous System (CNS) is particularly sensitive to such exposures: permanent behavioral, psychiatric and neurological complications are common in this group of patients. Regional cerebral blood perfusion (rCBF) analysis has been used to study these conditions with PET and SPECT for a long time. According to the literature, it is clear that drug exposure (particularly cocaine) does produce significant changes over rCBF, nevertheless the vast majority of SPECT and some PET studies are difficult to reproduce because they were analyzed using subjective (visual) and/or ROI's to address the changes. Aim: To study the pattern of rCBF change of chronic cocaine and other drugs (polidrug) users/abusers population using brain SPECT and SPM (Statistical Parametric Mapping). Material and Methods: From a population of 163 addicted patients, 55 chronic cocaine and other drugs users/abuser were selected. A pre-treatment brain SPECT under basal conditions was performed in all of them. 99mTc-ECD was used as rCBF tracer and SPM (Statistical Parametric Mapping) as a framework to address statistically significant rCBF variations of change. The whole group was compared with a population of normal patients (both sexes, aged between 20 and 40 y.o., no history of trauma, drug exposure, neurological or psychiatric disorders). Results: Significant areas of reduced (hypoperfusion) and increased (hyperperfusion) rCBF were identified in the patients group. The hypoperfusion areas involve mainly the left insula region and the surrounding frontal and temporal lobe and a smaller area in the anterior and inferior portion of the right frontal lobe. The increased perfusion areas were identified at the left thalamus and the right fronto-parietal cortical region. Conclusion: Our results suggest that chronic cocaine exposure produce activation/damage to

  13. Cerebral perfusion scintigraphy and the exploration of dementia syndromes: An illustration with five clinical cases

    International Nuclear Information System (INIS)

    Farid, K.; Perdrisot, R.; Habert, M.O.

    2007-01-01

    The epidemiological evidence suggests that individuals with higher education level have a reduced risk of developing dementia. Because cognitive reserve and its compensation mechanisms may modulate the clinical expression in neuro-degenerative pathology, it is important to study subjects who present mild cognitive disturbance with functional imaging. The cerebral SPECT has been used to determine regional uptake of radiotracer into the brain of patients with cognitive impairment. These abnormalities of blood flow were correlated with cognitive impairment. The cerebral SPECT is also useful to investigate preclinical dementia and to predict the evolution of cognitive disturbance. This article, reports some technical and semeiological notions and illustrate with five clinical cases the scintigraphic aspect of some dementia syndrome. (authors)

  14. Epileptic patterns of local cerebral metabolism and perfusion in man determined by emission computed tomography of 18FDG and 13NH3

    International Nuclear Information System (INIS)

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

    1979-01-01

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

  15. 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.

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

    International Nuclear Information System (INIS)

    Lombard, Yves.

    1976-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-07-07

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

  18. New possibilities for quantitative measurements of regional cerebral blood flow with Au-195 m

    International Nuclear Information System (INIS)

    Lindner, P.; Nickel, O.

    1984-01-01

    A previously reported theory for quantitative cerebral blood flow measurement for nondiffusible radiotracers has been applied on patients after stroke and an volunteers undergoing a mental stimulation exercise. Quantitative measurements of cerebral blood flow patterns not only in p-a. but also in lateral views of the brain are possible by the use of the recently developed generator for the short lived (30 sec) isotope Au-195 m. The energy spectrum of the eluate of the generator shows two strong photon peaks, one at an energy level of 68 KeV and a second at an energy-level of 262 KeV. The low energy peak is suitable for perfusion studies in lateral views of the hemispheres, no ''look through'' effect is seen. The high energy level is good for studies in p-a-positions. The studies last less than 1 minute and can be repeated after 3 minutes. Parametric images for quantitative regional cerebral blood flow can be generated. The area of occluded vessels in the case of stroke can be detected. Quantitative activation patterns of cerebral blood flow during mental stimulation can be generated. The results prove that not only with freely diffusible indicators like Xenon but also with nondiffusible indicators it is possible to measure quantitatively cerebral blood flow patterns. (orig.)

  19. Study of regional cerebral blood flow in obsessive compulsive disorder patients with SPM and ROI method

    International Nuclear Information System (INIS)

    Li Peiyong; Jiang Xufeng; Zhang Liying; Guo Wanhua; Zhu Chengmo

    2002-01-01

    Objective: To investigate the alternations in regional cerebral blood flow (rCBF) in obsessive compulsive disorder (OCD) patients using statistical parametric mapping (SPM). Methods: rCBF measurements using 99 Tc m -ethyl cysteinate dimer (ECD) SPECT was performed on 14 OCD patients and 23 age-matched healthy volunteers. The rCBF distribution was compared between these two groups with SPM under the conditions of increased and decreased perfusion, and with regions of interest (ROIs) using cerebral template. P value was set at 0.01 level. Results: SPM analysis showed that rCBF decreased in cerebral areas including bilateral putamen, superior temporal gyrus and precuneus, and right orbital gyrus, superior and middle frontal gyrus, and left temporo-occipital lobule and superior parietal gyrus, and vermis. rCBF was also increased in left inferior frontal gyrus and posterior cingulate gyrus. With ROIs method, rCBF was decreased in right anterior frontal, temporo-parietal lobule and left temporo-occipital lobule. Conclusions: The study supports the viewpoint that rCBF abnormality of fronto-striatal circuits is involved in OCD patients. SPM method is a forceful tool in analyzing cerebral regional characters

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-10-15

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

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

    International Nuclear Information System (INIS)

    Verfaillie, Sander C.J.; Adriaanse, Sofie M.; Binnewijzend, Maja A.A.; Benedictus, Marije R.; Ossenkoppele, Rik; Wattjes, Mike P.; Lammertsma, Adriaan A.; Boellaard, Ronald; Berckel, Bart N.M. van; Barkhof, Frederik; Pijnenburg, Yolande A.L.; Scheltens, Philip; Flier, Wiesje M. van der; Kuijer, Joost P.A.

    2015-01-01

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

  2. Regional cerebral blood flow in neuropediatrics

    International Nuclear Information System (INIS)

    Junik, R.

    2001-01-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  3. Regional cerebral blood flow in fibromyalgia

    International Nuclear Information System (INIS)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K.

    1998-01-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  4. Regional cerebral blood flow in fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K. [The Queen Elizabeth Hospital , Adelaide, SA (Australia)

    1998-06-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  5. Dynamic exercise enhances regional cerebral artery mean flow velocity

    DEFF Research Database (Denmark)

    Linkis, P; Jørgensen, L G; Olesen, H L

    1995-01-01

    Dynamic exercise enhances regional cerebral artery mean flow velocity. J. Appl. Physiol. 78(1): 12-16, 1995.--Anterior (ACA) and middle (MCA) cerebral artery mean flow velocities (Vmean) and pulsatility indexes were determined using transcranial Doppler in 14 subjects during dynamic exercise afte...

  6. Aortic arch reconstruction: deep and moderate hypothermic circulatory arrest with selective antegrade cerebral perfusion.

    Science.gov (United States)

    Wu, YanWen; Xiao, LiQiong; Yang, Ting; Wang, Lei; Chen, Xin

    2017-07-01

    To compare the effects of moderate and deep hypothermic circulatory arrest (DHCA) with selective antegrade cerebral perfusion (SACP) during aortic arch surgery in adult patients and to offer the evidence for the detection of the temperature which provides best brain protection in the subjects who accept aortic arch reconstruction surgery. A total of 109 patients undergoing surgery of the aortic arch were divided into the moderate hypothermic circulatory arrest group (Group I) and the deep hypothermic circulatory arrest group (Group II). We recorded the data of the patients and their cardiopulmonary bypass (CPB) time, aortic clamping time, SACP time and postoperative anesthetized recovery time, tracheal intubation time, time in the intensive care unit (ICU) and postoperative neurologic dysfunction. Patient characteristics were similar in the two groups. There were four patients who died in Group II and 1 patient in Group I. There were no significant differences in aortic clamping time of each group (111.4±58.4 vs. 115.9±16.2) min; SACP time (27.4±5.9 vs. 23.5±6.1) min of the moderate hypothermic circulatory arrest group and the deep hypothermic circulatory arrest group; there were significant differences in cardiopulmonary bypass time (207.4±20.9 vs. 263.8±22.6) min, postoperative anesthetized recovery time (19.0±11.1 vs. 36.8±25.3) hours, extubation time (46.4±15.1 vs. 64.4±6.0) hours; length of stay in the intensive care unit (ICU) (4.7±1.7 vs. 8±2.3) days and postoperative neurologic dysfunction in the two groups. Compared to deep hypothermic circulatory arrest, moderate hypothermic circulatory arrest can provide better brain protection and achieve good clinical results.

  7. Cerebral perfusion pressure, microdialysis biochemistry and clinical outcome in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Paraforou Theoniki

    2011-12-01

    Full Text Available Abstract Background Traumatic Brain Injury (TBI is a major cause of death and disability. It has been postulated that brain metabolic status, intracranial pressure (ICP and cerebral perfusion pressure (CPP are related to patients' outcome. The aim of this study was to investigate the relationship between CPP, ICP and microdialysis parameters and clinical outcome in TBIs. Results Thirty four individuals with severe brain injury hospitalized in an intensive care unit participated in this study. Microdialysis data were collected, along with ICP and CPP values. Glasgow Outcome Scale (GOS was used to evaluate patient outcome at 6 months after injury. Fifteen patients with a CPP greater than 75 mmHg, L/P ratio lower than 37 and Glycerol concentration lower than 72 mmol/l had an excellent outcome (GOS 4 or 5, as opposed to the remaining 19 patients. No patient with a favorable outcome had a CPP lower than 75 mmHg or Glycerol concentration and L/P ratio greater than 72 mmol/l and 37 respectively. Data regarding L/P ratio and Glycerol concentration were statistically significant at p = 0.05 when patients with favorable and unfavorable outcome were compared. In a logistic regression model adjusted for age, sex and Glasgow Coma Scale on admission, a CPP greater than 75 mmHg was marginally statistically significantly related to outcome at 6 months after injury. Conclusions Patients with favorable outcome had certain common features in terms of microdialysis parameters and CPP values. An individualized approach regarding CPP levels and cut -off points for Glycerol concentration and L/P ratio are proposed.

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

    International Nuclear Information System (INIS)

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

    1981-01-01

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

  9. Regional cerebral blood flow in childhood headache

    International Nuclear Information System (INIS)

    Roach, E.S.; Stump, D.A.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured in 16 cranial regions in 23 children and adolescents with frequent headaches using the non-invasive Xenon-133 inhalation technique. Blood flow response to 5% carbon dioxide (CO2) was also determined in 21 patients, while response to 50% oxygen was measured in the two patients with hemoglobinopathy. Included were 10 patients with a clinical diagnosis of migraine, 4 with musculoskeletal headaches, and 3 with features of both types. Also studied were 2 patients with primary thrombocythemia, 2 patients with hemoglobinopathy and headaches, 1 patient with polycythemia, and 1 with headaches following trauma. With two exceptions, rCBF determinations were done during an asymptomatic period. Baseline rCBF values tended to be higher in these young patients than in young adults done in our laboratory. Localized reduction in the expected blood flow surge after CO2 inhalation, most often noted posteriorly, was seen in 8 of the 13 vascular headaches, but in none of the musculoskeletal headache group. Both patients with primary thrombocythemia had normal baseline flow values and altered responsiveness to CO2 similar to that seen in migraineurs; thus, the frequently reported headache and transient neurologic signs with primary thrombocythemia are probably not due to microvascular obstruction as previously suggested. These data support the concept of pediatric migraine as a disorder of vasomotor function and also add to our knowledge of normal rCBF values in younger patients. Demonstration of altered vasomotor reactivity to CO2 could prove helpful in children whose headache is atypical

  10. Quantitative cerebral H215O perfusion PET without arterial blood sampling, a method based on washout rate

    International Nuclear Information System (INIS)

    Treyer, Valerie; Jobin, Mathieu; Burger, Cyrill; Buck, Alfred; Teneggi, Vincenzo

    2003-01-01

    The quantitative determination of regional cerebral blood flow (rCBF) is important in certain clinical and research applications. The disadvantage of most quantitative methods using H 2 15 O positron emission tomography (PET) is the need for arterial blood sampling. In this study a new non-invasive method for rCBF quantification was evaluated. The method is based on the washout rate of H 2 15 O following intravenous injection. All results were obtained with Alpert's method, which yields maps of the washin parameter K 1 (rCBF K1 ) and the washout parameter k 2 (rCBF k2 ). Maps of rCBF K1 were computed with measured arterial input curves. Maps of rCBF k2* were calculated with a standard input curve which was the mean of eight individual input curves. The mean of grey matter rCBF k2* (CBF k2* ) was then compared with the mean of rCBF K1 (CBF K1 ) in ten healthy volunteer smokers who underwent two PET sessions on day 1 and day 3. Each session consisted of three serial H 2 15 O scans. Reproducibility was analysed using the rCBF difference scan 3-scan 2 in each session. The perfusion reserve (PR = rCBF acetazolamide -rCBF baseline ) following acetazolamide challenge was calculated with rCBF k2* (PR k2* ) and rCBF K1 (PR K1 ) in ten patients with cerebrovascular disease. The difference CBF k2* -CBF K1 was 5.90±8.12 ml/min/100 ml (mean±SD, n=55). The SD of the scan 3-scan 1 difference was 6.1% for rCBF k2* and rCBF K1 , demonstrating a high reproducibility. Perfusion reserve values determined with rCBF K1 and rCBF k2* were in high agreement (difference PR k2* -PR K1 =-6.5±10.4%, PR expressed in percentage increase from baseline). In conclusion, a new non-invasive method for the quantitative determination of rCBF is presented. The method is in good agreement with Alpert's original method and the reproducibility is high. It does not require arterial blood sampling, yields quantitative voxel-by-voxel maps of rCBF, and is computationally efficient and easy to implement

  11. Cerebral Hypoperfusion in Posterior Reversible Encephalopathy Syndrome is Different from Transient Ischemic Attack on CT Perfusion.

    Science.gov (United States)

    Vanacker, Peter; Matias, Gonçalo; Hagmann, Patric; Michel, Patrik

    2015-01-01

    PRES is a reversible neurotoxic state presenting with headache, altered mental status, visual loss, and seizures. Delayed diagnosis can be avoided if radiological patterns could distinguish PRES from cerebral ischemia. Clinical and radiological data were collected on all hospitalized patients who had (1) discharge diagnosis of PRES and (2) acute CTP/CTA. Data were compared with 10 TIA patients with proven cytotoxic edema on MRI. Of the four PRES patients found, three were correlated with acute blood pressure and one with chemotherapy. At the radiological level, quantitative analyses of the CTP parameters showed that 2 out of 4 patients had bilaterally reduced CBF-values (23.2-47.1 ml/100g/min) in occipital regions, as seen in the pathological regions of TIA patients (27.3 ± 13.5 ml/100g/min). When compared with TIA patients, the pathological ROI's demonstrated decreased CBV-values (3.4-5.6 ml/100g). Vasogenic edema on MRI FLAIR imaging was seen in only one PRES patient, and cytotoxic edema on DWI-imaging was never found. CT angiography showed in one PRES patient a vasospasm-like unilateral posterior cerebral artery. If confirmed by other groups, CTP and CTA imaging in patients with acute visual loss and confusion may help to distinguish PRES from bi-occipital ischemia. These radiological parameters may identify PRES patients at risk for additional tissue infarction. Copyright © 2014 by the American Society of Neuroimaging.

  12. Quantitative determination of the regional cerebral blood flow with 133Xe

    International Nuclear Information System (INIS)

    Otto, H.J.; Abraham, K.; Freitag, J.; Koch, R.D.; Freitag, G.; Hoefs, R.

    1982-01-01

    After injection of 133 Xe into the A. carotis interna, the regional blood flow in the brain was determined with a 10-channel measuring unit. From the first clinical evaluation of the findings in 35 patients, the following conclusions can be drawn: 1. In epileptics, a localized hyperemia indicates very probably a latent increased convulsive activity. 2. The measurement of the cerebral blood flow does not yield a contribution to the diagnosis of the type of cerebral tumors. 3. As consequence of mass shifting of space occupying processes particularly endangered brain sections, also remote from the focus proper, show a localized pathological hyeperemia (morbid 'luxus perfusion'). 4. Of greatest importance is the method with regard to the elucidation of pathophysiological relations, as well as of questions in connection with the blood/brain barrier function, and concerning the indication for and the estimation of the results of vascular interventions. (author)

  13. Analysis of Regional Cerebral Blood Flow Using {sup 99m}Tc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-03-15

    {sup 99m}Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, {sup 99m}Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  14. Development and application of an automated analysis method for individual cerebral perfusion single photon emission tomography images

    International Nuclear Information System (INIS)

    Cluckie, Alice Jane

    2001-01-01

    Neurological images may be analysed by performing voxel by voxel comparisons with a group of control subject images. An automated, 3D, voxel-based method has been developed for the analysis of individual single photon emission tomography (SPET) scans. Clusters of voxels are identified that represent regions of abnormal radiopharmaceutical uptake. Morphological operators are applied to reduce noise in the clusters, then quantitative estimates of the size and degree of the radiopharmaceutical uptake abnormalities are derived. Statistical inference has been performed using a Monte Carlo method that has not previously been applied to SPET scans, or for the analysis of individual images. This has been validated for group comparisons of SPET scans and for the analysis of an individual image using comparison with a group. Accurate statistical inference was obtained independent of experimental factors such as degrees of freedom, image smoothing and voxel significance level threshold. The analysis method has been evaluated for application to cerebral perfusion SPET imaging in ischaemic stroke. It has been shown that useful quantitative estimates, high sensitivity and high specificity may be obtained. Sensitivity and the accuracy of signal quantification were found to be dependent on the operator defined analysis parameters. Recommendations for the values of these parameters have been made. The analysis method developed has been compared with an established method and shown to result in higher specificity for the data and analysis parameter sets tested. In addition, application to a group of ischaemic stroke patient SPET scans has demonstrated its clinical utility. The influence of imaging conditions has been assessed using phantom data acquired with different gamma camera SPET acquisition parameters. A lower limit of five million counts and standardisation of all acquisition parameters has been recommended for the analysis of individual SPET scans. (author)

  15. Regional cerebral blood flow changes in patients with internet addiction.

    Science.gov (United States)

    Otte, Andreas

    2016-01-01

    Dear Editor, Internet addiction (IA) has become a severe challenge of our modern world today, though little is known about its pathology. In this context, the interesting study by Liu et al. in the May-August 2016 issue of HJNM using 99m Tc-labelled ethylene biyldicysteinate dimer single photon emission tomography (SPET) at rest and after pharmaceutical (adenosine) stress is more than welcomed. As this seems to be the first perfusion SPET study in this indication, the obtained data may be discussed carefully. There are mainly the following questions: a) Regional cerebral blood flow (rCBF): There is no description on how the rCBF was calculated: Was it scaled relatively to the whole brain mean value or to the cerebellar mean value? b) P value threshold and clusters: There is no indication of whether the authors are performing any kind of correction for multiple comparisons in the statistical parametric mapping (SPM) t-test. This, combined with the use of a really "liberal" voxel P value of only 0.01 could be subject to providing many false positive results. Generally a P value threshold of 0.001 should be used. In addition, there is no information related to the clusters. For the question of the validity of parametric statistical methods used for the analysis of functional neuroimaging data, we would like to mention the important recent paper by Eklund et al. 2016. c) Data analysis: The authors state (p. 97): "As some abnormal rCBF in adenosine-stressed state might relate with normal responses to adenosine compared to resting state, we excluded those regions that showed abnormal rCBF in stressed state in healthy controls (Table 4) from those in IA group (Table 5). The rest abnormal regions were compared between the IA group and the control group". For this, with SPM a flexible factorial design with all the data rather than only t-tests would have been interesting to find out whether the difference between the groups at stress is the same difference observed between

  16. Dynamic emission tomography of regional cerebral blood flow

    International Nuclear Information System (INIS)

    Lassen, N.A.

    1984-01-01

    The author reviews three tomographic methods for measuring the regional cerebral blood flow: single photon transmission tomography; dual photon emission tomography; and single photon emission tomography. The latter technique is discussed in detail. (Auth.)

  17. Regional cerebral blood flow changes associated with focal electrically administered seizure therapy (FEAST).

    Science.gov (United States)

    Chahine, George; Short, Baron; Spicer, Ken; Schmidt, Matthew; Burns, Carol; Atoui, Mia; George, Mark S; Sackeim, Harold A; Nahas, Ziad

    2014-01-01

    Use of electroconvulsive therapy (ECT) is limited by cognitive disturbance. Focal electrically-administered seizure therapy (FEAST) is designed to initiate focal seizures in the prefrontal cortex. To date, no studies have documented the effects of FEAST on regional cerebral blood flow (rCBF). A 72 year old depressed man underwent three single photon emission computed tomography (SPECT) scans to capture the onset and resolution of seizures triggered with right unilateral FEAST. We used Bioimage Suite for within-subject statistical analyses of perfusion differences ictally and post-ictally compared with the baseline scan. Early ictal increases in regional cerebral blood flow (rCBF) were limited to the right prefrontal cortex. Post-ictally, perfusion was reduced in bilateral frontal and occipital cortices and increased in left motor and precuneus cortex. FEAST appears to triggers focal onsets of seizure activity in the right prefrontal cortex with subsequent generalization. Future studies are needed on a larger sample. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Dynamic alteration of regional cerebral blood flow during carotid compression and proof of reversibility

    International Nuclear Information System (INIS)

    Asahi, Kouichi; Hori, M; Hamasaki, N; Sato, S; Nakanishi, H; Kuwatsuru, R; Sasai, K; Aoki, S

    2012-01-01

    It is difficult to non-invasively visualize changes in regional cerebral blood flow caused by manual compression of the carotid artery. To visualize dynamic changes in regional cerebral blood flow during and after manual compression of the carotid artery. Two healthy volunteers were recruited. Anatomic features and flow directions in the circle of Willis were evaluated with time-of-flight magnetic resonance angiography (MRA) and two-dimensional phase-contrast (2DPC) MRA, respectively. Regional cerebral blood flow was visualized with territorial arterial spin-labeling magnetic resonance imaging (TASL-MRI). TASL-MRI and 2DPC-MRA were performed in three states: at rest, during manual compression of the right carotid artery, and after decompression. In one volunteer, time-space labeling inversion pulse (Time-SLIP) MRA was performed to confirm collateral flow. During manual carotid compression, in one volunteer, the right thalamus changed to be fed only by the vertebrobasilar system, and the right basal ganglia changed to be fed by the left internal carotid artery. In the other volunteer, the right basal ganglia changed to be fed by the vertebrobasilar system. 2DPC-MRA showed that the flow direction changed in the right A1 segment of the anterior cerebral artery and the right posterior communicating artery. Perfusion patterns and flow directions recovered after decompression. Time-SLIP MRA showed pial vessels and dural collateral circulation when the right carotid artery was manually compressed. Use of TASL-MRI and 2DPC-MRA was successful for non-invasive visualization of the dynamic changes in regional cerebral blood flow during and after manual carotid compression

  19. The evaluation of cerebral hemodynamics in patients with intracranial tumors by stable xenon CT; The effect of glycerol administration on regional cerebral blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Shimoda, Masami; Kawamata, Fumio; Yamamoto, Masahiro; Ohsuga, Hitoshi; Hidaka, Mitsuru; Oda, Shinri; Shibuya, Naoki; Yamamoto, Isao; Sato, Osamu (Tokai Univ., Isehara, Kanagawa (Japan). School of Medicine)

    1989-04-01

    In evaluating cerebral regional blood flow (rCBF), stable xenon-enhanced tomography (XeCT) study associated with simultaneous blood sampling was applied in 15 cases of intracranial neoplasms. The effect of intravenous glycerol infusion on rCBF was also investigated. The results indicated that intratumoral rCBF values were not only variable and unrelated to their histological types and grades, but also were not correlated with the vascularity of the lesion as demonstrated by angiography. When a tumor mass was enhanced after the injection of iodinated contrast media, it proved to be useful in distinguishing tumor mass and its associated edema that the rCBF of the peritumoral edematous region was predominantly low (10{plus minus}5 ml/100 g/min). The regional cerebral blood flow in remote areas, both ipsilateral and contralateral to the lesion, was low in value, and there was no statistical significance between affected and sound sides. Following glycerol administration, rCBF was increased in the whole intracranial region, but not inside of the neoplasm, particularly when the intracranial pressure (ICP) was increased. It was assumed that the elevated rCBF after glycerol administration was due to the increase in the cerebral perfusion pressure resulting from the ICP reduction, the hemodilution effect, cerebral vessel dilatation after metabolic acidosis, and/or mechanically rectified microcirculation after edema reduction. (author).

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

    International Nuclear Information System (INIS)

    Binnewijzend, Maja A.A.; Wattjes, Mike P.; Berckel, Bart N.M. van; Barkhof, Frederik; Benedictus, Marije R.; Prins, Niels D.; Scheltens, Philip; Kuijer, Joost P.A.; Flier, Wiesje M. van der; Teunissen, Charlotte E.

