Acquired Perfusion Defect

2021 ◽  
Vol 57 (11) ◽  
pp. 701
Author(s):  
Firas Bahdi ◽  
Audra J. Schwalk ◽  
Saadia A. Faiz
Keyword(s):  
Perfusion Defect

scholarly journals EXPRESS: Rapid dynamic bedside assessment of pulmonary perfusion defect by electrical impedance tomography in a patient with acute massive pulmonary embolism

2020 ◽  
pp. 204589402098404
Author(s):  
Siyi Yuan ◽  
Huaiwu He ◽  
Yun Long ◽  
Yi Chi ◽  
Inéz Frerichs ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Electrical Impedance Tomography ◽  
Perfusion Defect ◽  
Electrical Impedance ◽  
Massive Pulmonary Embolism ◽  
Lung Perfusion ◽  
Regional Perfusion ◽  
Pulmonary Perfusion ◽  
Impedance Tomography ◽  
Regional Lung

Background: Several animal studies have shown that regional lung perfusion could be effectively estimated by the hypertonic saline contrast electrical impedance tomography (EIT) method. Here, we reported an application of this method to dynamically assess regional pulmonary perfusion defect in a patient with acute massive pulmonary embolism. Case presentation: A 68-year-old man experienced sudden dyspnea and cardiac arrest during out-of-bed physical activity on the first day after partial mediastinal tumor resection. Acute pulmonary embolism (PE) was suspected due to acute enlargement of right heart and fixed inferior venous cava measured with bedside ultrasound. The computed tomography pulmonary angiography further confirmed large embolism in both left and right main pulmonary arteries and branches. The regional time impedance curves, which were obtained by a bolus of 10ml 10% NaCl through the central venous catheter, were then analyzed to quantitatively assess regional perfusion. Normal ventilation distribution with massive defects in regional perfusion in both lungs was observed, leading to a ventilation-perfusion mismatch and low oxygenation index (PaO2/FiO2=86 mmHg) at the first day of PE. The anticoagulation was performed with heparin, and the patient’s condition (such as shock, dyspnea, hypoxemia etc.), regional lung perfusion defect and ventilation-perfusion mismatch continuously improved in the following days. Conclusions: This case implies that EIT might have the potential to assess and monitor regional perfusion for rapid diagnosis of fatal PE in clinical practice.

A 201Tl perfusion defect in a case with rate-dependent left bundle-branch block (LBBB)

1985 ◽  
Vol 10-10 (3-4) ◽  
Author(s):  
Chinori Kurata ◽  
Hajime Terada ◽  
Toru Fujii ◽  
Reiichiro Fujita ◽  
Yasuto Sasaki
Keyword(s):  
Left Bundle Branch Block ◽  
Perfusion Defect ◽  
Bundle Branch Block ◽  
Rate Dependent

Method for estimation of the perfusion defect in shock

1976 ◽  
Vol 20 (2) ◽  
pp. 77-84 ◽  
Author(s):  
W.C. Shoemaker ◽  
W.J. Launder ◽  
J. Castagna ◽  
D. State
Keyword(s):  
Perfusion Defect

Hybrid coronary computed tomography angiography and positron emission tomography myocardial perfusion imaging in evaluation of recurrent symptoms after coronary artery bypass grafting

2018 ◽  
Vol 20 (11) ◽  
pp. 1298-1304 ◽  
Author(s):  
Teemu Maaniitty ◽  
Samuli Jaakkola ◽  
Antti Saraste ◽  
Juhani Knuuti
Keyword(s):  
Myocardial Perfusion ◽  
Perfusion Defect ◽  
Hybrid Imaging ◽  
Coronary Computed Tomography Angiography ◽  
Artery Bypass ◽  
Emission Tomography ◽  
Bypass Grafting ◽  
Bypass Grafts ◽  
Complementary Information ◽  
Positron Emission

