Quantitative capillary topography and blood flow in the cerebral cortex of cats: an in vivo microscopic study

Cerebrovascular dynamics of autoregulation and hypoperfusion. An MRI study of CBF and changes in total and microvascular cerebral blood volume during hemorrhagic hypotension

BACKGROUND AND PURPOSE

To determine how cerebral blood flow (CBF), total and microvascular cerebral blood volume (CBV), and blood oxygenation level-dependent (BOLD) contrast change during autoregulation and hypotension using hemodynamic MRI.

METHODS

Using arterial spin labeling and steady-state susceptibility contrast, we measured CBF and changes in both total and microvascular CBV during hemorrhagic hypotension in the rat (n=9).

RESULTS

We observed CBF autoregulation for mean arterial blood pressure (MABP) between 50 and 140 mm Hg, at which average CBF was 1.27+/-0.44 mL. g(-1). min(-1) (mean+/-SD). During autoregulation, total and microvascular CBV changes were small and not significantly different from CBF changes. Consistent with this, no significant BOLD changes were observed. For MABP between 10 and 40 mm Hg, total CBV in the striatum increased slightly (+7+/-12%, P<0.05) whereas microvascular CBV decreased (-15+/-17%, P<0.01); on the cortical surface, total CBV increases were larger (+21+/-18%, P<0.01) and microvascular CBV was unchanged (3+/-22%, P>0.05). With severe hypotension, both total and microvascular CBV decreased significantly. Over the entire range of graded global hypoperfusion, there were increases in the CBV/CBF ratio.

CONCLUSIONS

Parenchymal CBV changes are smaller than those of previous reports but are consistent with the small arteriolar fraction of total blood volume. Such measurements allow a framework for understanding effective compensatory vasodilation during autoregulation and volume-flow relationships during hypoperfusion.

Dynamic in vivo measurement of erythrocyte velocity and flow in capillaries and of microvessel diameter in the rat brain by confocal laser microscopy

A new method for studying brain microcirculation is described. Both fluorescently labeled erythrocytes and plasma were visualized on-line through a closed cranial window in anesthetized rats, using laser-scanning two-dimension confocal microscopy. Video images of capillaries, arterioles, and venules were digitized off-line to measure microvessel diameter and labeled erythrocyte flow and velocity in parenchymal capillaries up to 200 microm beneath the brain surface. The method was used to analyze the rapid adaptation of microcirculation to a brief decrease in perfusion pressure. Twenty-second periods of forebrain ischemia were induced using the tour-vessel occlusion model in eight rats. EEG, arterial blood pressure, and body temperature were continuously controlled. In all conditions, labeled erythrocyte flow and velocity were both very heterogeneous in capillaries. During ischemia, capillary perfusion was close to 0, but a low blood flow persisted in arterioles and venules, while EEG was flattening. The arteriole and venule diameter did not significantly change. At the unclamping of carotid arteries, there was an instantaneous increase (by about 150%) of arteriole diameter. Capillary erythrocyte flow and velocity increased within 5 seconds, up to, respectively, 346 +/- 229% and 233 +/- 156% of their basal value. No capillary recruitment of erythrocytes was detected. All variables returned to their basal levels within less than 100 seconds after declamping. The data are discussed in terms of a possible involvement of shear stress in the reperfusion period.

In vivo determination of absolute cerebral blood volume using hemoglobin as a natural contrast agent: an MRI study using altered arterial carbon dioxide tension

The ability of the magnetic resonance imaging transverse relaxation time, R2 = 1/T2, to quantify cerebral blood volume (CBV) without the need for an exogenous contrast agent was studied in cats (n = 7) under pentobarbital anesthesia. This approach is possible because R2 is directly affected by changes in CBF, CBV, CMRO2, and hematocrit (Hct), a phenomena better known as the blood-oxygenation-level-dependent (BOLD) effect. Changes in CBF and CBV were accomplished by altering the carbon dioxide pressure, PaCO2, over a range from 20 to 140 mm Hg. For each PaCO2 value, R2 in gray and white matter were determined using MRI, and the whole-brain oxygen extraction ratio was obtained from arteriovenous differences (sagittal sinus catheter). Assuming a constant CMRO2, the microvascular CBV was obtained from an exact fit to the BOLD theory for the spin-echo effect. The resulting CBV values at normal PaCO2 and normalized to a common total hemoglobin concentration of 6.88 mmol/L were 42+/-18 microL/g (n = 7) and 29+/-19 microL/g (n = 5) for gray and white matter, respectively, in good agreement with the range of literature values published using independent methodologies. The present study confirms the validity of the spin-echo BOLD theory and, in addition, shows that blood volume can be quantified from the magnetic resonance imaging spin relaxation rate R2 using a regulated carbon dioxide experiment.

Oxygenation of the cat primary visual cortex

Tissue PO2 was measured in the primary visual cortex of anesthetized, artificially ventilated normovolemic cats to examine tissue oxygenation with respect to depth. The method utilized 1) a chamber designed to maintain cerebrospinal fluid pressure and prevent ambient PO2 from influencing the brain, 2) a microelectrode capable of recording electrical activity as well as local PO2, and 3) recordings primarily during electrode withdrawal from the cortex rather than during penetrations. Local peaks in the PO2 profiles were consistent with the presence of numerous vessels. Excluding the superficial 200 microm of the cortex, in which the ambient PO2 may have influenced tissue PO2, there was a slight decrease (4.9 Torr/mm cortex) in PO2 as a function of depth. After all depths and cats were weighted equally, the average PO2 in six cats was 12.8 Torr, with approximately one-half of the values being </=10 Torr. The kurtosis of the PO2 histogram, with all depths and cats weighted equally, was 3.61, and the skewness was 1.70.

