Arterial spin labeling for moyamoya angiopathy: A preoperative and postoperative evaluation method.

Objectives: Studies have shown that arterial spin labeling (ASL) effectively replaces traditional MRI perfusion imaging for detecting cerebral blood flow (CBF) in patients with Moyamoya angiopathy (MMA). However, there are few reports on the relationship between neovascularization and cerebral perfusion in patients with MMA. The aim of this study is to investigate the effects of neovascularization on cerebral perfusion with MMA after bypass surgery. Methods: We selected patients with MMA in the Department of Neurosurgery between September 2019 and August 2021 and enrolled them based on the inclusion and exclusion criteria. ASL imaging was used to monitor the baseline CBF level before surgery and determine the changes in cerebral vessels at postoperative 1 week and 6 months, respectively. The Alberta stroke grade, modified Rankin Scale (mRS), and digital subtraction angiography images were used to evaluate the effect of postoperative CBF status and prognosis. Ninety hemispheres from 51 patients were included in this study. There were no significant differences in the baseline data of the enrolled patients. At 1 week and 6 months post-surgery, the CBF state in the operation area was significantly changed compared with that at baseline (P < 0.05). The preoperative Alberta score (t = 2.714, P = 0.013) and preoperative mRS score (t = 6.678, P < 0.001) correlated with postoperative neovascularization. Conclusion: ASL is an effective method for detecting CBF and plays an important role in the long-term follow-up of patients with MMA. Combined cerebral revascularization significantly improves CBF in the operation area both in the short and long terms. Patients with lower preoperative Alberta scores and higher mRS scores were more likely to benefit from combined cerebral revascularization surgery. However, regardless of the type of patient, CBF reconstruction can effectively improve prognosis.

Gas-liquid mass transfer characteristics of aviation fuel scrubbing in an aircraft fuel tank.

Dissolved oxygen evolving from aviation fuel leads to an increase in the oxygen concentration in an inert aircraft fuel tank ullage that may increase the flammability of the tank. Aviation fuel scrubbing with nitrogen-enriched air (NEA) can largely reduce the amount of dissolved oxygen and counteract the adverse effect of oxygen evolution. The gas-liquid mass transfer characteristics of aviation fuel scrubbing are investigated using the computational fluid dynamics method, which is verified experimentally. The effects of the NEA bubble diameter, NEA superficial velocity and fuel load on oxygen transfer between NEA and aviation fuel are discussed. Findings from this work indicate that the descent rate of the average dissolved oxygen concentration, gas holdup distribution and volumetric mass transfer coefficient increase with increasing NEA superficial velocity but decrease with increasing bubble diameter and fuel load. When the bubble diameter varies from 1 to 4 mm, the maximum change of descent rate of dissolved oxygen concentration is 18.46%, the gas holdup is 8.73%, the oxygen volumetric mass transfer coefficient is 81.45%. When the NEA superficial velocities varies from 0.04 to 0.10 m/s, the maximum change of descent rate of dissolved oxygen concentration is 146.77%, the gas holdup is 77.14%, the oxygen volumetric mass transfer coefficient is 175.38%. When the fuel load varies from 35 to 80%, the maximum change of descent rate of dissolved oxygen concentration is 21.15%, the gas holdup is 49.54%, the oxygen volumetric mass transfer coefficient is 44.57%. These results provide a better understanding of the gas and liquid mass transfer characteristics of aviation fuel scrubbing in aircraft fuel tanks and can promote the optimal design of fuel scrubbing inerting systems.

Impact of blood pressure changes in cerebral blood perfusion of patients with ischemic Moyamoya disease evaluated by SPECT.

Our aim was to determine the impact of targeted blood pressure modifications on cerebral blood flow in ischemic moyamoya disease patients assessed by single-photon emission computed tomography (SPECT). From March to September 2018, we prospectively collected data of 154 moyamoya disease patients and selected 40 patients with ischemic moyamoya disease. All patients underwent in-hospital blood pressure monitoring to determine the mean arterial pressure baseline values. The study cohort was subdivided into two subgroups: (1) Group A or relative high blood pressure (RHBP) with an induced mean arterial pressure 10-20% higher than baseline and (2) Group B or relative low blood pressure (RLBP) including patients with mean arterial pressure 10-20% lower than baseline. All patients underwent initial SPECT study on admission-day, and on the following day, every subgroup underwent a second SPECT study under their respective targeted blood pressure values. In general, RHBP patients showed an increment in perfusion of 10.13% (SD 2.94%), whereas RLBP patients showed a reduction of perfusion of 12.19% (SD 2.68%). Cerebral blood flow of moyamoya disease patients is susceptible to small blood pressure changes, and cerebral autoregulation might be affected due to short dynamic blood pressure modifications.