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[Tomographic analysis of CBF in cerebral infarction]
No to Shinkei = Brain and Nerve
|June 1, 1983
Summary
This study introduces a computed tomographic method for measuring cerebral blood flow (CBF) in occlusive diseases. The technique provides high-resolution maps, identifying ischemic thresholds and pathological changes in various cerebrovascular conditions.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Cerebral blood flow (CBF) assessment is crucial for diagnosing and managing occlusive cerebrovascular diseases.
- Conventional methods for CBF measurement often lack high resolution or direct anatomical correlation.
- Computed tomography (CT) offers a potential platform for advanced functional imaging of the brain.
Purpose of the Study:
- To evaluate a novel computed tomographic method for quantifying cerebral blood flow (CBF) in patients with various occlusive cerebrovascular diseases.
- To establish normal CBF values and identify ischemic thresholds using this CT-based technique.
- To correlate CT-derived CBF patterns with specific pathological changes and clinical presentations of occlusive diseases.
Main Methods:
- Employed a CT method involving xenon inhalation (40-60%) with serial CT scanning for 25 minutes.
- Calculated regional cerebral blood flow (CBF), build-up rate (K), and partition coefficient (lambda) using Fick's principle from CT values and expired xenon.
- Displayed quantitative CBF data as color-coded maps (K-map, lambda-map, CBF-map) for detailed anatomical analysis.
Main Results:
- Established normal gray matter CBF at 82 ± 11 ml/100 gm/min and white matter CBF at 24 ± 5 ml/100 gm/min.
- Identified an ischemic threshold for gray matter at approximately 20 ml/100 gm/min.
- Observed distinct CBF patterns in various conditions, including hyperemia in hemorrhagic infarcts, watershed infarction in periventricular areas, and reduced anterior circulation flow in Moyamoya disease.
Conclusions:
- The CT-based xenon inhalation method provides high-resolution, anatomically correlated CBF maps for evaluating occlusive cerebrovascular diseases.
- The method effectively delineates ischemic thresholds and characterizes perfusion abnormalities associated with infarction, laminar necrosis, and Moyamoya disease.
- This technique offers advantages over conventional isotope-based methods for detailed cerebral perfusion assessment.