• Title/Summary/Keyword: Cerebral perfusion

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The Usefulness of Deconvolution Perfusion CT in Patients with Acute Cerebral Infarction : Comparison with Diffusion MRI (급성 뇌경색 환자에서 Deconvolution perfusion CT의 유용성 : Diffusion MRI와 비교)

  • Eun, Sung-Jong;Kim, Young-Keun
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.25-31
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    • 2003
  • This study was performed to evaluate the usefulness of Deconvolution perfusion CT in patients with acute cerebral infarction. Nine patients with acute cerebral infarction underwent conventional CT and cerebral perfusion CT within 23 hours of the onset of symptoms. The perfusion CT scan for each patient was obtained at the levels of basal ganglia and 1cm caudal to the basal ganglia. By special imaging software, perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), and mean transit time(MTT) maps were created. The created lesions were evaluated on each perfusion maps by 3 radiolocical technician. MTT delay time was measured in the perfusion defect lesion and symmetric contralateral normal cerebral hemisphere. Lesion sire were measured on each perfusion map and compared with the value obtained by diffusion weighted MR imaging(DWMRI). All perfusion CT maps showed the perfusion defect lesion in all patients. There were remarkable CT delay in perfusion defect lesion. In comparison of lesion size between each perfusion map and DWMRI, the lesion on CBF map was the most closely correlated with the lesion on DWMRI(7/9). The size of perfusion defect lesion on MTT map was larger than that of lesion on DWMRI, suggesting that m map can evaluate the ischemic penumbra. Deconvolution Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra but also hemodynamic status in perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

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Regional Cerebral Perfusion in Progressive Supranuclear Palsy (진행성 핵상 마비에서의 국소 뇌혈류)

  • Lee, Won-Yong;Lee, Kyung-Han;Lee, Ki-Hyeong;Yoon, Byung-Woo;Lee, Myung-Chul;Lee, Sang-Bok;Jeon, Beom-S.
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.47-55
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    • 1996
  • Progressive supranuclear palsy (PSP) is a parkinson-plus syndrome characterized clinically by supranuclear ephthalmoplegia, 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 abnormality 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 $^{99m}Tc$-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.

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Implementation of Non-Invasive Cerebral Perfusion Platform (비침습적 대뇌관류 장치의 구현)

  • Lee, Jean;Kwon, Seong-tae;Kim, Young-kil
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2016.10a
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    • pp.105-108
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    • 2016
  • Shipping Along with the aging of the total population, its importance is greater cause of stroke, which is one of the diseases are listed cerebral perfusion is about 80%,.ie that the flow of blood flowing to the brain is reduced as the cause. One of the most typical prophylaxis and treatment of these stroke is to enhance cerebral perfusion. However, since the method of enhancing conventional cerebral perfusion have been conducted mainly in invasive method, giving a burden to the patient, the problem of inducing a number of complications were noted. Therefore, in this paper, an attempt to supplement the shortcomings of such invasive brain perfusion increase method, to provide a device to enhance the non-invasively brain perfusion.

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The functional imaging to Diagnose Acute Cerebral infarction Comparing between CT Perfusion and MR Diffusion Imaging (급성 뇌경색 진단을 위한 CT관류영상과 MR확산영상의 비교)

  • Kim, Seon-Hee;Eun, Sung-Jong;Rim, Chae-Pyeong
    • Journal of the Korean Society of Radiology
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    • v.6 no.1
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    • pp.19-26
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    • 2012
  • It is very important for early diagnosis and therapy with ischamic cerebral infarction patients. This study was to know the ischemic penumbra lesion which compared CT-perfusion and diffusion weighted MRI(DWMRI) with acute cerebral infarction patients. 12 acute cerebral infarction patients had performed perfusion CT and performed DWMRI. Perfusion images including cerebral blood volume(CBV), cerebral blood flow(CBF), time to peak(TTP) and mean transit time(MTT) maps obtained the values with defect lesion and contralateral normal cerebral hemisphere and DWMRI was measured by signal intensity and compared of lesion size between each perfusion map. All perfusion CT maps showed the perfusion defect lesions in all patients. There were remarkable TTP and MTT delay in perfusion defect lesions. The lesions on CBF map was the most closely correlated with the lesions on DWMRI. The size of perfusion defect lesions on TTP and MTT map was larger than that of lesions on DWMRI, suggesting that MTT map can evaluate the ischemic penumbra. Perfusion CT maps make it possible to evaluate not only ischemic core and ischemic penumbra, but also hemodynamic status in the perfusion defect area. These results demonstrate that perfusion CT can be useful to the diagnosis and treatment in the patients with acute cerebral ischemic infarction.

