SPECT measurement of regional cerebral blood flow, blood volume, and hematocrit in stroke
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SPECT measurement of regional cerebral blood flow, blood volume, and hematocrit in stroke

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Abstract

The clinical importance of measurement of the regional cerebral hemodynamics, using positron emission tomography (PET) or single-photon emission computed tomography (SPECT), is to ascertain the viability of the ischemic tissue or to predict the functional outcome after ischemic cerebral vascular diseases. Specifically, the following aspects may be considered important: I) to determine the state of the hemodynamics in regions of the brain identified from clinical signs and symptoms as ischemic or infarcted, 2) to determine whether the local flow is sufficient or at risk, 3) to estimate the prognosis with or without intervention and 4) to assess whether the risk of a second post-acute infarction has been reduced after treatment. In addition to investigations of the regional cerebral blood flow (CBF), there is now a growing interest in the role of the cerebral blood volume (CBV) and blood viscosity in the pathophysiology of cerebral ischemia. Recent studies have focused on the effectiveness of hemorheological approaches, including hemodilution ther­ apy, in the treatment of cerebral vascular diseases [1]. Employing PET, Gibbs et al. [2] and Powers et al. [3] suggested that the cerebral mean transit time derived from the ratio between CBF and CBV might serve as a sensitive parameter for estimating the circulatory reserve in the ischemic tissue. In the present study, SPECT was used to measure the regional CBF, CBV and cerebral hematocrit in normals and patients with occlusive cerebral vascular dis­ eases. Based on these three cerebral hemodynamic parameters, the regional patho­ physiology during the acute stages of cerebral infarction and of transient ischemic attack (TIA) was evaluated.

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