Feasibility of SPECT for studies of brain perfusion during cardiopulmonary bypass.
Single-photon emission computed tomography (SPECT) and transcranial Doppler (TCD) ultrasonography were used to assess brain perfusion during cardiopulmonary bypass. Intravenous injections of technetium 99 m-hexamethylpropyleneamineoxime (99mTc-HMPAO) were administered before surgery and intraoperatively after the first 2 minutes in the first patient and at the end (42 minutes) of cardiopulmonary bypass in the second patient. The total middle cerebral artery territory counts were calculated using the region-of-interest method and compared to cerebellar regional counts. 99mTc-HMPAO uptake on SPECT scans was increased at the beginning and at the end of cardiopulmonary bypass, compared to baseline preoperative values (11-17%) in the presence of multiple microembolic signals on TCD (n1 = 35 and n2 = 42 for unilateral middle cerebral artery monitoring). These results indicate the feasibility of using HMPAO-SPECT to study brain perfusion changes during cardiac surgery. A combination of SPECT and TCD ultrasonography may be used to study the impact of microembolism during cardiac surgery with cardiopulmonary bypass.
Marochnik
S
S
Department of Anesthesiology, Buffalo General Hospital, State University of New York, USA.
Alexandrov
A V
AV
Anthone
D
D
Lewin
C
C
Caldwell
C B
CB
Pullicino
P M
PM
D001921:Brain / Q000000981:diagnostic imaging*; D006348:Cardiac Surgical Procedures; D002315:Cardiopulmonary Bypass; D002531:Cerebellum / Q000098:blood supply; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000502:physiology; D002560:Cerebrovascular Circulation; D004453:Echoencephalography; D005240:Feasibility Studies; D006801:Humans; D002542:Intracranial Embolism and Thrombosis / Q000000981:diagnostic imaging; D016343:Monitoring, Intraoperative; D015609:Organotechnetium Compounds; D010091:Oximes; D010865:Pilot Projects; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D017585:Ultrasonography, Doppler, Transcranial
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime