Evaluation Of Cerebral Blood Flow Research Articles

Impact of perioperative cerebral blood flow evaluation using arterial spin labeling in a patient undergoing carotid artery stenting.

Hyperperfusion syndrome (HPS) is one of the most serious complications after carotid artery stenting (CAS). Arterial spin labeling (ASL) is a noninvasive method for assessing cerebral perfusion. This study aimed to evaluate the utility of ASL compared to that of SPECT in evaluating changes in intracranial blood flow during the perioperative period of CAS. We retrospectively reviewed prospectively collected data from 49 cases of CAS conducted for symptomatic and asymptomatic carotid artery stenosis. We calculated the relative cerebral blood flow (rCBF) from ASL (post labeling delay [PLD] of 1500ms and 2500ms) and SPECT, both pre- and post-CAS. Cerebrovascular reactivity (CVR) was assessed using SPECT with an acetazolamide challenge. We defined the change rate from PLD 1500ms to 2500ms before CAS as ΔrASL. Hyperperfusion phenomenon was observed in four cases (8.2%), with one case (2.0%) resulting in cerebral hemorrhage and diagnosed as HPS. Positive correlations were noted between ASL and SPECT at both pre- and post-CAS (r=0.42-0.65, p<0.01). A negative correlation was found between ΔrASL obtained from the two PLDs before CAS and CVR (r=-0.41, p<0.01). ASL using two PLDs is a useful method for evaluating changes in CBF during the perioperative period of CAS.

Gait Performance and Brain Activity Are Improved by Gait Automatization during Robot-Assisted Gait Training in Patients with Burns: A Prospective, Randomized, Single-Blinded Study.

Background: Patients with lower extremity burn injuries have decreased gait function. Gait dysfunctions are compensated by activation of executive areas such as the prefrontal cortex (PFC). Although robot-assisted gait training (RAGT) can improve gait function, the training mechanisms of RAGT are unknown. We aimed to determine the clinical effects of RAGT in patients with burns and investigate their underlying mechanisms. Methods: This single-blind, randomized controlled trial involved 54 patients with lower extremity burns. The RAGT group underwent RAGT using SUBAR® and conventional training. The control (CON) group underwent only conventional training. The primary outcome was cortical activity measured using a functional near-infrared spectroscopy device before and after 8 weeks of training to confirm the compensatory effect of gait dysfunction. The secondary outcomes were the functional ambulation category (FAC) to evaluate gait performance, 6-min walking test (6 MWT) distance to measure gait speed, isometric force and range of motion (ROM) of lower extremities to evaluate physical function, and the visual analog scale (VAS) score to evaluate subjective pain during gait. Results: PFC activation during the gait phase in the RAGT group decreased significantly compared with that of the CON. The VAS score decreased and FAC score improved after 8 weeks of training in both groups. The 6 MWT scores, isometric strengths (the left knee flexor and bilateral ankle plantar flexors), and the ROMs (the extensions of bilateral hip and bilateral knee) of the RAGT group were significantly improved compared with those of the CON. RAGT improved gait speed, lower extremity ROMs, and lower extremity muscles strengths in patients with burns. Conclusions: The improvement in gait speed and cerebral blood flow evaluation results suggests that the automatization of gait is related to the treatment mechanism during RAGT.

Quantitative analysis of systemic perfusion and cerebral blood flow in the modeling of aging and orthostatic hypotension.

Introduction: Orthostatic hypotension (OH) is common among the older population. The mechanism hypothesized by OH as a risk factor for cognitive decline and dementia is repeated transient cerebral blood flow deficiency. However, to our knowledge, quantitative evaluation of cardiac output and cerebral blood flow due to acute blood pressure changes resulting from postural changes is rare. Methods: We report a new fluid-structure interaction model to analyze the quantitative relationship of cerebral blood flow during OH episodes. A device was designed to simulate the aging of blood vessels. Results and Discussion: The results showed that OH was associated with decreased transient cerebral blood flow. With the arterial aging, lesions, the reduction in cerebral blood flow is accelerated. These findings suggest that systolic blood pressure regulation is more strongly associated with cerebral blood flow than diastolic blood pressure, and that more severe OH carries a greater risk of dementia. The model containing multiple risk factors could apply to analyze and predict for individual patients. This study could explain the hypothesis that transient cerebral blood flow deficiency in recurrent OH is associated with cognitive decline and dementia.