Increased brain capillaries in chronic hypoxia

The effect of chronic hypobaric hypoxia (28 days, 455 Torr) on the organization of brain vessels was studied in Balb/c mice. In comparison to age-matched controls kept at sea level, emulsion-perfused capillaries in hypoxic mice showed marked dilation in all brain areas studied. Capillary length per unit volume of tissue (Lv) was increased in the cerebellar granular layer, the caudate nucleus, the globus pallidus, the substantia nigra, the superior colliculus, and the dentate gyrus. There was a selective increase of Lv in the hippocampus (CA1 strata pyramidale and lacunosum and CA3 strata pyramidale and oriens) and in somatosensory cortex layers V and VI, motor cortex layers II, III, V, and VI, and auditory cortex layers II and III. An increase in capillary surface area per unit volume of tissue was also determined in several brain areas, including layer IV of somatosensory cortex, where Lv was not significantly increased. The O2 diffusion conductance and PO2 in the tissues were estimated with a mathematical model. The remodeling of capillary diameter and length during chronic hypoxia accounts for the significant increase of O2 conductance to neural tissues. Also the estimated tissue PO2 in chronic brain hypoxia is markedly increased in the caudate nucleus and the substantia nigra compared with acute hypoxia. These results suggest that formation of new capillaries is an important mechanism to restore the O2 deficit in chronic brain hypoxia and that local rates of energy utilization may influence angiogenesis in different areas of the brain.

Analytical model of susceptibility-induced MR signal dephasing: effect of diffusion in a microvascular network

A deterministic analytical model that describes the time course of magnetic resonance signal relaxation due to magnetic field inhomogeneity induced by a vascular network is developed. Both static and diffusion dephasing are taken into account. The contribution of the diffusion dephasing is calculated for relatively large vessels (R>10 microm) or short measurement times when the diffusion length is smaller than the vessel radius. The signal is found to possess the following features: a) an initial deviation from the monoexponential relaxation which is more pronounced for the imaginary part of the signal; b) a deviation from monoexponential relaxation at short echo times for the spin-echo (SE) signal measured as a function of the echo time; c) the echo maximum of the SE signal shifted from the nominal echo time to a shorter time; and d) a diffusion effect much stronger for the SE than for the free induction decay experiment. The model presented agrees within its validity domain with a known Monte Carlo simulation.

A model for the regulation of cerebral oxygen delivery

On the basis of the assumption that oxygen delivery across the endothelium is proportional to capillary plasma PO2, a model is presented that links cerebral metabolic rate of oxygen utilization (CMRO2) to cerebral blood flow (CBF) through an effective diffusivity for oxygen (D) of the capillary bed. On the basis of in vivo evidence that the oxygen diffusivity properties of the capillary bed may be altered by changes in capillary PO2, hematocrit, and/or blood volume, the model allows changes in D with changes in CBF. Choice in the model of the appropriate ratio of Omega identical with (DeltaD/D)/(DeltaCBF/CBF) determines the dependence of tissue oxygen delivery on perfusion. Buxton and Frank (J. Cereb. Blood Flow. Metab. 17: 64-72, 1997) recently presented a limiting case of the present model in which Omega = 0. In contrast to the trends predicted by the model of Buxton and Frank, in the current model when Omega > 0, the proportionality between changes in CBF and CMRO2 becomes more linear, and similar degrees of proportionality can exist at different basal values of oxygen extraction fraction. The model is able to fit the observed proportionalities between CBF and CMRO2 for a large range of physiological data. Although the model does not validate any particular observed proportionality between CBF and CMRO2, generally values of (DeltaCMRO2/CMRO2)/(DeltaCBF/CBF) close to unity have been observed across ranges of graded anesthesia in rats and humans and for particular functional activations in humans. The model's capacity to fit the wide range of data indicates that the oxygen diffusivity properties of the capillary bed, which can be modified in relation to perfusion, play an important role in regulating cerebral oxygen delivery in vivo.

Comparison of gadopentetate dimeglumine and albumin-(Gd-DTPA)30 for microvessel characterization in an intracranial glioma model

To compare the performance of macromolecular albumin gadolinium-diethylenetriamine pentaacetic acid (Gd-DTPA)30 and low molecular weight gadopentetate dimeglumine for microvessel characterization, we examined an intracranial 9L glioma model in which increased angiogenesis, hypervascularity, and hyperpermeability mimic characteristics of clinical malignant brain tumors. Dynamic MRI data were analyzed using a bidirectional, two-compartment kinetic model to extract quantitative estimates for fractional blood volume (fBV) and permeability surface area product (PS). Three criteria were used for comparison of contrast agent performance: (a) tumor conspicuity, defined as the contrast-to-noise ratio (CNR); (b) dynamic range of differential permeability estimates between tumor and normal brain; (c) reasonableness of blood volume estimates. Gadopentetate was superior to macromolecular albumin-(Gd-DTPA)30 for detection of 9L brain gliomas and for measurements of hyperpermeability.

Wavelength-dependent differences between optically determined functional maps from macaque striate cortex

This study investigates the role of wavelength in determining the source and dynamic range of activity-driven reflectance changes in macaque striate cortex. By using short (600 nm) and long (720 nm) wavelengths to map ocular dominance, orientation, and position from the same region of cortex on alternate trials, we isolated wavelength-dependent differences in the contributions of different tissue compartments. In agreement with previous reports, 600-nm illumination was found to produce optical signals that were more than twice the size of those obtained with 720-nm illumination. In addition, 600- and 720-nm images were found to correlate everywhere except in regions occluded by blood vessels, where the images obtained at 600 nm correlated with the overlying vasculature. Since the 720-nm images do not correlate with the vasculature, this difference suggests that differential images obtained under 600-nm illumination are disproportionately sensitive to vascular events (e.g., changes in blood flow, volume, etc.). This finding is supported by the absorption spectra of hemoglobin and its derivatives, which absorb 600-nm light 4-1000 times more strongly than 720-nm light. Hence, for the 40% of cortex covered by blood vessels larger than 50 microns, images obtained at 600 nm are dominated by the vascular compartment to the exclusion of signals from the neural compartment below.

Quantitative assessment of blood flow, blood volume and blood oxygenation effects in functional magnetic resonance imaging

The ability to measure the effects of local alterations in blood flow, blood volume and oxygenation by nuclear magnetic resonance has stimulated a surge of activity in functional MRI of many organs, particularly in its application to cognitive neuroscience. However, the exact description of these effects in terms of the interrelations between the MRI signal changes and the basic physiological parameters has remained an elusive goal. We here present this fundamental theory for spin-echo signal changes in perfused tissue and validate it in vivo in the cat brain by using the physiological alteration of hypoxic hypoxia. These experiments show that high-resolution absolute blood volume images can be obtained by using hemoglobin as a natural intravascular contrast agent. The theory also correctly predicts the magnitude of spin-echo MRI signal intensity changes on brain activation and thereby provides a sound physiological basis for these types of studies.

Can the IVIM model be used for renal perfusion imaging?

