• 제목/요약/키워드: Perfusion

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Monitoring Cerebral Perfusion Changes Using Arterial Spin-Labeling Perfusion MRI after Indirect Revascularization in Children with Moyamoya Disease

  • Seul Bi Lee;Seunghyun Lee;Yeon Jin Cho;Young Hun Choi;Jung-Eun Cheon;Woo Sun Kim
    • Korean Journal of Radiology
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    • 제22권9호
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    • pp.1537-1546
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    • 2021
  • Objective: To assess the role of arterial spin-labeling (ASL) perfusion MRI in identifying cerebral perfusion changes after indirect revascularization in children with moyamoya disease. Materials and Methods: We included pre- and postoperative perfusion MRI data of 30 children with moyamoya disease (13 boys and 17 girls; mean age ± standard deviation, 6.3± 3.0 years) who underwent indirect revascularization between June 2016 and August 2017. Relative cerebral blood flow (rCBF) and qualitative perfusion scores for arterial transit time (ATT) effects were evaluated in the middle cerebral artery (MCA) territory on ASL perfusion MRI. The rCBF and relative time-to-peak (rTTP) values were also measured using dynamic susceptibility contrast (DSC) perfusion MRI. Each perfusion change on ASL and DSC perfusion MRI was analyzed using the paired t test. We analyzed the correlation between perfusion changes on ASL and DSC images using Spearman's correlation coefficient. Results: The ASL rCBF values improved at both the ganglionic and supraganglionic levels of the MCA territory after surgery (p = 0.040 and p = 0.003, respectively). The ATT perfusion scores also improved at both levels (p < 0.001 and p < 0.001, respectively). The rCBF and rTTP values on DSC MRI showed significant improvement at both levels of the MCA territory of the operated side (all p < 0.05). There was no significant correlation between the improvements in rCBF values on the two perfusion images (r = 0.195, p = 0.303); however, there was a correlation between the change in perfusion scores on ASL and rTTP on DSC MRI (r = 0.701, p < 0.001). Conclusion: Recognizing the effects of ATT on ASL perfusion MRI may help monitor cerebral perfusion changes and complement quantitative rCBF assessment using ASL perfusion MRI in patients with moyamoya disease after indirect revascularization.

혈액희석 체외순환법에 관한 임상적 관찰 -상온하 Rygg-Kyvsgaard 산화기 및 Sigmamotor pump 사용예를 중심으로- (Studies on the Hemodilution Perfusion with Rygg-Kyvsgaard Oxygenator)