Effects of Background Music on Work Efficiency: Cerebral Blood Flow and Subjective Evaluation

Effects of Background Music on Work Efficiency: Cerebral Blood Flow and Subjective Evaluation

Angiography-based hemodynamic features predict recurrent ischemic events after angioplasty and stenting of intracranial vertebrobasilar atherosclerotic stenosis

ObjectivesTo assess the predictive value of hemodynamic features for stroke relapse in patients with intracranial vertebrobasilar atherosclerotic stenosis treated with percutaneous transluminal angioplasty and stenting (PTAS) using quantitative digital subtraction angiography (q-DSA).MethodsIn this retrospective longitudinal study, patients with intracranial vertebrobasilar atherosclerotic stenosis and who underwent PTAS treatment between January 2012 and May 2020 were enrolled. The q-DSA assessment was performed before and after PTAS. ROIs 1–4 were placed along the vertebral artery, proximal and distal basilar artery, and posterior cerebral artery; ROIs 5–8 were in 5 mm and 10 mm proximal and distal to the lesion, respectively. Relative time to peak (rTTP) was defined as the difference in TTP between ROIs. Cox regression analyses were performed to determine risk factors for recurrent stroke.ResultsA total of 137 patients (mean age, 62 years ± 10 [standard deviation], 83.2% males) were included, and 26 (19.0%) patients had stroke relapse during follow-up (median time of 42.6 months [interquartile range, 19.7–60.7]). Preprocedural rTTP4-1 (adjusted hazard ratio (HR) = 2.270; 95% CI 1.371–3.758; p = 0.001) and preprocedural rTTP8-5 (adjusted HR = 0.240; 95% CI 0.088–0.658; p = 0.006) were independently associated with the recurrent stroke. These hemodynamic parameters provided an incremental prognostic value for stroke relapse (AUC, 0.817 [0.704–0.931]; the net reclassification index, 0.431 [0.057–0.625]; and the integrated discrimination index, 0.140 [0.035–0.292]).ConclusionsIn patients with intracranial vertebrobasilar atherosclerosis treated with PTAS, preprocedural prolonged TTP of the target vessel and shortened trans-stenotic TTP difference were associated with stroke relapse. Q-DSA-defined hemodynamic parameters provided incremental predictive value over conventional parameters for stroke recurrence.Clinical relevance statementQuantitative DSA analysis enables intuitive observation and semi-quantitative evaluation of peri-therapeutic cerebral blood flow. More importantly, quantitative DSA–defined hemodynamic parameters have the potential for risk stratification of patients with intracranial atherosclerotic stenosis.Key PointsSemi-quantitative angiography-based parameters can reflect pre- and postprocedural subtle changes in blood flow in patients with intracranial atherosclerotic stenosis.Although angioplasty procedures can significantly improve blood flow status, patients with more restricted baseline blood flow still show a higher risk of stroke recurrence.Angiography-based hemodynamic features possess prognostic value and can serve as clinical markers to assess stroke risk of patients with intracranial atherosclerotic stenosis.

White-Matter Lesions and Cortical Cerebral Blood Flow Evaluation by 3D Arterial Spin-Labeled Perfusion MRI in Asymptomatic Divers: Correlation with Patent Foramen Ovale Ocurrence.

Cerebral white-matter lesions (cWML) can be caused by dilation of Virchow-Robin spaces or may correspond to true lacunar ischemic lesions. The aim of our study was to evaluate in asymptomatic divers the relationship between the presence of patent foramen ovale (PFO) and cWML, as well as their possible effects on cortical cerebral blood flow (CBF) by magnetic resonance (MRI) through the arterial spin labeling (ASL) sequence. Transthoracic echocardiography was performed for the identification of PFO, and cerebral magnetic resonance including the 3D-ASL sequence for CBF quantification. Thirty-eight divers, with a mean age 45.8 ± 8.6 years, were included. Nineteen healthy volunteers, mean age 41 ± 15.2 years, served as the control group. A total of 28.9% of divers had completed more than 1000 dives. It was found that 26.3% of divers presented with PFO in the echocardiographic study. cWML was evidenced in 10.5% of diver MRI studies. There was no statistically significant relationship between the presence of PFO and cWML (p = 0.95). We observed a lower blood flow in all brain areas assessed by the 3D-ASL sequence in the group of divers, compared with the control group. We did not find statistical differences in CBF as a function of the presence or absence of PFO, number of dives, or cWML evidence.

Edaravone Dexborneol Downregulates Neutrophil Extracellular Trap Expression and Ameliorates Blood-Brain Barrier Permeability in Acute Ischemic Stroke.