OBJECTIVE

Renal perfusion imaging may provide information about the hemodynamic significance of a renal artery stenosis and could improve noninvasive characterization when combined with angiography. It was proposed previously that diffusion sequences could provide useful perfusion indices based on the intravoxel incoherent motion (IVIM) model. Owing to motion artifacts, diffusion imaging has been restricted to relatively immobile organs like the brain. With the availability of single-shot echo-planar imaging (EPI) our purpose was to evaluate the IVIM model in renal perfusion.

METHODS AND MATERIAL

Eight volunteers underwent diffusion-sensitive magnetic resonance (MR) imaging of the kidneys using a spin echo (SE) EPI sequence. The diffusion coefficients determined by a linear regression analysis and fits to the IVIM function were calculated.

RESULTS AND CONCLUSION

Our preliminary experience does not support the possibility of obtaining perfusion information using the IVIM model in the kidneys.

Effects of hypoxia and hypercapnia on capillary flow velocity in the rat cerebral cortex

The velocity of red blood cells (RBC) in individual capillaries of the rat cerebral cortex was assessed using direct, intravital video microscopy under normal conditions and during systemic hypoxia or hypercapnia. The movement of RBC in capillaries within 50-microm depth of the parietal cortex was visualized with the aid of fluorescent labeling of RBC in a closed cranial window preparation in pentobarbital-anesthetized, artificially ventilated adult rats. Hypoxia was produced by lowering the concentration of oxygen in the inspired gas from 30 to 15% for 5 min. Hypercapnia was achieved by increasing the inspired CO2 concentration (FiCO2) from 0 to 5% and then to 10% for 5 min at each level. The mean arterial pressure was maintained constant during both maneuvers. Under control conditions, fast and heterogeneous RBC flow in multioriented, tortuous capillaries was observed. During hypoxia, RBC velocity increased from 0.61 +/- 0.06 to 0.82 +/- 0.10 mm/sec (35% change). During hypercapnia, RBC velocity increased from 0.73 +/- 0.05 to 1.07 +/- 0. 11 mm/sec (46% change) at 5% CO2 and to 1.19 +/- 0.11 mm/sec (63% change) at 10% CO2. Corresponding changes in regional blood flow as assessed by laser-Doppler flowmetry during hypercapnia were 69 +/- 7 and 128 +/- 21%, respectively. The RBC velocity increased in almost all capillaries during hypoxia and during moderate hypercapnia. However, a substantial number of capillaries showed no change or a small decrease in RBC velocity during severe hypercapnia. A significant negative correlation between the velocity change at 10% CO2 and the normocapnic resting velocity was found in a group of capillaries isolated by cluster analysis. These results suggest that the dominant component of cerebral hyperemic response to hypoxia and to moderate hypercapnia is an increase in capillary RBC flow velocity. A more complex change in the velocity distribution occurs during severe hypercapnia and results in increased homogeneity of RBC perfusion in the cerebrocortical capillary network.

Comparison of blood oxygenation and cerebral blood flow effects in fMRI: estimation of relative oxygen consumption change

The most widely-used functional magnetic resonance imaging (fMRI) technique is based on the blood oxygenation level dependent (BOLD) effect, which requires at least partial uncoupling between cerebral blood flow (CBF) and oxygen consumption changes during increased mental activity. To compare BOLD and CBF effects during tasking, BOLD and flow-sensitive alternating inversion recovery (FAIR) images were acquired during visual stimulation with red goggles at a frequency of 8 Hz in an interleaved fashion. With the FAIR technique, absolute and relative CBF changes were determined. Relative oxygen consumption changes can be estimated using the BOLD and relative CBF changes. In gray matter areas in the visual cortex, absolute and relative CBF changes in humans during photic stimulation were 31 +/- 11 SD ml/100 g tissue/min and 43 +/- 16 SD % (n = 12), respectively, while the relative oxygen consumption change was close to zero. These findings agree extremely well with previous results using positron emission tomography. The BOLD signal change is not linearly correlated with the relative CBF increase across subjects and negatively correlates with the oxygen consumption change. Caution should be exercised when interpreting the BOLD percent change as a quantitative index of the CBF change, especially in inter-subject comparisons.

Multi-slice perfusion-based functional MRI using the FAIR technique: comparison of CBF and BOLD effects

Perfusion-weighted imaging techniques employing blood water protons as an endogenous tracer have poor temporal resolution because each image should be acquired with an adequate spin 'tagging' time. Thus, perfusion-based functional magnetic resonance imaging studies are typically performed on a single slice. To alleviate this problem, a multi-slice flow-sensitive alternating inversion recovery technique has been developed. Following a single inversion pulse and a delay time, multi-slice echo-planar images are acquired sequentially without any additional inter-image delay. Thus, the temporal resolution of multi-slice FAIR is almost identical to that of single slice techniques. The theoretical background for multi-slice FAIR is described in detail. The multi-slice FAIR technique has been successfully applied to obtain three-slice cerebral blood flow based functional images during motor tasks. The relative CBF change in the contralateral motor/sensory area during unilateral thumb-digit opposition is 45.0+/-12.2% (n=9), while the blood oxygenation level dependent signal change is 1.5+/-0.4 SD%. Relative changes of the oxygen consumption rate can be estimated from CBF and BOLD changes using FAIR. The BOLD signal change is not correlated with the relative CBF increase, and thus caution should be exercised when interpreting the BOLD change as a quantitative index of the CBF change, especially in inter-subject comparisons.

Blood flow structuring and its alterations in capillaries of the cerebral cortex

Various manifestations of blood flow structuring were investigated in rabbit cerebral cortex capillaries, which possess the most narrow lumina of all parts of the body. Blood flow structuring in the capillaries was characterized by the presence of a stable and comparatively large parietal plasma layer, which changed insignificantly under control and ischemic conditions, but disappeared when blood stasis developed inside the capillaries. The axial core of the blood flow in the capillaries, which occupied almost two-thirds of the intracapillary volume under normal conditions, consisted of significantly deformed (stretched along the microvessels' axes) and nonaggregated erythrocytes. During ischemia the shape of the erythrocytes did not change appreciably; only the blood plasma intervals between them increased significantly, demonstrating reduction of the local hematocrit. During primary blood stasis caused by enhanced intravascular erythrocyte aggregation, typical blood flow structuring became significantly disturbed: red cells filled the whole, or almost the whole, capillary lumina and did not leave visible space for plasma inside the microvessel lumina. We concluded that normal blood flow structuring is a deciding factor in the blood rheological properties of microvessels. Its disturbance, caused by fast accumulation of erythrocytes in the capillary lumina, results in blood rheological disorders and in a slow down to a full stop of the blood flow, despite a preserved arteriolovenular pressure difference.

