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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">kpccz</journal-id><journal-title-group><journal-title xml:lang="ru">Комплексные проблемы сердечно-сосудистых заболеваний</journal-title><trans-title-group xml:lang="en"><trans-title>Complex Issues of Cardiovascular Diseases</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2306-1278</issn><issn pub-type="epub">2587-9537</issn><publisher><publisher-name>Federal State Budgetary Institution “Research Institute for Complex Issues of Cardiovascular Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17802/2306-1278-2018-7-4-101-111</article-id><article-id custom-type="elpub" pub-id-type="custom">kpccz-487</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>АНАЛИТИЧЕСКИЙ ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ANALYTICAL REVIEW</subject></subj-group></article-categories><title-group><article-title>ИССЛЕДОВАНИЕ ПЕРФУЗИИ ПРИ НАРУШЕНИЯХ ЦЕРЕБРАЛЬНОГО КРОВООБРАЩЕНИЯ. ЧАСТЬ III (БЕСКОНТРАСТНЫЕ СПОСОБЫ. ЦЕЛЕСООБРАЗНОСТЬ И БЕЗОПАСНОСТЬ). ОБЗОР</article-title><trans-title-group xml:lang="en"><trans-title>CEREBRAL PERFUSION AND CIRCULATION DISTURBANCES. PART III (NON-CONTAST METHODS, RATIONALE AND SAFETY): A REVIEW</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семенов</surname><given-names>С. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenov</surname><given-names>S. E.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семенов Станислав Евгеньевич, доктор медицинских наук, ведущий научный сотрудник лаборатории рентгеновской и томографической диагностики</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Semenov Stanislav E., PhD, leading researcher at the Laboratory for Radiology and Tomography Diagnosis</p><p>6, Sosnoviy Blvd, Kemerovo, 650002</p></bio><email xlink:type="simple">dr_semenov_s@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Милиневский</surname><given-names>Н. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Milinevskiy</surname><given-names>N. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Милиневский Николай Игоревич, врач-радиолог</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Milinevsky Nikolay I., radiologist</p><p>6, Sosnoviy Blvd, Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Короткевич</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Korotkevich</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Короткевич Алексей Алексеевич, врач-радиолог</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Korotkevich Aleksey A., radiologist</p><p>6, Sosnoviy Blvd, Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Портнов</surname><given-names>Ю. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Portnov</surname><given-names>Yu. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Портнов Юрий Михайлович, младший научный сотрудник лаборатории рентгеновской и томографической диагностики</p><p>Сосновый бульвар, 6, Кемерово, 650002</p></bio><bio xml:lang="en"><p>Portnov Yury M., research assistant at the Laboratory for Radiology and Tomography Diagnosis</p><p>6, Sosnoviy Blvd, Kemerovo, 650002</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Семенов</surname><given-names>А. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Semenov</surname><given-names>A. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Семенов Александр Станиславович, врач-ординатор</p><p>ул. Лотарингская, 31, Саарланд, 66740</p></bio><bio xml:lang="en"><p>Semenov Alekandr S., resident</p><p>31, Lothringer Str., Saarlouis, Saarland, 66740</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru">Федеральное государственное бюджетное научное учреждение «Научно-исследовательский институт комплексных проблем сердечно-сосудистых заболеваний»<country>Россия</country></aff><aff xml:lang="en">Federal State Budgetary Scientifc Institution “Research Institute for Complex Issues of Cardiovascular Diseases”<country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru">Радиологическая врачебная практика Вольфганга Теобальда<country>Германия</country></aff><aff xml:lang="en">Praxis Wolfgang Theobald Facharzt für Radiologie<country>Germany</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2018</year></pub-date><pub-date pub-type="epub"><day>18</day><month>12</month><year>2018</year></pub-date><volume>7</volume><issue>4</issue><fpage>101</fpage><lpage>111</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Семенов С.Е., Милиневский Н.И., Короткевич А.А., Портнов Ю.М., Семенов А.С., 2018</copyright-statement><copyright-year>2018</copyright-year><copyright-holder xml:lang="ru">Семенов С.Е., Милиневский Н.И., Короткевич А.А., Портнов Ю.М., Семенов А.С.</copyright-holder><copyright-holder xml:lang="en">Semenov S.E., Milinevskiy N.I., Korotkevich A.A., Portnov Y.M., Semenov A.S.</copyright-holder><license license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.nii-kpssz.com/jour/article/view/487">https://www.nii-kpssz.com/jour/article/view/487</self-uri><abstract><p>Третья часть обзорной статьи посвящена вопросам полезности изучения тканевой/клеточной перфузии мозга при хронической недостаточности мозгового кровообращения, часто сопровождающей стено-окклюзивные состояния при сочетанном поражении каротидных и коронарных артерий мультифокальным атеросклерозом. Актуальной задачей радиологов становится определение исходного состояния регионарного мозгового кровотока и цереброваскулярной реактивности в предоперационный период реваскуляризирующих операций. Отчасти выбор тактики в очередности или симультанности реваскуляризации сонных и коронарных артерий должен зависеть от этих параметров. Выполняемые, как правило, контрастные перфузионные методики магнитно-резонансной перфузии (ПМРТ) и компьютерно-томографической перфузии (ПКТ) сопряжены с довольно высоким риском побочных реакций в отличие от довольно широко распространенной однофотонной эмиссионной компьютерной томографии (ОЭКТ), а также бурно развивающейся в последнее десятилетие бесконтрастной МР-методики ASL (arterial spin labeling). Клинические исследования и внедрение в рутинную практику радионуклидной диагностики (ОЭКТ) и бесконтрастной МР-методики (ASL) позволят минимизировать такой риск, обеспечивая при этом клиницистов полноценной информацией о состоянии и резерве мозгового кровотока, имеющем в определении тактики лечения нисколько не меньшее значение, чем состояние и резерв кровоснабжения миокарда.</p></abstract><trans-abstract xml:lang="en"><p>The third part of the review article provides new insights into tissue / cell brain perfusion in chronic cerebral vascular insuffciency, commonly accompanied by polyvascular disease, i.e. stenotic and occlusive lesions of the carotid and coronary arteries. The evaluation of regional cerebral blood ﬂow and cerebrovascular reactivity in the preoperative period of revascularization procedures remains an issue of concern for radiologists. Partly the choice of revascularization strategy, staged or simultaneous revascularization of the carotid and coronary arteries, depends on these parameters. Contrast-enhanced perfusion magnetic resonance imaging (MRI) and computed tomography perfusion (CTP) are commonly associated with a rather high risk of adverse reactions, compared to the widespread single-photon emission computed tomography (SPECT) and arterial spin labelling (ASL) MR perfusion technique, rapidly growing in the last decade. Clinical studies and the introduction of radionuclide diagnostics (SPECT) and non-contrast MR methods (ASL) into routine clinical practice will minimize these risks, while providing clinicians with accurate information on the capacity and cerebral blood ﬂow reserve, which play signifcant role in determining the treatment strategy, similar to the capacity and myocardial blood ﬂow reserve.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>Хроническая ишемия мозга</kwd><kwd>CBF</kwd><kwd>ОЭКТ</kwd><kwd>ASL</kwd><kwd>Безопасность</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Chronic brain ischemia</kwd><kwd>Cerebral blood ﬂow</kwd><kwd>SPECT</kwd><kwd>ASL</kwd><kwd>Safety</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Starling E. H. On the absorption of ﬂuids from the connective tissue spaces. The Journal of Physiology. 1896; 19 (4): 312–26. 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