Background Our previous work has shown that inflammatory processes play a detrimental role in the pathophysiology of acute ischemic stroke (AIS). Neutrophil extracellular traps (NETs) have been recognized as a key contributor to the proinflammatory response in AIS and could aggravate blood-brain barrier (BBB) damage. Recently, experimental and clinical researches showed that Edaravone Dexborneol (Eda.B), which is comprised of two active ingredients, Edaravone and (+)-Borneol, was effective in treatment of AIS. However, it is not clear whether the effects of Eda.B against AIS are related to NETs and BBB permeability. Methods Experiment 1 was to detect the effects of Eda.B in AIS patients. Serum samples of volunteers and AIS patients were collected before and 3 days after Edaravone Dexborneol treatment. Markers of NETs and occludin were detected by ELISA kit. Experiment 2 was to explore the effects of Eda.B on experimental stroke mice. Male C57BL/6 mice were subjected to distal middle cerebral artery occlusion (MCAO) and treated with vehicle, Eda.B, or DeoxyribonueleaseI (DNase I). After stroke, the neurobehavioral tests, infarct volume, and cerebral blood flow evaluation were determined. Leakage of Evans blue was to assess the integrity of BBB. Western blot, real-time quantitative polymerase chain reaction (RT-qPCR), and immunofluorescence were used to examine the expression of NETs and tight junction- (TJ-) associated proteins. Results Eda.B significantly improved neurological function and cerebral blood flow but reduced infarct volume after experimental stroke. Eda.B downregulated level of NETs in serum samples of AIS patients and tissue samples of MCAO mouse cortex. Eda.B and DNase I alleviated BBB permeability by upregulating TJ-associated proteins. Conclusion NETs are related to the early stage of AIS. Eda.B exerted neuroprotective effects and ameliorated BBB permeability after AIS.

THE EFFECT OF RENAL DENERVATION ON CEREBRAL BLOOD FLOW IN DIABETIC PATIENTS WITH RESISTANT HYPERTENSION

Objective: Long-term and persistent increase in blood pressure (BP) leads to vascular remodeling, which deteriorates cerebral blood flow. The combination of hypertension (HTN) with diabetes mellitus (DM) accelerates the vascular damage and impairs the cerebral blood flow autoregulation, which may be accompanied by an uncompensated decrease in cerebral perfusion in response to a decrease in BP. Renal denervation (RDN) leads to a rapid and sustained decrease in BP, therefore the aim of this study was to assess of changes in cerebral blood flow in patients with resistant HTN (RHTN) and type 2 DM at 6 month after the intervention. Design and method: Evaluation of cerebral blood flow was performed in 21 patients with RHTN and type 2 DM, who were included in single-arm prospective interventional studies (protocol numbers NCT01499810 and NCT02667912 on ClinicalTrials.gov) (mean age 61.4 ± 7.6 years, mean office (systolic/diastolic) BP (SBP/DBP) 167.1 ± 19.4/85.6 ± 15.9 mmHg, HbA1c 7.1 ± 1.3%, 8 men (32%), 19 pts (91%) had atherosclerosis of internal carotid arteries (ICA) with mean values of stenosis 22.2 ± 9.7%). All patients were undergone to ambulatory 24-hour BP, Doppler high-resolution ultrasound of ICA and middle cerebral arteries (MCA) at baseline and 6 month follow-up. The patients were instructed not to change their medication regimen during the study. Results: There was a significant decrease in mean 24-hour BP (systolic/diastolic) (-12.6/-7.3 mmHg, p &lt; 0.05). At the same time, there was no deterioration in blood flow of ICA and MCA at 6 months after RDN. Conclusions: Our data indicate that the significant decrease in BP after RDN does not lead to deterioration of cerebral blood flow and therefore indicates the safety of this procedure for the brain in patients with RHTN with type 2 DM.

Multidelay ASL of the pediatric brain.

Arterial spin labeling (ASL) is a powerful noncontrast MRI technique for evaluation of cerebral blood flow (CBF). A key parameter in single-delay ASL is the choice of postlabel delay (PLD), which refers to the timing between the labeling of arterial free water and measurement of flow into the brain. Multidelay ASL (MDASL) utilizes several PLDs to improve the accuracy of CBF calculations using arterial transit time (ATT) correction. This approach is particularly helpful in situations where ATT is unknown, including young subjects and slow-flow conditions. In this article, we discuss the technical considerations for MDASL, including labeling techniques, quantitative metrics, and technical artefacts. We then provide a practical summary of key clinical applications with real-life imaging examples in the pediatric brain, including stroke, vasculopathy, hypoxic-ischemic injury, epilepsy, migraine, tumor, infection, and metabolic disease.