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-02-15

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

  2. 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.)

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

    International Nuclear Information System (INIS)

    Hata, T.; Meyer, J.S.; Tanahashi, N.

    1987-01-01

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

  4. Regional glucose utilization in infarcted and remote myocardium: its relation to coronary anatomy and perfusion.

    Science.gov (United States)

    Fragasso, G; Chierchia, S L; Landoni, C; Lucignani, G; Rossetti, E; Sciammarella, M; Vanoli, G E; Fazio, F

    1998-07-01

    We studied the relationship between coronary anatomy, perfusion and metabolism in myocardial segments exhibiting transient and persistent perfusion defects on stress/rest 99Tcm-MIBI single photon emission tomography in 35 patients (31 males, 4 females, mean age 56 +/- 7 years) with a previous myocardial infarction. Quantitative coronary angiography and assessment of myocardial perfusion reserve and glucose metabolism were performed within 1 week of one another. Perfusion was assessed by SPET after the intravenous injection of 740 MBq of 99Tcm-MIBI at rest and after exercise. Regional myocardial glucose metabolism was assessed by position emission tomography at rest (200 MBq of 18F-2-deoxyglucose, FDG) after an overnight fast with no glucose loading. All 35 patients exhibited persistent perfusion defects consistent with the clinically identified infarct site, and 27 (77%) also showed various degrees of within-infarct FDG uptake; 11 patients developed exercise-induced transient perfusion defects within, or in the vicinity of, 15 infarct segments and resting FDG uptake was present in 10 of these segments (67%). Five patients also showed exercise-induced transient perfusion defects in nine segments remote from the site of infarct: resting FDG uptake was present in six of these regions (67%). Finally, nine patients had increased glucose uptake in non-infarcted regions not showing transient perfusion defects upon exercise testing and perfused by coronary arteries with only minor irregularities. Our results confirm the presence of viable tissue in a large proportion of infarct sites. Moreover, FDG uptake can be seen in regions perfused by coronary arteries showing minor irregularities, not necessarily resulting in detectable transient perfusion defects on a MIBI stress scan. Since the clinical significance of such findings is not clear, further studies should be conducted to assess the long-term evolution of perfusion, function and metabolism in non

  5. Regional cerebral blood flow characteristics of the Sturge-Weber syndrome

    International Nuclear Information System (INIS)

    Riela, A.R.; Stump, D.A.; Roach, E.S.; McLean, W.T. Jr.; Garcia, J.C.

    1985-01-01

    Four patients with the Sturge-Weber syndrome were studied using the non-invasive Xenon-133 inhalation technique. All four patients had decreased regional cerebral blood flow in the area of their lesion, and in two patients who were subsequently tested with 5% carbon dioxide inhalation, impaired vasomotor reactivity was documented. Diminished regional cerebral blood flow is consistent with previously described nuclide flow studies which demonstrated a delay in the initial perfusion blush in the region of the abnormal vasculature. The focal decrease in blood flow was greatest in the most severely affected patient, but was also prominent in the two younger patients, both of whom have excellent neurologic function. These studies suggest that localized decrease in blood flow and vasomotor dysfunction in Sturge-Weber syndrome can precede the occurrence of severe neurologic impairment and extensive cerebral atrophy and possibly be a major contributing factor in progressive dysfunction. A secondary observation was that the blood flow in the unaffected hemisphere was significantly greater in two children compared to the two adults and was similar to the age-related differences reported for normal children and adults

  6. Assessment of relationship between regional perfusion and ventricular function in patients with severely depressed ejection fraction

    International Nuclear Information System (INIS)

    Teresinska, A.; Konieczna, S.; Szumilak, B.; Gosiewska-Marcinkowska, E.; Potocka, J.

    1998-01-01

    Patients with low ventricular (LV) ejection fraction (EF) and with regional or global LV dysfunction, considered for myocardial revascularization, are often submitted to myocardial perfusion study to ptrove perfusion preserved and to approximate viability. The aim of this work is to evaluate, to what extent SPECT with Tc-99m-MIBI (SPECT-MIBI) additionally differentiatesa and enlarges the information on LV contractility achieved from radioisotopic ventriculography (RNV). Seventy-three patients with EF=0.11-0.35 (mean: 0.26 ± 0.06, calculated from RNV) were studied. Planar gated RNV and SPECT-MIBI were performed within 2 months (mean: 15 ± 14 days). RNV, after in vivo red cells labeling with Tc-99m, was recorded in rest in LAO45 and RAO30 views. Global EF and contractility of 5 regions (anterior, posterior, lateral walls, septum and apex) were evaluated. Assessment was performed by means of LV in 'cine' mode,m ED and ES outlines and amplitude-phase images. Regional contractility abnormalities were classified as dyskinesis, akinesis and hypokinesis. SPECT-MIBI was performed in rest and stress. Perfusion abnormalities in 5 above mentioned regions was classified as large (more intense than 50% of myocardial maximum) or small persistent defects (DEFpers), large or small partially reversible defects (DEFpart-rev), large or small completely reversible defects (DEFrev). Hypokinesis was detected in 23-35 regions (65%) , dyskinesis - in 63 (17%), akinesis - in 37 (10%), normokinesis - in 27 (7%). In dyskinetic regions, there existed large DEFpers (79%) or large DEFpart-rev (21%). In akinetic regions, there also existed large DEFpers (68%) or large DEFpart-rev (32%). In hypokinetic regions, there were no perfusion defects (31% of regions), small DEFpers, DEFrev and DEFpart-rev (42%) and also large DEFpers (27%). In most of normokinetic regions, different types of perfusion defects were observed (large DEFpers existed in 26% of regions). In summary: In dyskinetic and akinetic

  7. 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.)

  8. Deficits in Regional Cerebral Blood Flow on Brain SPECT Predict Treatment Resistant Depression.

    Science.gov (United States)

    Amen, Daniel G; Taylor, Derek V; Meysami, Somayeh; Raji, Cyrus A

    2018-03-22

    Depression remains an important risk factor for Alzheimer's disease, yet few neuroimaging biomarkers are available to identify treatment response in depression. To analyze and compare functional perfusion neuroimaging in persons with treatment resistant depression (TRD) compared to those experiencing full remission. A total of 951 subjects from a community psychiatry cohort were scanned with perfusion single photon emission computed tomography (SPECT) of the brain in both resting and task related settings. Of these, 78% experienced either full remission (n = 506) or partial remission (n = 237) and 11% were minimally responsive (n = 103) or non-responsive (11%. n = 106). Severity of depression symptoms were used to define these groups with changes in the Beck Depression Inventory prior to and following treatment. Voxel-based analyses of brain SPECT images from full remission compared to the worsening group was conducted with the statistical parametric mapping software, version 8 (SPM 8). Multiple comparisons were accounted for with a false discovery rate (p <  0.001). Persons with depression that worsened following treatment had reduced cerebral perfusion compared to full remission in the multiple regions including the bilateral frontal lobes, right hippocampus, left precuneus, and cerebellar vermis. Such differences were observed on both resting and concentration SPECT scans. Our findings identify imaging-based biomarkers in persons with depression related to treatment response. These findings have implications in understanding both depression to prognosis and its role as a risk factor for dementia.

  9. Changes in intracranial morphology, regional cerebral water content and vital physiological variables during epidural bleeding

    International Nuclear Information System (INIS)

    Ganz, J.C.; Inst. of Surgical Research, National Hospital, Oslo; Thuomas, K.AA.; Inst. of Surgical Research, National Hospital, Oslo; Vlajkovic, S.; Inst. of Surgical Research, National Hospital, Oslo; Nilsson, P.; Inst. of Surgical Research, National Hospital, Oslo; Bergstroem, K.; Inst. of Surgical Research, National Hospital, Oslo; Ponten, U.; Inst. of Surgical Research, National Hospital, Oslo; Zwetnow, N.N.; Inst. of Surgical Research, National Hospital, Oslo

    1993-01-01

    Epidural bleeding was produced in 8 anaesthetised and heparinised dogs by an artificial system. Changes in vital physiological variables were related to intracranial shifts and tissue water content assessed with MR imaging. Six animals survived while 2 succumbed. In the surviving animals intracranial shifts and compressions remained unchanged from an early stage. The cerebral perfusion pressure was reduced from between 80 and 110 mm Hg to between 40 and 60 mm Hg. Some increase in supratentorial white matter tissue water was observed. In the lethal experiments cerebral perfusion pressure fell to less than 40 mm Hg. Moreover, secondary delayed anatomical changes were seen including hydrocephalus. Increase in cerebral tissue water was more intense and widespread than in the survivors. These findings indicate that the outcome of epidural bleeding is related to cerebral perfusion pressure with secondary deterioration resulting from additional volume loading from increased tissue water and hydrocephalus. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1979-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-05-15

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

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

    DEFF Research Database (Denmark)

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

    2013-01-01

    )), glucose and lactate across the brain. The molar ratio between the cerebral uptake of O(2) versus carbohydrate (O(2)-carbohydrate index; O(2) / [glucose + 0.5 lactate]; OCI), the cerebral metabolic rate of O(2) (CMRO(2)) and changes in mitochondrial O(2) tension (P(mito)O(2)) were calculated. W...

  13. Evaluation of cerebral perfusion in patients with neuropsychiatric systemic lupus erythematosus using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Yoshida, Atsuko; Shishido, Fumio; Kato, Kazuo; Watanabe, Hiroshi; Seino, Osamu

    2007-01-01

    In the course of systemic lupus erythematosus (SLE), central nervous system (CNS) complications occur at a high frequency. An accurate diagnosis of CNS lupus, differentiated from secondary CNS involvement, is difficult. CNS lupus is indicative of advancing primary disease and is treated by steroid pulse therapy or increased dosage of steroids. In contrast, if symptoms are caused by secondary CNS complications, it is possible to observe or treat these complications using symptomatic therapy. We examined whether quantitative cerebral blood flow (CBF) measured using cerebral perfusion single photon emission computed tomography (SPECT) can be used to differentiate CNS lupus from secondary CNS involvement. We divided 18 SLE patients with CNS symptoms into a CNS lupus group and a non-CNS lupus group, and then compared the mean cerebral blood flow (mCBF) of each group of patients. SPECT was performed with N-isopropyl-p-[ 123 I] iodoamphetamine (IMP), with quantitation carried out by table look-up and autoradiographic methods. The mCBF of both groups was decreased; however, the mCBF of patients with CNS lupus was significantly lower than that of non-CNS lupus patients. Quantitative CBF may provide a useful tool to distinguish CNS lupus from non-CNS lupus. (author)

  14. Mechanisms regulating regional cerebral activation during dynamic handgrip in humans

    DEFF Research Database (Denmark)

    Williamson, James; Friedman, D B; Mitchell, J H

    1996-01-01

    Dynamic hand movement increases regional cerebral blood flow (rCBF) of the contralateral motor sensory cortex (MS1). This increase is eliminated by regional anesthesia of the working arm, indicating the importance of afferent neural input. The purpose of this study was to determine the specific...

  15. Measurement of regional cerebral blood flow with single photon emission computed tomography in patients with aphasia

    International Nuclear Information System (INIS)

    Reischies, F.M.; Muellmann, A.; Hedde, J.P.; Freie Univ. Berlin; Christe, W.

    1984-01-01

    5 cases are demonstrated of patients with aphasia whose brain perfusion as measured regionally by SPECT using 133 Xe was correlated to the lesions seen in the CT study. Perfusion reductions exceeded the CT visible lesions, such as, that in cortical lesions perfusion in the region of basal ganglia is diminished and vice versa. The findings are discussed in relation to recent work on brain perfusion and metabolism. (orig.) [de

  16. 99mTc-ECD brain SPECT in patients with Moyamoya disease: a reflection of cerebral perfusion status at tissue level in the disease process

    International Nuclear Information System (INIS)

    Kashyap, Raghava; Mittal, Bhagwant Rai; Sunil, Hejjaji Venkataramarao; Bhattacharya, Anish; Singh, Baljinder; Mukherjee, Kanchan Kumar; Gupta, Sunil Kumar

    2011-01-01

    Moyamoya disease is a rare, progressive cerebrovascular disorder caused by intracranial stenosis of the circle of Willis, resulting in successive ischemic events. Computed tomography (CT) and magnetic resonance imaging (MRI) play a major role in diagnosis. The aim of the study was to describe the spectrum of findings on brain SPECT in patients with Moyamoya disease and to compare the findings with other investigations. 99m Tc-ECD SPECT scans of seventeen patients (7 children and 10 adults) were analysed to study the brain perfusion. Features of Moyamoya disease were detected on DSA in 11 patients, CTA in one, MR angiography in one patient. Brain perfusion SPECT analysis showed unilateral perfusion defects in 11 patients, normal perfusion in 2 and bilateral defects in 4 patients. No perfusion defects despite bilateral vascular changes were noted in one patient. Cerebral infarcts were detected on MRI unilaterally in three subjects while multiple infarcts were identified in one. 99m Tc-ECD Brain SPECT showed perfusion defects that were more extensive compared to those detected on MRI. Post acetazolamide studies for assessment of cerebrovascular reserve were done in three patients. Two of them showed good cerebrovascular reserve (>1). Follow-up studies post-surgical procedures (Myo-dura synangiosis) done in two patients showed partial resolution of perfusion defects in the involved areas. Brain perfusion scintigraphy is an important adjunct in evaluation of patients with Moyamoya disease yielding information about the direct end results of the pathology in the vessels and also prognostic information. (author)

  17. SPECT for smokers brain perfusion evaluation; SPECT para avaliacao da perfusao cerebral em fumantes

    Energy Technology Data Exchange (ETDEWEB)

    Maliska, C.M.; Martins, E.F.; Barros, D.S.; Lopes, M.M.S.; Lourenco, C.; Goncalves, S.; Goncalves, M.B.; Miranda, M.M.B.G.; Neto, L.M.; Penque, E.; Antonucci, J.B. [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil)

    2002-07-01

    Cigarette smoking increases brain stroke risk, however,five to fifteen years after ceasing this habit, brain perfusion recovers normal pattern. We propose to compare brain perfusion patterns performing brain SPECT scans of smokers and non-smokers. Thirteen volunteers age range 20-30 years old) composed of six non-smokers and seven smokers were studied by brain scans (SPECT).We used ECD- {sup 99m} Tc radiolabelled as recommended by the manufacturer. All patients received 740 MBq of the radiopharmaceutical through intravenous injection, with their eyes opened and their ears unplugged, in a quiet room. We used a one head SPECT camera ( General Electric/ StarCam 4000 and Siemens/ E.Cam) with low-energy ultrahigh resolution collimator. Imaging begin 40 minutes after tracer injection. For reconstruction we used a Butterworth filter.The preliminary results showed brain perfusion deficit areas on five of the smokers while all non- smokers had normal brain perfusion scans. We believe that smoking increases the possibility of brain perfusion deficits. (author)

  18. INTRAVENOUS REGIONAL ANTIBIOTIC PERFUSION THERAPY AS AN ADJUNCTIVE TREATMENT FOR DIGITAL LESIONS IN SEABIRDS.

    Science.gov (United States)

    Fiorello, Christine V

    2017-03-01

    Foot infections are a common problem among seabirds in wildlife rehabilitation. Pododermatitis and digital infections are often challenging to treat because of the presence of suboptimal substrates, abnormal weight-bearing due to injuries, and suboptimal nutritional or health status. Seabirds represent the majority of animals requiring rehabilitation after oil spills, and foot problems are a common reason for euthanasia among these birds. Antibiotic intravenous regional perfusion therapy is frequently used in humans and other species to treat infections of the distal extremities, but it has not been evaluated in seabirds. During the 2015 Refugio oil spill response, four birds with foot lesions (pododermatitis, osteomyelitis, or both) were treated with ampicillin/sulbactam administered intravenously to the affected limb(s) in addition to systemic antibiotics and anti-inflammatories. Three of the birds, all brown pelicans ( Pelecanus occidentalis ) recovered rapidly and were released. Two of these birds had acute pododermatitis and were treated once with intravenous regional perfusion. They were released approximately 3 wk after the perfusion therapy. The third pelican had osteomyelitis of a digit. It was treated twice with intravenous regional perfusion and was released about 1 mo after the initial perfusion therapy. The fourth bird, a Pacific loon ( Gavia pacifica ), was treated once with perfusion therapy but did not respond to treatment and was euthanatized. No serious adverse effects were observed. This technique should be explored further in avian species.

  19. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    International Nuclear Information System (INIS)

    Kitamura, Shin

    1983-01-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways. (J.P.N.)

  20. Studies of cerebral atrophy and regional cerebral blood flow in patients with Parkinson's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Shin [Nippon Medical School, Tokyo

    1983-04-01

    Cerebral atrophy and regional cerebral blood flow (rCBF) of 25 patients with Parkinson's disease were studied. The rCBF was measured with the intra-arterial Xe-133 injection method. The results obtained were as follows: 1) Sixty four % of Parkinson's disease patients showed ventricular dilation, and 76% of Parkinson's disease patients showed cortical atrophy on the CT scan, but we had to allow for the effects of the natural aging process on these results. 2) No correlation was recognized either between cerebral atrophy and the severity of Parkinson's disease, or between cerebral atrophy and the duration of Parkinson's disease. 3) In Parkinson's disease patients, the mean rCBF was lower than that of normal control subjects. The difference was even more remarkable in older patients. Only 40% of Parkinson's disease patients showed hyperfrontal pattern. 4) There was no correlation either between the mean rCBF and the severity of Parkinson's disease, or between the mean rCBF and the duration of Parkinson's disease. There was no significant difference between the mean rCBF of Parkinson's disease patients receiving levodopa and that of untreated patients. 5) The mean rCBF decreased in patients with cerebral atrophy on the CT scan. 6) Parkinson's disease patients with intellectual impairment showed cerebral atrophy and a remarkable decrease of the mean rCBF. 7) The effect of aging on cerebral atrophy on the CT scan had to be allowed for, but judging from the decrease of the mean rCBF, the cerebral cortex is evidently involved in Parkinson's disease. 8) The rCBF decline in Parkinson's disease patients may be related with the diminished cortical metabolic rate due to a remote effect of striatal dysfunction and a disturbance of mesocortical dopaminergic pathways.

  1. Disparity in regional cerebral blood flow during electrically induced seizure

    DEFF Research Database (Denmark)

    Sestoft, D; Meden, P; Hemmingsen, R

    1993-01-01

    This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized on electroencepha......This is a presentation of 2 cases in which the intraictal regional cerebral blood flow distribution was measured with the 99mTc-HMPAO single photon emission computerized tomography technique during an electrically induced seizure. Although the seizure was verified as generalized...... electroencephalography-verified generalized seizures....

  2. Regional effects of craniotomy on cerebral circulation and metabolism

    International Nuclear Information System (INIS)

    Abumiya, Takeo; Sayama, Ichiro; Asakura, Ken; Hadeishi, Hiromu; Mizuno, Makoto; Suzuki, Akifumi; Yasui, Nobuyuki; Shishido, Fumio; Uemura, Kazuo

    1990-01-01

    Regional effects of craniotomy on cerebral circulation and metabolism, such as regional cerebral blood flow (rCBF), regional cerebral oxygen consumption (rCMRO 2 ), regional oxygen extraction fraction (rOEF), and regional cerebral blood volume (rCBV) were examined by a PET (positron emission tomography) study concerning surgery that was performed on un-ruptured aneurysm patients. Eight patients with intracranial un-ruptured aneurysms were studied pre- and post-operatively by the 15 O labelled-gas steady-state method, using HEADTOME-III. All patients underwent aneurysmal surgery performed by the transsylvian approach. There was a significant increase in the mean OEF values taken from the whole-brains of 8 patients, but there was not a significant change in CBF, CMRO 2 or CBV. The increase in OEF was caused by decrease of O 2 content, which was caused by post-operative decrease in the Hb value. So, this OEF increase was not the direct effect of craniotomy. In 2 patients, the rCBF and rCMRO 2 , in the fronto-temporal region (where craniotomy was performed) increased post-operatively. This regional effect suggests transient reactive hyperemia following compressive ischemia during the operative procedure, and metabolic demands for recovery of brain function. In 2 other patients, who had relatively low rCBFs during the pre-operative study, rCBF and rCMRO 2 in the bi-frontal region had decreased more at the post-operative study. This change appears to have been caused by removal of cerebrospinal fluid and depression of the frontal lobe. From this study, it becomes evident that the regional effect of craniotomy on cerebral circulation and metabolism is not so great, when adequate microsurgical techniques are used. (author)

  3. Prolonged Cerebral Circulation Time Is the Best Parameter for Predicting Vasospasm during Initial CT Perfusion in Subarachnoid Hemorrhagic Patients.

    Directory of Open Access Journals (Sweden)

    Chun Fu Lin

    Full Text Available We sought to imitate angiographic cerebral circulation time (CCT and create a similar index from baseline CT perfusion (CTP to better predict vasospasm in patients with subarachnoid hemorrhage (SAH.Forty-one SAH patients with available DSA and CTP were retrospectively included. The vasospasm group was comprised of patients with deterioration in conscious functioning and newly developed luminal narrowing; remaining cases were classified as the control group. The angiography CCT (XA-CCT was defined as the difference in TTP (time to peak between the selected arterial ROIs and the superior sagittal sinus (SSS. Four arterial ROIs were selected to generate four corresponding XA-CCTs: the right and left anterior cerebral arteries (XA-CCTRA2 and XA-CCTLA2 and right- and left-middle cerebral arteries (XA-CCTRM2 and XA-CCTLM2. The CCTs from CTP (CT-CCT were defined as the differences in TTP from the corresponding arterial ROIs and the SSS. Correlations of the different CCTs were calculated and diagnostic accuracy in predicting vasospasm was evaluated.Intra-class correlations ranged from 0.96 to 0.98. The correlations of XA-CCTRA2, XA-CCTRM2, XA-CCTLA2, and XA-CCTLM2 with the corresponding CT-CCTs were 0.64, 0.65, 0.53, and 0.68, respectively. All CCTs were significantly prolonged in the vasospasm group (5.8-6.4 s except for XA-CCTLA2. CT-CCTA2 of 5.62 was the optimal cut-off value for detecting vasospasm with a sensitivity of 84.2% and specificity 82.4.CT-CCTs can be used to interpret cerebral flow without deconvolution algorithms, and outperform both MTT and TTP in predicting vasospasm risk. This finding may help facilitate management of patients with SAH.

  4. Perfusion measurements of the brain: using dynamic CT for the quantitative assessment of cerebral ischemia in acute stroke

    International Nuclear Information System (INIS)

    Klotz, Ernst; Koenig, Matthias

    1999-01-01

    Objective: Perfusion CT has been successfully used as a functional imaging technique for the differential diagnosis of patients with hyperacute stroke. We investigated to what extent this technique can also be used for the quantitative assessment of cerebral ischemia. Methods and material: We studied linearity, spatial resolution and noise behaviour of cerebral blood flow (CBF) determination with computer simulations and phantom measurements. Statistical ROI based analysis of CBF images of a subset of 38 patients from a controlled clinical stroke study with currently more than 75 patients was done to check the power of relative cerebral blood flow (rCBF) values to predict definite infarction and ischemic penumbra. Classification was performed using follow-up CT and MR data. Results: Absolute CBF values were systematically underestimated, the degree depended on the cardiac output of the patients. Phantom measurements and simulations indicated very good linearity allowing reliable calculation of rCBF values. Infarct and penumbra areas in 19 patients receiving standard heparin therapy had mean rCBF values of 0.19 and 0.62, respectively. The corresponding values for 19 patients receiving local intraarterial fibrinolysis were 0.18 and 0.57. The difference between infarct and penumbra values was highly significant (P<0.0001) in both groups. No penumbra area was found with an rCBF value of less than 0.20. While in the heparin group only 25% of all areas with an rCBF between 0.20 and 0.35 survived, in the fibrinolytic group 61% of these areas could be saved (P<0.05). Conclusion: Perfusion CT is a fast and practical technique for routine clinical application. It provides substantial and important additional information for the selection of the optimal treatment strategy for patients with hyperacute stroke. Relative values of cerebral blood flow discriminate very well between areas of reversible and irreversible ischemia; an rCBF value of 0.20 appears to be a definite lower

  5. 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?

    Science.gov (United States)

    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.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    mmHg and luminally perfused. All vessels used attained spontaneous contractile tone (34.9+/-1.8% of resting tone) and responded to luminal adenosine triphosphate (ATP) with dilatation (24.1+/-4.0%), which showed functioning endothelium. Luminally added ergotamine or DHE induced maximal contractions...

  7. Microstructure oriented modelling of hierarchically perfused porous media for cerebral blood flow evaluation

    Czech Academy of Sciences Publication Activity Database

    Tonar, Z.; Kochová, P.; Cimrman, R.; Witter, K.; Janáček, Jiří; Rohan, V.