  • 손광현
    • Journal of Chest Surgery
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    • 제3권2호
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    • pp.73-90
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    • 1970
  • Clinical perfusion data on 16 cases of cardiopulmonary bypass using Sigmamotor pump and RyggKyvsgaard Oxygenator which performed at Seoul National University Hospital during the period of Aug. 1968 to Aug. 1970 was analized. AIl cases were hemodiluted and the perfusion was carried out under the normothermic condition. The age of the patients ranged between 6 and 43 years. The b:dy weight varied between 18.3 and 54.0 kg and the body surface area between 0.78 and 1. 59$M^2$. The priming solution was consiste:I with fresh ACD blood. Hartmann solution and Mannitol. The average amount of priming was approximately 2242 ml. The average hemodilution rate was 17%. The flow rate ranged from 1.7L to 3.5L/Min/$M^2$ and averaged 2.4L/Min/$M^2$ or 78mI/Min/kg. The duration of perfusion varied from 22 to 110 min with average of 56.9 minutes. Some hemodynamic responses were observed. The arterial pressure dropped immediately after the initiation of partial perfusion and was more marked after the total perfusion foIlowed by gradual increase to the safety level. The central venous pressure reflected the reduced blood volume especially in the cases of prolonged perfusion which lasted over 60 min. In most of the cases, red blood cell count decreased and white blood ceIl count increased after the perfusion. Hemoglobin level was decreased, averaging of 12.5mg%, Hct 3.3% and platelets count of 18% postoperatively. Plasma hemoglobin increased mildly, from pre-perfusion average value of 4. 06mg% to postperfusion value of 22.5mg%. Serum potassium was 4.4mEq/L pre-operatively and was decreased to 3.7mEq/L postoperatively. Five cases showed definite hypopotassemia immediately after the operation. Sodium and chloride decreased mildly. These electrolyte changes are thought to be related with hemodilution. diuretics and reduced blood volume during and after the perfusion. Arterial blood pH value revealed minimal to moderate elevation from preperfusion average value of 7.376 to 7.461 during perfusion and then 7.365 after perfusion. The pC02 and hicarbonate showed minimal to moderately lowered values. The total CO2 was decreased. Buffer base decreased during perfusion (Av. 42.6mEq/L) and further decreased after the perfusion (Av. 40.8mEq/L). These arterial blood acid base changes suggested that the metabolic acidosis was accompanied by respiratory alkalosis during and immediately after the perfusion. Authors belived that the acidosis could more effectively be corrected with the more additional dose of bicarbonate than we used by this study. The chest tune drainage during the first 24 hours following operation was 1158 ml in average. One case (Case No. 15) showd definite bleeding tendency and it was believed that the cause might be due to the defect of heparin and protamine titration. The average urinary out put during 24 hours post-perfusion was 1291ml. One case (Case No. ]) showed definite post perfusion oliguria. As conclusion hemodilution using fresh ACD blood. Hartmann and Mannitol solution added with Bivon and high flow rate unler normothermia. was thought to amelioratc the severity of mctabolic acidosis during and after perfusion with relatively satisfactory effect on the diuresis and bleeding tendency.

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관류자기공명영상의 이해 (Understanding of Perfusion MR Imaging)

  • 구은회
    • 대한디지털의료영상학회논문지
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    • 제15권1호
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    • pp.27-31
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    • 2013
  • Perfusion MR imaging is how to use exogenous and endogenous contrast agent. Exogenous perfusion MRI methods which are dynamic susceptibility contrast using $T2^*$ effect and dynamic contrast-enhanced using T1 weighted image after injection contrast media. An endogenous perfusion MRI method which is arterial spin labeling using arterial blood flow in body. In order to exam perfusion MRI in human, technical access are very important according to disease conditions. For instance, dynamic susceptibility contrast is used in patients with acute stroke because of short exam time, while dynamic susceptibility contrast or dynamic contrast enhancement provides the various perfusion information for patients with tumor, vascular stenosis. Arterial spin labeling is useful for children, women who are expected to be pregnant. In this regard, perfusion MR imaging is required to understanding, and the author would like to share information with clinical users

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기관지 이물 환자에서 폐장관류주사(pulmonary perfusion scan)의 적용 의의 (Diagnostic Value of Pulmonary Perfusion Scan in Patients of Airway Foreign Body)

  • 최종욱;정광윤;민헌기;황찬승;김혜정
    • 대한기관식도과학회지
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    • 제1권1호
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    • pp.75-81
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    • 1995
  • To evaluate the diagnostic value of pulmonary perfusion scan, we obtained 99mTc MAA per-fusion lung scan from 25 cases of airway foreign bodies. The results were as follows. 1) Significant changes in blood gases were not observed after the establishment of regional hypoperfusion caused by airway foreign body. 2) Near total or total defect was noted on perfusion scan from most of the airway foreign body. 3) There was correspondance of findings of perfusion lung scan and duration of airway foreign body. 4) After the removal of airway foreign bodies, perfusion scan abnormalities were reversed in parallel with the recovery of pulmonary blood flow. We concluded that pulmonary perfusion scan may be valuable for detection of foreign body and reversible hypoperfusion.