Application of contrast agents in the evaluation of stroke: conventional MR and echo-planar MR imaging

The availability of new therapeutic interventions, including neuroprotective agents and endovascular thrombolysis, has given new hope to patients suffering an acute stroke. Early intervention remains a key factor in the effectiveness of these new and traditional treatments. More importantly, the capability to assess the viability and reversibility of the ischemic tissue became essential for better delineation and differentiation of infarcted versus ischemic tissue and patient management. Abnormal MR imaging (MRI) findings during acute stroke usually reflect the underlying pathophysiologic changes, which can be classified into three sequential stages: (a) hypoperfusion, (b) cellular dysfunction and (c) breakdown of the blood-brain barrier. The first stage is a kinetic phenomenon (not biologic) and, therefore, can be detected immediately. Contrast agents accentuate the abnormal flow kinetics and facilitate the early diagnosis of ischemia using either conventional MRI or newly developed echo-planar perfusion imaging (EPPI). The demonstration of abnormal arterial or parenchymal enhancement on conventional MRI during acute stroke provides the earliest sign of vascular occlusion/stenosis. EPPI, in contrast, provides information related to microcirculation (< 100 microns) and tissue reserve (cerebral blood volume) that cannot be obtained by conventional angiography and is directly related to the target end-organ. Further information obtained from both contrast MRI and EPPI may have a predictive value in the clinical outcome of acute stroke patients.

A model for the coupling between cerebral blood flow and oxygen metabolism during neural stimulation

A general mathematical model for the delivery of O2 to the brain is presented, based on the assumptions that all of the brain capillaries are perfused at rest and that all of the oxygen extracted from the capillaries is metabolized. The model predicts that disproportionately large changes in blood flow are required in order to support small changes in the O2 metabolic rate. Interpreted in terms of this model, previous positron emission tomography (PET) studies of the human brain during neural stimulation demonstrating that cerebral blood flow (CBF) increases much more than the oxygen metabolic rate are consistent with tight coupling of flow and oxidative metabolism. The model provides a basis for the quantitative interpretation of functional magnetic resonance imaging (fMRI) studies in terms of changes in local CBF.

Decreased heterogeneity of capillary plasma flow in the rat whisker-barrel cortex during functional hyperemia

The pattern of capillary plasma perfusion was investigated in the rat brain during functional activation. Functional hyperemia was induced in the left whisker-barrel cortex by deflection of the right mystacial vibrissae for 2 min at frequencies of 1-7 Hz. Rats were decapitated under anesthesia 3-4 s after i.v. bolus injection of Evans blue dye. The steep increase of the arterial dye concentration ensures that divergent capillary plasma transit times result in unequal intracapillary dye concentrations. Plasma perfusion heterogeneity was determined from the coefficient of variation (CV) of Evans blue concentrations measured in numerous single capillaries of the whisker-barrel cortex. Functional hyperemia was quantified from measurements of CBF using the [14C]-iodoantipyrine technique in a second experimental group. CBF in the left whisker-barrel cortex increased with the stimulation frequency and was maximal at 5 Hz compared to the right side. Conversely, plasma perfusion heterogeneity decreased with stimulation frequency in a reciprocal way, being minimal at 5 Hz. Results indicate a decrease in the microcirculatory flow heterogeneity during functional hyperemia in the brain.

In vivo visualization of hippocampal cells and dynamics of Ca2+ concentration during anoxia: feasibility of a fiber-optic plate microscope system for in vivo experiments

The feasibility of a fiber-optic plate (FOP) microscope system employing a bundle of optical fibers and videomicroscopy for in vivo experiments was investigated. The FOP used here consisted of optical fibers 3 microns in diameter. By inserting the FOP into an animal, optical signals from the deep-lying tissue invisible from the surface could be obtained as two-dimensional images. Using this system, hippocampal cells stained with a fluorescent dye in an anesthetized rat were visualized. Elevation of intracellular free calcium concentration ([Ca2+]i) in the hippocampus of the rat during anoxic exposure was also detected with a fluorescent indicator dye. These results showed that the FOP microscope system was sufficiently applicable to in vivo experiments for studying tissue structure and physiological activity even in the deep regions with fluorometric techniques.

The role of microvasculature in normal and perturbed bone healing as revealed by intravital microscopy

Bone chamber intravital microscopy brings to the study of bone circulation a combination of the control volume of in vitro models and the chemical complexity of in vivo models. As an optical tool it provides a window to circulatory events at the tissue level of magnification. In particular, it allows measures of microvascular physiology 1) in space by magnifying local perfused vasculature and microcirculation at any instant and 2) in time by providing the same volume of tissue for weekly viewing of an evolving process such as bone healing. This hollow screw's windows have revealed: 1) a consistent order for vascular and bone progression during healing, 2) vascular changes in response to implanted polymers and 3) preliminary data about effects of hyperbaric oxygenation and pulsed electromagnetic fields on vascular aspects of healing. The parameters measured are osteogenesis, angiogenesis, blood supply and permeability.

Tracer oxygen distribution is barrier-limited in the cerebral microcirculation

The kinetics of tracer oxygen distribution in the brain microcirculation of the awake dog were investigated with the multiple indicator dilution technique. A bolus containing 51Cr-labeled red blood cells, previously totally desaturated and then resaturated with [18O]2 (oxygen), 125I-albumin, 22Na, and [3H]water, was injected into the carotid artery, and serial anaerobic blood samples were collected from the sagittal sinus over the next 30 seconds. The outflow recovery curves were analyzed with a distributed-in-space two-barrier model for water and a one-barrier model for oxygen. The analysis provided an estimate of flow per gram brain weight as well as estimates for the tracer water and oxygen rate constants for blood-to-brain exchange and tracer oxygen parenchymal sequestration. Flow to tissue was found to vary between different animals, in concert with parallel changes in oxygen consumption. The 18O2 outflow curves showed an early peak, coincident with and more than half the magnitude of its vascular reference curve (labeled red blood cells), whereas the [3H]water curve increased abruptly to a low-in-magnitude curve at low flow values and to a small early peak at high flow values. Analysis indicates that the transfers of both 18O2 and [3H]water indicators from blood to brain are barrier-limited, with the former highly so because of the large red blood cell capacity for oxygen, and that the proportion of the tracer oxygen returning to the circulation from tissue is a small fraction of the total tracer emerging at the outflow.