    2011-01-01

    Roč. 465, č. 2011 (2011), s. 286-289 ISSN 1013-9826. [International Conference on Materials Structure & Micromechanics of Fracture /6./. Brno, 28.06.2010-30.06.2010] Institutional research plan: CEZ:AV0Z50110509 Keywords : brain * perfusion * morphometry * microvessels * stereology * modelling Subject RIV: EA - Cell Biology

  8. Dynamic susceptibility contrast (DSC) perfusion MRI in differential diagnosis between radionecrosis and neoangiogenesis in cerebral metastases using rCBV, rCBF and K2.

    Science.gov (United States)

    Muto, Mario; Frauenfelder, Giulia; Senese, Rossana; Zeccolini, Fabio; Schena, Emiliano; Giurazza, Francesco; Jäger, Hans Rolf

    2018-07-01

    Distinction between treatment-related changes and tumour recurrence in patients who have received radiation treatment for brain metastases can be difficult on conventional MRI. In this study, we investigated the ability of dynamic susceptibility contrast (DSC) perfusion in differentiating necrotic changes from pathological angiogenesis and compared measurements of relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF) and K2, using a dedicated software. Twenty-nine patients with secondary brain tumors were included in this retrospective study and underwent DSC perfusion MRI with a 3-month follow-up imaging after chemo- or radiation-therapy. Region-of-interests were drawn around the contrast enhancing lesions and measurements of rCBV, rCBF and K2 were performed in all patients. Based on subsequent histological examination or clinico-radiological follow-up, the cohort was divided in two groups: recurrent disease and stable disease. Differences between the two groups were analyzed using the Student's t test. Sensitivity, specificity and diagnostic accuracy of rCBV measurements were analyzed considering three different cut-off values. Between patients with and without disease, only rCBV and rCBF values were significant (p < 0.05). The only cut-off value giving the best diagnostic accuracy of 100% was rCBV = 2.1 (sensitivity = 100%; specificity = 100%). Patients with tumor recurrence showed a higher mean value of rCBV (mean = 4.28, standard deviation = 2.09) than patients with necrotic-related changes (mean = 0.77, standard deviation = 0.44). DSC-MRI appears a clinically useful method to differentiate between tumor recurrence, tumor necrosis and pseudoprogression in patients treated for cerebral metastases. Relative CBV using a cut-off value of 2.1 proved to be the most accurate and reliable parameter.

  9. Acute cerebral vascular accident associated with hyperperfusion

    International Nuclear Information System (INIS)

    Soin, J.S.; Burdine, J.A.

    1976-01-01

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133 Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

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

    Directory of Open Access Journals (Sweden)

    Josep Puig

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

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

    Science.gov (United States)

    Puig, Josep; Blasco, Gerard; Daunis-i-Estadella, Pepus; van Eendendburg, Cecile; Carrillo-García, María; Aboud, Carlos; Hernández-Pérez, María; Serena, Joaquín; Biarnés, Carles; Nael, Kambiz; Liebeskind, David S.; Thomalla, Götz; Menon, Bijoy K.; Demchuk, Andrew; Wintermark, Max; Pedraza, Salvador

    2017-01-01

    Objective Blood-brain barrier (BBB) permeability has been proposed as a predictor of hemorrhagic transformation (HT) after tissue plasminogen activator (tPA) administration; however, the reliability of perfusion computed tomography (PCT) permeability imaging for predicting HT is uncertain. We aimed to determine the performance of high-permeability region size on PCT (HPrs-PCT) in predicting HT after intravenous tPA administration in patients with acute stroke. Methods We performed a multimodal CT protocol (non-contrast CT, PCT, CT angiography) to prospectively study patients with middle cerebral artery occlusion treated with tPA within 4.5 hours of symptom onset. HT was graded at 24 hours using the European-Australasian Acute Stroke Study II criteria. ROC curves selected optimal volume threshold, and multivariate logistic regression analysis identified predictors of HT. Results The study included 156 patients (50% male, median age 75.5 years). Thirty-seven (23,7%) developed HT [12 (7,7%), parenchymal hematoma type 2 (PH-2)]. At admission, patients with HT had lower platelet values, higher NIHSS scores, increased ischemic lesion volumes, larger HPrs-PCT, and poorer collateral status. The negative predictive value of HPrs-PCT at a threshold of 7mL/100g/min was 0.84 for HT and 0.93 for PH-2. The multiple regression analysis selected HPrs-PCT at 7mL/100g/min combined with platelets and baseline NIHSS score as the best model for predicting HT (AUC 0.77). HPrs-PCT at 7mL/100g/min was the only independent predictor of PH-2 (OR 1, AUC 0.68, p = 0.045). Conclusions HPrs-PCT can help predict HT after tPA, and is particularly useful in identifying patients at low risk of developing HT. PMID:29182658

  12. Fused cerebral organoids model interactions between brain regions.

    Science.gov (United States)

    Bagley, Joshua A; Reumann, Daniel; Bian, Shan; Lévi-Strauss, Julie; Knoblich, Juergen A

    2017-07-01

    Human brain development involves complex interactions between different regions, including long-distance neuronal migration or formation of major axonal tracts. Different brain regions can be cultured in vitro within 3D cerebral organoids, but the random arrangement of regional identities limits the reliable analysis of complex phenotypes. Here, we describe a coculture method combining brain regions of choice within one organoid tissue. By fusing organoids of dorsal and ventral forebrain identities, we generate a dorsal-ventral axis. Using fluorescent reporters, we demonstrate CXCR4-dependent GABAergic interneuron migration from ventral to dorsal forebrain and describe methodology for time-lapse imaging of human interneuron migration. Our results demonstrate that cerebral organoid fusion cultures can model complex interactions between different brain regions. Combined with reprogramming technology, fusions should offer researchers the possibility to analyze complex neurodevelopmental defects using cells from neurological disease patients and to test potential therapeutic compounds.

  13. Characteristic pattern of cerebral perfusion in patients with the early stage of subcortical vascular dementia compared with Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

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

    2004-07-01

    Brain perfusion SPECT has been commonly used to evaluate several different types of dementia. The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVD (mean age; 68.0{+-}7.0 years, educational period; 6.3{+-}5.6 years, CDR; 0.80{+-}0.26). 46 AD (mean age; 69.9{+-}7.4 years, educational period; 5.4{+-}4.7 years, CDR; 0.86{+-}0.23) and 12 normal control subjects (mean age; 67.1{+-}7.7 years, educational period; 6.2{+-}4.2 years) participated in this study. We included the patients with SVD and AD according to NINCDS-ADRDA criteria for probable AD and NINDS-AIREN criteria for probable or possible VD. They were all matched for age, education and clinical dementia scale scores. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and right thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyral regions in patients with SVD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in patients with AD compared with control subjects (uncorrected p<0.01). SVD patients revealed significant hypoperfusion in the right parahippocampal gyrus, right cingulated gyrus, left insula, and both frontal subgyral regions compared with AD patients (uncorrected p<0.01). SVD patients revealed significant hyperperfusion in right superior frontal gyrus, left pre- and postcentral gyri, left paracentral lobule, left precuneus and both medial frontal gyri compared with AD patients (uncorrected p<0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVD and AD, and these results may be helpful to discriminate the two conditions in the

  14. Regional cerebral blood flow in pure dysarthria. A 3D-SSP study

    International Nuclear Information System (INIS)

    Okamoto, Kensho; Kamogawa, Kenji; Okuda, Bungo; Kawabata, Keita; Tachibana, Hisao

    2007-01-01

    Pure dysarthria from brain infarction is a rare condition, and its pathophysiology remains unclear. To clarify the underlying mechanism of pure dysarthria, we investigated the lesion sites and regional cerebral blood flow in patients with pure dysarthria. We examined 18 consecutive patients with pure dysarthria (9 men and 9 women; mean age, 71 years) who underwent MRI and cerebral blood flow studies. To visualize the regional cerebral blood flow, we generated Z score images using the three-dimensional stereotactic surface projection (3D-SSP) method with single-photon emission computed tomography (SPECT) and N-isopropyl-p [ 123 I]iodoamphetamine. Data on the brain surface perfusion extracted by the 3D-SSP analysis were compared between the pure dysarthria (PD) patients and 9 control subjects. MRI revealed multiple lacunar infarctions involving the internal capsule and/or corona radiata in 11 patients, left internal capsule-corona radiata infarction in 4 patients, and pontine infarction in 3 patients. SPECT with 3D-SSP demonstrated bilateral frontal cortical hypoperfusion in all patients, particularly in the anterior opercular region. Based on intergroup comparisons, the PD group exhibited pronounced cortical hypoperfusion in the opercular and medial frontal regions, left more than right. In conclusion, pure dysarthria is considered to originate from frontal cortical hypoperfusion, mainly in the anterior opercular and medial frontal regions, which is probably due to interruption of the corticosubcortical neural networks relevant to speech expression and articulation. In addition, it is suggested that left hemispheric lesions may make a greater contribution to the development of pure dysarthria than do right ones. (author)

  15. Regional cerebral blood flow in primary degenerative dementia

    International Nuclear Information System (INIS)

    Kawakatsu, Shinobu; Totsuka, Shiro; Shinohara, Masao; Koyama, Hideki; Sagawa, Katsuo; Morinobu, Shigeru; Oiji, Arata; Komatani, Akio

    1991-01-01

    Regional cerebral blood flow (rCBF) was examined, using SPECT by Xe-133 inhalation, in patients with primary degenerative dementia who were subgrouped according to predominant symptoms with respect to amnesia, apraxia, agnosia, aphasia, and personality changes. Also the effect of sex and age at dementia onset on the rCBF patterns was assessed. (author). 26 refs.; 1 fig.; 7 tabs

  16. Patterns of regional cerebral blood flow in acute stroke

    DEFF Research Database (Denmark)

    Olsen, T S; Skriver, E B

    1981-01-01

    In a consecutive group of 56 stroke patients the regional cerebral blood flow was measured within 84 hours after stroke. A 254 multidetector scintillation camera and the intracarotid Xenon-133 injection method was used to study rCBF. Typical rCBF-patterns are described and compared to the findings...

  17. 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

  18. Alterações de difusão e perfusão cerebral por RM em angioplastia carotídea com \\"stent\\" sob proteção cerebral por filtros

    OpenAIRE

    Antenor Tavares de Sá Júnior

    2009-01-01

    INTRODUÇÃO: A angioplastia carotídea com stent (ACS) sob proteção cerebral é opção terapêutica em pacientes com estenose carotídea. Existe o risco de embolia apesar da utilização do filtro e as modificações na perfusão cerebral após tratamento da estenose carotídea não são claras. O propósito deste estudo é avaliar, após ACS sob proteção cerebral por filtros, modificações nas seqüências de RM de difusão (DWI) e perfusão (PWI), correlacionando-as com os aspectos técnicos da ACS, com as caracte...

  19. Activation of different cerebral functional regions following ...

    African Journals Online (AJOL)

    Background: To explore the brain function regions characteristics of the acupoint combination, this study observed activity changes in the brain regions of healthy volunteers after acupuncture at both Taixi (KI3) and Taichong (LR3) (KI3 + LR3) and KI3 alone using resting-state functional magnetic resonance imaging(fMRI).

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

    Directory of Open Access Journals (Sweden)

    Niklaus Denier

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

  1. Regional cerebral blood flow measurement in brain tumors

    International Nuclear Information System (INIS)

    Izunaga, Hiroshi; Hirota, Yoshihisa; Takahashi, Mutsumasa; Fuwa, Isao; Kodama, Takafumi; Matsukado, Yasuhiko

    1986-01-01

    The regional cerebral blood flow (CBF) was determined on seventeen patients with brain tumors. Ring type single photon emission CT (SPECT) was used following intravenous injection of 133 Xe. Case materials included eleven meningiomas and six malignant gliomas. Evaluation was performed with emphasis on the following points; 1. Correlation of the flow data within tumors to the angiographic tumor stains, 2. Influence of tumors on the cerebral blood flow of the normal brain tissue, 3. Correlation between degree of peripheral edema and the flow data of the affected hemispheres. There was significant correlation between flow data within tumors and angiographic tumor stains in meningiomas. Influence of tumors on cerebral blood flow of the normal tissue was greater in meningiomas than in gliomas. There was negative correlation between the degree of peripheral edema and the flow data of the affected hemisphere. It has been concluded that the measurement of CBF in brain tumors is a valuable method in evaluation of brain tumors. (author)

  2. Regional cerebral blood flow measurement in brain tumors

    Energy Technology Data Exchange (ETDEWEB)

    Izunaga, Hiroshi; Hirota, Yoshihisa; Takahashi, Mutsumasa; Fuwa, Isao; Kodama, Takafumi; Matsukado, Yasuhiko

    1986-10-01

    The regional cerebral blood flow (CBF) was determined on seventeen patients with brain tumors. Ring type single photon emission CT (SPECT) was used following intravenous injection of /sup 133/Xe. Case materials included eleven meningiomas and six malignant gliomas. Evaluation was performed with emphasis on the following points; 1. Correlation of the flow data within tumors to the angiographic tumor stains, 2. Influence of tumors on the cerebral blood flow of the normal brain tissue, 3. Correlation between degree of peripheral edema and the flow data of the affected hemispheres. There was significant correlation between flow data within tumors and angiographic tumor stains in meningiomas. Influence of tumors on cerebral blood flow of the normal tissue was greater in meningiomas than in gliomas. There was negative correlation between the degree of peripheral edema and the flow data of the affected hemisphere. It has been concluded that the measurement of CBF in brain tumors is a valuable method in evaluation of brain tumors.

  3. Regional cerebral blood flow and CSF pressures during Cushing response induced by a supratentorial expanding mass

    International Nuclear Information System (INIS)

    Schrader, H.; Zwetnow, N.N.; Moerkrid, L.

    1985-01-01

    In order to delineate the critical blood flow pattern during the Cushing response in intracranial hypertension, regional cerebral blood flow was measured with radioactive microspheres in 12 anesthetized dogs at respiratory arrest caused either by expansion of an epidural supratentorial balloon or by cisternal infusion. Regional cerebrospinal fluid pressures were recorded and the local cerebral perfusion pressure calculated in various cerebrospinal compartments. In the 8 dogs of the balloon expansion group, the systemic arterial pressure was unmanipulated in 4, while it was kept at a constant low level (48 and 70 mm Hg) in 2 dogs and, in another 2 dogs, at a constant high level (150 and 160 mm Hg) induced by infusion of Aramine. At respiratory arrest, regional cerebral blood flow had a stereotyped pattern and was largely independent of the blood pressure level. In contrast, concomitant pressure gradients between the various cerebrospinal compartments varied markedly in the 3 animal groups increasing with higher arterial pressure. Flow decreased by 85-100% supratentorially and by 70-100% in the upper brain stem down to the level of the upper pons, while changes in the lower brain stem were minor, on the average 25%. When intracranial pressure was raised by cisternal infusion in 4 dogs, the supratentorial blood flow pattern at respiratory arrest was appriximately similar to the flow pattern in the balloon inflation group. However, blood flow decreased markedly (74-85%) also in the lower brain stem. The results constitute another argument in favour of the Cushing response in supratentorial expansion being caused by ischemia in the brain stem. The critical ischemic region seems to be located rostrally to the oblongate medulla, probably in the pons. (author)

  4. Effect of pregnancy on regional cerebral blood flow

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Hoshi, Hiroaki; Jinnouchi, Seishi; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Ikeda, Tomoaki; Mori, Norimasa

    1993-01-01

    Regional cerebral blood flow (r-CBF) of 10 pregnant women were quantified by 133 Xe SPECT study with inhalation method before and after artificial abortion. During pregnancy, value of r-CBF in each region except occipital lobe was significantly higher than that of the post abortion. Arterial blood gas was analyzed after SPECT procedure. P co2 concentration increased significantly after artificial abortion. Although its mechanism is unknown, our preliminary work demonstrates that r-CBF increased by pregnancy. (author)

  5. First Episode Schizophrenia Regional Cerebral Blood Flow Assessment after Atypical Antipsychotics

    International Nuclear Information System (INIS)

    Rimbu, A.; Mititelu, R.; Marinescu, G.; Ghita, S.; Mazilu, C.; Codorean, I.; Gheorghe, M.

    2006-01-01

    Full text: Aim: Since regional cerebral blood flow (rCBF) findings in schizophrenic patients are inconsistent, the aim of our study was to evaluate and compare rCBF in the first episode of schizophrenia, before and after atypical antipsychotic treatment. Method: 21 patients who met criteria for schizophrenia were assessed PANSS score and tomographic brain perfusion (SPECT). The treatment was administered for 10-12 weeks and the dose was 4.8mg/day Risperidone, 11.6mg/day Olanzepine, 440mg/day Quetiapine. After finishing treatment all patients underwent a control SPECT study. Results: PANSS scores revealed two groups: group A-14 patients with predominant positive symptoms; 9 received Olanzapine and 5 Quetiapine. In group B -7 patients with predominant negative symptoms received Risperidone. Positive symptoms were associated with hypoperfusion in posterior parietal regions and superior temporal gyrus, bilaterally; for negative symptoms we found hypoperfusion in prefrontal cortex, predominantly in left side and a hyper perfusion in left basal ganglia. All patients that received atypical antipsychotic drugs had clinical improvement and decreases in PANSS scores; the control SPECT analysis revealed the same cortical changes as first studies in 15 patients and an increase of the rCBF in frontal lobes for 4 patients. 14 patients we noticed an increased rCBF at subcortical level, especially in left caudate nuclei. Conclusions: We found nonspecific features of rCBF in patients with first episode of schizophrenia, suggesting a perfusion dynamic balance rather than a fixed model. Those aspects are much more related to clinical symptoms, than to the therapeutical response. The rCBF changes in subcortical level after treatment (64.4% increase of rCBF; 35.6% not modified), can have a good prognostic value for therapeutic response. (author)

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

    DEFF Research Database (Denmark)

    Sillesen, H; Nedergaard, Majken; Schroeder, T

    1988-01-01

    0.005), which in turn had larger infarcts than the sham-operated animals (p less than 0.001). These results indicate that patients with hypoperfusion, due to severe ICA stenosis and impaired collateral blood supply, are at higher risk of developing major stroke, when embolism into a cerebral artery...

  7. [Regional cerebral oxygen saturation as a marker of hemodynamic state following cardiac surgery].

    Science.gov (United States)

    García-Hernández, J A; Aldemira-Liz, A; Martínez-López, A I; Cayuela, A; Charlo-Molina, M T; Cano-Franco, J; Loscertales-Abril, M

    2013-10-01

    Regional cerebral oxygen saturation (rSO₂) is a measure of the general state of perfusion and oxygenation. We aim to analyze the relationship between this and various hemodynamic and respiratory parameters. Forty-three patients, operated on between October 2011 and July 2012, were included in this prospective observational descriptive study. The following parameters were measured: mean arterial pressure, both arterial and central venous oxygen saturation and partial pressures of oxygen and carbon dioxide, and lactate levels. From these parameters, the oxygenation index and the oxygen extraction ratio were calculated. These measurements were studied to evaluate whether rSO₂ correlated significantly with the other parameters. The average age and weight of the patients were 27.3 months and 9.2 kg, respectively. The rSO₂ correlated positively with both central venous oxygen saturation (r=0.73, P 0.4) between the rSO₂ and central venous oxygen saturation, and between the rSO₂ and oxygen extraction ratio. Regional cerebral oxygen saturation correlates well with hemodynamic parameters - mean arterial pressure, venous saturation, and the tissue oxygen extraction. However, it does not correlate with respiratory parameters. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  8. A neutral lipophilic technetium-99m complex for regional cerebral blood flow imaging

    International Nuclear Information System (INIS)

    Narra, R.K.; Nunn, A.D.; Kuczynski, B.L.; DiRocco, R.J.; Feld, T.; Silva, D.A.; Eckelman, W.C.

    1990-01-01

    Technetium-99m-DMG-2MP (Chloro[bis[2,3-butanedionedioxime(1-)-0][2,3- butanedionedioximato (2-)-N,N',N double-prime,N'double-prime,N double-prime double-prime,N'double-prime double-prime] (2-methylpropyl borato (2-))technetium]), also known as SQ 32097 is a member of a family of neutral lipophilic compounds generally known as boronic acid adducts of technetium dioxime complexes (BATOs). After i.v. administration, the concentration of [ 99m Tc]DMG-2MP in various regions of the brain appears to be proportional to blood flow. In rats, 1.1% ID was in the brain at 5 min postinjection when the blood contained less than 3% ID. Over 24 hr excretion was 59% in the feces and 23% in the urine. The activity in monkey brain at 5 min was 2.8% ID and it cleared with a t1/2 of 86 min. Autoradiographs of monkey brain sections showed excellent regional detail with a gray/white ratio of 3.6 at 10 min. The distribution of [ 99m Tc]DMG-2MP in the monkey brain corresponds to the known cytoarchitectural pattern of cerebral glucose metabolism. The properties of [ 99m Tc]DMG-2MP make it a potentially useful agent for cerebral perfusion imaging in man

  9. Measurement of regional cerebral blood flow by positron emission tomography

    International Nuclear Information System (INIS)

    Herscovitch, P.; Powers, W.J.

    1987-01-01

    The principal advantage of positron emission tomography over other methods for measuring cerebral blood flow stems from the accurate, quantitative three-dimensional measurements of regional brain radioactivity that are possible with this technique. As a result, accurate quantitative measurements of regional cerebral blood flow can be obtained for both superficial and deep cerebral structures. The value of PET for investigating central nervous system physiology and pathology extends far beyond this, however. Through the use of different radiotracers and appropriate mathematical models, PET can be applied to the measurement of a wide variety of physiologic variables. Measurements of rCBF tell only part of the story. Experience with PET and with a variety of other techniques has taught us that rCBF is at times a poor indicator of the metabolic, functional, and biochemical status of cerebral tissue. It is only by understanding the interaction of all of these factors that our understanding of neurologic disease can advance. It is in the investigation of these complex relationships that the real value of PET resides

  10. Reliability of perfusion MR imaging in symptomatic carotid occlusive disease. Cerebral blood volume, mean transit time and time-to-peak

    International Nuclear Information System (INIS)

    Kim, J.H.; Lee, E.J.; Lee, S.J.; Choi, N.C.; Lim, B.H.; Shin, T.

    2002-01-01

    Purpose: Perfusion MR imaging offers an easy quantitative evaluation of relative regional cerebral blood volume (rrCBV), relative mean transit time (rMTT) and time-to-peak (TTP). The purpose of this study was to investigate the reliability of these parameters in assessing the hemodynamic disturbance of carotid occlusive disease in comparison with normative data. Material and Methods: Dynamic contrast-enhanced T2*-weighted perfusion MR imaging was performed in 19 patients with symptomatic unilateral internal carotid artery occlusion and 20 control subjects. The three parameters were calculated from the concentration-time curve fitted by gamma-variate function. Lesion-to-contralateral ratios of each parameter were compared between patients and control subjects. Results: Mean±SD of rrCBV, rMTT and TTP ratios of patients were 1.089±0.118, 1.054±0.031 and 1.062±0.039, respectively, and those of control subjects were 1.002±0.045, 1.000±0.006, 1.001±0.006, respectively. The rMTT and TTP ratios of all patients were greater than 2SDs of control data, whereas in only 6 patients (32%), rrCBV ratios were greater than 2SDs of control data. The three parameter ratios of the patients were significantly high compared with those of control subjects, respectively (p<0.01 for rrCBV ratios, p<0.0001 for rMTT ratios, and p<0.0001 for TTP ratios). Conclusion: Our results indicate that rMTT and TTP of patients, in contrast to rrCBV, are distributed in narrow ranges minimally overlapped with control data. The rMTT and TTP could be more reliable parameters than rrCBV in assessing the hemodynamic disturbance in carotid occlusive disease

  11. Positron emission tomography in cerebrovascular disease: The relationship between regional cerebral blood flow, blood volume and oxygen metabolism

    Energy Technology Data Exchange (ETDEWEB)

    Herold, S.

    1985-03-01

    Positron emission tomography in cerebrovascular disease has demonstrated the importance of the relationship between regional cerebral blood flow and the cerebral metabolic activity. In acute stroke it has been found that within the first hours after the onset of symptoms cerebral blood flow in the affected area is more depressed than cerebral oxygen utilisation. This relative preservation of oxygen utilisation results from an increase in the oxygen extraction ratio far above its normal value. However, the oxygen extraction fraction subsequently falls in the following days indicating the transition from a situation of possibly reversible ischaemia to irreversible infarction. In patients with carotid occlusive disease an increase in the oxygen extraction ratio has been observed only in very few cases. It has been shown, however, that at an earlier stage the relationship between CBF and CBV (as CBF/CBV-ratio) provides a sensitive measure of diminished perfusion pressure which could be helpful for the selection of patients for EC-IC bypass surgery. In patients with sickle cell anaemia it has been found that oxygen delivery to the brain is maintained by an increase in cerebral blood flow, whereas the oxygen extraction ratio is not increased despite the presence of a low oxygen affinity haemoglobin. Preliminary observations in classical migraine suggest an ischaemic situation during the attack.

  12. Position of perfusion scintigraphy in the diagnostic strategy of cerebral circulatory disturbances and tumors

    International Nuclear Information System (INIS)

    Otto, H.J.; Willenberg, E.; Mueller, D.; Hoefs, R.; Freitag, J.; Fiedler, A.; Steinke, R.

