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Pre-and postoperative cerebral blood flow changes in patients with idiopathic normal pressure hydrocephalus measured by computed tomography (CT)-perfusion.

Artikel i vetenskaplig tidskrift
Författare Doerthe Ziegelitz
Jonathan Arvidsson
Per Hellström
Mats Tullberg
Carsten Wikkelsö
Göran Starck
Publicerad i Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism
Volym 36
Nummer/häfte 10
Sidor 1755-1766
ISSN 1559-7016
Publiceringsår 2016
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för radiofysik
Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Institutionen för kliniska vetenskaper, Avdelningen för radiologi
Sidor 1755-1766
Språk en
Länkar dx.doi.org/10.1177/0271678X15608521
Ämnesord CT-perfusion, cerebral blood flow, idiopathic normal pressure hydrocephalus, correlation of blood flow and symptomatology, preoperative, postoperative
Ämneskategorier Radiofysik, Radiologi

Sammanfattning

In idiopathic normal pressure hydrocephalus (iNPH), the cerebral blood flow (CBF) is of pathophysiological interest and a potential biomarker. Computed tomography perfusion (CTP), an established technique with high spatial resolution and quantitative measurements, has not yet been used in the iNPH context. If CTP were sensitive to the CBF levels and changes in iNPH, this technique might provide diagnostic and prognostic absolute perfusion thresholds. The aim of this work was to determine the applicability of CTP to iNPH. CBF measurements of 18 patients pre- and 17 three months postoperatively, and six healthy individuals (HI) were evaluated in 12 cortical and subcortical regions of interest. Correlations between CBF and symptomatology were analyzed in shunt-responders. Compared to HI, the preoperative CBF in iNPH was significantly reduced in normal appearing and periventricular white matter (PVWM), the lentiform nucleus and the global parenchyma. No CBF differences were shown between responders and non-responders. In responders, the CBF recovered postoperatively by 2.5-32% to approximately the level of HI, but remained significantly decreased in the PVWM of non-responders. The pre- and postoperative CBF of cortical and subcortical regions correlated with the intensity of symptoms. In spite of limited spatial coverage, CTP can measure CBF changes in iNPH.

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