scholarly journals Cerebral Blood Flow and Metabolism Measurement Using Positron Emission Tomography before and during Internal Carotid Artery Test Occlusions: Feasibility of Rapid Quantitative Measurement of CBF and OEF/CMRO2

2012 ◽  
Vol 18 (3) ◽  
pp. 264-274 ◽  
Author(s):  
N. Kawai ◽  
M. Kawanishi ◽  
A. Shindou ◽  
N. Kudomi ◽  
Y. Yamamoto ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Internal Carotid ◽  
False Negative ◽  
Photon Emission ◽  
Emission Tomography ◽  
Positron Emission

Balloon test occlusion (BTO) of the internal carotid artery (ICA) combined with cerebral blood flow (CBF) study is a sensitive test for predicting the outcome of permanent ICA occlusion. However, false negative results sometimes occur using single photon emission tomography (SPECT). We have recently developed a rapid positron emission tomography (PET) protocol that measures not only the CBF but also the cerebral oxygen metabolism before and during BTO in succession. We measured acute changes in regional CBF and OEF/CMRO2 before and during BTO in three cases with large or giant cerebral aneurysms using the rapid PET protocol. Although no patients showed ischemic symptoms during BTO, PET studies exhibited mildly to moderately decreased CBF (9∼34%) compared to the values obtained before BTO in all cases. The average OEF during BTO was significantly increased (21% and 43%) than that of before BTO in two cases. The two cases were considered to be non-tolerant for permanent ICA occlusion and treated without ICA sacrifice. Measurement of the CBF and OEF/CMRO2 using a rapid PET protocol before and during BTO is feasible and can be used for accurate assessment of tolerance prediction in ICA occlusion.

[O-15]H2O Positron Emission Tomography Determination of Cerebral Blood Flow Reserve after Intravenous Acetazolamide during Balloon Test Occlusion of the Internal Carotid Artery

1998 ◽  
Vol 4 (1) ◽  
pp. 57-62 ◽  
Author(s):  
K.J. Murphy ◽  
J.P. Deveikis ◽  
J.A. Brunberg ◽  
D.A. Jamadar ◽  
K.A. Frey
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Balloon Occlusion ◽  
Emission Tomography ◽  
Balloon Test Occlusion ◽  
Positron Emission ◽  
O 15

The purpose of this paper was to evaluate the effects of acetazolamide on cerebral blood flow (CBF) measured by [O-15] H2O positron emission tomography (PET) during balloon test occlusion (BTO) of the internal carotid artery (ICA). [O-15] H2O PET cerebral blood flow studies were completed in 20 patients undergoing BTO. CBF determinations were obtained without carotid occlusion as a baseline, following balloon occlusion, and as a third scan with balloon occlusion after an intravenous acetazolamide bolus. The balloon was left deflated between scans, and was only inflated immediately before and during the 90 second period of time needed for CBF determination. Significance was determined at the P<0.05 level. Two of twenty studies were technical failures. Prior to acetazolamide there was a significant decrease in CBF (P<0.0007) ipsilateral to the occlusion. After acetazolamide administration there was no statistically significant change in flow on the occluded side (P<0.3047); however, there was a significant increase in cerebral blood flow (P<0.0002) on the non-occluded side. In this patient population, there was no acetazolamide-induced CBF decompensation (steal) phenomenon or haemodynamically significant risk in CBF ipsilateral to the occlusion.

scholarly journals Noninvasive Estimation of the Arterial Input Function in Positron Emission Tomography Imaging of Cerebral Blood Flow

2012 ◽  
Vol 33 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Yi Su ◽  
Ana M Arbelaez ◽  
Tammie LS Benzinger ◽  
Abraham Z Snyder ◽  
Andrei G Vlassenko ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid ◽  
Arterial Input Function ◽  
Input Function ◽  
Emission Tomography ◽  
Positron Emission ◽  
Arterial Sampling