    1987-01-01

    The results of an evaluation of the perfusion scintigraphy findings of 350 hospitalized neurological patients and 55 more strictly selected neurosurgical patients with cerebrovascular complaints, revealed an accuracy of 83%, a sensitivity of 89%, and a specificity of 83%. The selection of patients had no influence on the results as a whole. Compared with contrast medium angiography, incorrect diagnosis must be expected in 17% of the cases with 10% being false negative. Causes for misinterpretation are suggested, and biological and methodological limitations of the method are discussed. (author)

  13. Preliminary study of the scan-delay-time during the combined examation of CT perfusion and CT angiography after contrast media administration in cerebral and cervical CT angiography

    International Nuclear Information System (INIS)

    Cai Wu; Gong Jianping; Zhu Jiangtao; Qiao Fang; Chen Guangqiang; Zhang Bo; Yi Bixing; Qian Minghui

    2010-01-01

    Objective: To discuss the feasibility of the time to peak of cerebral CT perfusion (CTP) in predicting the scan-delay-time after contrast media administration in cerebral and cervical CT angiography (CTA). Methods: Retrospective Analysis was performed in eighty patients who had been examined with cerebral and cervical CTA, they were divided randomly into two groups. Group A:40 patients were performed by the method of experience of 20 seconds as scan-delay-time. Group B:the other 40 patients were examined with the combination scanning technology of CTP-CTA. They were all measured with enhancement value of CT in the M1 segment of left middle cerebral artery, superior sagittal sinus , left common carotid artery adjacent to the fourth cervical vertebrace and internal jugular vein, and then calculate the difference between the arterys and the veins in the same layer. Statistical significance was determined with t test. Results: (1)The enhancement value of CT in the cerebral and cervical artery vessels and the resolving power between the arterys and the veins in the same layer of group B were higher than that in group A. (2) Group B whose cerebral and cervical artery vessels rescontructed from the raw CT data set showed clearly; There were an advance in 3 cases (7.5%), a delay in 5 cases (12.5%) in group A whose cerebral and cervical artery vessels rescontructed from the raw CT data set didn't show clearly.Conclusion It's a satisfactory method based on successful cerebral and cervical CTA study to take the time to peak in CT perfusion as the scan-delay-time during the combined examination of CTP and CTA with 64-detector spiral CT. (authors)

  14. Quantitative perfusion computed tomography measurements of cerebral hemodynamics: Correlation with digital subtraction angiography identified primary and secondary cerebral collaterals in internal carotid artery occlusive disease

    International Nuclear Information System (INIS)

    Cheng Xiaoqing; Tian Jianming; Zuo Changjing; Liu Jia; Zhang Qi; Lu Guangming

    2012-01-01

    Background: The aim of the present study was to assess hemodynamic variations in symptomatic unilateral internal carotid artery occlusion (ICAO) patients with primary collateral flow via circle of Willis or secondary collateral flow via ophthalmic artery and/or leptomeningeal collaterals. Methods: Thirty-eight patients with a symptomatic unilateral ICAO were enrolled in the study. Based on digital subtraction angiography (DSA) findings, patients were classified into 2 groups: primary collateral (n = 14) and secondary collateral (n = 24) groups. Collateral flow hemodynamics were investigated with perfusion computed tomography (PCT) by measuring the cerebral blood flow (CBF), cerebral blood volume (CBV) and time to peak (TTP) in the hemispheres ipsilateral and contralateral to ICAO. Based on the measurements, the ipsilateral to contralateral ratio for each parameter was calculated and compared. Results: Irrespective of the collateral patterns, ipsilateral CBF was not significantly different from that of the contralateral hemisphere (P = 0.285); ipsilateral CBV and TTP was significantly increased compared with those of the contralateral hemisphere (P = 0.000 and P = 0.000 for CBV and TTP, respectively). Furthermore, patients with secondary collaterals had significantly larger ipsilateral-to-contralateral ratios for both CBV (rCBV, P = 0.0197) and TTP (rTTP, P = 0.000) than those of patients with only primary collaterals. These two groups showed no difference in ipsilateral-to-contralateral ratio for CBF (rCBF, P = 0.312). Conclusion: Patients with symptomatic unilateral ICAO in our study were in an autoregulatory vasodilatation status. Moreover, secondary collaterals in ICAO patients were correlated with ipsilateral CBV and delayed TTP that suggested severe hemodynamic impairment, presumably increasing the risk of ischemic events.

  15. Regional cerebral blood flow during comprehension and speech (in cerebrally healthy subjects)

    International Nuclear Information System (INIS)

    Lechevalier, B.; Petit, M.C.; Eustache, F.; Lambert, J.; Chapon, F.; Viader, F.

    1989-01-01

    Regional cerebral blood flow (rCBF) was measured by the xenon-133 inhalation method in 10 cerebrally healthy subjects at rest and during linguistic activation tests. These consisted of a comprehension test (binaural listening to a narrative text) and a speech test (making sentences from a list of words presented orally at 30-s intervals). The comprehension task induced a moderate increase in the mean right CBF and in both inferior parietal areas, whereas the speech test resulted in a diffuse increase in the mean CBF of both hemispheres, predominating regionally in both inferior parietal, left operculary, and right upper motor and premotor areas. It is proposed that the activation pattern induced by linguistic stimulation depends on not only specific factors, such as syntactic and semantic aspects of language, but also the contents of the material proposed and the attention required by the test situation

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

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

  17. Ventilation-perfusion scans in neonatal regional pulmonary emphysema complicating ventilatory assistance

    International Nuclear Information System (INIS)

    Leonidas, J.C.; Moylan, F.M.B.; Kahn, P.C.; Ramenofsky, M.L.

    1978-01-01

    Two cases of ventilator-related neonatal lobar overexpansion with similar radiographic appearance, but probably different pathogenesis, are presented. In one infant, persistent interstitial lobar emphysema was confirmed by markedly decreased perfusion shown on scintigraphy; this information was of great value in predicting the beneficial effect of lobectomy. In the other case, ventilation and perfusion scans indicated functional value of the emphysematous lobe and correctly suggested conservative management. Radioisotope lung scans may provide valuable information regarding lung function in regional pulmonary emphysema associated with assisted ventilation in neonatal respiratory distress syndrome, and thus determine patient management

  18. Regional distribution of perfusion and ventilation in hamartoangiomyomatosis of the lung

    Energy Technology Data Exchange (ETDEWEB)

    Tominaga, Shigeru; Ohsaka, Tomohisa; Nanbu, Masashi; Toyoda, Keiko; Mori, Yutaka; Kawakami, Kenji; Inatomi, Keiko; Kira, Shiro

    1989-01-01

    We investigated regional distribution of perfusion and ventilation in three cases of hamartoangiomyomatosis (HAM) by /sup 133/Xe gas and /sup 99m/Tc-MAA. In two cases, /sup 133/Xe washout were dominantly delayed in middle lung field and in the third case, it was delayed in upper lung field. This distribution was different from the result in the other chronic obstructive pulmonary disease (COPD). In most cases of COPD, /sup 133/Xe washout was prominently delayed in the lower lung field. Distribution of pulmonary perfusion in HAM were consistent with that of ventilation as in COPD.

  19. Regional cerebral blood flow in aphasia

    DEFF Research Database (Denmark)

    Soh, K; Larsen, B; Skinhøj, E

    1978-01-01

    . In motor (nonfluent) aphasia, the rCBF method showed areas of cortical dysfunction that always included the lower part of the rolandic area while Broca's area was not consistently affected. In sensory (fluent) aphasia, the superior-posterior temporal cortex was involved in all cases. In global aphasia......, the abnormalities included both regions consistently involved in the other types of aphasia. The 133Xe injection method for mapping abnormalities relevant for localizing the cortical speech areas was superior to the classical neuroradiological methods in that several cases failed to show any relevant lesion...

  20. Regional cerebral blood flow in endogenous depression

    International Nuclear Information System (INIS)

    Sagawa, Katsuo; Morinobu, Shigeru; Kawakatsu, Shinobu

    1990-01-01

    The subjects were twenty-nine depressed patients who met the DSM-III rd criteria for bipolar disorder or major depression. The rCBF was determined by the Xe-133 inhalation method (HEADTOME: ring type SPECT). There were no significant differences in the rCBF values between the patients with bipolar depression and normal controls. The rCBF values of patients with unipolar depression were significantly lower than those of controls, especially in the left temporo-parietal region (p L) were more noticeable (p<0.01) in unipolar depression patients than in bipolar depression patients. (author)

  1. Reduced cerebral perfusion on sudden immersion in ice water: a possible cause of drowning

    DEFF Research Database (Denmark)

    Mantoni, Teit; Belhage, Bo; Pedersen, Lars M

    2007-01-01

    Near-drowning incidents and drowning deaths after accidental immersion in open waters have been linked to cold shock response. It consists of inspiratory gasps, hyperventilation, tachycardia, and hypertension in the first 2-3 min of cold-water immersion. This study explored the immediate changes...... in cerebral blood flow velocity (Vmean) during cold-water immersion since cold shock induced hyperventilation may diminish Vmean and lead to syncope and drowning....

  2. MRI in acute cerebral ischaemia: perfusion imaging with superparamagnetic iron oxide in a rat model

    International Nuclear Information System (INIS)

    Forsting, M.; Reith, W.; Doerfler, A.; Kummer, R. von; Hacke, W.; Sartor, K.

    1994-01-01

    An imaging technique capable of detecting ischaemic cerebral injury at an early stage could improve diagnosis in acute or transient cerebral ischaemia. We compared the ability of superparamagnetically contrast-enhanced MRI and conventional T2-weighted MRI to detect ischaemic injury early after unilateral occlusion of the middle cerebral artery in 12 male Wistar rats. Permanent vessel occlusion was achieved by a transvascular approach, which has the advantage of not requiring a craniectom. At 45-60 min after the procedure, the animals had conventional T2-weighted MRI before and after administration of a superparamagnetic contrast agent (iron oxide particles). Unenhanced images were normal in all animals. After administration of iron oxide particles, the presumed ischaemic area was clearly visible, as relatively increased signal, in all animals; this high signal area corresponded to the area of ischaemic brain infarction seen on histological studies. Our results suggest that superparamagnetic iron particles may significantly reduce the interval between an ischaemic insult and the appearance of parenchymal changes on MRI. (orig./UWA)

  3. Regional cerebral blood flow measurement using a scintillation camera

    International Nuclear Information System (INIS)

    Heiss, W.D.

    1979-01-01

    A scintillation camera connected to auxillary equipment with off-line data processing or connected to an on-line dedicated computer system permits measurement of hemispheric and regional cerebral blood flow. Reliable flow values are obtained from regions limited in size by spatial resolution and the count rates achieved. Flow measurements obtained with the camera are able to resolve inhomogeneities of cerebral circulation in normal subjects. In a variety of clinical conditions, the localization, severity and extent of flow alterations are shown. Results of flow measurements in individual cases elucidate the pathogenesis of neurologic deficits, quantify the damage to the brain, indicate therapeutic measures of potential value and permit an estimation of the further clinical course. With restricted spatial resolution, flow measurements after intravenous 133 Xe injection are also feasible

  4. TU-EF-204-02: Hiigh Quality and Sub-MSv Cerebral CT Perfusion Imaging

    International Nuclear Information System (INIS)

    Li, Ke; Niu, Kai; Wu, Yijing; Chen, Guang-Hong

    2015-01-01

    Purpose: CT Perfusion (CTP) imaging is of great importance in acute ischemic stroke management due to its potential to detect hypoperfused yet salvageable tissue and distinguish it from definitely unsalvageable tissue. However, current CTP imaging suffers from poor image quality and high radiation dose (up to 5 mSv). The purpose of this work was to demonstrate that technical innovations such as Prior Image Constrained Compressed Sensing (PICCS) have the potential to address these challenges and achieve high quality and sub-mSv CTP imaging. Methods: (1) A spatial-temporal 4D cascaded system model was developed to indentify the bottlenecks in the current CTP technology; (2) A task-based framework was developed to optimize the CTP system parameters; (3) Guided by (1) and (2), PICCS was customized for the reconstruction of CTP source images. Digital anthropomorphic perfusion phantoms, animal studies, and preliminary human subject studies were used to validate and evaluate the potentials of using these innovations to advance the CTP technology. Results: The 4D cascaded model was validated in both phantom and canine stroke models. Based upon this cascaded model, it has been discovered that, as long as the spatial resolution and noise properties of the 4D source CT images are given, the 3D MTF and NPS of the final CTP maps can be analytically derived for a given set of processing methods and parameters. The cascaded model analysis also identified that the most critical technical factor in CTP is how to acquire and reconstruct high quality source images; it has very little to do with the denoising techniques often used after parametric perfusion calculations. This explained why PICCS resulted in a five-fold dose reduction or substantial improvement in image quality. Conclusion: Technical innovations generated promising results towards achieving high quality and sub-mSv CTP imaging for reliable and safe assessment of acute ischemic strokes. K. Li, K. Niu, Y. Wu: Nothing to

  5. TU-EF-204-02: Hiigh Quality and Sub-MSv Cerebral CT Perfusion Imaging

    Energy Technology Data Exchange (ETDEWEB)

    Li, Ke; Niu, Kai; Wu, Yijing; Chen, Guang-Hong [University of Wisconsin, Madison, WI (United States)

    2015-06-15

    Purpose: CT Perfusion (CTP) imaging is of great importance in acute ischemic stroke management due to its potential to detect hypoperfused yet salvageable tissue and distinguish it from definitely unsalvageable tissue. However, current CTP imaging suffers from poor image quality and high radiation dose (up to 5 mSv). The purpose of this work was to demonstrate that technical innovations such as Prior Image Constrained Compressed Sensing (PICCS) have the potential to address these challenges and achieve high quality and sub-mSv CTP imaging. Methods: (1) A spatial-temporal 4D cascaded system model was developed to indentify the bottlenecks in the current CTP technology; (2) A task-based framework was developed to optimize the CTP system parameters; (3) Guided by (1) and (2), PICCS was customized for the reconstruction of CTP source images. Digital anthropomorphic perfusion phantoms, animal studies, and preliminary human subject studies were used to validate and evaluate the potentials of using these innovations to advance the CTP technology. Results: The 4D cascaded model was validated in both phantom and canine stroke models. Based upon this cascaded model, it has been discovered that, as long as the spatial resolution and noise properties of the 4D source CT images are given, the 3D MTF and NPS of the final CTP maps can be analytically derived for a given set of processing methods and parameters. The cascaded model analysis also identified that the most critical technical factor in CTP is how to acquire and reconstruct high quality source images; it has very little to do with the denoising techniques often used after parametric perfusion calculations. This explained why PICCS resulted in a five-fold dose reduction or substantial improvement in image quality. Conclusion: Technical innovations generated promising results towards achieving high quality and sub-mSv CTP imaging for reliable and safe assessment of acute ischemic strokes. K. Li, K. Niu, Y. Wu: Nothing to

  6. Value of conventional, and diffusion- and perfusion weighted MRI in the management of patients with unclear cerebral pathology, admitted to the intensive care unit

    International Nuclear Information System (INIS)

    Sundgren, P.C.; Reinstrup, P.; Romner, B.; Holtaas, S.; Maly, P.

    2002-01-01

    The aim of our retrospective study was to determine the extent to which diffusion- and perfusion- weighted MRI combined with conventional MRI could be helpful in the evaluation of intensive care unit (ICU) patients who have unknown or unclear cerebral pathology underlying a serious clinical condition. Twenty-one ICU patients with disparity between the findings on brain CT scan and their clinical status were studied. All patients underwent conventional MR and diffusion-weighted imaging and 14 also had MR perfusion studies. Abnormalities were present on diffusion-weighted imaging of 17 of the 21 patients and on perfusion-weighted studies of 7 of 14 patients. The MRI results changed the preliminary/working diagnosis in six patients. In eight other patients, MRI revealed additional pathology that had not been suspected clinically, and/or characterized more closely findings that had already been detected by CT or suspected clinically. MRI showed abnormalities in four of the five patients who had normal CT. MRI findings suggested a negative clinical outcome in all nine patients who subsequently died. MRI findings also suggested positive long-term outcome in five of nine patients who improved significantly as based on Glasgow and extended Glasgow outcome scales. In the three unconscious patients who had normal diffusion- and perfusion-weighted imaging the clinical outcome was good. This study suggests that MRI in seriously ill ICU patients with unclear cerebral pathology can provide information that changes, characterizes, or supports diagnoses and/or prognoses and therefore facilitates further management. (orig.)

  7. 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.)

  8. Cerebral Perfusion Pressure Targets Individualized to Pressure-Reactivity Index in Moderate to Severe Traumatic Brain Injury: A Systematic Review.

    Science.gov (United States)

    Needham, Edward; McFadyen, Charles; Newcombe, Virginia; Synnot, Anneliese J; Czosnyka, Marek; Menon, David

    2017-03-01

    Traumatic brain injury (TBI) frequently triggers a disruption of cerebral autoregulation. The cerebral perfusion pressure (CPP) at which autoregulation is optimal ("CPPopt") varies between individuals, and can be calculated based on fluctuations between arterial blood pressure and intracranial pressure. This review assesses the effect of individualizing CPP targets to pressure reactivity index (a measure of autoregulation) in patients with TBI. Cochrane Central Register of Controlled Trials, MEDLINE®, Embase, and Cumulative Index of Nursing and Allied Health Literature were searched in March 2015 for studies assessing the effect of targeting CPPopt in TBI. We included all studies that assessed the impact of targeting CPPopt on outcomes including mortality, neurological outcome, and physiological changes. Risk of bias was assessed using the RTI Item Bank and evidence quality was considered using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Eight cohort studies (based on six distinct data sets) assessing the association between CPPopt and mortality, Glasgow Outcome Scale and physiological measures in TBI were included. The quality of evidence was deemed very low based on the GRADE criteria. Although the data suggest an association between variation from CPPopt and poor clinical outcome at 6 months, the quality of evidence prevents firm conclusions, particularly regarding causality, from being drawn. Available data suggest that targeting CPPopt might represent a technique to improve outcomes following TBI, but currently there is insufficient high-quality data to support a recommendation for use in clinical practice. Further prospective, randomized controlled studies should be undertaken to clarify its role in the acute management of TBI.

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

  10. Regional cerebral glucose metabolism in patients with alcoholic Korsakoff's syndrome

    International Nuclear Information System (INIS)

    Kessler, R.M.; Parker, E.S.; Clark, C.M.; Martin, P.R.; George, D.T.; Weingartner, H.; Sokoloff, L.; Ebert, M.H.; Mishkin, M.

    1985-01-01

    Seven alcoholic male subjects diagnosed as having Korsakoff's syndrome and eight age-matched male normal volunteers were studied with /sup 18/F 2-fluoro-2-deoxy-D-glucose (2/sup 18/FDG). All subjects were examined at rest with eyes covered in a quiet, darkened room. Serial plasma samples were obtained following injection of 4 to 5 mCi of 2/sup 18/FDG. Tomographic slices spaced at 10mm axial increments were obtained (in-plane resolution = 1.75 cm, axial resolution = 1.78 cm). Four planes were selected from each subject, and a total of 46 regions of interest were sampled and glucose metabolic rates for each region calculated. The mean glucose metalbolic rate for the 46 regions in the Korsakoff subjects was significantly lower than that in the normal controls (5.17 +- .43 versus 6.6 +- 1.31). A Q-component analysis, which examined each subject's regional rates relative to his mean rate, revealed two distinct patterns in the Korsakoff group. Glucose metabolism was significantly reduced in 37 of the 46 regions sampled. Reduced cerebral glucose metabolism in a nondemented group of subjects has not previously been reported. The reduction in cortical metabolism may be the result of damage to sub-cortical projecting systems. The differing patterns of cerebral metabolism in Korsakoff's syndrome suggests subgroups with differing neuropathology. Regions implicated in memory function, medial temporal, thalamic and medial prefrontal were among the regions reduced in metabolism

  11. Age and gender effects on normal regional cerebral blood flow studied using two different voxel-based statistical analyses; Effets de l'age et du genre sur la perfusion cerebrale regionale etudiee par deux methodes d'analyse statistique voxel-par-voxel

    Energy Technology Data Exchange (ETDEWEB)

    Pirson, A.S.; George, J.; Krug, B.; Vander Borght, T. [Universite Catholique de Louvain, Service de Medecine Nucleaire, Cliniques Universitaires de Mont-Godinne, Yvoir (Belgium); Van Laere, K. [Leuven Univ. Hospital, Nuclear Medicine Div. (Belgium); Jamart, J. [Universite Catholique de Louvain, Dept. de Biostatistiques, Cliniques Universitaires de Mont-Godinne, Yvoir (Belgium); D' Asseler, Y. [Ghent Univ., Medical Signal and Image Processing Dept. (MEDISIP), Faculty of applied sciences (Belgium); Minoshima, S. [Washington Univ., Dept. of Radiology, Seattle (United States)

    2009-10-15

    Fully automated analysis programs have been applied more and more to aid for the reading of regional cerebral blood flow SPECT study. They are increasingly based on the comparison of the patient study with a normal database. In this study, we evaluate the ability of Three-Dimensional Stereotactic Surface Projection (3 D-S.S.P.) to isolate effects of age and gender in a previously studied normal population. The results were also compared with those obtained using Statistical Parametric Mapping (S.P.M.99). Methods Eighty-nine {sup 99m}Tc-E.C.D.-SPECT studies performed in carefully screened healthy volunteers (46 females, 43 males; age 20 - 81 years) were analysed using 3 D-S.S.P.. A multivariate analysis based on the general linear model was performed with regions as intra-subject factor, gender as inter-subject factor and age as co-variate. Results Both age and gender had a significant interaction effect with regional tracer uptake. An age-related decline (p < 0.001) was found in the anterior cingulate gyrus, left frontal association cortex and left insula. Bilateral occipital association and left primary visual cortical uptake showed a significant relative increase with age (p < 0.001). Concerning the gender effect, women showed higher uptake (p < 0.01) in the parietal and right sensorimotor cortices. An age by gender interaction (p < 0.01) was only found in the left medial frontal cortex. The results were consistent with those obtained with S.P.M.99. Conclusion 3 D-S.S.P. analysis of normal r.C.B.F. variability is consistent with the literature and other automated voxel-based techniques, which highlight the effects of both age and gender. (authors)

  12. Regional cerebral blood flow pattern in normal young and aged volunteers: a 99mTc-HMPAO SPET study

    International Nuclear Information System (INIS)

    Catafau, A.M.; Lomena, J.; Pavia, J.; Parellada, E.; Bernardo, M.; Setoain, J.; Tolosa, E.

    1996-01-01

    The aim of this study was to investigate the normal pattern of regional cerebral blood flow (rCBF) distribution in normal young and aged volunteers using technetium-99m hexamethylpropylene amine oxime ( 99m -Tc-HMPAO) as a tracer. The region brain perfusion of young and aged subjects was compared, especially regarding rCBF differences due to age and gender, and interhemispheric rCBF asymmetries. Sixty-eight right-handed normal volunteers -40 young (mean age 29.5±6.3 years) and 28 aged (mean age 71.2±4.3 years) - were included in the study. rCBF was estimated on the basis of a semiquantitative approach by means of a left-right index and two region/reference ratios, using the cerebellum and the whole brain activity as references. A good correlation between these two region/reference ratios was found (P<0.005 in all cerebral regions). The highest rCBF ratios corresponded to the cerebellum, followed by the occipital lobe. The remaining cortical regions (temporal, parietal, frontal and basal ganglia) showed slightly lower values. The white matter showed rCBF ratios substantially lower than the grey matter. In neighter young nor aged subjects were significant rCBF differences between the genders found in any of the two region/reference indices employed. Aged sugjects showed significantly lower rCBF ratios than young subjects in the left frontal lobe and in the posterior region of the left temporal lobe. In both young and aged subjects, lower perfusion was found in the left hemisphere, except for the white matter region in both age groups and the frontal lobe in the young subjects. Aged subjects presented a slightly higher interhemispheric asymmetry in the frontal lobe. However, interhemispheric asymmetry was minimal (-1.01% to 3.14%). Consequently, a symmetrical rCBF distribution can be assumed between homologous regions, independent of age. (orig.)

  13. Endovascular treatment of cerebral aneurysms at Altai Regional Vascular Center

    Directory of Open Access Journals (Sweden)

    Д. А. Долженко

    2015-10-01

    Full Text Available A retrospective analysis of the results of endovascular treatment of patients with the brain aneurysms was carried out at the Neurosurgical Department of Regional Clinical Hospital in Barnaul over a period from 2009 to 2011. 52 patients with 57 cerebral aneurysms were included in the study and 55 endovascular interventions were performed. Total embolization (type A was used in 77% of patients, embolization type B was performed in 19% of cases, incomplete embolization (type C occurred in 4% of cases. 14 (26,9% patients were operated in the acute period of SAH. Conclusions are made relating to the effectiveness and relative safety of intravascular treatment of aneurysms, the need for differentiated approaches to the tactics of surgical treatment of patients in the acute period of hemorrhagic stroke due to the rupture of a cerebral aneurysm.

