Regional cerebral blood flow (rCBF) and cerebrovascular reserve capacity (CVRC) in cerebrovascular disease: pathophysiology and effects of operative therapy

1996 ◽  
Vol 93 ◽  
pp. 112-112 ◽  
Author(s):  
M. N. Nemati ◽  
M. Scholz ◽  
M. Hardenack ◽  
K. Schmieder ◽  
A. Harders ◽  
...  
1987 ◽  
Vol 26 (05) ◽  
pp. 192-197 ◽  
Author(s):  
T. Kreisig ◽  
P. Schmiedek ◽  
G. Leinsinger ◽  
K. Einhäupl ◽  
E. Moser

Using the 133Xe-DSPECT technique, quantitative measurements of regional cerebral blood flow (rCBF) were performed before and after provocation with acetazolamide (Diamox) i. v. in 32 patients without evidence of brain disease (normals). In 6 cases, additional studies were carried out to establish the time of maximal rCBF increase which was found to be approximately 15 min p. i. 1 g of Diamox increases the rCBF from 58 ±8 at rest to 73±5 ml/100 g/min. A Diamox dose of 2 g (9 cases) causes no further rCBF increase. After plotting the rCBF before provocation (rCBFR) and the Diamox-induced rCBF increase (reserve capacity, Δ rCBF) the regression line was Δ rCBF = −0,6 x rCBFR +50 (correlation coefficient: r = −0,77). In normals with relatively low rCBF values at rest, Diamox increases the reserve capacity much more than in normals with high rCBF values before provocation. It can be expected that this concept of measuring rCBF at rest and the reserve capacity will increase the sensitivity of distinguishing patients with reversible cerebrovascular disease (even bilateral) from normals.


1988 ◽  
Vol 27 (06) ◽  
pp. 232-236
Author(s):  
Th. Chatzipanagiotou ◽  
E. W. Radü ◽  
J. Rem ◽  
R. Fridrich ◽  
J. Müller-Brand

Using the 16-detector 133Xe-NaCI-technique (Novo Cerebrograph) quantitative measurements of regional cerebral blood flow (rCBF) were performed in 14 patients with unilateral carotis obstruction before and during stimulation with 3% CO2 inhalation. In all patients resting studies did not show any significant differences in hemispheric perfusion. In 11 patients the hemispheric blood flow increased significantly (by more than 6%) during CO2 inhalation on the side without carotis obstruction. The following results were found after 3% CO2-stimulation over the hemisphere with the obstructed carotid artery: 1) rCBF increased significantly on both sides (n = 6) indicating the sufficiency of cerebral collateral circulation; 2) a side-to-side significant difference (n = 4) with the lower perfusion on the pathological side, indicating a decreased or suspended reserve capacity; and 3) bilateral loss of cerebrovascular reactivity (n = 4) as indicator of insufficiency of cerebral collateral circulation. Asymmetry in rCBF or missing cerebrovascular reserve are indications for surgical treatment of the carotis obstruction.


1988 ◽  
Vol 13 (3) ◽  
pp. 197-201 ◽  
Author(s):  
HANS L. LAGREZE ◽  
ROSS L. LEVINE ◽  
JOHN S. SUNDERLAND ◽  
ROBERT J. NICKLES

1988 ◽  
Vol 27 (02) ◽  
pp. 51-56 ◽  
Author(s):  
H. Braun ◽  
A. Ferbert ◽  
H. Stirner ◽  
C. Weiller ◽  
E. B. Ringelstein ◽  
...  

In 53 patients with cerebrovascular disease (CVD), regional cerebral blood flow (CBF) and blood volume (CBV) were imaged by SPECT within one session. Slice division (CBF: CBV) yielded distribution of regional cerebral perfusion reserve (CPR). Semiquantitative evaluation was obtained from manually set ROIs by interhemispherical ratios (for CBF, CBV and CPR), using 2 SD from a normal group (n = 10) as a threshold. Sensitivities were 59% for CBF, 94% for CBV and 83% for CPR. Combined sensitivity was 98%. Establishing three constellations for CBF, CBV and CPR, regionally normal CBFs but quantitatively increased CBVs (+69%) and decreased CPRs (−31 %) were found in relatively early stages of CVD. Very advanced cases showed decreased CBFs (−65%), CBVs (−40%), CPRs (−49%) and a surrounding penumbra. In 87% (46/53 patients), such Theologically postulated constellations could be demonstrated. We conclude that combined CBF and CBV SPECT, assisted by CPR images, is a promising tool to detect CVD and to assess its individual regional severity.


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