• Title/Summary/Keyword: cerebral perfusion

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Dynamic Characteristic Change of the Cerebral Blood Volume in Cats Using Perfusion MR Imaging (MR 관류영상을 이용한 고양이 대뇌 혈류량의 동적특성 변화)

  • 박병래;김학진;전계록
    • Journal of Biomedical Engineering Research
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    • v.25 no.4
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    • pp.243-251
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    • 2004
  • This study was to quantitative analysis compare to dynamic characteristic change of the regional cerebral blood volume (rCBV) after development of cerebral fat embolism in cats using perfusion MR Imaging. Forty-four adult rats were used. Triolein (n = 15), oleic acid (n = 9) and linoleic acid (n = 11) were injected into the internal carotid artery using microcatheter through the transfemoral approach. Polyvinyl alcohol (Ivalon) (n = 9) was injected as a control group. Perfusion MR images were obtained at 30 minutes and 2 hours after embolization, based on T2 and diffusion-weighted images. The data was time-to-signal intensity curve and ΔR$_2$* curve were obtained continuously with the aid of home-maid image proc in.leased significantly at 2 hours compared with those of 30 minutes (P<0.005). In conclusion, cerebral blood flow decreased in cerebral fat embolism immediately after embolization and recovered remarkably in time course. It is thought that clinically informations to dynamic characteristic change of the cerebral hemodynamics to the early finding in cerebral infarction by DWI and PWI

The Changes of Cerebral Metabolic and Hemodynamic Parameters, Brain Histology, and Serum Levels of Neuron-Specific Enolase During Retrograde Cerebral Perfusion Under Pofound Hypothermic total Circulatory Arrest in Pigs (돼지에서 초저체온 순환정지 하의 역행성 뇌관류시 뇌대사, 혈류역학 지표, 뇌조직 소견 및 혈청 내 neuron-specific enolase의 변화)

  • Kim, Kyung-Hwan;Ahn, Hyuk
    • Journal of Chest Surgery
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    • v.33 no.6
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    • pp.445-468
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    • 2000
  • Background: Retrograde cerebral perfusion(RCP) is currently used for brain protection during aorta surgery, however, for the safety of it, various data published so far are insufficient. We performed RCP using pig and investiaged various parameters of cerebral metabolism and brain injury after RCP under deep hypothermia. Material and Method: We used two experimental groups: in group I(7 pigs, 20 kg), we performed RCP for 120 minutes and in group II (5 pigs, 20 kg), we did it for 90 minutes. Nasopharyngeal temperature, jugular venous oxygen saturation, electroencephalogram were continuously monitored, and we checked the parameters of cerebral metabolism, histological changes and serum levels of neuron-specific enolose(NSE) and lactic dehydrogenase(LDH). Central venous pressure during RCP was mainained in the range of 25 to 30 mmHg. Result: Perfusion flow rates(ml/min) during RCP were 130$\pm$57.7(30 minutes), 108.6$\pm$55.2(60 minutes), 107.1$\pm$58.8(90 minutes), 98.6$\pm$58.7(120 minutes) in group I and 72$\pm$11.0(30 minutes), 72$\pm$11.0(60 minutes), 74$\pm$11.4(90 minutes) in group II. The ratios of drain flow to perfusion flow were 0.18(30 minutes), 0.19(60 minutes), 0.17(90 minutes), 0.16(120 minutes) in group I and 0.21, 0.20, 0.17 in group II. Oxygen consumptions(ml/min) during RCP were 1.80$\pm$1.37(30 minutes), 1.72$\pm$1.23(60 minutes), 1.38$\pm$0.82(90 minutes), 1.18$\pm$0.67(120 minutes) in group I and 1.56$\pm$0.28(30 minutes), 1.25$\pm$0.28(60 minutes), 1.13$\pm$0.26(90 minutes). We could observe an decreasing tendency of oxygen consumption after 90 minutes of RCP in group I. Cerebrovascular resistance(dynes.sec.cm-5) during RCP in group I incrased from 71370.9$\pm$369145.5 to 83920.9$\pm$49949.0 after the time frame of 90 minutes(p<0.05). Lactate(mg/min) appeared after 30 minutes of RCP and the levels were 0.15$\pm$0.07(30 minutes), 0.18$\pm$0.10(60 minutes), 0.19$\pm$0.19(90 minutes), 0.18$\pm$0.10(120 minutes) in group I and 0.13$\pm$0.09(30 minutes), 0.19$\pm$0.03(60 minutes), 0.29$\pm$0.11(90 minutes) in group II. Glucose utilization, exudation of carbon dioxide, differences of cerebral tissue acidosis between perfusion blood and drain blood were maintained constantly during RCP. Oxygen saturation levels(%) in drain blood during RCP were 22.9$\pm$4.4(30 minutes), 19.2$\pm$4.5(60 minutes), 17.7$\pm$2.8(90 minutes), 14.9$\pm$2.8(120 minutes) in group I and 21.3$\pm$8.6(30 minutes), 20.8$\pm$17.6(60 minutes), 21.1$\pm$12.1(90 minutes) in group II. There were no significant changes in cerebral metabolic parameters between two groups. Differences in serum levels of NSE and LDH between perfusion blood and drain blood during RCP showed no statistical significance. Serum levels of NSE and LDH after resuming of cardipulmonary bypass decreased to the level before RCP. Brain water contents were 0.73$\pm$0.03 in group I and 0.69$\pm$0.06 in group II and were higher than those of the controls(p<0.05). The light microscopic findings of cerebral neocortex, basal ganglia, hippocampus(CA1 region) and cerebellum showed no evidence of cerebral injury in two groups and there were no different electron microscopy in both groups(neocortex, basal ganglia and hippocampus), but they were thought to be reversible findings. Conclusion: Although we did not proceed this study after survival of pigs, we could perform the RCP successfully for 120 minutes with minimal cerebral metabolism and no evidence of irreversible brain damage. The results of NSE and LDH during and after RCP should be reevaluated with survival data.

