Own experience of mri T2 and ct perfusion of the brain, how to avoid «failures»

Introduction. To reduce the number of cerebral perfusion studies, the interpretation of which is not possible or can be performed with errors, we retrospectively analyzed cerebral perfusion studies for three years, analyzed the identified errors at the stage of data collection and the stage of study interpretation.Aims and objectives: to analyze and divide into groups the reasons that led to limitations or impossibility to assess perfusion during interpretation of the obtained data, to develop an algorithm of actions to reduce the number of uninterpreted studies.Materials and Methods. The study retrospectively evaluated 275 CT and MRI brain perfusion studies performed between 2017 and 2019 on 1.5 T MR and 32-slice CT scans.Results. The result of this study was a better understanding of the causes of the most common errors in perfusion studies. Analysis of the causes allowed us to identify factors that affect the performance of the study and the interpretation of the data obtained. Discussion. In order to perform a quality perfusion study, given the many factors affecting the interpretation of the data obtained, a number of conditions on the planning and execution of the study, as well as on the evaluation of the data obtained, must be followed. Conclusions. Understanding the reasons that lead to limitations or inability to evaluate MRI and CT perfusion studies, adhering to guidelines for planning and evaluating studies allows for correct data and avoids obtaining uninformative studies or studies whose interpretation is limited.

Radiological CT findings and time evolution in acute stroke: case report

Case report of a 95-year-old female patient that was admitted to the emergency room with a sudden weakness on the right who underwent propaedeutic imaging with cerebral perfusion study by CT using artificial intelligence (AI) software for clinical suspicion of acute stroke. The case illustrates a frequent and specific imaging finding for stroke and its disappearance in the control exam even without optimized treatment.

Initial experience in direct graft perfusion assessment following orthotopic liver transplant

Objective: classical methods of determining arterial blood supply of the graft following orthotopic liver transplantation (OLT) reflect the presence of blood flow in the trunk and large branches of the A. hepatica, without the characteristic of completeness of blood filling of peripheral sections, which is very important for objective evaluation of function. The aim of this study is to establish the diagnostic value of a direct perfusion study (IFlow) of the graft. Materials and methods. From 1998 to 2019, 245 OLTs were conducted. From 2015 to 2019, arterial changes were detected in 24 (23%) patients after 104 OLTs. A perfusion study was performed in 9 patients with suspected arterial graft failure. According to the IFlow study, liver hypoperfusion due to stenosis and/or splenic steal syndrome was detected in 8 cases and became an indication for therapeutic intervention. Results. Hepatic stenting and/or splenic artery embolization was performed to improve arterial blood supply to the liver. Endovascular procedures performed restored the perfusion index from 0.24 (0.01–0.89) to 0.61 (0.35–0.98). Conclusion. Absence of ultrasound and multispiral computed tomography signs of arterial complications does not rule out the need for perfusion angiography. Perfusion angiography allows to objectify the angiography data and perform corrective intervention in good time.