BACKGROUND Global and regional cerebral blood flow(CBF)changes in patients with unilateral internal carotid artery occlusion(ICAO)are unclear when the dual post-labeling delays(PLD)arterial spin labeling(ASL)magnetic ...BACKGROUND Global and regional cerebral blood flow(CBF)changes in patients with unilateral internal carotid artery occlusion(ICAO)are unclear when the dual post-labeling delays(PLD)arterial spin labeling(ASL)magnetic resonance imaging(MRI)technique is used.Manual delineation of regions of interest for CBF measurement is time-consuming and laborious.AIM To assess global and regional CBF changes in patients with unilateral ICAO with the ASL-MRI perfusion technique.METHODS Twenty hospitalized patients with ICAO and sex-and age-matched controls were included in the study.Regional CBF was measured by Dr.Brain's ASL software.The present study evaluated differences in global,middle cerebral artery(MCA)territory,anterior cerebral artery territory,and Alberta Stroke Program Early Computed Tomography Score(ASPECTS)regions(including the caudate nucleus,lentiform nucleus,insula ribbon,internal capsule,and M1-M6)and brain lobes(including frontal,parietal,temporal,and insular lobes)between ICAO patients and controls at PLD 1.5 s and PLD 2.5 s.RESULTS When comparing CBF between ICAO patients and controls,the global CBF in ICAO patients was lower at both PLD 1.5 s and PLD 2.5 s;the CBF on the occluded side was lower in 15 brain regions at PLD 1.5 s,and it was lower in 9 brain regions at PLD 2.5 s;the CBF in the contralateral hemisphere was lower in the caudate nucleus and internal capsule at PLD 1.5 s and in M6 at PLD 2.5 s.The global CBF in ICAO patients was lower at PLD 1.5 s than at PLD 2.5 s.The ipsilateral CBF at PLD 1.5 s was lower than that at PLD 2.5 s in 15 regions,whereas the contralateral CBF was lower at PLD 1.5 s than at PLD 2.5 s in 12 regions.The ipsilateral CBF was lower than the contralateral CBF in 15 regions at PLD 1.5 s,and in M6 at PLD 2.5 s.CONCLUSION Unilateral ICAO results in hypoperfusion in the global and MCA territories,especially in the ASPECTS area.Dual PLD settings prove more suitable for accurate CBF quantification in ICAO.展开更多
Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many...Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).展开更多
背景:在康复训练中,随着倒立器械的出现,越来越多的人应用该器械进行头低位训练,那么头低位训练中人体不同体位变化时,颈动脉血流变化特征如何值得关注。目的:探索康复训练中人体不同体位颈动脉血流量变化特征。方法:招募104名在校大学...背景:在康复训练中,随着倒立器械的出现,越来越多的人应用该器械进行头低位训练,那么头低位训练中人体不同体位变化时,颈动脉血流变化特征如何值得关注。目的:探索康复训练中人体不同体位颈动脉血流量变化特征。方法:招募104名在校大学生志愿者(男60名,女44名),应用PHILPS COLOR DOPPLER CV850彩色超声等在不同体位进行颈动脉血流动力学检测。结果与结论:(1)与仰卧位相比,直立位时女性右颈总动脉(P=0.031),男性左颈总动脉(P=0.033)、右颈总动脉(P=0.003)、右颈内动脉(P=0.030)血流量明显降低,差异有(非常)显著性意义;(2)与仰卧位相比,头低位-30°时女性左颈总动脉(P=0.018)、右颈总动脉(P=0.001)、左椎动脉(P=0.049),男性左颈总动脉(P=0.007)、右颈总动脉(P=0.005)血流量明显降低,差异有(非常)显著性意义;(3)与仰卧位相比,头低位-90°时,男女性左颈总动脉(P=0.000)、右颈总动脉(P=0.000),女性左颈内动脉(P=0.002)、右颈内动脉(P=0.002),男性左颈内动脉(P=0.001)、右颈内动脉(P=0.000)、左椎动脉(P=0.003)血流量明显降低,差异有(非常)显著性意义;(4)上述结果表明,健康人体体位由直立位、仰卧位、头低位-30°到头低位-90°的顺序变化时,与仰卧位相比,在头低位-30°、头低位-90°时,颈总动脉、颈内动脉、椎动脉血流量变化百分比较大,尤其是头低位-90°变化最大。展开更多
基金Supported by The Key Research and Development Program Projects of Shaanxi Province of China,No.S2023-YF-YBSF-0273Natural Science Foundation of Shaanxi Province of China,No.2022JQ-900.