Abstract Aims Recurrent chest pain after coronary artery bypass grafting (CABG) poses a diagnostic challenge. We hypothesized that combining anatomy of bypass grafts and native coronary arteries with ischaemia detection by hybrid imaging could be used to gain valuable and complementary information in patients with recurrent symptoms after CABG. Methods and results We analysed 36 consecutive patients (67 ± 9 years, 81% male) who had undergone hybrid imaging using coronary computed tomography angiography (CCTA) and [15O]H2O positron emission tomography (PET) myocardial perfusion imaging due to recurrent symptoms after CABG. Coronary tree and left ventricular myocardium were divided into three main territories, yielding a total of 108 coronary territories in 36 patients. The presence of obstructive (≥50%) stenosis and the patency of grafts were evaluated by CCTA, while myocardial ischaemia was assessed by quantitative adenosine-stress PET. Altogether 28 (78%) of the 36 study patients presented with matched PET/CCTA abnormalities. Forty-one coronary territories were supplied by non-obstructed bypass grafts or native coronary arteries (protected territory). However, 12 (29%) of these presented with a perfusion defect. In six cases, the perfusion defect involved myocardium distal to the graft-coronary anastomosis, as interpreted on the PET/CCTA fusion images. In turn, in 48 coronary territories the supplying artery was obstructed on CCTA (unprotected territory). Of these, 41 (85%, P < 0.001 vs. protected) presented with abnormal perfusion, involving myocardium distal to the anastomosis in 29 cases. Conclusion Hybrid imaging provides complementary information on the presence and localization of atherosclerotic lesions and myocardial perfusion abnormalities in symptomatic patients with previous CABG.

scholarly journals NOGA-Guided Analysis of Regional Myocardial Perfusion Abnormalities Treated With Intramyocardial Injections of Plasmid Encoding Vascular Endothelial Growth Factor A-165 in Patients With Chronic Myocardial Ischemia

Circulation ◽  
2005 ◽  
Vol 112 (9_supplement) ◽  
Author(s):  
Mariann Gyöngyösi ◽  
Aliasghar Khorsand ◽  
Sholeh Zamini ◽  
Wolfgang Sperker ◽  
Christoph Strehblow ◽  
...  
Keyword(s):  
Myocardial Perfusion ◽  
Perfusion Defect ◽  
Single Photon ◽  
Photon Emission ◽  
Tracer Uptake ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Background— The aim of this substudy of the EUROINJECT-ONE double-blind randomized trial was to analyze changes in myocardial perfusion in NOGA-defined regions with intramyocardial injections of plasmid encoding plasmid human (ph)VEGF-A 165 using an elaborated transformation algorithm. Methods and Results— After randomization, 80 no-option patients received either active, phVEGF-A 165 (n=40), or placebo plasmid (n=40) percutaneously via NOGA-Myostar injections. The injected area (region of interest, ROI) was delineated as a best polygon by connecting of the injection points marked on NOGA polar maps. The ROI was projected onto the baseline and follow-up rest and stress polar maps of the 99m-Tc-sestamibi/tetrofosmin single-photon emission computed tomography scintigraphy calculating the extent and severity (expressed as the mean normalized tracer uptake) of the ROI automatically. The extents of the ROI were similar in the VEGF and placebo groups (19.4±4.2% versus 21.5±5.4% of entire myocardium). No differences were found between VEGF and placebo groups at baseline with regard to the perfusion defect severity (rest: 69±11.7% versus 68.7±13.3%; stress: 63±13.3% versus 62.6±13.6%; and reversibility: 6.0±7.7% versus 6.7±9.0%). At follow-up, a trend toward improvement in perfusion defect severity at stress was observed in VEGF group as compared with placebo (68.5±11.9% versus 62.5±13.5%, P =0.072) without reaching normal values. The reversibility of the ROI decreased significantly at follow-up in VEGF group as compared with the placebo group (1.2±9.0% versus 7.1±9.0%, P =0.016). Twenty-one patients in VEGF and 8 patients in placebo group ( P <0.01) exhibited an improvement in tracer uptake during stress, defined as a ≥5% increase in the normalized tracer uptake of the ROI. Conclusions— Projection of the NOGA-guided injection area onto the single-photon emission computed tomography polar maps permits quantitative evaluation of myocardial perfusion in regions treated with angiogenic substances. Injections of phVEGF A 165 plasmid improve, but do not normalize, the stress-induced perfusion abnormalities.

Abstract 407: Modulation of Delta-Like Ligand-4 Signaling Improves Myocardial Revascularization Following Coronary Ischemia

2015 ◽  
Vol 117 (suppl_1) ◽  
Author(s):  
S R Kumar ◽  
Christopher Yi ◽  
Timothy Martens ◽  
Sydney J Zagger ◽  
Antonio Duarte ◽  
...  
Keyword(s):  
Ct Angiography ◽  
Perfusion Defect ◽  
Therapeutic Potential ◽  
Ischemia Reperfusion ◽  
Myocardial Revascularization ◽  
Pcr Analysis ◽  
End Diastolic Volume ◽  
Myocardial Area ◽  
Coronary Ischemia ◽  
Dose Dependent