Induced response to hypercapnia in the two-compartment total cerebral blood volume: influence on brain vascular reserve and flow efficiency

This study was undertaken to investigate the mechanisms of CBF increase as induced by hypercapnia. It was achieved in anesthetized rats by determining total cerebral blood volume (TCBV), parenchymal blood (CBV), plasma (CPV), erythrocyte (CEV) volumes and cerebral hematocrit (CHct) as well as CBF at about 40, 60, and 80 mm Hg PaCO2. TCBV was measured by a noninvasive blood dilution method using [99mTc]pertechnetate. CBV, CPV, and CEV were measured on isolated brain by 125I-serum albumin and 51Cr-erythrocytes. CBF was measured by both [131I/14C]iodoantipyrine and 57Co-microsphere extractions. The extraparenchymal blood volume (ECBV) was evaluated by subtracting CBV from TCBV. Under normocapnia, ECBV was 2.8 times larger than CBV. Under moderate hypercapnia, ECBV increased by 44%, CBV was not modified, and CBF increased by 52%. These results demonstrate that the main site of vasodilation is located in the extraparenchymal vasculature, which thus acts as a vascular reserve. By contrast, under severe hypercapnia, ECBV remained unchanged, whereas CBV then increased by 17%; CBF simultaneously showed an additional augmentation of either 52 or 309% when diffusible tracer or microspheres were used. This important increase in CBF cannot be explained either by capillary recruitment of closed capillaries or by active diameter lengthening of already open capillaries. The concomitant and great increase in capillary blood velocity was also shown to reduce cerebral flow efficiency, a situation consistent with a "luxury perfusion."

MR contrast due to intravascular magnetic susceptibility perturbations

A particularly powerful paradigm for functional MR imaging of microvascular hemodynamics incorporates paramagnetic materials that create significant image contrast. These include exogenous (lanthanide chelates) and endogenous (deoxygenated hemoglobin) agents for mapping cerebral blood volume and neuronal activity, respectively. Accurate interpretation of these maps requires an understanding of the biophysics of susceptibility-based image contrast. The authors developed a novel Monte Carlo model with which the authors quantified the relationship between microscopic tissue parameters, NMR imaging parameters, and susceptibility contrast in vivo. The authors found vascular permeability to water and the flow of erythrocytes to be relatively unimportant contributors to susceptibility-induced delta R2. However, pulse sequence, echo time, and concentration of contrast agent have profound effects on the vessel size dependence of delta R2. For a model vasculature containing both capillaries and venules, the authors predicted a linear volume fraction dependence for physiological volume changes based on recruitment and dilation, and a concentration dependence that is nonlinear and pulse sequence dependent. Using the model, the authors demonstrated that spin echo functional images have greater microvascular sensitivity than gradient echo images, and that the specifies of the volume fraction and concentration dependence of transverse relaxivity change should allow for robust mapping of relative blood volume. The authors also demonstrated excellent agreement between the predictions of their model and experimental data obtained from the serial injection of superparamagnetic contrast agent in a rat model.

Quantification of relative cerebral blood flow change by flow-sensitive alternating inversion recovery (FAIR) technique: application to functional mapping

Relative cerebral blood flow changes can be measured by a novel simple blood flow measurement technique with endogenous water protons as a tracer based on flow-sensitive alternating inversion recovery (FAIR). Two inversion recovery (IR) images are acquired by interleaving slice-selective inversion and nonselective inversion. During the inversion delay time after slice-selective inversion, fully magnetized blood spins move into the imaging slice and exchange with tissue water. The signal enhancement (FAIR image) measured by the signal difference between two images is directly related to blood flow. For functional MR imaging studies, two IR images are alternatively and repeatedly acquired during control and task periods. Relative signal changes in the FAIR images during the task periods represent the relative regional cerebral blood flow changes. The FAIR technique has been successfully applied to functional brain mapping studies in humans during finger opposition movements. The technique is capable of generating microvascular-based functional maps.

Changes in the cerebrocortical capillary network following venous sinus occlusion in cats

BACKGROUND

Although the important protective effect of venous collateral pathways in sinus occlusion on parenchymal injury has been demonstrated in previous works, the vascular response in the capillary microcirculation itself after cerebral venous occlusion has not been fully elucidated. We examined the morphology of the capillary network after venous occlusion by relating stereologic morphometric parameters to changes in local cerebral blood flow and the development of brain edema.

METHODS

Experimental venous sinus occlusion was induced by injection of 0.5 mL of cyanoacrylate into the superior sagittal sinus and by immediate ligation of both external jugular veins in chloralose-urethane anesthetized cats (n = 24). Capillaries in the adjacent cortex (marginal and suprasylvian cortex) and remote cortex (piriform cortex) were injected with Evans blue dye 2 minutes before sacrifice at 15-minute and 120-minute postsinus occlusion. The stereologic morphometric parameters including volume density, minimum intercapillary distance, capillary diameter, and number of perfused capillaries were computed on a fluorescence microscopic photograph using an image analysis system. Cerebral blood flow (CBF) was measured by hydrogen clearance method, and brain tissue water content was measured using the dry-wet method.

RESULTS

In the cortex adjacent to the superior sagittal sinus, the volume density and the number of perfused capillaries were increased significantly (p < 0.02, and p < 0.05, respectively) and the minimum intercapillary distance was decreased significantly (p < 0.02) at 15 minutes after venous occlusion (n = 10). Cerebral blood flow (CBF) was also decreased to 53% of that in the control group (p < 0.01). Although the morphologic parameters returned to the control level by 120 minutes after venous occlusion, the CBF remained decreased after venous occlusion. No change was observed in the water content of the adjacent gray matter at 15 minutes after venous occlusion; however, it was increased (p < 0.05) at 120 minutes.

CONCLUSION

These results indicate that the recruitment of reserve capillaries occurs during the early phase of venous occlusion. While CBF decreased to half of the control after venous occlusion, capillary perfusion remained above or near the control level until 120 minutes postocclusion, suggesting that venous recruitment would be potentially beneficial in clinical patients in the early stage of venous occlusion.