Application value of new nano-drug carrier in biphasic 3D-pCASL in the evaluation of cerebral perfusion blood flow in symptomatic and asymptomatic unilateral middle cerebral artery subtotal occlusion

We investigate the use of superparamagnetic iron oxide nanoparticles as a contrast agent for the cerebral perfusion of unilateral middle cerebral artery (MCA) subtotal occlusion by magnetic resonance three-dimensional pseudo-continuous arterial spin-labelled imaging (3D-pCASL) dual-phase scanning technology for the application value of blood flow to evaluate the difference of cerebral perfusion between symptomatic and asymptomatic patients. We found through research that the biphasic 3D-pCASL technology can accurately detect cerebral perfusion blood flow in patients with subtotal middle cerebral artery occlusion. Asymptomatic patients have higher cerebral perfusion than symptomatic patients with collateral circulation superparamagnetic iron oxide nanoparticles. Phase (PLD) equal to 1.5 s is more sensitive than 2.5 s, and PLD = 2.5 s can accurately reflect secondary collateral circulation's compensation status.

Application value of new nano-drug carrier in biphasic 3D-pCASL in the evaluation of cerebral perfusion blood flow in symptomatic and asymptomatic unilateral middle cerebral artery subtotal occlusion

Application value of new nano-drug carrier in biphasic 3D-pCASL in the evaluation of cerebral perfusion blood flow in symptomatic and asymptomatic unilateral middle cerebral artery subtotal occlusion

Application of Magnetic Resonance Imaging in the Evaluation of Nutritional Status: A Literature Review with Focus on Dialysis Patients.

Magnetic resonance imaging (MRI) is indispensable in clinical medicine for the morphological and tomographic evaluation of many parenchymal organs. With varied imaging methods, diverse biological information, such as the perfusion volume and measurements of metabolic products, can be obtained. In addition to conventional MRI for morphological assessment, diffusion-weighted MRI/diffusion tensor imaging is used to evaluate white matter structures in the brain; arterial spin labeling is used for cerebral blood flow evaluation; magnetic resonance elastography for fatty liver and cirrhosis evaluation; magnetic resonance spectroscopy for evaluation of metabolites in specific regions of the brain; and blood oxygenation level-dependent imaging for neurological exploration of eating behavior, obesity, and food perception. This range of applications will continue to expand in the future. Nutritional science is a multidisciplinary and all-inclusive field of research; therefore, there are many different applications of MRI. We present a literature review of MRI techniques that can be used to evaluate the nutritional status, particularly in patients on dialysis. We used MEDLINE as the information source, conducted a keyword search in PubMed, and found that, as a nutritional evaluation method, MRI has been used frequently to comprehensively and quantitatively evaluate muscle mass for the determination of body composition.

Perfusion -Weighted Magnetic Resonance Imaging Techniques and Protocols in the Evaluation of Cerebral Blood Flow, Blood Volume, and Vascular Permeability of Brain Neoplasms

Objective : To identify the efficiency of perfusion, weighted magnetic resonance imaging techniques andprotocols in, evaluation of cerebral blood, flow, blood volume, &amp; vascular, permeability of a tumor in thebrain in correlation with viability of brain neoplastic tissues.Material and Methods : One hundred and fifteen patients with histologically proven brain tumors wereexamined by 1.5 Tesla PHILIPS MR System. For four months, patients who were referred in an MRIassessment were included in this review. Conventional MRIs protocol, (axial T2WI (TSE), Axial T1WI(FSE), axial T2WI FALIR, axial T1WI post contrast). PW-MRI protocol axial Fast Echo –Echo PlannerImage (FE-EPI) Neuro-T2* Perfusion Dynamic Contrast Enhancement agent (DCE-MRI), (Gadolinium(Gd)contrast Magnevist).Results and discussion: Magnetic Resonance Imaging in (10) patients (8.70%) revealed feature consistentwith brain tumors (control cases), the brain has been evaluated by routine study or conventional (protocolC). (105) patients (91.3%) underwent examination with PW-MRI (FE-EPI) Neuro-T2* Perfusion (DCEMRI)( protocol P). (18) patients (15.65%) with the anaplastic astrocytoma WHO grade (III), (17) patients(14.78%) with metastatic brain tumors, (15) patients (13.04%) with non-recurrence of post-operative braintumors, (11) patients (9.57%) with high grade glioma, (10) patients (8.70%) with craniopharyngioma, (9)patients (7.83%) with glioblastoma multiform WHO grade IV, (9) patients (7.83%) with low grade glioma,(8) patients (6.96 %) with meningioma, the agemistocytic astrocytoma WHO grade(II) was the lowestdiagnosed brain tumor (2.61%).