  14. Cerebral perfusion inhomogeneities in schizophrenia demonstrated with single photon emission computed tomography and Tc99m-hexamethylpropyleneamineoxim

    International Nuclear Information System (INIS)

    Bajc, M.; Basic, M.; Topuzovic, N.; Babic, C.; Medved, V.

    1989-01-01

    Cerebral blood flow was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM-III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4-6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m-HMPAO and SPECT might be used to distinguish various types of schizophrenia. (author)

  15. Reduced cerebral perfusion on sudden immersion in ice water: a possible cause of drowning

    DEFF Research Database (Denmark)

    Mantoni, Teit; Belhage, Bo; Pedersen, Lars M

    2007-01-01

    INTRODUCTION: Near-drowning incidents and drowning deaths after accidental immersion in open waters have been linked to cold shock response. It consists of inspiratory gasps, hyperventilation, tachycardia, and hypertension in the first 2-3 min of cold-water immersion. This study explored the imme......INTRODUCTION: Near-drowning incidents and drowning deaths after accidental immersion in open waters have been linked to cold shock response. It consists of inspiratory gasps, hyperventilation, tachycardia, and hypertension in the first 2-3 min of cold-water immersion. This study explored...... cerebral artery (MCA) was measured together with ventilatory parameters and heart rate before, during, and after immersion. RESULTS: Within seconds after immersion in ice water, heart rate increased from 74 +/- 16 to 107 +/- 18 bpm (mean +/- SD; p elevation...

  16. Effects of smoking on regional cerebral blood flow in cerebral vascular disease patients and normal subjects

    International Nuclear Information System (INIS)

    Kubota, Kazuo; Yamaguchi, Tatsuo; Fujiwara, Takehiko; Matsuzawa, Taiju

    1987-01-01

    The chronic effect of smoking on the regional cerebral blood flow (r-CBF) was studied by 133-Xenon inhalation method and described with the Initial Slope Index (ISI). Fifty-two patients as the control group who had no abnormality neurologically or with CT scan, 32 patients with old cerebral infarction and 20 patients with old cerebral hemorrhage were introduced to the present study, and these patients were divided into smokers and non-smokers in each group. Those whose smoking index of 200 or more [(number of cigarettes/day) x (years of smoking history) ≥ 200] were designated as smokers. ISI values were decreased significantly in smokers than non-smokers in all groups. Mean ISI value of unaffected hemisphere in smokers decreased by 16 % in the infarction group and 22 % in the hemorrhage group comparing to the non-smokers', respectively. In the control group, mean ISI value of right hemisphere decreased by 15 % and left 14 % in smokers compared to the non-smokers. The r-CBF values in 44 of the 47 smokers were found to be lower than the expected age matched values in non-smokers. Serum high density lipoprotein cholesterol value in smokers was significantly lower than that in non-smokers. We demonstrated preliminarily that the smoking chronically reduced the r-CBF. Advanced atherosclerosis associated with the smoker was suggested to affect the CBF. (author)

  17. Cerebral perfusion and metabolism in relation to the evolution of unilateral spatial neglect due to cerebral infarction. Contribution of bilateral hemispheres in appearance and recovery

    International Nuclear Information System (INIS)

    Kato, Haruhisa

    2006-01-01

    To investigate the mechanisms underlying the evolution of unilateral spatial neglect (USN) due to cerebral infarction, the cerebral oxygen metabolism was measured quantitatively by positron emission tomography (PET). Out of 189 consecutive patients with right hemisphere lesions who underwent PET, we recruited 13 patients (group A) who exhibited USN at the time of PET examination, 11 patients (group B) who had already recovered from USN, and 27 patients (group C) with right hemisphere infarction who failed to present with USN throughout. Eight normal volunteers (group NV) served as controls. Statistical comparisons were performed on the local values of the cerebral metabolic rate of oxygen (CMRO 2 ) from the region of interest (ROI) in the right dorsolateral frontal lobe, superior temporal gyrus, inferior parietal lobule, cingulate gyrus, basal ganglia and thalamus which are associated with USN. We also obtained CMRO 2 values for the contralateral areas. As compared with group C or NV, there were significant decreases in CMRO 2 in the right frontal, right temporal and right parietal lobes, right basal ganglia, right thalamus and bilateral cingulate gyri in groups A and B. Except for the left inferior parietal lobule, no significant differences in regional CMRO 2 were noted between groups A and B. These findings indicate that extensive right hemisphere lesions may produce USN, but no specific brain region is associated with its recovery. Different from aphasics, no definite relationship is evident between recovery from USN and the role of the contralateral left hemisphere. This could be explained partly by the complexity of the pathogenetic mechanisms underlying USN. (author)

  18. Use of ultrafast computed tomography to quantitate regional myocardial perfusion: a preliminary report

    International Nuclear Information System (INIS)

    Rumberger, J.A.; Feiring, A.J.; Lipton, M.J.; Higgins, C.B.; Ell, S.R.; Marcus, M.L.

    1987-01-01

    The purpose of this study was to assess the potential for rapid acquisition computed axial tomography (Imatron C-100) to quantify regional myocardial perfusion. Myocardial and left ventricular cavity contrast clearance curves were constructed after injecting nonionic contrast (1 ml/kg over 2 to 3 seconds) into the inferior vena cava of six anesthetized, closed chest dogs (n = 14). Independent myocardial perfusion measurements were obtained by coincident injection of radiolabeled microspheres into the left atrium during control, intermediate and maximal myocardial vasodilation with adenosine (0.5 to 1.0 mg/kg per min, intravenously, respectively). At each flow state, 40 serial short-axis scans of the left ventricle were taken near end-diastole at the midpapillary muscle level. Contrast clearance curves were generated and analyzed from the left ventricular cavity and posterior papillary muscle regions after excluding contrast recirculation and minimizing partial volume effects. The area under the curve (gamma variate function) was determined for a region of interest placed within the left ventricular cavity. Characteristics of contrast clearance data from the posterior papillary muscle region that were evaluated included the peak myocardial opacification, area under the contrast clearance curve and a contrast clearance time defined by the full width/half maximal extent of the clearance curve. Myocardial perfusion (microspheres) ranged from 35 to 450 ml/100 g per min (mean 167 +/- 125)

  19. Regional cerebral blood flow in patients with hypertensive intracerebral hemorrhage

    International Nuclear Information System (INIS)

    Kuroda, Kiyoshi

    1982-01-01

    Regional cerebral blood flow (rCBF) was measured in 36 patients with hypertensive intracerebral hemorrhage (putaminal hemorrhage) treated surgically, using the Xenon-133 intracarotid injection method. The correlations between CBF in four regions, (the hemisphere, the frontal region, the sensori-motor area and the focal area) and the duration from the operation, the conscious level, the hematoma volume and motor function were investigated. Mean cerebral blood flow (MCBF), rCBF in sensori-motor area and in the focal area showed a value below 30 ml/100g/min. for any duration after the operation within one year. However, in the frontal region rCBF tends to increase from 4 months after the operation. There was a close correlation between the conscious level and CBF, especially in the frontal region. The higher CBF was noted in the better consciousness group. In hematoma cases the larger the hematoma volume (especially those over 31 ml)the lower the CBF in all three regions. In the focal area rCBF showed the lowest value among these three regions and was dependent on the hematoma volume, while frontal region revealed the highest flow value of them all, even in cases with a hematoma volume over 81 ml. There was a significant difference in rCBF between cases with severe motor disturbance and cases with moderate motor disturbance, except in the focal area. In the frontal region rCBF coincides rather well to the degree of motor disturbance. While, rCBF in the focal area was less than 30 ml/100g/min., and showed no correlation to motor function. (J.P.N.)

  20. Assessment of Cu-ETS as a PET radiopharmaceutical for evaluation of regional renal perfusion

    International Nuclear Information System (INIS)

    Green, Mark A.; Mathias, Carla J.; Willis, Lynn R.; Handa, Rajash K.; Lacy, Jeffrey L.; Miller, Michael A.; Hutchins, Gary D.

    2007-01-01

    The copper(II) complex of ethylglyoxal bis(thiosemicarbazone) (Cu-ETS) was evaluated as a positron emission tomography (PET) radiopharmaceutical for assessment of regional renal perfusion. Methods: The concordance of renal flow estimates obtained with 11- and 15-μm microspheres was confirmed in four immature farm pigs using co-injected 46 Sc- and 57 Co-microspheres administered into the left ventricle. With the use of both immature farm pigs (n=3) and mature Goettingen minipigs (n=6), regional renal radiocopper uptake following intravenous [ 64 Cu]Cu-ETS administration was compared to microsphere measurements of renal perfusion. The distribution and kinetics of [ 64 Cu]Cu-ETS were further studied by PET imaging of the kidneys. The rate of [ 64 Cu]Cu-ETS decomposition by blood was evaluated in vitro, employing octanol extraction to recover intact [ 64 Cu]Cu-ETS. Results: The co-injected 11- and 15-μm microspheres provided similar estimates of renal flow. A linear relationship was observed between the renal uptake of intravenous [ 64 Cu]Cu-ETS and regional renal perfusion measured using microspheres. [ 64 Cu]Cu-ETS provided high-quality PET kidney images demonstrating the expected count gradient from high-flow outer cortex to low-flow medulla. When incubated with pig blood in vitro at 37 o C, the [ 64 Cu]Cu-ETS radiopharmaceutical was observed to decompose with a half-time of 2.8 min. Conclusion: Cu-ETS appears suitable for use as a PET radiopharmaceutical for evaluation of regional renal perfusion, affording renal uptake of radiocopper that varies linearly with microsphere perfusion measurements. Quantification of renal perfusion (in ml min -1 g -1 ) with [ 60,61,62,64 Cu]Cu-ETS will require correcting the arterial input function for the fraction of blood radiocopper remaining present as the intact Cu-ETS radiopharmaceutical, since the Cu-ETS chelate has limited chemical stability in blood. Rapid octanol extraction of blood samples appears suitable as an approach

  1. Assessment of Cu-ETS as a PET radiopharmaceutical for evaluation of regional renal perfusion

    Energy Technology Data Exchange (ETDEWEB)

    Green, Mark A. [Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47907 (United States)]. E-mail: magreen@purdue.edu; Mathias, Carla J. [Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47907 (United States); Willis, Lynn R. [Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Handa, Rajash K. [Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Lacy, Jeffrey L. [Proportional Technologies, Inc., Houston, TX 77054 (United States); Miller, Michael A. [Department of Radiology and the Indiana Center of Excellence in Biomedical Imaging, Indiana University School of Medicine, Indianapolis, IN 46202 (United States); Hutchins, Gary D. [Department of Radiology and the Indiana Center of Excellence in Biomedical Imaging, Indiana University School of Medicine, Indianapolis, IN 46202 (United States)

    2007-04-15

    The copper(II) complex of ethylglyoxal bis(thiosemicarbazone) (Cu-ETS) was evaluated as a positron emission tomography (PET) radiopharmaceutical for assessment of regional renal perfusion. Methods: The concordance of renal flow estimates obtained with 11- and 15-{mu}m microspheres was confirmed in four immature farm pigs using co-injected {sup 46}Sc- and {sup 57}Co-microspheres administered into the left ventricle. With the use of both immature farm pigs (n=3) and mature Goettingen minipigs (n=6), regional renal radiocopper uptake following intravenous [{sup 64}Cu]Cu-ETS administration was compared to microsphere measurements of renal perfusion. The distribution and kinetics of [{sup 64}Cu]Cu-ETS were further studied by PET imaging of the kidneys. The rate of [{sup 64}Cu]Cu-ETS decomposition by blood was evaluated in vitro, employing octanol extraction to recover intact [{sup 64}Cu]Cu-ETS. Results: The co-injected 11- and 15-{mu}m microspheres provided similar estimates of renal flow. A linear relationship was observed between the renal uptake of intravenous [{sup 64}Cu]Cu-ETS and regional renal perfusion measured using microspheres. [{sup 64}Cu]Cu-ETS provided high-quality PET kidney images demonstrating the expected count gradient from high-flow outer cortex to low-flow medulla. When incubated with pig blood in vitro at 37{sup o}C, the [{sup 64}Cu]Cu-ETS radiopharmaceutical was observed to decompose with a half-time of 2.8 min. Conclusion: Cu-ETS appears suitable for use as a PET radiopharmaceutical for evaluation of regional renal perfusion, affording renal uptake of radiocopper that varies linearly with microsphere perfusion measurements. Quantification of renal perfusion (in ml min{sup -1} g{sup -1}) with [{sup 60,61,62,64}Cu]Cu-ETS will require correcting the arterial input function for the fraction of blood radiocopper remaining present as the intact Cu-ETS radiopharmaceutical, since the Cu-ETS chelate has limited chemical stability in blood. Rapid octanol

  2. Changes in Muscle and Cerebral Deoxygenation and Perfusion during Repeated Sprints in Hypoxia to Exhaustion

    Directory of Open Access Journals (Sweden)

    Sarah J. Willis

    2017-10-01

    Full Text Available During supramaximal exercise, exacerbated at exhaustion and in hypoxia, the circulatory system is challenged to facilitate oxygen delivery to working tissues through cerebral autoregulation which influences fatigue development and muscle performance. The aim of the study was to evaluate the effects of different levels of normobaric hypoxia on the changes in peripheral and cerebral oxygenation and performance during repeated sprints to exhaustion. Eleven recreationally active participants (six men and five women; 26.7 ± 4.2 years, 68.0 ± 14.0 kg, 172 ± 12 cm, 14.1 ± 4.7% body fat completed three randomized testing visits in conditions of simulated altitude near sea-level (~380 m, FIO2 20.9%, ~2000 m (FIO2 16.5 ± 0.4%, and ~3800 m (FIO2 13.3 ± 0.4%. Each session began with a 12-min warm-up followed by two 10-s sprints and the repeated cycling sprint (10-s sprint: 20-s recovery test to exhaustion. Measurements included power output, vastus lateralis, and prefrontal deoxygenation [near-infrared spectroscopy, delta (Δ corresponds to the difference between maximal and minimal values], oxygen uptake, femoral artery blood flow (Doppler ultrasound, hemodynamic variables (transthoracic impedance, blood lactate concentration, and rating of perceived exertion. Performance (total work, kJ; −27.1 ± 25.8% at 2000 m, p < 0.01 and −49.4 ± 19.3% at 3800 m, p < 0.001 and pulse oxygen saturation (−7.5 ± 6.0%, p < 0.05 and −18.4 ± 5.3%, p < 0.001, respectively decreased with hypoxia, when compared to 400 m. Muscle Δ hemoglobin difference ([Hbdiff] and Δ tissue saturation index (TSI were lower (p < 0.01 at 3800 m than at 2000 and 400 m, and lower Δ deoxyhemoglobin resulted at 3800 m compared with 2000 m. There were reduced changes in peripheral [Δ[Hbdiff], ΔTSI, Δ total hemoglobin ([tHb

  3. Regional cerebral blood flow in focal cortical epilepsy

    DEFF Research Database (Denmark)

    Hougaard, Kristina Dupont; Oikawa, T; Sveinsdottir, E

    1976-01-01

    Regional cerebral blood flow (rCBF) was studied in ten patients with focal cortical epilepsy. The blood flow was measured by the intra-arterial injection of xenon 133 (133Xe), and the isotope clearance was recorded by a multidetector scintillation camera with 254 detectors. Three patients were....... This finding accords with earlier studies. All nine patients studied in the interictal phase showed, either spontaneously or during activation by intermittent light, focal flow increases in areas presumed to comprise the epileptic focus. These interictal hyperemic foci probably reflect subictal neuronal...

  4. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders

    Directory of Open Access Journals (Sweden)

    David Vállez García

    2016-08-01

    Full Text Available There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD. However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1 to validate previous results showing alterations of regional cerebral blood flow (rCBF in cWAD, (2 to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3 to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H215O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing.

  5. Grading of cerebral gilomas: correlation with perfusion MRI, spectroscopic MRI and histopathology

    International Nuclear Information System (INIS)

    Law, M.; Cha, S.; Knopp, E.A.; Johnson, G.; Litt, A.W.

    2002-01-01

    Full text: The aim of this study was to determine the correlation between perfusion MRI (pMRI), spectroscopic MRI (sMRI) and histopathologic grading of primary glial neoplasms. Echo-planar pMRI has already been shown to be a robust physiological tool in preoperatively predicting tumor grade and guiding stereotactic biopsy (1). Thirty-four patients with a primary glial neoplasm underwent conventional MR imaging, T2*-weighted echo planar pMRI and sMRI. Four rCBV measurements were obtained from the colour maps of each lesion to determine the maximum rCBV. Spectroscopic MRI utilizing 2D chemical shift imaging at a TE of 135 provided multi-voxel spectroscopic data in sixteen of these patients. The maximum Cho/NAA, Cho/Cr, and minimum NAA/Cr ratios were obtained as well as documenting the presence of lactate and lipids. This was compared with the histopathological grading (including staining with H and E, GFAP, vimentin and MIB1, proliferative index) obtained from volumetric resection or stereotactic biopsy. The maximum rCBV in high grade tumors (n=26) ranged from 1.34 to 5.15, with a mean of 3.00 ± 1.21 (SD), and in the low grade tumors (n=8) ranged from 1.47 to 2.49, with a mean of 1.81 ± 1.21 (SD).This difference was statistically significant (p<0.001; Student t test). Maximum values for Cho/NAA, Cho/Cr and minimum NAA/Cr values were 3.24 ± 3.26, 2.49 ± 1.17 and 1.02 ± 0.34, respectively in the high grade (n = 11), and 1.3 ± 0.39, 1.58 ± 0.45 and 0.89 ± 0.37 respectively in the low-grade tumors (n = 5). A statistically significant difference was found for the Cho/Cr ratio (p<0.05) between the high grade and low grade groups. Relative CBV measurements and spectroscopic metabolic ratios are complementary and correlate with histopathology (2,3). These tools provide powerful physiological and metabolic information for preoperative prediction of tumor grade and will guide pre and post operative planning and management. Copyright (2002) Blackwell Science Pty Ltd

  6. Comparison of neurocognitive results after coronary artery bypass grafting and thoracic aortic surgery using retrograde cerebral perfusion.

    Science.gov (United States)

    Miyairi, Takeshi; Takamoto, Shinichi; Kotsuka, Yutaka; Takeuchi, Atsuko; Yamanaka, Katsuo; Sato, Hajime

    2005-07-01

    Retrograde cerebral perfusion (RCP) is used as an adjunctive method to hypothermic circulatory arrest to enhance cerebral protection in patients undergoing thoracic aortic surgery. It remains unclear whether RCP provides improved neurological and neuropsychological outcome. Forty-six patients undergoing thoracic aortic surgery using RCP, and 28 undergoing coronary artery bypass grafting (CABG; n = 28) with CPB, were enrolled in the study. Patients receiving RCP were subdivided into two groups, those with less than 60 min of RCP (S-RCP; n = 27) and with 60 min or more (L-RCP; n = 19). The patients' neurocognitive state was assessed by the revised Wechsler Adult Intelligence Scale a few days before operation, at 2-3 weeks and 4-6 months after operation. There were no stroke, seizure, and hospital mortality in either group. Significant decline between baseline and early scores were seen in three subtests (digit span, arithmetic, and picture completion) for S-RCP and four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP. Significant decline between baseline and late scores were seen in one subtest (arithmetic) for S-RCP, four (digit span, arithmetic, picture completion, and picture arrangement) for L-RCP, and one (object assembly) for CABG. The mean change of scores for one late test (digit symbol) was significantly lower in S-RCP than in CABG. The mean change of scores for three early tests (digit span, vocabulary, and picture arrangement) and four late tests (information, digit span, picture completion, and picture arrangement) were significantly lower in L-RCP than in CABG. Stepwise logistic regression analysis disclosed that, after considering the other variables, significant difference in test score changes were observed between CABG and L-RCP for two early tests (picture completion and digit symbol) as well as for three late tests (digit span, similarities, and picture completion). None of test score changes showed significant

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

    International Nuclear Information System (INIS)

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

    2010-01-01

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

  8. Type of aphasia and regional cerebral blood flow

    International Nuclear Information System (INIS)

    Tagawa, Koichi; Sugimoto, Keiko; Minematsu, Kazuo; Yamaguchi, Takenori; Naritomi, Hiroaki; Sawada, Tohru

    1982-01-01

    In 40 patients with aphasia due to cerebral infarction, regional cerebral blood flow (rCBF) was measured after 2 months of ictus with 133 Xe inhalation method. There were 18 cases with motor aphasia and 22 with sensory aphasia. On the measurements of rCBF, 3 detectors were placed over frontal region (group F), 3 over temporal region (group T), and remaining 3 over parietal region (group P), of the dominant hemisphere. The flow values were compared with the rCBF values obtained from 21 control subjects who had no abnormality in CT scan and on neurological examinations. The control subjects revealed the hyperfrontal pattern of flow distribution; rCBF values in groups F, T and P, which were expressed as an initial slope index, were 50.0 +- 4.8, 48.0 +- 5.1 and 47.4 +- 4.5, respectively. The hyperfrontal pattern was absent in cases with motor aphasia. In this group, rCBF in groups F, T and P were 42.0 +- 8.3, 44.7 +- 8.4 and 41.0 +- 8.5, respectively, and rCBF in frontal region was significantly reduced compared with that in the control group. In sensory aphasia, rCBF values in groups F, T and P were all significantly reduced compared to the controls showing 44.0 +- 5.7, 42.8 +- 5.1 and 40.6 +- 5.4, respectively. In this group, the hyperfrontal pattern was maintained at a low flow level. When absolute rCBF values were compared between motor and sensory aphasia, there was no significant difference between these 2 groups. However, regional flow distribution in motor aphasia was significantly different from that of sensory aphasia, and the cases having the lowest value in group F were more frequently found in the former than in the latter. (J.P.N.)

  9. Age-specific cerebral perfusion in 4- to 15-year-old children: a high-resolution brain SPET study using 99mTc-ECD

    International Nuclear Information System (INIS)

    Barthel, H.; Dannenberg, C.; Bettin, S.; Sattler, B.; Knapp, W.H.; Wiener, M.

    1997-01-01

    This study addresses the question of whether the normal range for distribution of local cerebral blood flow (lCBF) in adults can be transferred to the 4- to 15-year-old age group. Twenty-three children (age: 4-15 years; mean 11±3 years, group I) and 10 adults (age: 27-56 years; mean 45±10 years, group II) without evidence of cerebrovascular disease or other brain diseases underwent technetium-99m ethyl cysteinate dimer single-photon emission tomography. Counts in cortical and subcortical regions of interest (ROIs) were related to those in cerebellar ROIs (= 100%). Relative cortical activity in group I exceeded that in group II, particularly in left parietal (107.6%±9.8% vs 84.1%±12.4%), left frontal (97.7%±6.7% vs 79.4%±8.9%) and left temporal areas (99.7%±7.4% vs 84.9%±10.1%) and in the cingulate cortex (112.1%±9.1% vs 95.9%±10.1%, P<0.05). Cerebral activity uptake per injected dose was inversely correlated with age in 19 children of group I (r -0.77, P<0.001). In group I, there was also an inverse correlation between age and the relative local count density in the parietal (r = -0.42 to -0.57), frontal (r = -0.48), temporal (r=-0.42 to -0.58) and occipital cortex (r=-0.44). In these cortical regions relative counts differed when subgroups of children aged 4-10 and 11-15 years were analysed. It is concluded that there are systematic differences between 4- to 15-year-old children and adults with regard to normal lCBF. Diagnostic use of perfusion agents has to consider age-adjusted normal flow maps; normal ranges should be determined separately for the age groups 4-10 and 11-15 years. (orig.)

  10. Regional cerebral blood flow in diagnosis of childhood onset partial epilepsy

    International Nuclear Information System (INIS)

    Mitsuyoshi, Izuru; Tamaki, Kyoko; Mutoh, Kozo; Iwasaki, Yasushi; Konishi, Junji; Mikawa, Haruki; Okuno, Takehiko.