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

  • 은성종;김영근
    • 대한방사선기술학회지:방사선기술과학
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    • 제26권3호
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    • pp.25-31
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    • 2003
  • 급성 허혈성 뇌경색 환자에서 Deconvolution 관류 전산화 단층촬영(computed tomography, CT)의 뇌혈류용적(cerebral blood volume, CBV), 뇌혈류(cerebral blood flow, CBF) 그리고 평균 조영제 통과 시간(mean transit time, MTT) 지도를 확산 강조(Diffusion weighted) MRI과 비교하여 그 유용성을 알아보고자 하였다. 뇌관류 CT와 확산강조 자기공명영상(diffusion weighted MR imaging, DWMRI)을 시행한 급성뇌경색 환자를 대상으로 Deconvolution 기법으로 획득한 CBV, CBF, MTT 지도에서 병변의 면적과 DWMRI의 병변의 면적을 비교 측정하여 일치도를 알아보았다. 또한, 병변 부위와 정상측 대칭부위의 MTT시간을 측정하여 차이를 알아보았다. 본 연구의 모든 예에서 CBV, CBF, 그리고 MTT 세 지도 모두 관류 결손을 인지할 수 있었고, 관류 결손이 인지되는 부위에서 MTT 시간의 현저한 지연이 있었다. 뿐만 아니라, MTT 지도의 결손부위 면적은 DWMRI 보다 크게 나타나 허혈성 패넘브라를 추측할 수 있었다. 결론적으로 Deconvolution 관류 CT의 지도를 이용하면 뇌경색의 조기진단뿐만 아니라 허혈 중심부, 그리고 허혈성 페넘브라를 예측할 수 있어 DWMRI에 비해 관류결손 부위의 혈류 역학적 상태의 평가나 효과적인 치료계획을 세우는데 보다 유용할 것으로 생각된다.

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어린이 모야모야병에서 휴식/아세타졸아미드 Tc-99m-HMPAO SPECT를 이용한 수술결과 평가 (Evaluation of Surgical Outcome with Pre-and Post-operative Rest/Acetazolamide Tc-99m HMPAO SPECT in Children with Moyamoya Disease)

  • 이동수;현인영;왕규창;조병규;정준기;이명철
    • 대한핵의학회지
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    • 제32권4호
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    • pp.314-324
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    • 1998
  • 목적: 이 연구의 목적은 어린이 모야모야병 환자에서 휴식기/아세타졸아미드 부하 Tc-99m-HMPAO SPECT가 Encephalo-duro-arterio-synangiosis (EDAS) 수술 후의 호전여부를 평가할 수 있는지를 알아보고자 함이었다. 대상 및 방법: 어린이 모야모야병 18명에서 21개의 대뇌반구에 EDAS 수술을 하였다. 수술 전과 수술 후 3개월에 휴식기/아세타졸아미드 부하 Tc-99in-HMPAO SPECT를 시행하여 휴식기관류와 관류예비능을 평가하여 비교하였다. 결과: 대뇌반구 모두에서 휴식기관류 또는 관류예비능 감소가 관찰되었다. 84개 뇌엽과 294개 영역 중52%의 뇌엽과 50%의 영역에 관류이상이 나타났다. 수술 후 휴식기 관류 또는 관류예비능이 감소한 영역의 60%가 호전되었고 반구는 71%가 호전되었다. 수술 전 휴식기 관류 감소가 심하지 않았을 때 수술후 호전가능성이 높았다. 수술 전 휴식 부하기 관류의 차이가 있는 경우 즉 관류예비능이 감소하였을 때 수술 후 관류 호전 가능성이 높았다. 결론: 어린이 모야모야병에서 수술 전 휴식기/아세타졸아미드 Tc-99m-HMPAO SPECT로 수술 후 호전여부를 예측할 수 있다.

