|
ИСТИНА |
Войти в систему Регистрация |
ИСТИНА ИНХС РАН |
||
Assessment of cerebrovascular reactivity using hypercapnia during intraoperative ASL MRI perfusion in patients with chronic cerebral ischemiaтезисы доклада
- Авторы: SHULGINA Anna, LUKSHIN Vasily, USACHEV Dmitry
- Сборник: The 67th Annual Meeting of the Japanese Society of Cerebral Blood Flow and Metabolism (BRAIN Japan 2024) Abstract book
- Тезисы
- Год издания: 2024
- Место издания: Japanese Society of Cerebral Blood Flow and Metabolism Toyama, Japan Toyama, Japan
- Первая страница: 108
- Последняя страница: 108
- Номер статьи: O11-4
- Аннотация: Background It is commonly known that cerebrovascular reactivity (CVR) reflects the severity of chronic cerebral ischemia. There are several methods that can be used in assessment of this parameter, however, most of them are invasive methods. Hypercapnia has been long known as a potent stimulator of cerebral blood flow (CBF) through its vasodilatory effect on cerebral vasculature. Gas mixtures with elevated concentrations of carbon dioxide are commonly used in both the research and clinical settings to evaluate CVR. Objectives (or Aim) To demonstrate the feasibility of assessment of CVR using intraoperative ASL MRI perfusion during mild hypercapnia and to show that brain regions affected by the diseases have diminished vascular reactivity. Methods 36 patients with chronic cerebral ischemia due to stenotic or occlusive cerebrovascular disease underwent surgical revascularization using ioMRI. Mild hypercapnia (to determine CVR) under general anesthesia was applied before and after cerebral revascularization surgery in all patients (after the exclusion of acute ischemic foci on DWI). Hypercapnia was induced by increase in pCO2 from 35 to 45 mm Hg. There were strict control of blood pressure – it was maintained within normal values during all studies with the hypercapnia. Result All patients after hypercapnia showed pronounced decrease in CBF more than 15% compared to rest state and 60-75% compared to unaffected hemisphere. After applying the extra-intracranial bypass hypercapnic test (after the exclusion of acute ischemic foci on DWI) showed restoration of CBF in the whole MCA territory in all patients. In 10% there were signs of hyperperfusion – these cases demanded medical correction and blood pressure control. Conclusion Io hypercapnic ASL-MRI is an effective and informative tool for determining the degree of CBF restoration directly during surgery, which allows for timely adjustment of surgical treatment tactics, determining indications or contraindications for additional revascularization and excluding early ischemic complications. Use of hypercapnia during ASL study allows to assess cerebrovascular reactivity and distinguish the group of patients with exhausted cerebrovascular reserves.
- Добавил в систему: Шульгина Анна Алексеевна