    1993-01-01

    We compared regional cerebral blood flow assessed by [ 123 I]N-isopropyl-p-iodoamphetamine (IMP) single-photon emission tomography (SPECT) with magnetic resonance imaging (MRI), computed tomography (CT) and interictal surface electroencephalography (EEG) to evaluate its diagnostic potential in 24 patients with partial seizures with onset in childhood. Focal low uptake areas were observed in SPECT scans of 18 patients and were presumed to represent epileptogenic areas in 17. MRI revealed an abnormality in 12 and CT in 6 patients, and all organic lesions showed SPECT abnormalities, too. Six patients without focal structural abnormalities showed regional perfusion deficit on SPECT. Routine scalp EEG revealed an epileptic focus in 17 patients and three of them showed discordant results between SPECT and EEG, which suggested more serious brain disorders. In two patients without EEG localization only SPECT showed focal abnormalities in the probable epileptic area. [ 123 I]IMP-SPECT was useful in locating the epileptic focus, particularly during the early period after the onset of partial seizures when the EEG gave inconclusive results. (author)

  11. The natural history of misery perfusion in positron emission tomography

    Energy Technology Data Exchange (ETDEWEB)

    Nagata, Shinji; Fujii, Kiyotaka; Matsushima, Toshio; Fukui, Masashi; Sadoshima, Shouzou; Kuwabara, Yasuo (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    1992-03-01

    This report reviews the natural courses of misery perfusion in 5 patients with atherosclerotic cerebrovascular occlusion diseases. Cases 1 showed partial improvement and Case 2 showed deterioration of misery perfusion on positron emission tomography (PET). These 2 patients did not show any clinical changes during the follow-up periods. Case 3 showed remarkable improvement of misery perfusion during the 2-year follow-ups, but his neurological condition worsened. The EC-IC bypass improved both in PET and clinical symptoms. Case 4 had a stroke at the region of misery perfusion in PET. Case 5 had a lacunar infarction 2 years after the EC-IC bypass on the opposite side. PET taken one month before the stroke did not show any signs of hypoperfusion in the area of the lacunar infarction. Misery perfusion seems not to be a static but a dynamic condition that can develop into cerebral infarction by some hemodynamic stresses. Cerebral cortical or lobar infarction may occur in the region of severe misery perfusion. EC-IC bypass may prevent impending infarction of the cerebral cortex by improving the regional cerebral blood flow. However, EC-CI bypass will not prevent the lacunar infarction of the basal ganglia or internal capsule. (author).

  12. Regional cerebral blood flow changes and neuropsychological functioning in early and late onset alcoholism

    International Nuclear Information System (INIS)

    Demir, B.; Ulug, B.; Ergun, E.; Erbas, B.

    2002-01-01

    between rCBF parameters and neuropsychological scores. Conclusions: The results of this study indicate that subtypes of alcoholism based on a one-dimensional clinical application of Cloninger's typology showed similar patterns of regional cerebral blood flow and neuropsychological abnormalities excepting the finding of reduced relative perfusion in the right superior frontal region which was limited to the late onset alcoholics. Collectively, our data supports the previous evidence suggesting a key role of frontal lobe pathology in understanding the neurobiology of alcoholism

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-06-15

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

  14. Cerebral perfusion alterations in epileptic patients during peri-ictal and post-ictal phase: PASL vs DSC-MRI.

    Science.gov (United States)

    Pizzini, Francesca B; Farace, Paolo; Manganotti, Paolo; Zoccatelli, Giada; Bongiovanni, Luigi G; Golay, Xavier; Beltramello, Alberto; Osculati, Antonio; Bertini, Giuseppe; Fabene, Paolo F

    2013-07-01

    Non-invasive pulsed arterial spin labeling (PASL) MRI is a method to study brain perfusion that does not require the administration of a contrast agent, which makes it a valuable diagnostic tool as it reduces cost and side effects. The purpose of the present study was to establish the viability of PASL as an alternative to dynamic susceptibility contrast (DSC-MRI) and other perfusion imaging methods in characterizing changes in perfusion patterns caused by seizures in epileptic patients. We evaluated 19 patients with PASL. Of these, the 9 affected by high-frequency seizures were observed during the peri-ictal period (within 5hours since the last seizure), while the 10 patients affected by low-frequency seizures were observed in the post-ictal period. For comparison, 17/19 patients were also evaluated with DSC-MRI and CBF/CBV. PASL imaging showed focal vascular changes, which allowed the classification of patients in three categories: 8 patients characterized by increased perfusion, 4 patients with normal perfusion and 7 patients with decreased perfusion. PASL perfusion imaging findings were comparable to those obtained by DSC-MRI. Since PASL is a) sensitive to vascular alterations induced by epileptic seizures, b) comparable to DSC-MRI for detecting perfusion asymmetries, c) potentially capable of detecting time-related perfusion changes, it can be recommended for repeated evaluations, to identify the epileptic focus, and in follow-up and/or therapy-response assessment. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Measurement of regional cerebral blood flow with the Xenon-133 inhalation procedure in patients with cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Hartmann, A.

    1985-10-01

    Measurement of regional cerebral blood flow with inhalation of Xenon-133 and recording of regional clearance curves by stationary external detectors permits repeated estimation of bilateral cortical blood flow in resting position and after different activating procedures. Measurements can be performed on an outpatient basis, measurements in critical ill patients are possible as well. Compared to Xenon-133 single photon emission computerized tomography smaller doses can be used. Compared to Iodine-123 amphetamie SPECT actual flow calculation without arterial puncture is possible. Drawbacks of the technique are the two-dimensional imaging, unsufficient indication of the look through phenomenon and non-perfused tissue with zero-flow. However, measurement of rCBF with this technique are helpful in individual diagnosis of the following diseases: transient ischemic attacks with prolonged ischemia, communicating hydrocephalus with normal intracranial pressure, follow up studies in hemodilution, evaluation of patients with polyarterial vascular disease in respect to neurosurgical or vasculosurgical intervention, subarachnoid hemorrhage and head trauma. (orig.).

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

    Directory of Open Access Journals (Sweden)

    Valdo José Carreira

    2008-03-01

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

  17. Comparison of the xenon-133 washout method with the microsphere method in dog brain perfusion studies

    International Nuclear Information System (INIS)

    Heikkitae, J.; Kettunen, R.; Ahonen, A.

    1982-01-01

    The validity of the Xenon-washout method in estimation of regional cerebral blood flow was tested against a radioactive microsphere method in anaesthetized dogs. The two compartmental model seemed not to be well suited for cerebral perfusion studies by Xe-washout method, although bi-exponential analysis of washout curves gave perfusion values correlating with the microsphere method but depending on calculation method

  18. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders.

    Science.gov (United States)

    Vállez García, David; Doorduin, Janine; Willemsen, Antoon T M; Dierckx, Rudi A J O; Otte, Andreas

    2016-08-01

    There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing alterations of regional cerebral blood flow (rCBF) in cWAD, (2) to test if central hyperexcitability reflects changes in rCBF upon non-painful stimulation of the neck, and (3) to verify our hypothesis that the missing link in understanding the underlying pathophysiology could be the close interaction between the neck and midbrain structures. For this purpose, alterations of rCBF were explored in a case-control study using H2(15)O positron emission tomography, where each group was exposed to four different conditions, including rest and different levels of non-painful electrical stimulation of the neck. rCBF was found to be elevated in patients with cWAD in the posterior cingulate and precuneus, and decreased in the superior temporal, parahippocampal, and inferior frontal gyri, the thalamus and the insular cortex when compared with rCBF in healthy controls. No differences in rCBF were observed between different levels of electrical stimulation. The alterations in regions directly involved with pain perception and interoceptive processing indicate that cWAD symptoms might be the consequence of a mismatch during the integration of information in brain regions involved in pain processing. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

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

    International Nuclear Information System (INIS)

    Server, Andres; Nakstad, Per H.; Orheim, Tone E.D.; Graff, Bjoern A.; Josefsen, Roger; Kumar, Theresa

    2011-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-05-15

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

  1. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    OpenAIRE

    Gonzalez-Brito Manuel; Solano Juan; Sanchez Pablo; Georgiou Michael F; Capille Michael; McGoron Anthony J; Kuluz John W

    2008-01-01

    Abstract Background Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. Me...

  2. Cost-effectiveness of CT angiography and perfusion imaging for delayed cerebral ischemia and vasospasm in aneurysmal subarachnoid hemorrhage

    NARCIS (Netherlands)

    P.C. Sanelli (Pina C.); A. Pandya; A.Z. Segal; A. Gupta; S. Hurtado-Rua; J. Ivanidze; K. Kesavabhotla; D. Mir; A.I. Mushlin; M.G.M. Hunink (Myriam)

    2014-01-01

    textabstractBACKGROUND AND PURPOSE: Delayed cerebral ischemia and vasospasm are significant complications following SAH leading to cerebral infarction, functional disability, and death. In recent years, CTA and CTP have been used to increase the detection of delayed cerebral ischemia and vasospasm.

  3. Regional cerebral blood flow of the patients with schizophrenia. A study using 99mTc-ECD SPECT at rest and activation

    International Nuclear Information System (INIS)

    Hu Ping; Wu Kening; Zeng Shiquan; Lin Zengtao; Yu Jinlong

    1996-01-01

    Regional cerebral blood flow (rCBF) changes of the patients with schizophrenia were observed. 99m Tc-ECD SPECT was performed on 22 patients with schizophrenia and 10 healthy volunteers at rest and activation with a cognitive task: a modified Wisconsin Card Sorting Test. At rest state, only 4 patients have abnormal rCBF pattern: left hemisphere over-perfusion relative to the right. A significant relative activation deficit in the left inferior prefrontal region was revealed in the patients during activation. The patients with schizophrenia may have frontal lobe dysfunction

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

    International Nuclear Information System (INIS)

    Sekine, Hiroshi; Kawakami, Kenji; Shimada, Takao

    1983-01-01

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

  5. Assessment by three-dimensional power Doppler ultrasound of cerebral blood flow perfusion in fetuses with congenital heart disease.

    Science.gov (United States)

    Zeng, S; Zhou, J; Peng, Q; Tian, L; Xu, G; Zhao, Y; Wang, T; Zhou, Q

    2015-06-01

    To use three-dimensional (3D) power Doppler ultrasound to investigate cerebral blood flow perfusion in fetuses with congenital heart disease (CHD). The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) in the total intracranial volume and the main arterial territories (middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA)) were evaluated prospectively and compared in 112 fetuses with CHD and 112 normal fetuses using 3D power Doppler. Correlations between the 3D power Doppler indices and neurodevelopment scores at 12 months of age were assessed in a subset of the CHD group, and values were compared with those of controls. Compared with the controls, the VI, FI and VFI of the total intracranial volume and the three main arteries were significantly higher in fetuses with hypoplastic left heart syndrome and left-sided obstructive lesions (P power Doppler values in the ACA territory were significantly higher in fetuses with transposition of the great arteries (P power Doppler ultrasound might help to identify cases of brain vasodilatation earlier and inform parental counseling. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  6. Portable real time analysis system for regional cerebral blood flow

    International Nuclear Information System (INIS)

    Tiernan, T.; Entine, G.; Stump, D.A.; Prough, D.S.

    1988-01-01

    A very portable, regional cerebral blood flow (rCBF) analysis instrument system suitable for use in the operating theater during surgery is under development. Cadmium telluride (CdTe) solid state radiation detectors, an 8086 based data acquisition and communications module and a DEC Microvax computer are used so that the instrument is very compact, yet has the computational power to provide real time data analysis in the clinical environment. The instrument is currently being used at Bowman Gray School of Medicine to study rCBF during cardiopulmonary bypass surgery (CPB). Preliminary studies indicate that monitoring rCBF during this surgical procedure may provide insights into the mechanism that causes a significant fraction of these patients to suffer post operative neuropsychological deficit

  7. Aging, regional cerebral blood flow, and neuropsychological functioning

    International Nuclear Information System (INIS)

    MacInnes, W.D.; Golden, C.J.; Gillen, R.W.; Sawicki, R.F.; Quaife, M.; Uhl, H.S.; Greenhouse, A.J.

    1984-01-01

    Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers (56-88 years old), both healthy and demented, underwent the 133 xenon inhalation rCBF procedure and were given the LNNB. The decrements in the gray-matter blood flow paralleled decrements in performance on the LNNB. Using partial correlations, a significant proportion of shared variance was observed between gray-matter blood flow and the LNNB scales. However, there was much less of a relationship between white-matter blood flow and performance on the LNNB. This study suggests that even within a restricted age sample rCBF is related in a global way to neuropsychological functioning

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-10-01

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

  9. Regional cerebral blood flow assessed by single photon emission computed tomography (SPECT) in dogs with congenital portosystemic shunt and hepatic encephalopathy.

    Science.gov (United States)

    Or, Matan; Peremans, Kathelijne; Martlé, Valentine; Vandermeulen, Eva; Bosmans, Tim; Devriendt, Nausikaa; de Rooster, Hilde

    2017-02-01

    Regional cerebral blood flow (rCBF) in eight dogs with congenital portosystemic shunt (PSS) and hepatic encephalopathy (HE) was compared with rCBF in eight healthy control dogs using single photon emission computed tomography (SPECT) with a 99m technetium-hexamethylpropylene amine oxime ( 99m Tc-HMPAO) tracer. SPECT scans were abnormal in all PSS dogs. Compared to the control group, rCBF in PSS dogs was significantly decreased in the temporal lobes and increased in the subcortical (thalamic and striatal) area. Brain perfusion imaging alterations observed in the dogs with PSS and HE are similar to those in human patients with HE. These findings suggest that dogs with HE and PSS have altered perfusion of mainly the subcortical and the temporal regions of the brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Prediction of early neurological deterioration using diffusion- and perfusion-weighted imaging in hyperacute middle cerebral artery ischemic stroke.

    Science.gov (United States)

    Arenillas, Juan F; Rovira, Alex; Molina, Carlos A; Grivé, Elisenda; Montaner, Joan; Alvarez-Sabín, José

    2002-09-01

    Early neurological deterioration (END) occurs in approximately one third of all ischemic stroke patients and is associated with a poor outcome. Our study sought to assess the value of ultra-early MRI in the prediction of END in stroke patients. Between August 1999 and November 2001, 38 stroke patients with a proven middle cerebral artery (MCA) or intracranial internal carotid artery (ICA) occlusion on MR angiography underwent perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) within 6 hours after onset, and 30 fulfilled all inclusion criteria. Control DWI and MR angiography were performed between days 3 and 5. Cranial CT was performed to rule out hemorrhagic transformation. Vascular risk factors, temperature, blood pressure, glycemia, and blood count were assessed on admission. National Institutes of Health Stroke Scale (NIHSS) scores were obtained at baseline and at 6, 12, 24, and 48 hours. At the same time points, transcranial Doppler (TCD) examinations were conducted to assess arterial recanalization. END was defined as an increase in the NIHSS score >4. A logistic regression model was applied to detect independent predictors of END. The Kruskal-Wallis test was used to evaluate the relationship between infarct growth and duration of vessel occlusion. Initial MR angiography showed an occlusion of intracranial ICA in 7 patients (23.3%), of proximal MCA in 14 (46.6%), and of distal MCA in the remaining 9 (30%). A PWI-DWI mismatch >20% was observed in 28 patients (93.3%). END occurred in 7 patients (23.3%). Baseline NIHSS score (P=0.05), proximal site of occlusion (P=0.002), initial DWI (P=0.002) and PWI (P=0.003) volumes, and reduced PWI-DWI mismatch (P=0.038) were associated with END in the univariate analysis. Only hyperacute DWI volume remained as a predictor of END when a logistic regression model was applied (odds ratio, 11.5; 95% CI, 2.31 to 57.10; P=0.0028). A receiver operator characteristic curve identified a cutoff point of DWI >89 cm(3

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-04-15

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

  12. Regional cerebral blood flow and P300 in neurosurgical disorders

    International Nuclear Information System (INIS)

    Funahashi, Kazuyoshi; Hyoutani, Genhachi; Maeshima, Shinichirou; Miyamoto, Kazuki; Kuwata, Toshikazu; Terada, Tomoaki; Komai, Norihiko

    1990-01-01

    Changes in regional cerebral blood flow (rCBF), P300 and higher brain function were studied in neurosurgical patients with localized lesions on computed tomography (CT). Twenty-five patients ranging in age from 30 to 81 were studied. Nineteen of these suffered from cerebrovascular disease and six had tumors. Using the oddball paradigm, P300 components were elicited by rate tones (2 KHz) and recorded at Cz and Pz referred to linked ear-lobe electorodes. The P300 latencies of the patients were statistically compared with those of 27 normal subjects. Higher brain function was evaluated with the following psychological tests: a rating scale for psychological function (Sano and Tanemura), Mini-Mental State (MMS), Hasegawa's Dementia Scale (HDS) and the 'Kanahiroi' test. Regional CBF was measured in the bilateral cerebral cortices (the frontal, temporal and occipital lobes), thalamus and basal ganglia by means of a cold xenon CT method. The laterality indices of rCBF (Rt. rCBF/Lt. rCBF) in the bilateral symmetrical areas of the patients were compared to those of 8 normal subjects. Of the 25 patients, 12 revealed prolongation of P300 latency. Ten (86%) of the 12 with prolonged P300 latency showed reduction of rCBF in the right cerebral hemisphere (rt. frontal lobe, rt. thalamus and rt. basal ganglia). Significant correlations (P<0.025) were recognized between the P300 latencies and the laterality indices of rCBF in the frontal lobe and thalamus. There was a significant correlation (P<0.05) between the scores of MMS and HDS and the laterality indicies of rCBF in the frontal lobe only. In the 13 patients with normal P300 latency, 6 (46%) displayed no reduction in rCBF. The remaining 7 patients with normal P300 showed reduction of rCBF in the left hemisphere. Both right frontal lobe and right thalamus have an important role affecting the prolongation of P300 latency and disturbance of cognitive functions. (author)

  13. Brain perfusion CT in acute stroke: current status

    Energy Technology Data Exchange (ETDEWEB)

    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

  14. Relationship between white matter lesions and regional cerebral blood flow changes during longitudinal follow up in Alzheimer's disease.

    Science.gov (United States)

    Hanaoka, Takuya; Kimura, Noriyuki; Aso, Yasuhiro; Takemaru, Makoto; Kimura, Yuki; Ishibashi, Masato; Matsubara, Etsuro

    2016-07-01

    The aim of the present study was to evaluate the relationship between baseline white matter lesions (WML) and changes in regional cerebral blood flow during longitudinal follow up of patients with Alzheimer's disease (AD). A total of 38 patients with AD were included in the study (16 men, 22 women; mean age 77.8 years). All patients were evaluated using the Mini-Mental State Examination and brain perfusion single-photon emission computed tomography at baseline with an approximately 2-year follow up. The patients were divided into two subgroups according to the presence of WML on magnetic resonance imaging. Single-photon emission computed tomography data were analyzed using a voxel-by-voxel group analysis with Statistical Parametric Mapping 8 and region of interest analysis using FineSRT. Changes in Mini-Mental State Examination scores and regional cerebral blood flow were analyzed using the Wilcoxon signed-rank test. Mean Mini-Mental State Examination scores in AD patients with WML significantly decreased from 19.4 ± 4.8 to 15.5 ± 6.5 (P = 0.003). Statistical Parametric Mapping 8 and FineSRT analysis showed more severe and widespread regional cerebral blood flow reduction, mainly in the frontal and mesial temporal regions in AD patients with WML compared with those without WML. Baseline WML could predict a rapid progression of cognitive and brain functional impairment during longitudinal follow up in AD. Geriatr Gerontol Int 2016; 16: 836-842. © 2015 Japan Geriatrics Society.

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

    International Nuclear Information System (INIS)

    Nakajima, Hiroshi; Onishi, Katsuya; Kurita, Tairo

    2010-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Nakajima, Hiroshi; Onishi, Katsuya; Kurita, Tairo [Mie Univ., Graduate School of Medicine, Tsu, Mie (Japan)

    2010-11-15

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

  17. Improvements in the Quantitative Assessment of Cerebral Blood Volume and Flow with the Removal of Vessel Voxels from MR Perfusion Images

    Directory of Open Access Journals (Sweden)

    Michael Mu Huo Teng

    2013-01-01

    Full Text Available Objective. To improve the quantitative assessment of cerebral blood volume (CBV and flow (CBF in the brain voxels from MR perfusion images. Materials and Methods. Normal brain parenchyma was automatically segmented with the time-to-peak criteria after cerebrospinal fluid removal and preliminary vessel voxel removal. Two scaling factors were calculated by comparing the relative CBV and CBF of the segmented normal brain parenchyma with the absolute values in the literature. Using the scaling factors, the relative values were converted to the absolute CBV and CBF. Voxels with either CBV > 8 mL/100 g or CBF > 100 mL/100 g/min were characterized as vessel voxels and were excluded from the quantitative measurements. Results. The segmented brain parenchyma with normal perfusion was consistent with the angiographic findings for each patient. We confirmed the necessity of dual thresholds including CBF and CBV for proper removal of vessel voxels. The scaling factors were 0.208 ± 0.041 for CBV, and 0.168 ± 0.037, 0.172 ± 0.037 for CBF calculated using standard and circulant singular value decomposition techniques, respectively. Conclusion. The automatic scaling and vessel removal techniques provide an alternative method for obtaining improved quantitative assessment of CBV and CBF in patients with thromboembolic cerebral arterial disease.

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

    International Nuclear Information System (INIS)

    Dolatowski, K.; Malinova, V.; Frölich, A.M.J.; Schramm, R.; Haberland, U.; Klotz, E.; Mielke, D.; Knauth, M.; Schramm, P.

    2014-01-01

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

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

    International Nuclear Information System (INIS)

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

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-04-15

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

  1. Regional cerebral blood flow in the persistent vegetative state

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Masaharu; Kuroda, Ryotaro; Ioku, Masahiko [Kinki Univ., Osakasayama, Osaka (Japan). Faculty of Medicine; and others

    1989-05-01

    Regional cerebral blood flow (CBF) in eight patients in a persistent vegetative state was measured and compared with that in five healthy volunteers. The patients were classified into three groups: Group 1 (locked-in syndrome) consisted of a single patient, Group 2 (typical vegetative state) of five patients, and Group 3 (prolonged coma) of two patients. CBF was measured early after onset by single photon emission computed tomography with {sup 123}I-N-isopropyl-p-iodo-amphetamine and/or {sup 99m}Tc-hexamethyl-propyleneamine oxime. The regions of interest (ROIs) were the bilateral frontal, temporal, parietal, occipital, and cerebellar areas and basal ganglia. The values obtained in these areas were averaged, and the ratio for each ROI ((the value in the ROI/the mean value) x 100) was calculated. 'Hyper-frontal distribution' of CBF was found to be rare in both the normal condition and the vegetative state. Higher CBF values were noted in the left than in the right frontal area in four of the five volunteers but in only four of the eight patients. CBF distribution in the frontal lobe was characteristic for each group: Group 1 showed high CBF bilaterally, although the elevation was statistically significant only on the right side, and Group 3 exhibited significantly low values. In Group 2, CBF was variable but, for the most part, within normal limits. Awareness was closely correlated with frontal lobe function and alteration of CBF in the frontal region. (author).

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-03-15

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-05-15

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

  4. Age differences in intercorrelations between regional cerebral metabolic rates for glucose

    International Nuclear Information System (INIS)

    Horwitz, B.; Duara, R.; Rapoport, S.I.

    1986-01-01

    Patterns of cerebral metabolic intercorrelations were compared in the resting state in 15 healthy young men (ages 20 to 32 years) and 15 healthy elderly men (ages 64 to 83 years). Controlling for whole-brain glucose metabolism, partial correlation coefficients were determined between pairs of regional cerebral metabolic rates for glucose determined by positron emission tomography using [18F]fluorodeoxyglucose and obtained in 59 brain regions. Compared with the young men, the elderly men had fewer statistically significant correlations, with the most notable reductions observed between the parietal lobe regions, and between the parietal and frontal lobe regions. These results suggest that cerebral functional interactions are reduced in healthy elderly men

  5. Reduced deep regional cerebral venous oxygen saturation in hemodialysis patients using quantitative susceptibility mapping.

    Science.gov (United States)

    Chai, Chao; Liu, Saifeng; Fan, Linlin; Liu, Lei; Li, Jinping; Zuo, Chao; Qian, Tianyi; Haacke, E Mark; Shen, Wen; Xia, Shuang

    2018-02-01

    Cerebral venous oxygen saturation (SvO 2 ) is an important indicator of brain function. There was debate about lower cerebral oxygen metabolism in hemodialysis patients and there were no reports about the changes of deep regional cerebral SvO 2 in hemodialysis patients. In this study, we aim to explore the deep regional cerebral SvO 2 from straight sinus using quantitative susceptibility mapping (QSM) and the correlation with clinical risk factors and neuropsychiatric testing . 52 hemodialysis patients and 54 age-and gender-matched healthy controls were enrolled. QSM reconstructed from original phase data of 3.0 T susceptibility-weighted imaging was used to measure the susceptibility of straight sinus. The susceptibility was used to calculate the deep regional cerebral SvO 2 and compare with healthy individuals. Correlation analysis was performed to investigate the correlation between deep regional cerebral SvO 2 , clinical risk factors and neuropsychiatric testing. The deep regional cerebral SvO 2 of hemodialysis patients (72.5 ± 3.7%) was significantly lower than healthy controls (76.0 ± 2.1%) (P deep regional cerebral SvO 2 in patients. The Mini-Mental State Examination (MMSE) scores of hemodialysis patients were significantly lower than healthy controls (P deep regional cerebral SvO 2 did not correlate with MMSE scores (P = 0.630). In summary, the decreased deep regional cerebral SvO 2 occurred in hemodialysis patients and dialysis duration, parathyroid hormone, hematocrit, hemoglobin and red blood cell may be clinical risk factors.