The intravascular contribution to fMRI signal change: Monte Carlo modeling and diffusion-weighted studies in vivo

Understanding the relationship between fMRI signal changes and activated cortex is paramount to successful mapping of neuronal activity. To this end, the relative extravascular and intravascular contribution to fMRI signal change from capillaries (localized), venules (less localized) and macrovessels (remote, draining veins) must be determined. In this work, the authors assessed both the extravascular and intravascular contribution to blood oxygenation level-dependent gradient echo signal change at 1.5 T by using a Monte Carlo model for susceptibility-based contrast in conjunction with a physiological model for neuronal activation-induced changes in oxygenation and vascular volume fraction. The authors compared our Model results with experimental fMRI signal changes with and without velocity sensitization via bipolar gradients to null the intravascular signal. The model and experimental results are in agreement and suggest that the intravascular spins account for the majority of fMRI signal change on T2*-weighted images at 1.5 T.

Patterns of capillary plasma perfusion in brains in conscious rats during normocapnia and hypercapnia

The present study aimed to investigate the distribution pattern of plasma flow velocities in brain capillaries. We tested the hypothesis that plasma flow velocities are heterogeneous in the brain capillaries of normocapnic conscious rats and become more homogeneous during increased cerebral blood flow induced by hypercapnia. We developed a method that makes it possible to detect the distribution pattern of plasma flow velocities from the intravascular dye concentrations measured in different capillaries. Evans blue was injected intravenously as a bolus, and 3 to 4 seconds later the rats were decapitated. During this period, a steep increase in arterial dye concentration was verified by frequent arterial blood sampling. Under such conditions, divergent plasma flow velocities in different capillaries yield unequal intravascular dye concentrations. Dye concentrations were measured in several hundred capillaries of brain cryosections using quantitative fluorescence microscopy based on calibration curves obtained from anesthetized rats. The results show a high degree of variation in the intravascular dye concentration during normocapnia. During increasing stages of hypercapnia, the variation was gradually reduced. The coefficient of variation (SD/mean-100) of intracapillary dye concentration decreased from 76% at normocapnia to 22% at extreme hypercapnia (PCO2 of 87 mm Hg), thus showing an inverse correlation with arterial PCO2 (r = .97). The heterogeneity of intravascular dye concentrations observed in the present experiments indicates heterogeneous velocities of plasma perfusion in different brain capillaries during normocapnia and a more homogeneous distribution pattern during hypercapnic hyperemia.

Capillary perfusion of the rat brain cortex. An in vivo confocal microscopy study

Confocal laser-scanning microscopy was used to visualize subsurface cerebral microvessels labeled with intravascular fluorescein in a closed cranial window model of the anesthetized rat. In noninvasive optical sections up to 250 microns beneath the brain surface, plasma perfusion and blood cell perfusion of individual capillaries were studied. Under resting conditions, in all cerebral capillaries the presence of plasma flow as demonstrated by the appearance of an intravenously injected fluorescent tracer within 20 seconds after injection. Plasma flow was verified even in capillaries that contained stationary erythrocytes or leukocytes; 91.1% of the capillaries contained flowing blood cells, 5.2% contained stationary blood cells, and no blood cells were seen in 3.6%. Mean blood cell velocity was 498.3 +/- 443.9 microns/s, and the mean blood cell supply rate was 35.75 +/- 28.01 cells per second. When capillaries were continuously observed for 1 minute, "on" and "off" periods of blood cell flow were noted. During hypercapnia (increase of PCO2 from 33.25 to 50.26 mm Hg), mean blood cell flux increased from 38.6 +/- 17.2 to 55.5 +/- 12.2 per second (P < .005, paired t test of mean values in six animals), and blood cell velocity increased from 519.5 +/- 254.8 to 828.5 +/- 460.8 microns/s (P = .074, paired t test of mean values in six animals). Homogeneity of blood cell flux increased as indicated by the coefficient of variation decreasing from 44.6% to 22.0%, and the portion of poorly perfused capillaries (blood cell flux, < 40 per second) decreased from 59.2% to 22.4%.(ABSTRACT TRUNCATED AT 250 WORDS)

Measurement of regional blood oxygenation and cerebral hemodynamics

An echo planar linewidth mapping technique, Shufflebutt, has allowed temporal measurements of changes in linewidth caused by static inhomogeneities (delta LWSI) and transverse relaxation rate (delta R2) in models of hypoxia and hypercapnia. We demonstrate these changes are due to intravascular susceptibility differences/(delta chi) between the blood and tissue. Contrast agent injections at a delta chi equivalent to that of deoxygenated blood showed a twofold difference between the contrast agent and physiological anoxia values. Hypercapnia decreased both delta LWSI and delta R2 consistent with an increase in blood oxygenation. We attribute these findings to constant oxygen extraction during an increase in blood flow, resulting in less deoxygenated venous blood and thus reduced delta chi. For in vivo perturbations we found that delta R2/delta R2' approximately 0.33, a ratio much different from that measured in whole blood phantoms (delta R2/delta R2' approximately 2). This demonstrates that signal changes in these studies are produced predominantly by dephasing of extravascular protons due to field inhomogeneities produced by intravascular deoxygenated hemoglobin (deoxyHb).

Changes in brain capillary diameter during hypocapnia and hypercapnia

Since changes in the surface area of capillaries may be relevant to capillary exchange, the distensibility of brain capillaries was investigated. Brain capillary diameters were measured after perfusion fixation of brain tissue at a constant perfusion pressure during hypo- or hypercapnia. Sections were embedded, stained, and analyzed by light microscopy. The results showed significant differences in mean capillary diameter between the hypocapnic and the hypercapnic group. In the eight brain structures analyzed, capillary diameters were always larger in the hypercapnic group. Mean capillary diameter was 4.93 +/- 0.29 microns in the hypocapnic group and 5.91 +/- 0.10 microns in the hypercapnic group (means +/- SD). We conclude that brain capillaries exhibit a moderate degree of distensibility. Variations in the precapillary pressure of microvessels may therefore influence both capillary flow and capillary surface area.

