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. 2018 Dec 25;11(4):511-519.
doi: 10.3400/avd.oa.18-00116.

Prediction of Postoperative Cerebral Infarction after Cardiovascular Surgery Using Quantitative Measurement of Cerebral Blood Flow with Brain Single-Photon Emission Computed Tomography

Hiroshi Tomoeda  1 , Keita Mikasa  2 , Shingo Chihara  3 , Kentaro Sawada  4 , Hiroyuki Tanaka  5
Affiliations

Prediction of Postoperative Cerebral Infarction after Cardiovascular Surgery Using Quantitative Measurement of Cerebral Blood Flow with Brain Single-Photon Emission Computed Tomography

Hiroshi Tomoeda et al. Ann Vasc Dis. .

Abstract

Prediction of postoperative cerebral infarction after cardiovascular surgery is difficult. The present study investigated whether quantitative evaluation of preoperative cerebral blood flow used in the Japanese EC-IC Bypass Trial (JET) study is useful for the prediction of postoperative cerebral infarction after cardiovascular surgery. First, patients were divided into two groups based on preoperative cerebral blood flow. In an evaluation using preoperative imaging, patients with good or mildly decreased preoperative cerebral blood flow, divided into clinical stage I or II by quantitative evaluation showed no postoperative cerebral infarction. However, 24% of patients with poor cerebral blood flow who were categorized as clinical stage II, experienced postoperative cerebral infarction. The incidence rate was not statistically significantly different when the groups were compared. Second, patients were divided into two groups based on the anatomical area of the brain affected corresponding to clinical stage II. Patients with a 10% and greater brain involvement had a significantly higher incidence of postoperative cerebral infarction (38%) compared to others (0%, p<0.01). This method may be useful for the prediction of postoperative cerebral infarction after cardiovascular surgery, but a further prospective study is needed. (This is a translation of J Jpn Coll Angiol 2017; 57: 125-133.).

Keywords: JET-study; brain SPECT; cardiovascular surgery; postoperative cerebral infarction.

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Figures

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Fig. 1 a) Clinical stage classification of quantitative cerebral blood flow in case 1. Clinical stage II is shown for the lateral ventricle on both sides. b) Postoperative MRI in case 1. The MRI shows an acute infarction in the lateral ventricle on both sides.
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Fig. 2 a) Clinical stage classification of quantitative cerebral blood flow in case 2. Clinical stage II is shown in the left temporal lobe. b) Postoperative MRI in case 2. The MRI shows an acute infarction in the watershed area of the left anterior and middle cerebral artery.
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Fig. 3 a) Clinical stage classification of quantitative cerebral blood flow in case 3. Clinical stage II is shown in the right parietal and posterior lobe. b) Postoperative MRI in case 3. The MRI shows an acute infarction in the watershed area of the right parietal and posterior lobe.
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Fig. 4 a) Clinical stage classification of quantitative cerebral blood flow in case 4. Clinical stage II is shown in the watershed area of the right middle and posterior cerebral artery. b) Postoperative MRI in case 4. The MRI shows another acute infarction in the watershed area of the right parietal and posterior lobe.
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Fig. 5 a) Clinical stage classification of quantitative cerebral blood flow in case 5. Clinical stage II is shown in the posterior of the right ventricle. b) Postoperative MRI of case 5. The MRI shows an acute infarction in the in the posterior of the right ventricle.
See this image and copyright information in PMC

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