Noninvasive intracranial pressure monitoring methods: a critical review.

Intracranial pressure (ICP) monitoring has been used for decades in management of various neurological conditions. The gold standard for measuring ICP is a ventricular catheter connected to an external strain gauge, which is an invasive system associated with a number of complications. Despite its limitations, no noninvasive ICP monitoring (niICP) method fulfilling the technical requirements for replacing invasive techniques has yet been developed, not even in cases requiring only ICP monitoring without cerebrospinal fluid (CSF) drainage. Here, we review the current methods for niICP monitoring. The different methods and approaches were grouped according to the mechanism used for detecting elevated ICP or its associated consequences. The main approaches reviewed here were: physical examination, brain imaging (magnetic resonance imaging, computed tomography), indirect ICP estimation techniques (fundoscopy, tympanic membrane displacement, skull elasticity, optic nerve sheath ultrasound), cerebral blood flow evaluation (transcranial Doppler, ophthalmic artery Doppler), metabolic changes measurements (near-infrared spectroscopy) and neurophysiological studies (electroencephalogram, visual evoked potential, otoacoustic emissions). In terms of accuracy, reliability and therapeutic options, intraventricular catheter systems still remain the gold standard method. However, with advances in technology, noninvasive monitoring methods have become more relevant. Further evidence is needed before noninvasive methods for ICP monitoring or estimation become a more widespread alternative to invasive techniques.

Evaluation of cerebral blood flow in the hippocampus, thalamus, and basal ganglia and the volume of the hippocampus in dogs before and during treatment with prednisolone.

To examine whether glucocorticoid (GC) administration alters hippocampal cerebral blood flow (CBF) or volume in dogs. 6 clinically normal adult Beagles. Each dog underwent CT and MRI to measure the CBF in the hippocampus, basal ganglia, thalamus, and cerebral cortex and the volume of the hippocampus in each hemisphere of the brain before (day 0) and during (days 7 and 21) a 21-day treatment with prednisolone (1.0 mg/kg, PO, q 24 h) and famotidine (0.5 mg/kg, PO, q 12 h). Results for hippocampal volume, anesthesia-related variables, and semiquantitative measurements of CBF (hemisphere-specific ratios of the CBF in the hippocampus, basal ganglia, and thalamus relative to the CBF in the ipsilateral cerebral cortex and the left cerebral cortex CBF-to-right cerebral cortex CBF ratio) were compared across assessment time points (days 0, 7, and 21). The ratios of CBF in the right hippocampus and right thalamus to that in the right cerebral cortex on day 21 were significantly lower than those on day 0. No meaningful differences were detected in results for the hippocampal volume in either hemisphere or for the anesthesia-related variables across the 3 time points. Results indicated that GC administration reduced CBF in the hippocampus and thalamus in dogs of the present study, similar to that which occurs in humans. Research on GC-related brain alteration in dogs could potentially contribute to advancements in understanding Alzheimer disease in humans and neurodegenerative conditions in dogs.

Evaluation of Cerebral Blood Flow Measured by 3D PCASL as Biomarker of Vascular Cognitive Impairment and Dementia (VCID) in a Cohort of Elderly Latinx Subjects at Risk of Small Vessel Disease.

