title: The Value of syngo DynaPBV Neuro During Neuro-Interventional Hypotensive Balloon Occlusion Test.
abstract: OBJECTIVE
  This study explored the value of flat detector computed tomography based brain perfusion imaging in assessing patient's tolerance prior to the permanent internal carotid artery occlusion.
  
  
  METHODS
  Ten patients diagnosed with neurovascular diseases through digital subtracted angiography (DSA) were enrolled into this study. Temporary balloon occlusion test (BOT) was performed for each patient with hypotensive challenge. During the test, parametric color-coded quantitative DSA (CCQ-DSA) was generated to evaluate the venous filling symmetry on both hemispheres. In addition, cerebral blood volume (CBV) maps were acquired before and during the test. Regions of interests were defined to quantitatively extract CBV value from affected and unaffected hemispheres and calculate relative CBV (rCBV), indicating perfusion symmetry.
  
  
  RESULTS
  All the patients showed good perfusion symmetry before the test with rCBV close to 1.00. During the test, good perfusion symmetry was detected in 7 patients with averaged rCBV 1.03 ± 0.06. Only short venous delay and no ischemic complications were recognized. One patient had neither neurologic deficits nor long venous delay detected, however, showed hyper-perfusion in specific regions in the CBV maps. Two patients failed to pass the test, which showed significantly low CBV value from the affected hemisphere with maximum rCBV reduction close to 45%.
  
  
  CONCLUSIONS
  CBV map had in general good consistency with clinical manifestations as well as venous filling in the BOT. Besides, it may provide further evidence of hemodynamic variations and delayed ischemic complications, and thus, had a potential to reduce risks and increase treatment safety.
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China.|Neurosurgical Institute of PLA, Wuhan, PR China.
authors.forename: M
authors.initials: M
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China.|Neurosurgical Institute of PLA, Wuhan, PR China.
authors.forename: J
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China. mlt1937@163.com.|Neurosurgical Institute of PLA, Wuhan, PR China. mlt1937@163.com.
authors.forename: L
authors.initials: L
authors.lastname: Ma
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China.|Neurosurgical Institute of PLA, Wuhan, PR China.
authors.forename: L
authors.initials: L
authors.lastname: Pan
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China.|Neurosurgical Institute of PLA, Wuhan, PR China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, PLA, 627 Wuluo Avenue, 430070, Wuhan, Hubei, PR China.|Neurosurgical Institute of PLA, Wuhan, PR China.
authors.forename: G
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Neuroradiology, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: T
authors.initials: T
authors.lastname: Struffert
authors.affiliation: Siemens Ltd. China, Healthcare Sector, Beijing, PR China.
authors.forename: Q
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Siemens Ltd. China, Shanghai Branch, Healthcare Sector, Shanghai, PR China.
authors.forename: J
authors.initials: J
authors.lastname: Beilner
authors.affiliation: Siemens AG, Healthcare Sector, Erlangen, Germany.
authors.forename: Y
authors.initials: Y
authors.lastname: Deuerling-Zheng
mesh_terms: D000328:Adult; D000368:Aged; D021721:Balloon Occlusion / Q000379:methods*; D001810:Blood Volume; D001811:Blood Volume Determination / Q000379:methods*; D002533:Cerebral Angiography / Q000379:methods; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging / Q000379:methods; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods; D015641:Radiography, Interventional / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012984:Software; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Balloon occlusion test; Cerebral blood volume; Digital subtracted angiography; Flat detector computed tomography