Hypoxia increases velocity of blood flow through parenchymal microvascular systems in rat brain

The postulation that hypoxia increases local cerebral blood flow (lCBF) mainly by perfusing more capillaries (the capillary recruitment hypothesis) was tested in awake adult male Sprague-Dawley rats exposed to 10% O2 and control rats. The [14C]iodoantipyrine technique was used to measure lCBF. Local cerebral blood volume was determined by measuring plasma and red cell distribution spaces within the brain parenchyma with 125I-labeled serum albumin (RISA) and 55Fe-labeled red cells (RBC), respectively. Tissue radioactivity in 44 brain areas was estimated by quantitative autoradiography. Hypoxia raised lCBF by 25-90% in all brain areas. In about one-quarter of the brain areas, the rise in blood flow was associated with a small increase in microvascular plasma and blood volumes. This change in blood volume, which could be the result of perfusing more parenchymal microvessels and/or increasing parenchymal microvessel diameter, is not sufficient to account for the observed rise in lCBF. In the remaining areas the RISA, RBC, and blood spaces were either unchanged or only marginally increased by hypoxia. For this hypoxic perturbation, the major mechanism of raising blood flow appears to be increased velocity of microvessel perfusion and not perfusion of more capillaries. These findings provide only limited support for the capillary recruitment hypothesis.

The velocities of red cell and plasma flows through parenchymal microvessels of rat brain are decreased by pentobarbital

Local cerebral blood flow is lowered in many brain areas of the rat by high-dose pentobarbital (50 mg/kg). In the present study, the mechanism of this flow change was examined by measuring the distribution of radiolabeled red blood cells (RBCs) and albumin (RISA) in small parenchymal microvessels and calculating the microvascular distribution spaces and mean transit times of RBCs, RISA, and blood. In most brain areas, pentobarbital slightly decreased the RISA space, modestly increased the RBC space, and did not alter the blood space. The mean transit times of RBCs, RISA, and blood through the perfused microvessels were considerably greater in treated rats than in controls. These findings indicate that the mechanism by which high-dose pentobarbital diminishes local cerebral blood flow in rat brain is, in the main, a lowered linear velocity of plasma and RBC flow through small parenchymal microvessels and not decreased percentage of perfused capillaries (capillary retirement). This response is probably driven mainly by lowered local metabolism and may well entail a slight increase in the number of small microvessels that are perfused by RBCs.

Functional brain mapping by blood oxygenation level-dependent contrast magnetic resonance imaging. A comparison of signal characteristics with a biophysical model

It recently has been demonstrated that magnetic resonance imaging can be used to map changes in brain hemodynamics produced by human mental operations. One method under development relies on blood oxygenation level-dependent (BOLD) contrast: a change in the signal strength of brain water protons produced by the paramagnetic effects of venous blood deoxyhemoglobin. Here we discuss the basic quantitative features of the observed BOLD-based signal changes, including the signal amplitude and its magnetic field dependence and dynamic effects such as a pronounced oscillatory pattern that is induced in the signal from primary visual cortex during photic stimulation experiments. The observed features are compared with the results of Monte Carlo simulations of water proton intravoxel phase dispersion produced by local field gradients generated by paramagnetic deoxyhemoglobin in nearby venous blood vessels. The simulations suggest that the effect of water molecule diffusion is strong for the case of blood capillaries, but, for larger venous blood vessels, water diffusion is not an important determinant of deoxyhemoglobin-induced signal dephasing. We provide an expression for the apparent in-plane relaxation rate constant (R2*) in terms of the main magnetic field strength, the degree of the oxygenation of the venous blood, the venous blood volume fraction in the tissue, and the size of the blood vessel.

Absent recruitment of capillaries in brain tissue recovering from stroke

The density of perfused capillaries (dCAP), defined as capillaries that transport glucose, as well as the volume fraction of these capillaries in the vascular bed (fCAP), and the mean transit time of blood through the capillaries (tCAP), were calculated from hemodynamic variables obtained in vivo by positron tomography of brains of six patients affected by stroke. Each patient was studied twice, within 38 hrs of the insult, and one week later. 38 ischemic and 38 contralateral mirror regions were compared. The metabolic rate for glucose (CMRglc) was determined on the basis of regional calculations of the lumped constant. No significant change of the lumped constant was observed in any region. In normal regions, no significant differences of any variables existed between the first and second studies. In the infarct regions of the first study, CMRglc and CMRO2 (cerebral metabolic rate for oxygen) were 30-50% of control (deactivation) and CBF (cerebral blood flow), capillary density, and the capillary diffusion capacity for fluorodeoxyglucose (K1) were similarly reduced, although the oxygen/glucose ratio was only 3.75 in the ischemic regions. While fCAP decreased, tCAP doubled. One week after the first study, blood flow returned to normal in the infarct regions despite continued depression of metabolism. Capillary density and diffusion capacity remained low, indicating absent recruitment of nutrition vessels (perfusion capillaries).

Development and remodeling of cerebral blood vessels and their flow in postnatal mice observed with in vivo videomicroscopy

Changes of blood vessels in the mouse somatosensory (barrel) cortex were assessed from birth (P0) to adulthood. Surface vessel anatomy and flow were observed directly with videomicroscopy through closed cranial windows and with intravascular fluorescent tracers. Histology was used to determine the internal capillary density. At birth, arterioles had numerous anastomoses with each other, pial capillaries formed a dense surface plexus, and pial venules and veins were relatively small and irregular. Morphological changes over the next 2 weeks included (a) fewer arteriolar anastomoses, (b) formation and growth of venules, (c) more uniform diameters of all types of vascular segments, (d) increase in intraparenchymal capillary length density (Lv), and (e) decreases in superficial capillary density and diameters. A simple morphological test showed that wall shear rates at arteriolar branch points were matched on average in neonates and adults. Flow characteristics in single vessels were evaluated. In arterioles of like diameters, (a) Vmax, (b) peak wall shear rates, and (c) peak flows were similar at all ages; (d) velocity was very high in occasional arteriovenous (AV) shunts in newborns; and (e) flow in arteriolar anastomoses was slow and variable. Although flow was heterogeneous in all types of vessel, the marked similarities in newborn and adult mice of average peak velocities and calculated wall shear rates in arterioles of the same size suggest that blood flow regulates in part the remodeling of blood vessels during development (Rovainen et al., 1992). The rodent barrel cortex undergoes major neuronal and vascular development, functional differentiation, and remodeling during the first weeks after birth. It provides special opportunities for testing how blood vessels grow and adapt to supply the local metabolic requirements of neural modules in the brain.