Cerebral small vessel disease (cSVD) affects arterioles, capillaries, and venules and can lead to cognitive impairments and clinical symptomatology of vascular cognitive impairment and dementia (VCID). VCID symptoms are similar to Alzheimer’s disease (AD) but the neurophysiologic alterations are less well studied, resulting in no established biomarkers. The purpose of this study was to evaluate cerebral blood flow (CBF) measured by 3D pseudo-continuous arterial spin labeling (pCASL) as a potential biomarker of VCID in a cohort of elderly Latinx subjects at risk of cSVD. Forty-five elderly Latinx subjects (12 males, 69 ± 7 years) underwent repeated MRI scans ∼6 weeks apart. CBF was measured using 3D pCASL in the whole brain, white matter and 4 main vascular territories (leptomeningeal anterior, middle, and posterior cerebral artery (leptoACA, leptoMCA, leptoPCA), as well as MCA perforator). The test-retest repeatability of CBF was assessed by intra-class correlation coefficient (ICC) and within-subject coefficient of variation (wsCV). Absolute and relative CBF was correlated with gross cognitive measures and domain specific assessment of executive and memory function, vascular risks, and Fazekas scores and volumes of white matter hyperintensity (WMH). Neurocognitive evaluations were performed using Montreal Cognitive Assessment (MoCA) and neuropsychological test battery in the Uniform Data Set v3 (UDS3). Good to excellent test-retest repeatability was achieved (ICC = 0.77–0.85, wsCV 3–9%) for CBF measurements in the whole brain, white matter, and 4 vascular territories. Relative CBF normalized by global mean CBF in the leptoMCA territory was positively correlated with the executive function composite score, while relative CBF in the leptoMCA and MCA perforator territory was positively correlated with MoCA scores, controlling for age, gender, years of education, and testing language. Relative CBF in WM was negatively correlated with WMH volume and MoCA scores, while relative leptoMCA CBF was positively correlated with WMH volume. Reliable 3D pCASL CBF measurements were achieved in the cohort of elderly Latinx subjects. Relative CBF in the leptomeningeal and perforator MCA territories were the most likely candidate biomarker of VCID. These findings need to be replicated in larger cohorts with greater variability of stages of cSVD.

Usefulness of 2D-Perfusion Analysis for the Assessment of Unilateral Cervical Internal Carotid Artery Stenosis.

We investigated the usefulness of 2D-perfusion analysis for the evaluation of cerebral blood flow in unilateral cervical internal carotid artery stenosis. We conducted a 2D-perfusion analysis during cerebral angiography and 123I-iodoamphetamine (IMP) single photon emission computed tomography (SPECT) for unilateral cervical internal carotid artery stenosis without contralateral stenosis. The relationship between the ratio of the lesion side to the normal side in the parameters obtained by 2D-perfusion and the value calculated by stereotactic extraction estimation (SEE) analysis of SPECT was statistically examined. The ratios of the lesion side to the normal side regarding the peak arrival time (AT; time to peak [TTP]) of the contrast agent and the mean filling time (mean transit time [MTT]) of the contrast agent in 2D-perfusion significantly correlated with the area of Stage II and increase ratio (I.R) ≤30% in the SEE analysis (p = 0.002, 0.003). 2D-perfusion analysis can be used to estimate the extent of impaired cerebrovascular reserve (CVR) area in unilateral internal carotid artery stenosis.

Evaluation of cerebral blood flow with transcranial Doppler ultrasound in a dog with surgically treated intracranial subdural empyema

A three-year-old spayed female Yorkshire terrier presented with a three-week history of lethargy and weight loss. Physical examination showed left exophthalmos with left nasal discharge. A lesion in the left...

Phase I study of &lt;sup&gt;17&lt;/sup&gt;O-labeled water : safety and feasibility study of indirect proton MRI for the evaluation of cerebral blood flow [Presidential Award Proceedings

Phase I study of &lt;sup&gt;17&lt;/sup&gt;O-labeled water : safety and feasibility study of indirect proton MRI for the evaluation of cerebral blood flow [Presidential Award Proceedings

Prediction of Postoperative Cerebral Infarction after Cardiovascular Surgery Using Quantitative Measurement of Cerebral Blood Flow with Brain Single-Photon Emission Computed Tomography.

Prediction of postoperative cerebral infarction after cardiovascular surgery is difficult. The present study investigated whether quantitative evaluation of preoperative cerebral blood flow used in the Japanese EC-IC Bypass Trial (JET) study is useful for the prediction of postoperative cerebral infarction after cardiovascular surgery. First, patients were divided into two groups based on preoperative cerebral blood flow. In an evaluation using preoperative imaging, patients with good or mildly decreased preoperative cerebral blood flow, divided into clinical stage I or II by quantitative evaluation showed no postoperative cerebral infarction. However, 24% of patients with poor cerebral blood flow who were categorized as clinical stage II, experienced postoperative cerebral infarction. The incidence rate was not statistically significantly different when the groups were compared. Second, patients were divided into two groups based on the anatomical area of the brain affected corresponding to clinical stage II. Patients with a 10% and greater brain involvement had a significantly higher incidence of postoperative cerebral infarction (38%) compared to others (0%, p<0.01). This method may be useful for the prediction of postoperative cerebral infarction after cardiovascular surgery, but a further prospective study is needed. (This is a translation of J Jpn Coll Angiol 2017; 57: 125–133.)