Cerebral Hemodynamic Analysis in Pediatric Moyamoya Patients using Perfusion Weighted MRI (관류 강조 자기공명 영상을 이용한 소아 모야모야 환아의 뇌 혈역학 분석)

  • Chang, Won-Seok;Kim, Tae-Gon;Lee, Seung-Koo;Choi, Jung-Uhn;Kim, Dong-Seok
    • Journal of Korean Neurosurgical Society
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    • v.37 no.3
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    • pp.207-212
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    • 2005
  • Objective: Classically, single photon emission tomography is known to be the reference standard for evaluating the hemodynamic status of patients with moyamoya disease. Recently, T2-weighted perfusion magnetic resonance(MR) imaging has been found to be effective in estimating cerebral hemodynamics in moyamoya disease. We aim to assess the utility of perfusion-weighted MR imaging for evaluating hemodynamic status of moyamoya disease. Methods: The subjects were fourteen moyamoya patients(mean age: 7.21 yrs) who were admitted at our hospital between Sep. 2001 to Sep 2003. Four normal children were used for control group. Perfusion MR imaging was performed before any treatment by using a T2-weighted contrast material-enhanced technique. Relative cerebral blood volume(rCBV) and time to peak enhancement(TTP) maps were calculated. Relative ratios of rCBV and TTP in the anterior cerebral artery(ACA), middle cerebral artery(MCA) and basal ganglia were measured and compared with those of the posterior cerebral artery(PCA) in each cerebral hemispheres. Using this data, we analysed the hemodynamic aspect of pediatric moyamoya disease patients in regarding to the age, Suzuki stage, signal change in FLAIR MR imaging, and hemispheres inducing symptoms. Results: The mean rCBV ratio of ACA, MCA did not differ between normal children and moyamoya patients. However the significant TTP delay was observed at ACA, MCA territories (mean = 2.3071 sec, 1.2089 see, respectively, p < 0.0001). As the Suzuki stage of patients is advanced, rCBV ratio is decreased and TTP differences increased. Conclusion: Perfusion MR can be applied for evaluating preoperative cerebral hemodynamic status of moyamoya patients. Furthermore, perfusion MR imaging can be used for determine which hemisphere should be treated, first.

Retrograde Cerebral Perfusion in the Surgical Treatment of Ascending Aortic Aneurysm -Report of 4 Cases- (역행성 뇌혈 관류를 이용한 상행대동맥류 수술 -4례 보고-)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.8
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    • pp.788-791
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    • 1995
  • Dissecting aortic aneurysm of ascending aorta is a life threatening condition which requires prompt surgical correction. With deep hypothermic circulatory arrest and retrograde cerebral perfusion via superior vena cava, we could replaced ascending aorta in 4 cases safely. All of 4 cases; femoral artery, right auricle were used as cannulation site. The duration of circulatory arrest were 28, 30, 45, 60 minute in each cases and rectal temperature was 2$0^{\circ}C$ at that time. At the time of retrograde cerebral perfusion, we maintained central venous pressure under 25mmHg. We resected all of dissecting portion and replaced it with Hemashield graft. There were no deaths but two of four reoperated because of bleeding.

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Implementation of Non-Invasive Cerebral Perfusion Platform (비침습적 대뇌관류 장치의 구현)

  • Kwon, Seong-tae;Lee, Jean;Kim, Young-kil
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.5
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    • pp.1016-1026
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    • 2017
  • Shipping Along with the aging of the total population, its importance is greater cause of stroke, which is one of the diseases are listed cerebral perfusion is about 80%,.ie that the flow of blood flowing to the brain is reduced as the cause. One of the most typical prophylaxis and treatment of these stroke is to enhance cerebral perfusion. There are several ways to increase cerebral blood flow are a therapy through drugs, through surgery and invasive NeuroFlo. NeuroFlo is to insert a catheter to which a balloon is attached into a patient's artery. However, since the method of enhancing conventional cerebral perfusion have been conducted mainly in invasive method, giving a burden to the patient, the problem of inducing a number of complications were noted. In this paper, an attempt to supplement the shortcomings of such invasive brain perfusion increase method, to provide a device to enhance the non-invasively brain perfusion.

Repair of Distal Aortic Arch and Descending Aorta Dissection under Right Atrium-Retrograde Cerebral Perfusion (우심방-역행성 뇌관류 하에 원위 대동맥궁 및 하행대동맥 박리증의 수술)

  • 최종범;양현웅;박권재;임영혁
    • Journal of Chest Surgery
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    • v.35 no.10
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    • pp.740-744
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    • 2002
  • Retrograde cerebral perfusion under hypothermic circulatory arrest is a simple and useful adjunct to avoid cerebral ischemic injury in the treatment of aortic arch pathology. In the surgery of distal aortic arch and proximal descending aortic lesions through the left thoracotomy incision, right atrium-retrograde cerebral perfusion (RA-RCP) through a venous cannula positioned into the right atrium is simpler than retrograde cerebral perfusion through superior vena cava. The time limits for RA-RCP during aortic arch reconstruction have yet to be clarified. We, herein, present a case with uneventful recovery after RA-RCP of 94 minutes during reconstruction of aortic arch and descending aorta. These data suggest that RA-RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RA-RCP exceeds 90 minutes.

