Bedside assessment of regional cerebral perfusion using near-infrared spectroscopy and indocyanine green in patients with atherosclerotic occlusive disease

Abstract

This pilot study aimed to investigate the utility of near-infrared spectroscopy/indocyanine green (NIRS/ICG) for examining patients with occlusive cerebrovascular disease. Twenty-nine patients with chronic-stage atherosclerotic occlusive cerebrovascular disease were included. The patients were monitored using NIRS at the bedside. Using ICG time-intensity curves, the affected-to-unaffected side ratios were calculated for several parameters, including the maximum ICG concentration (ΔICGmax), time to peak (TTP), rise time (RT), and blood flow index (BFI = ΔICGmax/RT), and were compared to the affected-to-unaffected side ratios of the regional cerebral blood flow (rCBF) and regional oxygen extraction fraction (rOEF) obtained using positron emission tomography with 15O-labeled gas. The BFI ratio showed the best correlation with the rCBF ratio among these parameters (r = 0.618; P = 0.0004), and the RT ratio showed the best correlation with the rOEF ratio (r = 0.593; P = 0.0007). The patients were further divided into reduced rCBF or elevated rOEF groups, and the analysis revealed significant related differences. The present results advance the measurement of ICG kinetics using NIRS as a useful tool for the detection of severely impaired perfusion with reduced rCBF or elevated rOEF. This method may be applicable as a monitoring tool for patients with acute ischemic stroke.

Early Detection of Cerebral Infarction With Middle Cerebral Artery Occlusion With Functional Near-Infrared Spectroscopy: A Pilot Study

“…This capability allows for the assessment of rSO2 changes by a comparison of the HbO2 and HbR concentrations. Based on these principles, several studies have used fNIRS in different ways to monitor and evaluate patients with cerebral infarction and determine severity ( 6 – 11 , 14 – 17 ). In these studies, cerebral ischemia was characterized mainly by a marked decrease in HbO2 and an increase in HbR rather than a mild increase in cerebral blood volume.…”

“…Functional near-infrared spectroscopy (fNIRS) is an emerging technique that allows non-invasive monitoring of the perfusion status in multiple areas, such as the carotid artery during cardiac surgery or in patients with atherosclerotic occlusive diseases ( 6 – 11 ). This technique facilitates effective real-time measurement of cerebral perfusion.…”

Advances in translational imaging of the microcirculation

“…90 Near-infrared spectroscopy has been used as a neuro-monitor to investigate cerebral blood oxygenation in healthy and disease conditions, including neonates at risk for brain injury, [101][102][103] adult and pediatric patients undergoing cardiac surgery, 104,105 quantify absolute cerebral blood flow (CBF). [115][116][117] Diffuse correlation spectroscopy (DCS) is an optical modality in the NIRS spectrum that provides a direct measure of absolute CBF without the need for injectable contrast. 118,119 Hyperspectral NIRS can more accurately measure Cytochrome C oxidase (CCO), a mitochondrial enzyme that is a marker of cellular oxygen metabolism.…”

“…Functional NIRS (fNIRS) is a multi‐channel system capable of discrete localization of neurovascular coupling on the cortical surface 89 . Dynamic contrast‐enhanced NIRS can measure the kinetics of injectable tracers (e.g., ICG) to quantify absolute cerebral blood flow (CBF) 115–117 . Diffuse correlation spectroscopy (DCS) is an optical modality in the NIRS spectrum that provides a direct measure of absolute CBF without the need for injectable contrast 118,119 .…”

Optical biopsy methods and their prospects of application for intraoperative analysis of tissue metabolism and blood microcirculation in minimally invasive surgery

“…Этот метод широко применяется в химической и фармацевтической промышленности для исследования свойств органических и неорганических веществ, их содержания в различных объектах. В медицине данный вид спектроскопии используется для оценки оксигенации крови и лежит в основе многочисленных исследований мозговой активности в норме и патологии, при совершении каких-либо действий или эмоциональных нагрузках [25,39]. Кроме того, исследуется применение спектроскопии в ближней инфракрасной области при лапароскопических хирургических вмешательствах на органах брюшной полости [42,48].…”