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Effects of Crude Saponin and Saponin-free Fraction of Korea Red Ginseng on the Skin and Cerebral Blood Flow in the Rats (백서의 피부 및 뇌혈류에 미치는 고려홍삼 사포닌 및 비사포닌의 영향)

  • Kim, Shin-Hee;Kim, Cuk-Seong;Park, Jin-Bong;Han, Chan-Soo;Kim, Kwang-Jin;Kim, Shin-Hye;Kim, Se-Hoon;Nam, Ki-Yeul;Jeon, Byeong-Hwa
    • Journal of Ginseng Research
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    • v.26 no.3
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    • pp.132-138
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    • 2002
  • To study the effect of Korea red ginseng (KCG) on the skin and cerebral blood flow, we evaluated the change of skin perfusion rate and cerebral perfusion rate after the intravenous, intraperitoneal, and oral administration of crude saponin (CS) and saponin-free fraction (SFF) of KRG in the rats. The change of skin perfusion rate and cerebral perfusion rate was measured laser doppler flowmetry. The intravenous injections of CS or SFF of KRG and intraperitoneal injection of SFF of KRG did not change the relative skin and cerebral blood flow in the rats. When the rats were treated by the intraperitoneal injection of CS of KRG, relative cerebral blood flow was significantly increased with a time-dependent manner, however, relative skin blood flow was not influenced by the them. Oral administration of CS of KRG slightly increased skin blood flow in the rats. Also, the change of cerebral blood flow by transient bilateral carotid arterial clamp in the CS-treated rats was significantly decreased, compared with control groups. From the above results, it was suggested that Korea red ginseng have a increasing property of cerebral blood flow in the rats.

Thalamic Syndrome with Related Cortical Hypoperfusion on $^{99m}Tc-HMPAO$ Brain SPECT (시상 증후군에 동반된 대뇌 피질 혈류 변화에 대한 $^{99m}Tc-HMPAO$ Brain SPECT)

  • Kim, Eun-Kyung;Chung, Tae-Sub;Suh, Jung-Ho;Kim, Dong-Ik;Lee, Jong-Doo;Park, Chang-Yoon;Hong, Yong-Kook;Lee, Myung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.33-39
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    • 1992
  • Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

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Changes in the Regional Cerebral Perfusion after Eye Movement Desensitization and Reprocessing:A SPECT Study of Two Cases (안구운동 민감 소실 및 재처리 요법(Eye Movement Desensitization and Reprocessing) 치료 후 국소 뇌 혈류 변화:두 증례의 SPECT 연구)

  • Oh, Dong-Hoon;Choi, Joonho
    • Korean Journal of Biological Psychiatry
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    • v.11 no.2
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    • pp.173-180
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    • 2004
  • Over the last decade, EMDR(Eye Movement Desensitization and Reprocessing) has emerged as a promising new treatment for trauma and other anxiety-based disorders. However, neurobiological mechanism of EMDR has not been well understood. Authors report SPECT findings of two patients of PTSD before and after EMDR. Brain 99mTc-ECD-SPECT was performed before and after EMDR treatment. To evaluate the significance of changes in the regional cerebral perfusion, t-test was conducted on the resulting images using SPM99. In addition, clinical scales(CAPS, CGI, STAI) were employed to asses the changes in the clinical symptoms of the patients. After EMDR treatment, each showed significant improvement in clinical symptoms. The cerebral perfusion increased in bilateral dorsolateral prefrontal cortex, and decreased in the temporal association cortex. The differences in the cerebral perfusion between patients after treatment and normal controls decreased. These changes appeared mainly in the limbic area the and the prefrontal cortex. These results suggest that EMDR may show the therapeutic effect through 1) improvement in the emotional control by increased activity in the prefrontal cortex, 2) inhibited hyperstimuli on amygdala by deactivation of the association cortex, 3) inhibition on past trauma related memory, and 4) keeping the functional balance between the limbic area and the prefrontal cortex. This case report needs further replication from studies with larger sample.

