Four-Dimensional Flow MRI Analysis of Cerebral Blood Flow Before and After High-Flow Extracranial–Intracranial Bypass Surgery With Internal Carotid Artery Ligation

Internal carotid artery blood flow (IFBF) was determined in each of nine Macaca mulatta by means of a flow transducer implanted around an internal carotid artery. The monkeys were lightly anesthetized, intubated, and paralyzed. Normoxia and normocarbia were maintained stable throughout the experiment. ICBF was monitored while mean arterial blood pressure (MABP) was lowered by withdrawal of blood. MABP was kept within the known limits of autoregulation in order not to compromise CBF. Cerebrospinal fluid (CSF) from the cisterna magna was analyzed for pH PCO2, and PO2 before and after a 30-min hypotensive period in which MABP was lowered from 116 +/- 4 to 70 +/- 2 mmHg (mean +/- SE). Corresponding HCO3- concentrations were calculated. The decrease in MABP did not result in a significant reduction in ICBF but elicited a 37% reduction in calculated cerebrovascular resistance, indicating normal autoregulation. Mena CSF pH was not significantly decreased (P less than 0.05); it changed from 7.320 +/- 0.010 to 7.317 +/- 0.010 after the induced hypotensive period. Thus CSF pH does not appear to have a significant role in cerebral blood flow autoregulation.

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Massive Epistaxis from Nontraumatic Cavernous Carotid Aneurysm Treated by High-Flow Bypass and Cervical Internal Carotid Artery Ligation: A Case Report and Review of the Literature

World Neurosurgery ◽

10.1016/j.wneu.2019.04.213 ◽

2019 ◽

Vol 128 ◽

pp. 23-28 ◽

Cited By ~ 1

Author(s):

Kitiporn Sriamornrattanakul ◽

Nasaeng Akharathammachote

Keyword(s):

Case Report ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

High Flow ◽

Review Of The Literature ◽

Artery Ligation ◽

Carotid Artery Ligation ◽

Cavernous Carotid Aneurysm ◽

Cervical Internal Carotid Artery

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Simultaneous PET-MRI imaging of cerebral blood flow and glucose metabolism in the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease

European Journal of Nuclear Medicine and Molecular Imaging ◽

10.1007/s00259-019-04551-w ◽

2019 ◽

Vol 47 (7) ◽

pp. 1668-1677 ◽

Cited By ~ 2

Author(s):

Bixiao Cui ◽

Tianhao Zhang ◽

Yan Ma ◽

Zhongwei Chen ◽

Jie Ma ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Glucose Metabolism ◽

Cerebrovascular Disease ◽

Middle Cerebral Artery ◽

Cerebral Artery ◽

Bypass Surgery ◽

Internal Carotid ◽

Ischaemic Cerebrovascular Disease ◽

Before And After

Abstract Purpose Cerebral blood flow (CBF) and glucose metabolism are important and significant factors in ischaemic cerebrovascular disease. The objective of this study was to use quantitative hybrid PET/MR to evaluate the effects of surgery treatment on the symptomatic unilateral internal carotid artery/middle cerebral artery steno-occlusive disease. Methods Fifteen patients diagnosed with ischaemic cerebrovascular disease were evaluated using a hybrid TOF PET/MR system (Signa, GE Healthcare). The CBF value measured by arterial spin labelling (ASL) and the standardized uptake value ratio (SUVR) measured by 18F-FDG PET were obtained, except for the infarct area and its contralateral side, before and after bypass surgery. The asymmetry index (AI) was calculated from the CBF and SUVR of the ipsilateral and contralateral cerebral hemispheres, respectively. The ΔCBF and ΔSUVR were calculated as the percent changes of CBF and SUVR between before and after surgery, and paired t tests were used to determine whether a significant change occurred. Spearman’s rank correlation was also used to compare CBF with glucose metabolism in the same region. Results The analysis primarily revealed that after bypass surgery, a statistically significant increase occurred in the CBF on the affected side (P < 0.01). The postprocedural SUVR was not significantly higher than the preprocedural SUVR (P > 0.05). However, the postprocedural AI values for CBF and SUVR were significantly lower after surgery than before surgery (P < 0.01). A significant correlation was found between the AI values for preoperative CBF and SUVR on the ipsilateral hemisphere (P < 0.01). Conclusions The present study demonstrates that a combination of ASL and 18F-FDG PET could be used to simultaneously analyse changes in patients’ cerebral haemodynamic patterns and metabolism between before and after superficial temporal artery-middle cerebral artery (STA-MCA) bypass surgery. This therefore represents an essential tool for the evaluation of critical haemodynamic and metabolic status in patients with symptomatic unilateral ischaemic cerebrovascular disease.

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