Positron emission tomography (PET) with 15O-labeled water can provide reliable measurement of cerebral blood flow (CBF). Quantification of CBF requires knowledge of the arterial input function (AIF), which is usually provided by arterial blood sampling. However, arterial sampling is invasive. Moreover, the blood generally is sampled at the wrist, which does not perfectly represent the AIF of the brain, because of the effects of delay and dispersion. We developed and validated a new noninvasive method to obtain the AIF directly by PET imaging of the internal carotid artery in a region of interest (ROI) defined by coregistered high-resolution magnetic resonance angiography. An ROI centered at the petrous portion of the internal carotid artery was defined, and the AIF was estimated simultaneously with whole brain blood flow. The image-derived AIF (IDAIF) method was validated against conventional arterial sampling. The IDAIF generated highly reproducible CBF estimations, generally in good agreement with the conventional technique.

Pressure Autoregulation and Positron Emission Tomography-derived Cerebral Blood Flow Acetazolamide Reactivity in Patients with Carotid Artery Stenosis

Neurosurgery ◽  
2004 ◽  
Vol 55 (1) ◽  
pp. 63-68 ◽  
Author(s):  
Pawan S. Minhas ◽  
Piotr Smielewski ◽  
Peter J. Kirkpatrick ◽  
John D. Pickard ◽  
Marek Czosnyka
Keyword(s):  
Blood Pressure ◽  
Positron Emission Tomography ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Arterial Disease ◽  
Emission Tomography ◽  
Positron Emission ◽  
Carotid Arterial ◽  
Pressure Autoregulation

Abstract OBJECTIVE: Testing autoregulation is of importance in predicting risk of stroke and managing patients with occlusive carotid arterial disease. The use of small spontaneous changes in arterial blood pressure and transcranial Doppler (TCD) flow velocity can be used to assess autoregulation noninvasively without the need for a cerebrovascular challenge. We have previously described an index (called “Mx”) that achieves this. Negative or low positive values (&lt;0.4) indicate intact pressure autoregulation, whereas an Mx greater than 0.4 indicates diminished autoregulation. The objective of this study was to compare acetazolamide reactivity of positron emission tomography (PET)-derived cerebral blood flow (CBF) with Mx in patients with carotid arterial disease. METHODS: In 40 patients with carotid arterial disease, we used bilateral TCD recordings of the middle cerebral artery to derive Mx and compared this with PET-derived CBF measurements of acetazolamide reactivity. RESULTS: Mx correlated inversely with baseline PET CBF (P = 0.042, R = −0.349) but not with postacetazolamide CBF or cerebrovascular reactivity to acetazolamide. This may reflect discordance between pressure autoregulation and acetazolamide reactivity. Mx correlated significantly with degree of internal carotid artery stenosis (P = 0.022, R = 0.38), whereas CBF reactivity to acetazolamide did not correlate with Mx (P = 0.22). After the administration of acetazolamide, slow-wave activity in blood pressure and TCD flow velocity recordings was seen to diminish, rendering the calculation of Mx unreliable after acetazolamide. CONCLUSION: The measurement of Mx offers a noninvasive, safe technique for assessing abnormalities of pressure autoregulation in patients with carotid arterial disease.

Impact of transient hypotension on regional cerebral blood flow in humans

2015 ◽  
Vol 129 (2) ◽  
pp. 169-178 ◽  
Author(s):  
Nia C.S. Lewis ◽  
Kurt J. Smith ◽  
Anthony R. Bain ◽  
Kevin W. Wildfong ◽  
Tianne Numan ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Vertebral Artery ◽  
Regional Cerebral Blood Flow ◽  
Internal Carotid ◽  
Regional Cerebral Blood

Diameter reductions in the internal carotid artery (ICA) and vertebral artery (VA) contribute to the decline in brain blood with hypotension. The decline in vertebral blood flow with hypotension was greater when carbon dioxide was low; this was not apparent in the ICA.

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