  6. Multiphasic perfusion CT in acute middle cerebral artery ischemic stroke: prediction of final infarct volume and correlation with clinical outcome

    International Nuclear Information System (INIS)

    Yi, Chin A; Na, Dong Gyu; Ryoo, Jae Wook; Moon, Chan Hong; Byun, Hong Sik; Roh, Hong Gee; Moon, Won Jin; Lee, Kwang Ho; Lee, Soo Joo

    2002-01-01

    To assess the utility of multiphasic perfusion CT in the prediction of final infarct volume, and the relationship between lesion volume revealed by CT imaging and clinical outcome in acute ischemic stroke patients who have not undergone thrombolytic therapy. Thirty-five patients underwent multiphasic perfusion CT within six hours of stroke onset. After baseline unenhanced helical CT scanning, contrast-enhanced CT scans were obtained 20, 34, 48, and 62 secs after the injection of 90 mL contrast medium at a rate of 3 mL/sec. CT peak and total perfusion maps were obtained from serial CT images, and the initial lesion volumes revealed by CT were compared with final infarct volumes and clinical scores. Overall, the lesion volumes seen on CT peak perfusion maps correlated most strongly with final infarct volumes (R2=0.819, p<0.001, slope of regression line=1.016), but individual data showed that they were less than final infarct volume in 31.4% of patients. In those who showed early clinical improvement (n=6), final infarct volume tended to be overestimated by CT peak perfusion mapping and only on total perfusion maps was there significant correlation between lesion volume and final infarct volume (R2=0.854, p=0.008). The lesion volumes depicted by CT maps showed moderate correlation with baseline clinical scores and clinical outcomes (R=0.445-0.706, p≤0.007). CT peak perfusion maps demonstrate strong correlation between lesion volume and final infarct volume, and accurately predict final infarct volume in about two-thirds of the 35 patients. The lesion volume seen on CT maps shows moderate correlation with clinical outcome

  7. Regional cerebral blood flow in elderly patients with heart failure evaluated with SPECT

    International Nuclear Information System (INIS)

    Alves, T.C.T.F.; Fraguas, R.; Busatto, G.; Garrido, G.; Buchpiguel, C.A.; Rays, J.; Wajngarten, M.; Robilotta, C.C.; Meneghetti, J.C.

    2002-01-01

    Introduction: Heart failure (HF) may be related to brain dysfunction due to reduced cerebral blood flow (CBF) and white matter lesions. However, no studies have yet used quantitative regional CBF (rCBF) techniques to demonstrate the presence of significant functional abnormalities in representative samples of cardiac patients compared with normal controls. Aim: The purpose of this study was to investigate the rCBF distribution as assessed with SPECT in a group of elderly patients with HF in comparison with a normal control group. The hypothesis were: (1) HF would be associated with rCBF reductions in comparison to healthy controls. Methodology: We studied a group of 36 HF patients functional class II or III from New York Heart Association (NYHA), divided in 19 depressed (74.6 +/- 6.8 years) and 17 non depressed (73.7 +/- 5.4 years), and compared to 19 normal subjects (71.1 +/- 4.8 years), matched for age, sex, cerebral dominance and social level. Brain perfusion was evaluated with a double-headed SPECT system (Sophy-DST) with high-resolution collimators (128x128 matrix, 128 views, 30s/view) after 30mcI 99mTc-HMPAO injection. Group differences were investigated using SPM99, with a p<0.001 statistical threshold (uncorrected for multiple comparisons). Results: Significant rCBF reductions were seen in the HF non depressed group relative to healthy controls in the right lateral temporal lobe, cuneus and precuneus, as well as in a small area of the medial prefrontal cortex. In the HF depressed group, significant cortical rCBF reductions relative to healthy controls were seen in similar locations but more extensively. In addition, the HF depressed group showed significant rCBF reductions relative to controls limbic and subcortical areas, including the right parahypocampal gyrus, posterior cingulate, thalamus and caudate at the border of the lateral ventricle, and bilaterally in the posterior insula. Conclusion: The presence of greater areas of hypoperfusion in the HF

  8. Noninvasive detection of regional myocardial perfusion abnormality with /sup 201/Tl and /sup 81/Rb

    Energy Technology Data Exchange (ETDEWEB)

    Narita, M; Usami, M; Kurihara, T; Kawararadani, H; Kanao, K

    1977-05-01

    Myocardial scintigrams were performed at rest and during exercise using /sup 201/Tl and /sup 81/Rb. Patients underwent graded ergometer exercise stress tests. In normals, myocardial images were horse-shoe or O-shaped and concentration of radionuclide was relatively uniform throughout the myocardium. In 13 patients with old myocardial infarctions, and abnormal Q waves, regional myocardial perfusion defects (cold area) were detected. Their locations correlated with sites of the abnormal Q waves. Two patients had no abnormal Q waves at the examination, but their scintigrams showed cold areas, the locations of which coincided with coronary angiographic findings. Exercise stress ECG and stress scintigrams were performed. Myocardial perfusion defects, which developed from exercise stress, were detected in 9 of 10 positive exercise ECG patients, 2 of 4 equivocal exercise ECG patients, and 2 of 10 negative exercise ECG patients. These 2 patients (exercise ECG (-), stress scintigram (+)) had typical angina. Findings of exercise stress scintigrams coincided better with clinical findings than did those of exercise ECG. These scintigraphic methods appear to be excellent for detection of noninvasive coronary heart disease noninvasively.

  9. Correlated regions of cerebral blood flow with clinical parameters in Parkinson's disease. Comparison using 'Anatomy' and 'Talairach Daemon' software

    International Nuclear Information System (INIS)

    Yoon, Hyun Jin; Cheon, Sang Myung; Jeong, Young Jin; Kang, Do Young

    2012-01-01

    We assign the anatomical names of functional activation regions in the brain, based on the probabilistic cyto-architectonic atlas by Anatomy 1.7 from an analysis of correlations between regional cerebral blood flow (rCBF) and clinical parameters of the non-demented Parkinson's disease (PD) patients by statistical parametric mapping (SPM) 8. We evaluated Anatomy 1.7 of SPM toolbox compared to 'Talairach Daemon' (TD) Client 2.4.2 software. One hundred and thirty-six patients (mean age 60.0±9.09 years; 73 women and 63 men) with non-demented PD were selected. Tc-99m-HMPAO brain single-photon emission computed tomography (SPECT) scans were performed on the patients using a two-head gamma-camera. We analyzed the brain image of PD patients by SPM8 and found the anatomical names of correlated regions of rCBF perfusion with the clinical parameters using TD Client 2.4.2 and Anatomy 1.7. The SPM8 provided a correlation coefficient between clinical parameters and cerebral hypoperfusion by a simple regression method. To the clinical parameters were added age, duration of disease, education period, Hoehn and Yahr (H and Y) stage and Korean mini-mental state examination (K-MMSE) score. Age was correlated with cerebral perfusion in the Brodmann area (BA) 6 and BA 3b assigned by Anatomy 1.7 and BA 6 and pyramis in gray matter by TD Client 2.4.2 with p<0.001 uncorrected. Also, assigned significant correlated regions were found in the left and right lobules VI (Hem) with duration of disease, in left and right lobules VIIa crus I (Hem) with education, in left insula (Ig2), left and right lobules VI (Hem) with H and Y, and in BA 4a and 6 with K-MMSE score with p<0.05 uncorrected by Anatomy 1.7, respectively. Most areas of correlation were overlapped by two different anatomical labeling methods, but some correlation areas were found with different names. Age was the most significantly correlated clinical parameter with rCBF. TD Client found the exact anatomical name by the peak

  10. Physiological activation of the human cerebral cortex during auditory perception and speech revealed by regional increases in cerebral blood flow

    DEFF Research Database (Denmark)

    Lassen, N A; Friberg, L

    1988-01-01

    by measuring regional cerebral blood flow CBF after intracarotid Xenon-133 injection are reviewed with emphasis on tests involving auditory perception and speech, and approach allowing to visualize Wernicke and Broca's areas and their contralateral homologues in vivo. The completely atraumatic tomographic CBF...

  11. Acute effects of thalamotomy and pallidotomy on regional cerebral metabolism, evaluated by PET

    NARCIS (Netherlands)

    Henselmans, JML; de Jong, BM; Pruim, J; Staal, MJ; Rutgers, AWF; Haaxma, R

    The subacute effect of thalamotomy and pallidotomy on regional cerebral metabolism was studied by means of Positron Emission Tomography (PET). In this way we aimed to identify the pattern of functional deafferentiation following a specific lesion in the basal ganglia. The cerebral distribution of

  12. Cerebral activation during motor imagery in complex regional pain syndrome type 1 with dystonia

    NARCIS (Netherlands)

    Gieteling, Esther W.; van Rijn, Monique A.; de Jong, Bauke M.; Hoogduin, Johannes M.; Renken, Remco; van Hilten, Jacobus J.; Leenders, Klaus L.

    The pathogenesis of dystonia in Complex Regional Pain Syndrome type 1 (CRPS-1) is unclear. In primary dystonia, functional magnetic resonance imaging (fMRI) has revealed changes in cerebral networks during execution of movement. The aim of this study was to determine cerebral network function in

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  14. Regional cerebral blood flow in the patient with brain tumor

    International Nuclear Information System (INIS)

    Tsuchida, Shohei

    1993-01-01

    Regional cerebral blood flow (rCBF) was measured with xenon-enhanced CT (Xe-CT) in 21 cases of intracranial tumors (13 meningiomas, 5 gliomas, 3 metastatic brain tumors). Peritumoral edema was graded as mild, moderate or severe based on the extent of edema on CT and MRI. According to intratumoral blood flow distribution patterns, three patterns were classified as central type with relatively high blood flow at the center of the tumor, homogeneous type with an almost homogeneous blood flow distribution, and marginal type with relatively high blood flow at the periphery of the tumor. High grade astrocytoma and metastatic brain tumor showed marginal type blood flow and moderate or severe edema except in one case. Five meningiomas with severe peritumoral edema revealed marginal type blood flow and four with mild peritumoral edema showed central type blood flow, except for one case. No correlation was found between the extent of peritumoral edema and histological subtype, tumor size, location, duration of clinical history, vascularization on angiogram, and mean blood flow in the tumor. These results suggest that blood flow distribution patterns within the tumor may affect the extension of peritumoral edema. Pre- and postoperative rCBFs were evaluated with Xe-CT and IMP-SPECT in 7 cases, mean rCBF of peritumoral edema was 6.2 ml/100 g/min preoperatively, and discrepancy between rCBF on Xe-CT and that on IMP-SPECT was shown in the remote cortical region ipsilateral to the tumor. Postoperative rCBF revealed an improved blood flow in both adjacent and remote areas, suggesting that the decreased blood flow associated with brain tumors might be relieved after surgery. (author) 53 refs

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

    Directory of Open Access Journals (Sweden)

    Mark A Lum

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

  16. No detectable nephrotoxic side effect using a dimer, non-ionic contrast media in cerebral perfusion computed tomography in case of suspected brain ischemia

    International Nuclear Information System (INIS)

    Petrik, M.; Weigel, C.; Kirsch, M.; Hosten, N.

    2005-01-01

    Purpose: In suspected brain ischemia, the perfusion cerebral computed tomography (cCT) should be performed with the lowest amount of contrast media to avoid a contrast media induced nephropathy (CIN) even if the patient already is in renal failure. We were interested to find the best parameters for this examination. Material and methods: From February 2000 to March 2003, 138 patients (58 females, 80 males, mean age 66.8 years) underwent cCT-perfusion immediately after the admission to our stroke unit. Of these patients, 62% (n=86) had normal renal function and 38% (n=52) renal failure (up to 381 μmol/l basic serum creatinine). We varied volume (20-80 ml), flow (5 vs. 7.2. ml/s) and concentration (270 vs. 320 ml/mg iodine) of a dimer, non-ionic contrast media (Visipaque registered ) to establish 5 groups. So we got patients receiving 6 g, 12 g, 16 g, 19 g and 25 g of iodine. After generating the perfusion maps, two radiologists reviewed the quality of the maps and scored it (1-5). We measured the serum creatinine before contrast application and at follow up cCt (days 3 and 7). Results: The quality of the maps increases with increasing amount of iodine. However, the diagnostic result was not significantly better using more than about 16 g of iodine (e.g., 60 ml-7.2 ml/s - 270 mg/ml) in cCT-perfusion studies. Only one patient had a pathologic increase in serum creatinine (day 1: 93; day 4: 146 μmol/l) but died at day 5 because of massive co-morbidity and septic pneumonia. No CIN occurred even in the patient group with pre-existent renal failure. Conclusions: About 60 ml contrast media and a moderate flow rate of about 7 ml/s ensure good results in perfusion-cCT, even if the patients have poor blood circulation or arteriosclerosis. The use of a dimer, non-ionic contrast media (range of 6-25 g iodine) seems to minimize the risk of CIN in the daily routine. (orig.)

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  18. Differential inhibitory response to telcagepant on αCGRP induced vasorelaxation and intracellular Ca(2+) levels in the perfused and non-perfused isolated rat middle cerebral artery

    DEFF Research Database (Denmark)

    Erdling, André; Sheykhzade, Majid; Edvinsson, Lars

    2017-01-01

    BACKGROUND: Calcitonin gene-related peptide (CGRP) is one of the most potent endogenous vasodilators identified to date. The present study elucidates the differential interaction of CGRP, its receptor and the effect of the CGRP-receptor antagonist telcagepant on intracellular Ca(2+) -levels...... and tension in rat middle cerebral arteries (MCA) by pressurized arteriography, FURA-2/wire myography and immunohistochemistry. METHODS: A pressurized arteriograph system was used to evaluate changes in MCA tension when subjected to CGRP and/or telcagepant. Intracellular calcium levels were evaluated using......, while abluminal telcagepant inhibited the relaxation (10(-6) M). Using the FURA-2 method in combination with wire myography we observed that αCGRP reduced intracellular calcium levels and in parallel the vascular tone. Telcagepant (10(-6) M) inhibited both vasorelaxation and drop in intracellular...

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

    NARCIS (Netherlands)

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

    2003-01-01

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

  20. Regional cerebral blood flow and periventricular hyperintensity in silent cerebral infarction. Comparison with multi-infarct dementia

    International Nuclear Information System (INIS)

    Koshi, Yasuhiko; Kitamura, Shin; Nagazumi, Atushi; Tsuganesawa, Toshikazu; Terashi, Akiro

    1996-01-01

    In order to investigate relationship between regional cerebral blood flow (rCBF) and the white matter lesions on MRI in silent cerebral infarction, we quantitatively measured rCBF by 123 I-IMP autoradiography method (IMP ARG method) and single photon emission tomography (SPECT) in 36 patients with silent cerebral infarction (SCI group), 22 patients with multi-infarct dementia (MID group), and 16 control subjects without periventricular hyperintensity (PVH) and lacunar infarction on MRI (CL group). Regions of interest (ROIs) on rCBF images were set in the frontal (F), temporal (T), parietal (P), occipital (O) cortex, and the cerebral white matter (W). The severity of PVH on MRI T 2 -weighted image was divided into four grades (grade 0-3). Though the frequency of hypertension was significantly higher in SCI group and MID group compared with CL group, no significant difference was seen in the mean age among these three groups. rCBF in the white matter and cerebral cortices except the occipital cortex in SCI group was significantly low compared with CL group (rCBF SCI /rCBF CL : W 0.87, F 0.87, T 0.87, P 0.88, O 0.92). rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex, in MID group was significantly low compared with SCI group (rCBF MID /rCBF CL : W 0.69, F 0.71, T 0.74, P 0.75, O 0.81). The mean grade of PVH in MID group was significantly higher than that in SCI group (SCI 1.1 vs MID 2.5). The severity of PVH was significantly correlated with each rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex. Our findings suggest that the quantitative measurement of rCBF by IMP ARG method is useful for the follow-up study in the patients with silent cerebral infarction as well as the evaluation of the severity of PVH on MRI. (author)

  1. Antegrade versus retrograde cerebral perfusion for hemiarch replacement with deep hypothermic circulatory arrest: does it matter? A propensity-matched analysis.

    Science.gov (United States)

    Ganapathi, Asvin M; Hanna, Jennifer M; Schechter, Matthew A; Englum, Brian R; Castleberry, Anthony W; Gaca, Jeffrey G; Hughes, G Chad

    2014-12-01

    The choice of cerebral perfusion strategy for aortic arch surgery has been debated, and the superiority of antegrade (ACP) or retrograde (RCP) cerebral perfusion has not been shown. We examined the early and late outcomes for ACP versus RCP in proximal (hemi-) arch replacement using deep hypothermic circulatory arrest (DHCA). A retrospective analysis of a prospectively maintained database was performed for all patients undergoing elective and nonelective hemiarch replacement at a single referral institution from June 2005 to February 2013. Total arch cases were excluded to limit the analysis to shorter DHCA times and a more uniform patient population for whom clinical equipoise regarding ACP versus RCP exists. A total of 440 procedures were identified, with 360 (82%) using ACP and 80 (18%) using RCP. The endpoints included 30-day/in-hospital and late outcomes. A propensity score with 1:1 matching of 40 pre- and intraoperative variables was used to adjust for differences between the 2 groups. All 80 RCP patients were propensity matched to a cohort of 80 similar ACP patients. The pre- and intraoperative characteristics were not significantly different between the 2 groups after matching. No differences were found in 30-day/in-hospital mortality or morbidity outcomes. The only significant difference between the 2 groups was a shorter mean operative time in the RCP cohort (P = .01). No significant differences were noted in late survival (P = .90). In proximal arch operations using DHCA, equivalent early and late outcomes can be achieved with RCP and ACP, although the mean operative time is significantly less with RCP, likely owing to avoidance of axillary cannulation. Questions remain regarding comparative outcomes with straight DHCA and lesser degrees of hypothermia. Copyright © 2014 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  3. Changes in Regional Cerebral Blood Flow with Cognitive Behavioral Therapy in the Treatment of Panic Disorder

    International Nuclear Information System (INIS)

    Won, K. S.; Jun, S. K.; Kim, J. B.; Jang, E. J.

    2003-01-01

    This study attempted to prospectively investigate changes in regional cerebral blood flow (rCBF) on SPECT and clinical response to cognitive behavioral therapy (CBT) in patients with panic disorder with (PDA) and without (PD) agoraphobia. Using 99mTc-ECD brain SPECT, we assessed brain perfusion in 5 out patients at rest before and after CBT. The subjects received 12 weekly sessions of CBT. Subjects were assessed by Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, Anxiety Sensitivity Index, Beck Depression Inventory-II, Panic Disorder Severity Scale (PDSS) and clinical global improvement (CGI) scale measurement were used as outcome measures. Patients were considered responders to CBT if they are much or very much improved on CGI scale and have a PDSS score at least 30% below their baseline. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The baseline scans were compared to the post-CBT scans by using the statistics option multi subject, different conditions. Of 5 subjects 4 were male, 3 diagnosed PDA, and 4 on anti-anxiety medication. All of the subjects were classified as CBT responders. Their mean pretreatment and posttreatment PDSS were 17.4 (SD=8.2) and 4.2 (SD=3.1), respectively. The results of SPM analysis showed a significant decrease in blood flow after CBT in the thalamus bilaterally and right middle frontal gyrus (Brodmann's area 6). All results were thresholded at an uncorrected p<0.001 (for voxel height) and a corrected p<0.04 (for spatial extent). These preliminary data suggest that SPM analysis of 99mTc-ECD brain SPECT can reveal the change of rCBF in patient with panic disorder before and after CBT and the CBT effect may be associated with limbic and thalamic networks. However this study was a short trial with small number of subjects. Further studies with larger patient cohorts are needed

  4. Changes in Regional Cerebral Blood Flow with Cognitive Behavioral Therapy in the Treatment of Panic Disorder

    Energy Technology Data Exchange (ETDEWEB)

    Won, K. S.; Jun, S. K.; Kim, J. B.; Jang, E. J. [College of Medicine, Univ. of Kyemyoung, Taegu (Korea, Republic of)

    2003-07-01

    This study attempted to prospectively investigate changes in regional cerebral blood flow (rCBF) on SPECT and clinical response to cognitive behavioral therapy (CBT) in patients with panic disorder with (PDA) and without (PD) agoraphobia. Using 99mTc-ECD brain SPECT, we assessed brain perfusion in 5 out patients at rest before and after CBT. The subjects received 12 weekly sessions of CBT. Subjects were assessed by Agoraphobic Cognitions Questionnaire, Body Sensations Questionnaire, Beck Anxiety Inventory, Anxiety Sensitivity Index, Beck Depression Inventory-II, Panic Disorder Severity Scale (PDSS) and clinical global improvement (CGI) scale measurement were used as outcome measures. Patients were considered responders to CBT if they are much or very much improved on CGI scale and have a PDSS score at least 30% below their baseline. The scans were statistically analyzed by using statistical parametric mapping (SPM99). The baseline scans were compared to the post-CBT scans by using the statistics option multi subject, different conditions. Of 5 subjects 4 were male, 3 diagnosed PDA, and 4 on anti-anxiety medication. All of the subjects were classified as CBT responders. Their mean pretreatment and posttreatment PDSS were 17.4 (SD=8.2) and 4.2 (SD=3.1), respectively. The results of SPM analysis showed a significant decrease in blood flow after CBT in the thalamus bilaterally and right middle frontal gyrus (Brodmann's area 6). All results were thresholded at an uncorrected p<0.001 (for voxel height) and a corrected p<0.04 (for spatial extent). These preliminary data suggest that SPM analysis of 99mTc-ECD brain SPECT can reveal the change of rCBF in patient with panic disorder before and after CBT and the CBT effect may be associated with limbic and thalamic networks. However this study was a short trial with small number of subjects. Further studies with larger patient cohorts are needed.

  5. Changes in regional cerebral blood flow during auditory cognitive tasks

    International Nuclear Information System (INIS)

    Ohyama, Masashi; Kitamura, Shin; Terashi, Akiro; Senda, Michio.

    1993-01-01

    In order to investigate the relation between auditory cognitive function and regional brain activation, we measured the changes in the regional cerebral blood flow (CBF) using positron emission tomography (PET) during the 'odd-ball' paradigm in ten normal healthy volunteers. The subjects underwent 3 tasks, twice for each, while the evoked potential was recorded. In these tasks, the auditory stimulus was a series of pure tones delivered every 1.5 sec binaurally at 75 dB from the earphones. Task A: the stimulus was a series of tones with 1000 Hz only, and the subject was instructed to only hear. Task B: the stimulus was a series of tones with 1000 Hz only, and the subject was instructed to push the button on detecting a tone. Task C: the stimulus was a series of pure tones delivered every 1.5 sec binaurally at 75 dB with a frequency of 1000 Hz (non-target) in 80% and 2000 Hz (target) in 20% at random, and the subject was instructed to push the button on detecting a target tone. The event related potential (P300) was observed in task C (Pz: 334.3±19.6 msec). At each task, the CBF was measured using PET with i.v. injection of 1.5 GBq of O-15 water. The changes in CBF associated with auditory cognition was evaluated by the difference between the CBF images in task C and B. Localized increase was observed in the anterior cingulate cortex (in all subjects), the bilateral associate auditory cortex, the prefrontal cortex and the parietal cortex. The latter three areas had a large individual variation in the location of foci. These results suggested the role of those cortical areas in auditory cognition. The anterior cingulate was most activated (15.0±2.24% of global CBF). This region was not activated in the condition of task B minus task A. The anterior cingulate is a part of Papez's circuit that is related to memory and other higher cortical function. These results suggested that this area may play an important role in cognition as well as in attention. (author)

  6. MR perfusion/diffusion-weighted imaging of acute ischemia in an animal model with PET correlation

    International Nuclear Information System (INIS)

    Pickens, D.R.; Dawson, R.C.; Votaw, J.R.; Lorenz, C.H.; Holburn, G.E.; Price, R.R.

    1990-01-01

    This paper evaluates acute cerebral ischemia in an animal model with MR perfusion/diffusion-sensitive pulse sequences and to compare the results with PET regional cerebral blood flow (rCBF) measurements. An embolizing agent was injected into the proximal middle cerebral artery (MCA) of a dog, and this was followed by DSA. Next, the animal was imaged in a 1.5-T MR system with perfusion/diffusion-sensitive spin-echo pulse sequence. Then, PET imaging was performed with H 2 O 15 at corresponding levels of the brain

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

    Directory of Open Access Journals (Sweden)

    Sait Sager

    2014-01-01

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

  8. Establishment of modified reversible regional cerebral ischemic models

    International Nuclear Information System (INIS)

    Ji Xunming; Ling Feng; Zhao Xiqing; Xuan Yun; Wang Yueqin; Ling Xiaolan; Chang Hongjun; Zhang Zhiping

    2005-01-01

    Objective: Modifying the method of establishing reversible middle cerebral ischemic models in rats for improvement of the stability and rate of success, so as to raise the reliability of cerebral ischemic study. Methods: Sixty male Wistar rats were randomly divided into two groups, modified and control groups, 30 rats in each group. The method of silicone- tipping on one end of the nylon suture was used to modify the establishment of embolus, and tip-heating method was used to establish the traditional embolus with all the other steps of the procedure just the same. The Zea Longa 5 scoring scale was used to estimate the neurological deficiency while TTC staining method was used to measure and calculate the volume of cerebral infarction. The percentage of successful models with 3-4 grade scorings and the coefficient of the variations of cerebral infarct volume were used to estimate the stability of the models. Results: The rate of success of establishment models in the modification group was significantly higher in comparing with the traditional group (93% vs 60%, χ 2 =9.32, P=0.002). The percentage of model establishment with 3-4 grade neurological scores in modification group was higher than that in the traditional group 96.4% vs 61.2%, χ 2 =9.51, P=0.002). The cerebral infarct volume in modification group and traditional group were (4.1450±0.5019) cm 3 and (3.8435 ± 0.8164) cm 3 , and the coefficients of variation were 12.01% and 21.24% respectively, which indicated that the stability of models was significantly higher in modification group than in the traditional one. Conclusions: The rates of success and stability of the models for reversible focal cerebral ischemia made by the modification method were significantly improved, with decreasing the cost of model creation and increasing the accuracy of study of ischemic cerebral vascular disease. (authors)

  9. 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.