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Perfusion Cultivation of Transgenic Nicotiana tabacum Suspensions in Bioreactor for Recombinant Protein Production

  • Lee Sang-Yoon;Kim Dong-Il
    • Journal of Microbiology and Biotechnology
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    • 제16권5호
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    • pp.673-677
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    • 2006
  • A perfusion culture of transgenic Nicotiana tabacum cell suspensions, transformed to express recombinant glucuronidase (GUS), was successfully performed in a 5-1 stirred tank bioreactor. With 0.1 $day^{-1}$ of perfusion rate, the maximum dry cell weight (DCW) reached to 29.5 g/l in 16 days, which was 2.1-fold higher than the obtained in batch culture (14.3 g/l). In terms of the production of GUS, the volumetric activity could be increased up to 12.8 U/ml by using perfusion, compared with 4.9 U/ml in batch culture. The specific GUS activities in both perfusion and batch cultures were maintained at similar levels, 200-400 U/g DCW. Consequently, a perfusion culture could be a good strategy for the enhanced production of recombinant proteins in a plant cell culture system.

심근 관류 SOECT의 새로운 방법 (New Imaging Techniques in Myocardial Perfusion SPECT)

  • 이동수
    • 대한핵의학회지
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    • 제32권1호
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    • pp.1-9
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    • 1998
  • Gated myocardial SPECT and attenuation correction gave birth to new insights into the pathophysiology of ischemic myocardial perfusion and function in clinical routine practice. Gated myocardial Tc-99m-compound SPECT improved diagnostic accuracy of coronary artery disease and enabled us to observe motion and thickening of myocardial walls as well as myocardial perfusion at the same time. Quantitative and qualitative assessment of myocardial performance and perfusion let us to understand the myocardial physiology in ischemia and infarction. In every patient who underwent gated perfusion SPECT, we will find ejection fraction, left ventricular volumes and regional wall motion. There are hopes to use gated TI-201 SPECT for the same purpose and to use gated SPECT for evaluation of wall motion and thickening at stress or immediate post-stress. Attenuation correction could improve diagnostic accuracy mainly by increasing normalcy ratio or performance of non-expert physicians. Both gated methods and attenuation correction improved specificity of non-expert physicians in diagnosing patients with moderate pretest likelihood. New imaging techniques will fill the desire of cardiologists to examine function and perfusion, and possibly metabolism in their clinical routine practice.

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심근관류영상을 위한 심근부하 방법 및 검사 프로토콜 (Stress Testing and Imaging Protocols for Myocardial Perfusion Studies)

  • 김성민
    • Nuclear Medicine and Molecular Imaging
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    • 제43권3호
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    • pp.179-195
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    • 2009
  • Scince $^{201}$TI was introduced as a myocardial perfusion imaging agent in the early 1970s, scintigraphic evaluation of myocardial perfusion for the diagnosis of coronary artery disease is a valuable noninvasive diagnostic imaging modality. Stress radionuclide myocardial perfusion imaging is widely accepted to have high diagnostic and prognostic use in the assessment of patients with known or suspected coronary artery disease. With wise use of this nonivasive imaging technique, more patients are referred for stress perfusion imaging. Until now various protocols for stress testing and myocardial imaging were developed and used in worldwide. This article presented various protocols of stress testing and myocardial imaging for clinical use.

Laser Doppler Perfusion Imager (LDPI)로 측정한 자외선 조사부위의 혈류량과 최소 홍반량(MED)과의 상관관계 (Relationship between UV-induced MED and Perfusion Value Assessed by Laser Doppler Perfusion Imager)

  • 김남수;이경훈
    • 대한화장품학회지
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    • 제31권3호
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    • pp.259-263
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    • 2005
  • 혈류량은 자외선 조사량 증가에 비례하여 증가되는 양상을 보였다. 홍반을 유발하는데 필요한 자외선량(MED)의 차이가 혈류량의 변화와 어떠한 관계가 있는지를 알아본 실험에서, MED가 30 mJ로 비교적 낮았던 피험자들의 경우, 혈류량은 MED를 지나서 급격하게 증가되는 양상을 관찰하였으나 30 mJ 이상에서 MED가 관찰되었던 피험자들의 경우에는 자외선 조사에 따른 혈류량의 변화가 급격한 변화 없이 계속 완만하게 증가되는 양상을 보였다.