The cerebral perfusion of circulation disturbances . Part I (HISTORY, the basic postulates and methods of research ). Review

Abstract

In the first part of a review article highlights the key moments of the history of the study of cerebral microcirculation, formation of the basic theories and postulates a gradual improvement of the methods of qualitative and quantitative assessment of brain perfusion parameters in science and medical practice. Presented and discussed in terms of advantages and disadvantages of the current methods of assessing cerebral perfusion: transcranial Doppler (TCD), positron emission tomography (PET), single photon emission computed tomography (SPECT) perfusion computer tomography (PCT) and magnetic resonance tomography (PMRI) techniques. Most of all studies related to the use of radioisotopes or contrast media agents. It is noted that the TCD and perfusion CT and MRI prevail today in radiologic practice of cerebral circulation disturbances diagnostics. In recent years, more research is carried out in relation to clinical trial non-contrast MR technique (ASL), associated with endogenous labeling and registration of cerebral blood flow, which considering the absolute safety in the absence of external contrast makes it attractive for clinical use in the near future is possible. The second part of this article will devoted to a detailed consideration of the issues of diagnostic semiotics different clinical forms of violations of cerebral circulation using CT and MR perfusion study techniques that are by far the most accessible to a wide network of healthcare system. There will discuss the physical basis of blood flow parameters changes of brain tissue on the cards of cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT ) and time to peak (TT P) contrast in the «classical» and the «difficult» clinical cases on the basis of the works of the most respected researchers in the field.