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Value of Perfusion Weighted Magnetic Resonance Imaging in the Diagnosis of Supratentorial Anaplastic Astrocytoma

  • Lee, Kyung Mi;Kim, Eui Jong;Jahng, Geon-Ho;Park, Bong Jin
    • Journal of Korean Neurosurgical Society
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    • v.56 no.3
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    • pp.261-264
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    • 2014
  • We report perfusion weighted imaging (PWI) findings of nonenhanced anaplastic astrocytoma in a 30-year-old woman. Brain magnetic resonance imaging showed a nonenhanced brain tumor with mild peritumoral edema on the right medial frontal lobe and right genu of corpus callosum, suggesting a low-grade glioma. However, PWI showed increased relative cerebral blood volume, relative cerebral blood flow, and permeability of nonenhanced brain tumor compared with contralateral normal brain parenchyma, suggesting a high-grade glioma. After surgery, final histopathological analysis revealed World Health Organization grade III anaplastic astrocytoma. This case demonstrates the importance of PWI for preoperative evaluation of nonenhanced brain tumors.

Open Mitral Commissurotomy: A Report of 21 Cases (개방성 승모판막 절개술에 관한 연구)

  • 이영균
    • Journal of Chest Surgery
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    • v.6 no.1
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    • pp.69-88
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    • 1973
  • Twenty-one cases of open mitral commissurotomy were done between October 1963 and March 1973. 1] Preoperative embolism consists of 7 cerebral and 2 peripheral cases. Two operative cerebral embolism cases were noted. 2] There were two cases of restenosis, one associated valvular disease, three mitral insufficiency cases, and six cases of pulmonary hypertension. 3] Out of 21 cases, 13 cases of atrial fibrillation were found and two cases of atrial fibrillation were found postoperatively among 8 cases of preoperatively normal sinus rhythm. 4] During operation 10 cases of valvular calcification and 6 cases of left atrial thrombus were noted. 5] Complete blood count, electrolyte and acid base balance showed normal range of data. 6] Four helix reservoir whole blood total body perfusion and 17 cases of .hemodilution perfusion utilizing Rygg-Kyvsgaard bag oxygenator with sigma motor were performed. 7] EACA 125 mg/kg intravenous administration before cardiopulmonary bypass resulted in markedly diminished postoperative bleeding. 8] Post-perfusion urine amount was in satisfactory range. 9] There were 2 operative mortality due to coronary embolism and three cases of hospital death, 2 due to severe hepatic failure and one due to cerebral embolism. 10] Sixteen survival cases showed marked clinical improvements and almost all of them returned to their occupation satisfactorily after operation.

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Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis (일측 뇌경색 환자에서 반대측 뇌의 보상성 뇌관류 증가에 대한 SPM 분석)

  • Hong, Sun-Pyo;Yoon, Joon-Kee;Choi, Bong-Hoi;Joo, In-Soo;Yoon, Seok-Nam
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.5
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    • pp.347-353
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    • 2008
  • Purpose: Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Materials and Methods: Fifty seven $^{99m}TC-Ethylene$ Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=$56{\pm}17\;years$) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age=$36{\pm}10\;years$) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. Results: All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Conclusion: Using $^{99m}Tc-ECD$ SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

Clinical Application of Acute Ischemic Stroke in Perfusion Computed Tomography (초급성 허혈성 뇌졸중에서 관류 전산화단층촬영의 임상적 적용에 대한 연구)

  • Lee, Jong-Seok;Yoo, Beong-Gyu;Kweon, Dae-Cheol
    • Progress in Medical Physics
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    • v.18 no.3
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    • pp.149-160
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    • 2007
  • Recent advent of 64-multidetctor (MD) CT enables more coverage of Z-axis in the perfusion imaging. The purpose of this study was to evaluate the clinical usefulness of perfusion CT by using 64-MD CT in detecting the lesion in patients with acute stroke. The perfusion CT was performed by using 64-MD CT in 62 consecutive patients who were initially suspected to have subacute ischemic stroke symptoms during the period of recent 9 months. These patients had subacute stroke (n=62). CT scanning was conducted with Jog Mode which provided 16 imaging slices with 5 mm of slice thickness, and 8 cm of coverage in Z-axis. Scan interval was 1 seconds for each imaging slice and total 15 scans were repeated. After CT scanning, perfusion maps (CBV, CBF, MTT and TTP) were created at Extended Brilliance Workstation. The CBV and CBF maps showed that lesions were smaller images. While on the MTT and TTP map lesions were seen to be larger fifty-one were large than they appeared on these images. Two slices of perfusion maps obtained at the level of the basal ganglia were chosen to simulate conventional older perfusion CT with 8 cm of coverage in Z-axis. TTP and MTT maps may be clinically useful for evaluation of the penumbral zone in cases of aubacute cerebral ischemic stroke. The perfusion CT is useful in the assessment of acute stroke as an initial imaging modality.

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