Assessment of Hyperperfusion by Brain Perfusion SPECT in Transient Neurological Deterioration after Superficial Temporal Artery-Middle Cerebral Artery Anastomosis Surgery (천측두동맥-중대뇌동맥 문합술 후 발생한 일과성 신경학적 악화에서 뇌관류 SPECT를 이용한 과관류 평가)

  • Lee, Jeong-Won;Kim, Yu-Kyeong;Lee, Sang-Mi;Eo, Jae-Sun;Oh, Chang-Wan;Lee, Won-Woo;Paeng, Jin-Chul;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.4
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    • pp.267-274
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    • 2008
  • Purpose: Transient neurological deterioration (TND) is one of the complications after extracranial-intracranial bypass surgery, and it has been assumed to be caused by postoperative transient hyperperfusion. This study was performed to evaluate the relationship between TND and preoperative and postoperative cerebral perfusion status on brain perfusion SPECT following superficial temporal artery - middle cerebral artery (STA-MCA) anastomosis surgery. Materials and Methods: A total of 60 STA-MCA anastomosis surgeries of 56 patients (mean age: $50{\pm}16$ yrs; M:F=29:27; atherosclerotic disease: 33, moyamoya disease: 27) which were done between September 2003 and July 2006 were enrolled. The resting cerebral perfusion and cerebral vascular reserve (CVR) after acetazolamide challenge were measured before and 10 days after surgery using 99mTc-ethylcysteinate dimer (ECD) SPECT. Moreover, the cerebral perfusion was measured on the third postoperative day. With the use of the statistical parametric mapping and probabilistic brain atlas, the counts for the middle cerebral artery (MCA) territory were calculated for each image, and statistical analyses were performed. Results: In 6 of 60 cases (10%), TND occurred after surgery. In all patients, the preoperative cerebral perfusion of affected MCA territory was significantly lower than that of contralateral side (p=0.002). The cerebral perfusion on the third and tenth day after surgery was significantly higher than preoperative cerebral perfusion (p=0.001, p=0.02). In TND patients, basal cerebral perfusion and CVR on preoperative SPECT were significantly lower than those of non-TND patients (p=0.01, p=0.05). Further, the increases in cerebral perfusion on the third day after surgery were significant higher than those in other patients (p=0.008). In patients with TND, the cerebral perfusion ratio of affected side to contralateral side on third postoperative day was significantly higher than that of other patients (p=0.002). However, there was no significant difference of the cerebral perfusion ratio on preoperative and tenth postoperative day between patients with TND and other patients. Conclusion: In patients with TND, relative and moderate hyperperfusion was observed in affected side after bypass surgery. These finding may help to understand the pathophysiology of TND.

Effect of Intracarotid Cold Saline Infusion during Cerebral Ischemia on Brain Edema in the Rabbit (뇌허혈기동안 경동맥으로 냉각 생리식염수 주입이 허혈후 뇌부종에 미치는 영향)

  • Kim, Sae-Yeon;Choi, Kyu-Taek
    • Journal of Yeungnam Medical Science
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    • v.12 no.2
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    • pp.260-268
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    • 1995
  • Ischemia results when the decrease in tissue perfusion exceeds the tissues ability to increase an oxygen extraction from the blood. Brain edema has been defined as an abnormal accumulation of fluid within brain parenchyma associated with a volumetric enlargement of the brain tissue. In most instances, the labelling of edema as vasogenic or cytotoxic is only relative. For cerebral protection, there were many possible techniques which could increase or maintain cerebral perfusion and reduce cerebral metabolic demand for oxygen. This study was carried out the effect of mild brain hypothermia which was induced by infusion with cold saline into the carotid artery, during brief episodes of transient global ischemia on postischemic brain edema in rabbit. Eight rabbits were anesthetized with halothane and mechanically ventilated with oxygen. For isolated cerebral perfusion, polyethylene catheter was inserted left carotid artery for infusion of cold saline, external carotid artery was ligated, vertebral arteries were cautherized, right carotid artery was snared for ischemia and femoral artery and vein were also canulated for monitoring and drug treatment. At 3 hours After transient global ischemia, specific gravity of cerebral cortex and hippocampus was compared with no-perfusion group , perfusion with cold saline group and normal group. There was no significant differences in physiologic variables among the groups before transient global ischemia. But during transient global ischemia, brain temperature of perfusion group was decreased when compared to no perfusion group. Specific gravity of cerebral cortex and hippocampus of no-perfusion group and perfusion group was statistically significant when compared to normal group (p<0.01). The results of this study suggested that mild brain hypothermia with intracarotid cold saline infusion during brief episodes of transient global ischemia had decreased postischemic brain edema in rabbit.

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