  10. Measurement of regional cerebral glucose utilization in man by positron emission tomography

    International Nuclear Information System (INIS)

    Baron, J.C.

    1986-05-01

    The various methods available for the study of regional cerebral glucose consumption in man by positron emission tomography are described and their applications, limitations and principal physiopathological results are presented [fr

  11. Regional cerebral blood flow and oxygen metabolism in normal pressure hydrocephalus after subarachnoid hemorrhage

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Masatsune; Kikuchi, Haruhiko; Taki, Waro; Kobayashi, Akira; Nishizawa, Sadahiko; Yonekura, Yoshiharu; Konishi, Junji [Kyoto Univ. (Japan). Faculty of Medicine

    1989-05-01

    To clarify the pathophysiology of normal pressure hydrocephalus (NPH) after subarachnoid hemorrhage, the authors measured cerebral blood flow (CBF), cerebral oxygen metabolic rates (CMRO{sub 2}), the cerebral oxygen extraction fraction (OEF), and cerebral blood volume (CBV) in eight normal volunteers, six SAH patients with NPH, and seven patients without NPH by {sup 15}O-labeled gas and positron emission tomography (PET). In the NPH group, PET revealed a decrease in CBF in the lower regions of the cerebral cortex and a diffuse decrease in CMRO{sub 2}. The decrease in CBF in the lower frontal, temporal, and occipital cortices was significantly greater in the NPH than in the non-NPH group. Reduction of CMRO{sub 2} was also more extensive in the NPH group, and both CBF and CMRO{sub 2} were more markedly decreased in the lower frontal region. OEF was increased in all areas in both of the patient groups, but the increase was not significant in most areas. CBF, CMRO{sub 2} and OEF did not significantly differ between the non-NPH group and the normal volunteers. There was no significant difference in CBV among the three groups. These results indicate that NPH involves impairment of cerebral oxygen metabolism in the lower regions of the cerebral cortex, particularly in the lower frontal region. (author).

  12. Regional myocardial perfusion assessed by N-13 labeled ammonia and positron emission computerized axial tomography

    International Nuclear Information System (INIS)

    Schelbert, H.R.; Phelps, M.E.; Hoffman, E.J.; Huang, S.C.; Selin, C.E.; Kuhl, D.E.

    1978-01-01

    The usefulness of 13 NH 3 as an indicator of regional myocardial perfusion suitable for positron emission computerized axial tomography (PCT) has been suggested. However, the relationship between myocardial blood flow and uptake of 13 NH 3 has not been examined quantitatively. It was therefore the purpose of the current investigation to quantitate the relationship of myocardial 13 NH 3 tissue concentration to myocardial blood flow and to examine its suitability for PCT imaging. Twelve open chest dogs were studied. In 8 of the dogs 25 imaging procedures with 13 NH 3 and PCT were performed. In the remaining four dogs the relationship between flow and myocardial 13 NH 3 tissue concentration was assessed by in vitro techniques. The PCT technique provided high quality cross-sectional images of the distribution of 13 NH 3 in left ventricular myocardium. No significant redistribution of 13 NH 3 in myocardium occurred with time. Alterations in regional myocardial blood flow resulted in changes of the regional distribution of 13 NH 3 that were readily appreciated on the PCT images

  13. Semiquantifying regional cerebral blood flow by dynamic CT scanning

    International Nuclear Information System (INIS)

    Takeuchi, Totaro; Kasahara, Eishi; Takahashi, Eriko; Kojima, Seiichi; Ogawa, Haruhiko; Suzuki, Keiko; Miyamae, Tatsuya; Yamazaki, Setsuo.

    1990-01-01

    The study was undertaken to evaluate the semi-quantitative significance of the absolute value obtained by calculating the regional cerebral blood flow index (rCBFI) from dynamic CT in comparison with SPECT. rCBFI was calculated from mean transit time (MTT) and blood capacity index (BCI) obtained by rapidly infusing 50 ml of Omnipurk into the elbow vein by the use of Hitachi's W-600. [rCBFI=BCI/MTT unit/sec (U/S)] measurment of the rCBF by SPECT was made according to the semi-quantitative method by Matsuda et al. by the use of SHIMADZU's improved type HEADTOME SET-050 with rapid infusion of 123 I-IMP in 3.5 m Ci from the elbow vein. Patients in whom no abnormality was observed in the cardiopulmonary function were enrolled as subjects. The rCBFI in each intracranial site was calculated from dynamic CT in 10 normal adults (aged 35-60, averaging 46.7) as subjects and compared with the rCBF obtained from SPECT in the same cases and same site. Comparative investigation was made similarly between rCBFI and rCBF regarding 10 patients with tracranial diseases (age 29-65, averaging 51.2). The mean rCBFIs in the normal adults obtained from dynamic CT were 1.15±0.18 U/S in the frontal lobar cortex, 1.28±0.19 U/S in the temporal lobar cortex, 1.43±0.1 U/S in the occipital lobar cortex, 1.27±0.2 U/S in the basal ganglia region and 0.43±0.1 U/S in the white matter. On the other hand, the mean rCBFs by SPECT were 47.36±3.93 ml/100 g/min, 55.19±2.22 ml/100 g/min, 61.92±5.42 ml/100 g/min, 54.38±3.51 ml/100 g/min and 38.68±6.18 ml/100 g/min, respectively. Positive correlation was observed between rCBFIs and rCBFs of 10 normal adults and 10 patients with intracranial disease, totalling 20 cases (r=0.79, P<0.005). The rCBFI by dynamic CT has a correlation with the rCBF by SPECT, suggesting the possibility of its evaluation as an absolute value, though semi-quantitatively. (author)

  14. Perfusion-weighted MR imaging in persistent hemiplegic migraine

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  15. Perfusion-weighted MR imaging in persistent hemiplegic migraine

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-03-15

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

  16. Principle of cerebral hemodynamic perfusion in SPECT and new evaluation method of hemodynamic reserve capacity using {sup 99m}Tc tracer

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Masaaki; Mukai, Hironobu; Tada, Motoyuki; Miyazaki, Yoshiharu; Takimoto, Masamori; Shiozaki, Jun; Inoue, Hisashi [Noto General Hospital, Nanao, Ishikawa (Japan)

    2002-07-01

    We performed quantitative measurements of cerebral blood flow (CBF) using {sup 99m}Tc tracer by the Patlak Plot method with reference to normal aging and cerebrovascular reserve (CVR) capacity and then investigated a new evaluation method of CVR. Aging and decrease of ADL were significantly associated with reduction of the mean hemispheric CBF. In the acetazolamide (ACZ) stress test, these retrospective data showed some overlap in each ischemic grade on the relationship between rCBF and CVR response for the predictability of EC/IC bypass surgery. In these controversial problems, we must reconfirm the principle of cerebral hemodynamic perfusion in SPECT. First, retention tracer is distributed via the microcirculatory system to brain tissue. Second, therefore, we should understand not only the circulation of major vessels, but also the dynamics and rheology in parenchymal microcirculation to determine brain SPECT and CVR capacity. In the next step, we approached the new evaluation method of CVR capacity using {sup 99m}Tc tracer by a serial dynamic SPECT with a slip-ring rotational gamma camera. These preliminally findings suggest that a serial dynamic SPECT may be more useful for analyzing the pathophysiology on brain circulation and CVR than conventional approaches. (author)

  17. Simultaneous cardiac output and regional myocardial perfusion determination with PET and nitrogen 13 ammonia

    DEFF Research Database (Denmark)

    Hove, Jens D; Kofoed, Klaus F; Wu, Hsiao M

    2003-01-01

    The purpose of this study was to evaluate the possibility of measuring cardiac output during positron emission tomography (PET) examination of myocardial perfusion with nitrogen 13 ammonia.......The purpose of this study was to evaluate the possibility of measuring cardiac output during positron emission tomography (PET) examination of myocardial perfusion with nitrogen 13 ammonia....

  18. Regional differences between 99mTc-ECD and 99mTc-HMPAO SPET in perfusion changes with age and gender in healthy adults

    International Nuclear Information System (INIS)

    Inoue, Kentaro; Nakagawa, Manabu; Goto, Ryoi; Kinomura, Shigeo; Sato, Tachio; Sato, Kazunori; Fukuda, Hiroshi

    2003-01-01

    A number of studies using single-photon emission tomography (SPET) have shown perfusion changes with age in several cortical and subcortical areas, which might distort the results of perfusion imaging studies of neuropsychiatric disorders. Technetium-99m labelled ethyl cysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO) are both used as markers of cerebral perfusion, but have different pharmacokinetics and retention patterns. The aim of this study was to determine whether age and gender effects on perfusion SPET differ depending on whether 99m Tc-HMPAO or 99m Tc-ECD is used. Forty-five subjects (20 male and 25 female, mean age 52.8±6.6 years) were assigned to 99m Tc-HMPAO SPET (HMPAO group), and 39 subjects (24 male and 15 female, mean age 52.6±6.7 years) to 99m Tc-ECD SPET (ECD group). SPET images were obtained about 10 min after intravenous injection of approximately 800 MBq 99m Tc-HMPAO or 99m Tc-ECD using the same SPET scanner. Three-dimensional volumetric magnetic resonance imaging was performed to as7sess morphological changes in the grey matter. All image processing and statistical analyses were performed using SPM99 software. An area in the right anterior frontal lobe showed an increase in perfusion with age only in the HMPAO group, whereas areas in the bilateral retrosplenial cortex showed decreases in perfusion with age only in the ECD group; neither group showed corresponding changes in the grey matter. The present study shows that different effects of age on perfusion are observed depending on whether 99m Tc-HMPAO and 99m Tc-ECD is used. This suggests that the results of perfusion SPET are differently confounded depending on the tracer used, and that perfusion SPET with these tracers has limitations when used in research on subtle perfusion changes. (orig.)

  19. Regional differences between {sup 99m}Tc-ECD and {sup 99m}Tc-HMPAO SPET in perfusion changes with age and gender in healthy adults

    Energy Technology Data Exchange (ETDEWEB)

    Inoue, Kentaro; Nakagawa, Manabu; Goto, Ryoi; Kinomura, Shigeo; Sato, Tachio; Sato, Kazunori; Fukuda, Hiroshi [Department of Nuclear Medicine and Radiology, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi Aoba-ku, 980-8575, Sendai (Japan)

    2003-11-01

    A number of studies using single-photon emission tomography (SPET) have shown perfusion changes with age in several cortical and subcortical areas, which might distort the results of perfusion imaging studies of neuropsychiatric disorders. Technetium-99m labelled ethyl cysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO) are both used as markers of cerebral perfusion, but have different pharmacokinetics and retention patterns. The aim of this study was to determine whether age and gender effects on perfusion SPET differ depending on whether {sup 99m}Tc-HMPAO or {sup 99m}Tc-ECD is used. Forty-five subjects (20 male and 25 female, mean age 52.8{+-}6.6 years) were assigned to {sup 99m}Tc-HMPAO SPET (HMPAO group), and 39 subjects (24 male and 15 female, mean age 52.6{+-}6.7 years) to {sup 99m}Tc-ECD SPET (ECD group). SPET images were obtained about 10 min after intravenous injection of approximately 800 MBq {sup 99m}Tc-HMPAO or {sup 99m}Tc-ECD using the same SPET scanner. Three-dimensional volumetric magnetic resonance imaging was performed to as7sess morphological changes in the grey matter. All image processing and statistical analyses were performed using SPM99 software. An area in the right anterior frontal lobe showed an increase in perfusion with age only in the HMPAO group, whereas areas in the bilateral retrosplenial cortex showed decreases in perfusion with age only in the ECD group; neither group showed corresponding changes in the grey matter. The present study shows that different effects of age on perfusion are observed depending on whether {sup 99m}Tc-HMPAO and {sup 99m}Tc-ECD is used. This suggests that the results of perfusion SPET are differently confounded depending on the tracer used, and that perfusion SPET with these tracers has limitations when used in research on subtle perfusion changes. (orig.)

  20. Utility of Brain SPECT 99mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia DA and dissociative motor disorders DMD (previously termed as hysteria)

    International Nuclear Information System (INIS)

    Ali, F.

    2007-01-01

    Full text: The aim of the study was to assess the utility of Brain SPECT 99 mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia (DA) and dissociative motor disorders (DMD) (previously termed as Hysteria). Materials and Methods: 20 patients were included in the study with a mean age of 26 years, 08 of them suffering from DA and 12 from DMDs. A consultant psychiatrist on the basis of ICD-10 criteria made the diagnosis. Patients were divided into two categories according to the duration of their illness. Category A; included 10 patients having less than six months duration of illness. Category B; included 10 patients having duration of illness more than six months. Ten normal controls having no signs and symptoms of any psychiatric disorder were also included in the study. Brain SPECT study was carried out using 99 mTc-HMPAO. Semiquantitative analysis was done by calculating cortical and cerebellar ratios in normals and comparing the same in the patients. Results: By comparing regional cerebral blood flow ratios of both the categories with normal group, patients suffering from DA showed hypoperfusion in bilateral temporal lobes, in both frontal association areas and both orbito frontal regions and patients suffering for more than 06 months showed a slightly more exaggerated pattern of hypoperfusion in the same cortical areas. On the other hand in DMD only the patients suffering for more than 06 months showed altered cerebral blood perfusion like hypoperfusion in both of the frontal motor areas, hypoperfusion in both temporal lobes and marked hyperperfusion in both orbito frontal areas. Conclusion: Patients of DA show abnormal cerebral perfusion pattern whether in acute or chronic stage while only chronic DMD states precipitate altered cerebral perfusion patterns and these can be visualized on a Brain SPECT study. (author)

  1. Differences in cerebral perfusion deficits in mild traumatic brain injury and depression using single photon emission computed tomography

    OpenAIRE

    Kristoffer eRomero; Sandra E Black; Sandra E Black; Anthony eFeinstein

    2014-01-01

    Background: Numerous studies have shown decreased perfusion in the prefrontal cortex following mild traumatic brain injury (mTBI). However, similar hypoperfusion can also be observed in depression. Given the high prevalence of depressive symptoms following mTBI, it is unclear to what extent depression influences hypoperfusion in TBI.Methods: Mild TBI patients without depressive symptoms (mTBI-noD, n = 39), TBI patients with depressive symptoms (mTBI-D, n = 13), and 15 patients with major depr...

  2. Regional measurement of ventilation and perfusion to detect subtle lung abnormalities in coal miners

    International Nuclear Information System (INIS)

    Susskind, H.; Liu, J.; Brill, A.B.

    1986-01-01

    The relationship between regional pulmonary ventilation (V) and perfusion (Q) uniquely determines the amount of gas exchange that occurs in the lungs. Therefore, the pixel-by-pixel distributions of V and Q were measured with continuously inhaled Kr-81m and i.v. injected Tc-99m MAA, respectively, in a group of 71 subjects exposed to coal dust and then compared with those from a control group of 9 healthy volunteers. Each subject sat upright with his back against a large-field-of-view scintillation camera; 500,000 count images were obtained, analyzed by computer, and then displayed in a 64 x 64 matrix. Individual pixel values of V and Q were correlated by a best-fit regression line, whose slope was proportional to the overall V/Q ratio. The slopes of individual groups of nonsmokers, ex-smokers, and smokers (0.83-0.85) were significantly greater (p < 0.02) than the slope of the controls (0.70 +/- 0.07). In addition, the authors found that the skewness of plots of frequency distribution of V/Q and of V and Q vs V/Q for the individual patient groups was statistically different from that of the normals (p < 0.01). Statistical analysis of local and Q values therefore appears to be a potentially useful, non-invasive method to evaluate subtle regional lung impairment

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

    International Nuclear Information System (INIS)

    Stefaniak, B.

    2002-01-01

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

  4. Altered Regional Cerebral Blood Flow in Chronic Whiplash Associated Disorders

    NARCIS (Netherlands)

    Vállez García, David; Doorduin, Janine; Willemsen, Antoon T.M.; Dierckx, Rudi A.j.o.; Otte, Andreas

    There is increasing evidence of central hyperexcitability in chronic whiplash-associated disorders (cWAD). However, little is known about how an apparently simple cervical spine injury can induce changes in cerebral processes. The present study was designed (1) to validate previous results showing

  5. A study on regional cerebral circulation in stroke patients with aphasia

    International Nuclear Information System (INIS)

    Kudo, Ryozo

    1985-01-01

    To study the pathophysiology of aphasia due to cerebral stroke, regional cerebral blood flow (rCBF) was measured by the 133 Xe clearance method and the volume of low density area (LDA) was estimated on the basis of computerized tomography in 43 thrombotic (24 aphasia and 19 non-aphasia), 30 hemorrhagic (16 aphasia and 14 non-aphasia) and 6 non-stroke cases. 1) In the healthy hemisphere, rCBF showed no significant difference between aphasia and non-aphasia in both thrombotic and hemorrhagic cases. In the affected hemisphere, thrombotic cases showed significantly decreased rCBF in aphasic cases as compared to non-aphasic, however, hemorrhagic cases revealed no difference. 2) LDA volume showed no significant difference between aphasia and non-aphasia in cerebral thrombosis, however, LDA volume in non-aphasia was smaller than that in aphasia in cerebral hemorrage. 3) Significant differences in the pathophysiology of aphasia due to cerebral stroke were recognized between cerebral thrombosis and cerebral hemorrhage. Such differences should be taken into consideration in the management and treatment of aphasia caused by cerebral stroke. (author)

  6. Utility of the cerebral SPECT in schizophrenia

    International Nuclear Information System (INIS)

    Heuguerot, C.H.; Lopez-Lerena, J.J.; Quagliata, A.; Hermida, J.C.; Oliveira, M.C.; Anastasia, H.

    2002-01-01

    Objective: To compare cortical and subcortical cerebral perfusion in schizophrenics patients with normal controls, and analyze the relation to clinical patterns and neuroleptic treatment. Method: 18 patients meeting DSM-IV criteria for schizophrenia under neuroleptic treatment (except 3 cases), evaluated with clinical scales (BPRS and PANSS). The control group included 5 subjects in good health. All subjects were studied with single photon emission computed tomography (SPECT) using technetium-99 etilencisteinato (99mTc-ECD) as a tracer. Region of interest (ROI) were defined in cerebral cortex and thalamus-basal ganglia areas. The cortical cerebral blood flow was measured with a quantitative analysis, expressed as a ratio of regional tracer uptake to occipital cortex uptake. In basal ganglia and thalamus, regional blood flow was evaluated with a semiquantitative methodology, defining categories. Results: Schizophrenics patients showed a significant reduction of perfusion on a left anterior frontal cortex ('hipofrontality') and global decrease of perfusion on left hemisphere. The interhemispheric (left/right) ratio of perfusion was incremented respect control group. In thalamic-basal ganglia complex, a significant hypoperfusion was found in neuroleptic-free patients and control group. On the other hand, neuroleptic-treated patients revealed normal or increased regional blood flow in thalamus and basal ganglia. Only the clinical item 'thought disorder' had significant high correlation with perfusion on left structures (left anterior frontal, left lateral frontal, left temporo-parietal); the other items correlated with right structures. Conclusions: The findings suggest a pattern o left cerebral hypoperfusion in patients with an incremented interhemispheric ratio of cerebral blood flow. The pivotal role of thalamic and basal ganglia areas in the pathophysiology of schizophrenia and neuroleptic action was reaffirmed; apparently, perfusion in thalamic-basal ganglia

  7. Investigations of the cerebral blood flow by means of nuclear medicine in polycythemia vera rubra

    International Nuclear Information System (INIS)

    Franke, W.G.; Unger, L.; Mueller, J.

    1993-01-01

    P.v. represents a ''clinical model'' of diagnostic radionuclide application to evaluate the total and regional perfusion of brain. 107 polycythemians treated by or provided for radiophosphorus were studied by neurologic methods as EEG e.g. and with XCT if necessary. These studies were accomplished repeatedly in 62% of the surveyed patients. We found disturbed perfusion in brain: 32, diminuation of blood flow in vertebral-basilar region: 8, polyneuropathies: 27, psychic abnormalities: 60. Therapeutic effects became ascertained in 34% of hemipareses. The majority of polycythemic patients let recognize a regression of subjective complaints. The diagnostic informations obtained by radionuclide methods were compared to clinical and neurologic results as mentioned above. A good correlation could observed from radionuclide angiography, 133 Xe-studies of total and regional cerebral perfusion and HMPAO-SPECT to neurologic and radiological findings. 66% of studied patients showed abnormal radioactivity distribution at static scintigrams. Disturbances of cerebral perfusion were seen in 20 from 26 patients if radionuclide angiography was used. Especially the inflow to cerebral vessels was found retarded by this method. Even in 3 neurologically inconspicuous persons the cerebral perfusion was restricted. Only 5 patients without signs of decreased flow could be seen. In 9 of 10 cases studied using 133 Xenon referred to diminuation of cerebral perfusion. Both dynamic methods showed changes in perfusion depending from time course. Numerous localized defects of vascularization were detected by SPECT in some corresponding with neurologic symptoms in other patients differing from these ones. (orig./MG) [de

  8. Types of traumatic brain injury and regional cerebral blood flow assessed by [sup 99m]Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi [Chiba Univ. (Japan). School of Medicine

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with [sup 99m]technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: (1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, (2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and (3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author).

  9. Correlation of regional cerebral blood flow and positive/negative symptoms in schizophrenic patients: covariate SPM analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ki Chun; Kim, J. S.; Kim, C. Y.; Lee, H. K.; Moon, D. H. [Ulsan University, Seoul (Korea, Republic of)

    2002-07-01

    We investigated the relations between rCBF and psychopathology in schizophrenic patients using a SPM99. Thirty-two patients(M/F:22/10, 25{+-}5,6yr) with active symptoms of schizophrenia and 15 age matched normal controls underwent Tc-99m ECD brain perfusion SPECT. Psychopathology of all patients were also assessed according to PANSS (positive and negative syndrome scale in schizophrenia). By covariate SPM analysis, specific areas where rCBF correlated with sum scores of positive/negative synptoms were identified. Regional CBF of schizophrenics was different in several cortical regions from normal controls. Sum scores of positive symptoms were positively correlated with rCBF of both rectal and inferior frontal gyri and right transverse temporal gyrus, and negatively correlated with rCBF of left lingual and right middle temporal gyri (p<0.01). Sum scores of negative symptoms were positively correlated with rCBF of both middle temporal gyri and negatively correlated with rCBF of right superior parietal lobule and medial frontal gyrus (p<0.01). Positive and negative symptoms of schizophrenia were correlated with rCBF change in different regions of cerebral association cortex.

  10. Correlation of regional cerebral blood flow and positive/negative symptoms in schizophrenic patients: covariate SPM analysis

    International Nuclear Information System (INIS)

    Lim, Ki Chun; Kim, J. S.; Kim, C. Y.; Lee, H. K.; Moon, D. H.

    2002-01-01

    We investigated the relations between rCBF and psychopathology in schizophrenic patients using a SPM99. Thirty-two patients(M/F:22/10, 25±5,6yr) with active symptoms of schizophrenia and 15 age matched normal controls underwent Tc-99m ECD brain perfusion SPECT. Psychopathology of all patients were also assessed according to PANSS (positive and negative syndrome scale in schizophrenia). By covariate SPM analysis, specific areas where rCBF correlated with sum scores of positive/negative synptoms were identified. Regional CBF of schizophrenics was different in several cortical regions from normal controls. Sum scores of positive symptoms were positively correlated with rCBF of both rectal and inferior frontal gyri and right transverse temporal gyrus, and negatively correlated with rCBF of left lingual and right middle temporal gyri (p<0.01). Sum scores of negative symptoms were positively correlated with rCBF of both middle temporal gyri and negatively correlated with rCBF of right superior parietal lobule and medial frontal gyrus (p<0.01). Positive and negative symptoms of schizophrenia were correlated with rCBF change in different regions of cerebral association cortex

  11. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT.

    Science.gov (United States)

    Yamakami, I; Yamaura, A; Isobe, K

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99mtechnetium-hexamethyl propyleneamine oxime. Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurolog