Preoperative cerebrovascular reactivity to acetazolamide measured by brain perfusion SPECT predicts development of cerebral ischemic lesions caused by microemboli during carotid endarterectomy

2008 ◽  
Vol 36 (2) ◽  
pp. 294-301 ◽  
Author(s):  
Kenta Aso ◽  
Kuniaki Ogasawara ◽  
Makoto Sasaki ◽  
Masakazu Kobayashi ◽  
Yasunori Suga ◽  
...  
2021 ◽  
pp. 1-7
Author(s):  
Suguru Igarashi ◽  
Toshihiko Ando ◽  
Tatsuhiko Takahashi ◽  
Jun Yoshida ◽  
Masakazu Kobayashi ◽  
...  

OBJECTIVEA primary cause of cognitive decline after carotid endarterectomy (CEA) is cerebral injury due to cerebral hyperperfusion. However, the mechanisms of how cerebral hyperperfusion induces cerebral cortex and white matter injury are not known. The presence of cerebral microbleeds (CMBs) on susceptibility-weighted imaging (SWI) is independently associated with a decline in global cognitive function. The purpose of this prospective observational study was to determine whether cerebral hyperperfusion following CEA leads to the development of CMBs and if postoperative cognitive decline is related to these developed CMBs.METHODSDuring the 27-month study period, patients who underwent CEA for ipsilateral internal carotid artery stenosis (≥ 70%) also underwent SWI and neuropsychological testing before and 2 months after surgery, as well as quantitative brain perfusion SPECT prior to and immediately after surgery.RESULTSAccording to quantitative brain perfusion SPECT and SWI before and after surgery, 12 (16%) and 7 (9%) of 75 patients exhibited postoperative cerebral hyperperfusion and increased CMBs in the cerebral hemisphere ipsilateral to surgery, respectively. Cerebral hyperperfusion was associated with an increase in CMBs after surgery (logistic regression analysis, 95% CI 5.08–31.25, p < 0.0001). According to neuropsychological assessments before and after surgery, 10 patients (13%) showed postoperative cognitive decline. Increased CMBs were associated with cognitive decline after surgery (logistic regression analysis, 95% CI 6.80–66.67, p < 0.0001). Among the patients with cerebral hyperperfusion after surgery, the incidence of postoperative cognitive decline was higher in those with increased CMBs (100%) than in those without (20%; p = 0.0101).CONCLUSIONSCerebral hyperperfusion following CEA leads to the development of CMBs, and postoperative cognitive decline is related to these developed CMBs.


1999 ◽  
Vol 41 (10) ◽  
pp. 652-659 ◽  
Author(s):  
R Riikonen ◽  
I Salonen ◽  
K Partanen ◽  
S Verho

2020 ◽  
Vol 7 (1) ◽  
Author(s):  
Manon Bordonne ◽  
Mohammad B. Chawki ◽  
Pierre-Yves Marie ◽  
Timothée Zaragori ◽  
Véronique Roch ◽  
...  

Abstract Objective The aim of this study was to compare brain perfusion SPECT obtained from a 360° CZT and a conventional Anger camera. Methods The 360° CZT camera utilizing a brain configuration, with 12 detectors surrounding the head, was compared to a 2-head Anger camera for count sensitivity and image quality on 30-min SPECT recordings from a brain phantom and from 99mTc-HMPAO brain perfusion in 2 groups of 21 patients investigated with the CZT and Anger cameras, respectively. Image reconstruction was adjusted according to image contrast for each camera. Results The CZT camera provided more than 2-fold increase in count sensitivity, as compared with the Anger camera, as well as (1) lower sharpness indexes, giving evidence of higher spatial resolution, for both peripheral/central brain structures, with respective median values of 5.2%/3.7% versus 2.4%/1.9% for CZT and Anger camera respectively in patients (p < 0.01), and 8.0%/6.9% versus 6.2%/3.7% on phantom; and (2) higher gray/white matter contrast on peripheral/central structures, with respective ratio median values of 1.56/1.35 versus 1.11/1.20 for CZT and Anger camera respectively in patients (p < 0.05), and 2.57/2.17 versus 1.40/1.12 on phantom; and (3) no change in noise level. Image quality, scored visually by experienced physicians, was also significantly higher on CZT than on the Anger camera (+ 80%, p < 0.01), and all these results were unchanged on the CZT images obtained with only a 15 min recording time. Conclusion The 360° CZT camera provides brain perfusion images of much higher quality than a conventional Anger camera, even with high-speed recordings, thus demonstrating the potential for repositioning brain perfusion SPECT to the forefront of brain imaging.


1993 ◽  
Vol 18 (12) ◽  
pp. 1032-1038 ◽  
Author(s):  
MILOS J. JANICEK ◽  
RICHARD B. SCHWARTZ ◽  
PAULO A. CARVALHO ◽  
BASEM GARADA ◽  
B. LEONARD HOLMAN

2001 ◽  
Vol 26 (8) ◽  
pp. 729 ◽  
Author(s):  
HITOYA OHTA ◽  
HIDEHIKO YAMAMOTO ◽  
NORIYUKI KOJIMA ◽  
GIRO TODO ◽  
MASAHIKO NII

2009 ◽  
Vol 5 (4S_Part_17) ◽  
pp. e30-e30
Author(s):  
Raquel Lemos ◽  
Patrícia Figueiredo ◽  
Joana Caldas ◽  
Maria J. Cunha ◽  
J. Isidoro ◽  
...  

2008 ◽  
Vol 4 ◽  
pp. T366-T367
Author(s):  
Leonardo C. De Souza ◽  
Aurélie Kas ◽  
Marie Sarazin ◽  
Dalila Samri ◽  
Bruno Dubois ◽  
...  

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