文摘BACKGROUND Global and regional cerebral blood flow(CBF)changes in patients with unilateral internal carotid artery occlusion(ICAO)are unclear when the dual post-labeling delays(PLD)arterial spin labeling(ASL)magnetic resonance imaging(MRI)technique is used.Manual delineation of regions of interest for CBF measurement is time-consuming and laborious.AIM To assess global and regional CBF changes in patients with unilateral ICAO with the ASL-MRI perfusion technique.METHODS Twenty hospitalized patients with ICAO and sex-and age-matched controls were included in the study.Regional CBF was measured by Dr.Brain's ASL software.The present study evaluated differences in global,middle cerebral artery(MCA)territory,anterior cerebral artery territory,and Alberta Stroke Program Early Computed Tomography Score(ASPECTS)regions(including the caudate nucleus,lentiform nucleus,insula ribbon,internal capsule,and M1-M6)and brain lobes(including frontal,parietal,temporal,and insular lobes)between ICAO patients and controls at PLD 1.5 s and PLD 2.5 s.RESULTS When comparing CBF between ICAO patients and controls,the global CBF in ICAO patients was lower at both PLD 1.5 s and PLD 2.5 s;the CBF on the occluded side was lower in 15 brain regions at PLD 1.5 s,and it was lower in 9 brain regions at PLD 2.5 s;the CBF in the contralateral hemisphere was lower in the caudate nucleus and internal capsule at PLD 1.5 s and in M6 at PLD 2.5 s.The global CBF in ICAO patients was lower at PLD 1.5 s than at PLD 2.5 s.The ipsilateral CBF at PLD 1.5 s was lower than that at PLD 2.5 s in 15 regions,whereas the contralateral CBF was lower at PLD 1.5 s than at PLD 2.5 s in 12 regions.The ipsilateral CBF was lower than the contralateral CBF in 15 regions at PLD 1.5 s,and in M6 at PLD 2.5 s.CONCLUSION Unilateral ICAO results in hypoperfusion in the global and MCA territories,especially in the ASPECTS area.Dual PLD settings prove more suitable for accurate CBF quantification in ICAO.
文摘Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).
文摘背景:在康复训练中,随着倒立器械的出现,越来越多的人应用该器械进行头低位训练,那么头低位训练中人体不同体位变化时,颈动脉血流变化特征如何值得关注。目的:探索康复训练中人体不同体位颈动脉血流量变化特征。方法:招募104名在校大学生志愿者(男60名,女44名),应用PHILPS COLOR DOPPLER CV850彩色超声等在不同体位进行颈动脉血流动力学检测。结果与结论:(1)与仰卧位相比,直立位时女性右颈总动脉(P=0.031),男性左颈总动脉(P=0.033)、右颈总动脉(P=0.003)、右颈内动脉(P=0.030)血流量明显降低,差异有(非常)显著性意义;(2)与仰卧位相比,头低位-30°时女性左颈总动脉(P=0.018)、右颈总动脉(P=0.001)、左椎动脉(P=0.049),男性左颈总动脉(P=0.007)、右颈总动脉(P=0.005)血流量明显降低,差异有(非常)显著性意义;(3)与仰卧位相比,头低位-90°时,男女性左颈总动脉(P=0.000)、右颈总动脉(P=0.000),女性左颈内动脉(P=0.002)、右颈内动脉(P=0.002),男性左颈内动脉(P=0.001)、右颈内动脉(P=0.000)、左椎动脉(P=0.003)血流量明显降低,差异有(非常)显著性意义;(4)上述结果表明,健康人体体位由直立位、仰卧位、头低位-30°到头低位-90°的顺序变化时,与仰卧位相比,在头低位-30°、头低位-90°时,颈总动脉、颈内动脉、椎动脉血流量变化百分比较大,尤其是头低位-90°变化最大。