Delta-like ligand-4 (DLL4) is an arterial-specific Notch ligand and balanced signaling by DLL4 is required for functional neovascularization. We hypothesized that modest inhibition of DLL4 signaling improves myocardial revascularization following coronary ischemia. Myocardial infarction was induced by ligation of mid-left anterior descending (LAD) artery via rapid left thoracotomy in 6-8 week-old male mice with inducible endothelial-specific knockout or overexpression of DLL4. DLL4 silencing in homozygous mice on the day of or 5 days prior to LAD ligation resulted in significant reduction in revascularization. At four weeks, explanted hearts showed 1.8-fold fewer vessels in LAD territory, 3-fold greater myocardial hypoxia, 1.7-fold larger fibrotic scar and 17% increased perfusion defect in the left ventricle (LV) by scintigraphy. CT angiography confirmed fewer collateral vessels. Echocardiography showed increased LV dilation (37% higher end-diastolic volume) and 12% greater reduction in ejection fraction (EF) compared to baseline (all p<0.001). Overexpression of DLL4 showed a similarly worse outcome. Conversely, partial DLL4 knockout in heterozygous animals resulted in improved outcomes in all parameters. For translational application, animals were systemically administered 1.5mg/kg or 3mg/kg DLL4-Fc intraperitoneally three times a week beginning the day of ligation. RT-PCR analysis of downstream molecules confirmed that systemic DLL4-Fc partially inhibits Notch signaling in endothelial cells in the ischemic LV. When LAD was ligated very proximally, DLL4-Fc improved survival. With mid-LAD ligation, DLL4-Fc induced a dose-dependent increase in number of CD 31-positive vessels and by CT angiography. There was a dose-dependent reduction in hypoxic myocardial area, scar burden, and scintigraphic perfusion defect. DLL4-Fc treated mice had lower end-diastolic LV volume and preserved or improved EF. In an ischemia-reperfusion model, DLL4-Fc increased the number of vessels in the ischemic zone. Our data suggests that balanced DLL4 signaling is crucially required for myocardial angiogenic recovery following coronary ischemia. Modulation of DLL4 signaling has translational therapeutic potential.

Combining contrast-enhanced ultrasound and blood cell analysis to improve diagnostic accuracy of plasma cell mastitis

2021 ◽  
pp. 153537022110493
Author(s):  
Yan Zheng ◽  
Lin Wang ◽  
Xiu Han ◽  
Lin Shen ◽  
Chen Ling ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Blood Cell ◽  
Diagnostic Accuracy ◽  
Cancer Patients ◽  
Plasma Cell ◽  
Perfusion Defect ◽  
Cell Analysis ◽  
Contrast Enhanced Ultrasound ◽  
Breast Cancer Patients ◽  
Contrast Enhanced

Plasma cell mastitis is a benign suppurative disease of the breast, lack of specific clinical manifestations, which is easy to be misdiagnosed and mistreated, often confused with mastitis, breast cancer (BC), and other diseases. Thus, we aimed to establish a combined model of promoting diagnostic accuracy of plasma cell mastitis by contrast-enhanced ultrasound (CEUS) patterns and routine blood cell analysis. Eighty-eight plasma cell mastitis, 91 breast cancer, and 152 other benign breast diseases’ patients grouped according to pathological diagnosis underwent CEUS and blood cell analysis examination; 100 healthy female donors were involved. All the plasma cell mastitis and breast cancer patients presented hyperenhancement of CEUS breast lesions compared with others. The majority of plasma cell mastitis (65/88) showed perfusion defect of CEUS patterns with smooth edge (56/65) and multiple lesions (49/65); in contrast, fewer breast cancer patients (30/91) displayed perfusion defect. White blood cell count (WBC), neutrophils, and neutrophils/lymphocytes ratio of blood cell analysis in plasma cell mastitis patients increased significantly compared with other patients ( P < 0.0001). Combining perfusion defect of CEUS patterns and WBC yielded an area under the receiver operating characteristic curve of 0.831, higher than single 0.720 and 0.774, respectively. The cut-off value of WBC (7.28 × 109/L) helped remaining 65.2% (15/23) atypical cases to be correctly diagnosed as plasma cell mastitis, not misdiagnosed as breast cancer. In conclusion, CEUS presented a clear perfusion defect pattern of plasma cell mastitis lesion for the first time. A precise WBC by routine blood cell analysis test can assist CEUS examination in the differential diagnosis of plasma cell mastitis and breast cancer. It is a promised combination for laboratory diagnostic of PCM.

Sign in / Sign up

Export Citation Format

Share Document