MR imaging of cerebral perfusion by phase-angle reconstruction of bolus paramagnetic-induced frequency shifts

Phase-angle images are acquired dynamically during bolus paramagnetic contrast injection and demonstrate a phase-enhancement effect in perfused cerebral tissues. Signal-to-noise is comparable to that of susceptibility-based signal loss (delta R*) images. Assuming that phase shift is proportional to the tissue paramagnetic agent concentration, as supported by experimental data, the integrated area of the phase time response curves estimated the relative gray to white matter blood volume as 1.8:1 and was sensitive to acute ischemia. The relation between tissue phase shift and concentration is considered.

The capillary network: a link between IVIM and classical perfusion

MR measurements based on motion encoding gradients, such as intravoxel incoherent motion imaging, could provide, in principle, information on flowing blood volume and blood velocity. This note shows that, in addition, the knowledge of the capillary network organization may provide a link between these measurements and those obtained by conventional and MR perfusion techniques based on tracer uptake by tissues.

Time course EPI of human brain function during task activation

Using gradient-echo echo-planar MRI, a local signal increase of 4.3 +/- 0.3% is observed in the human brain during task activation, suggesting a local decrease in blood deoxyhemoglobin concentration and an increase in blood oxygenation. Images highlighting areas of signal enhancement temporally correlated to the task are created.

Separation of diffusion and slow flow effects by use of flow rephasing and dephasing

Spin-echo signal intensity alterations due to diffusion and slow flow are investigated in connection with modified Stejskal-Tanner pulse sequences for 2D Fourier MR imaging, one for flow rephasing and the other for flow dephasing gradient waveforms. The theoretical considerations and experimental results concerning the diffusion coefficient measurements of slowly flowing material by these sequences are summarized as follows: (a) By using the flow dephasing sequence with different diffusion and flow-sensitive gradients, slow flow effects can be distinguished from diffusion effects based on the quantitative difference between the diffusion- and flow-sensitive gradient amplitude dependences of these processes. (b) By using the combination of the flow rephasing and dephasing sequences with the same diffusion sensitivity, slow flow effects can be distinguished from diffusion effects directly based on their qualitative difference. By use of the latter approach, several in vivo images are also presented, which mainly represent macroscopic motions of spins, including slow flow such as tissue perfusion.

In-vivo confocal scanning laser microscopy of the cerebral microcirculation

Confocal scanning laser microscopy (CSLM) was used to study the microcirculation of the brain neocortex in anaesthetized rats. After removal of the dura mater, implantation of a closed cranial window, and intravenous injection of fluorescein, three-dimensional reconstructions of cortical capillaries were performed down to a depth of 250 microns below the pial surface. Using a one-dimensional approach (single line scanning), erythrocyte (negative contrast in fluorescently labelled plasma) and leucocyte (labelled with rhodamine 6 G) velocity and supply rate in cortical capillaries were measured. The effect of CO2-inhalation on capillary blood flow dynamics was studied. Capillaries were imaged continuously for up to 1 h without changes in flow or fluorescence pattern. However, by increasing the laser power 10-100-fold, aggregate formation was induced and capillaries were occluded, possibly due to damage to vascular endothelium. We conclude that CSLM can be used to study morphological and dynamic aspects of fluorescently labelled subsurface structures in organs of experimental animals.

MR imaging of microcirculation in rat brain: correlation with carbon dioxide-induced changes in blood flow

Considerable interest has been shown in developing a magnetic resonance (MR) imaging technique with quantitative capability in the evaluation of tissue microcirculation ("perfusion"). In the present study, the flow-dephased/flow-compensated (FD/FC) technique is evaluated for measuring rat cerebral blood flow (CBF) under nearly optimal laboratory conditions. Imaging was performed on a 2.0-T system equipped with shielded gradient coils. Rat CBF was varied by manipulating arterial carbon dioxide pressure (PaCO2). In parallel experiments, optimized MR imaging studies (seven rats) were compared with laser Doppler flowmetry (LDF) studies (nine rats). LDF values showed a high degree of correlation between CBF and PaCO2, agreeing with results in the literature. MR imaging values, while correlating with PaCO2, showed considerable scatter. The most likely explanation is unavoidable rat motion during the requisite long imaging times. Because of this motion sensitivity, the FD/FC technique cannot provide a quantitative measure of CBF. It can, however, provide a qualitative picture.

Computer simulation of growth of anastomosing microvascular networks

Stochastic growth of polygonal microvascular networks was simulated on computer by dichotomous terminal branching and bridging (anastomosing with an existing segment). The model was applied to describe microvascular growth into a rectangular plane from the sides when vessels bifurcate in a probabilistic manner. The angle of bifurcation was drawn from a normal distribution, the mean of which was varied between 40 degrees and 80 degrees. The resulting networks contained an average of 88-104 nodes of which 30-38% were due to bridging. Number of nodes, number of branches, number of vascular polygons and a fractal dimension representing the density of nodes were calculated for each simulated network. Capillary density increased when mean angle of bifurcation was increased between 40 degrees and 80 degrees. Distributions of normalized vessel lengths and polygon shapes were compared with those of a mesenteric vascular network. The distributions were not found to be significantly different (p less than 0.05) for most values of the mean angle of bifurcation, matching best for the mean bifurcation angle of 50 degrees. Vascular polygons had an average shape between pentagonal and hexagonal for the mesenteric network as well as for all values of the mean bifurcation angle used in this study.

Diffusion/microcirculation MRI in the rat brain

The CO2 fraction of an anesthetized rat's breathing mixture was changed (from 0 to 10%) to attempt to change the brain microcirculation and observe these changes in diffusion measurements of the neural tissue. Brain apparent diffusion coefficients were measured to be (0.71 +/- 0.01) X 10(-3) mm2/s before sacrifice and (0.39 +/- 0.01) X 10(-3) mm2/s after sacrifice. Multiple diffusion components were observed, consistent with flowing material, but the extra components did not increase with increased CO2. It is proposed that the additional components may be due to extracellular, extravascular water such as CSF.

Three-dimensional reconstruction of the rat brain cortical microcirculation in vivo

We used confocal laser scanning microscopy (CLSM) to investigate the morphology and three-dimensional relationships of the microcirculation of the superficial layers of the rat brain cortex in vivo. In anesthetized rats equipped with a closed cranial window (dura mater removed), after i.v. injection of 3 mg/100 g of body weight of fluorescein in 0.5 ml of saline, serial optical sections of the brain cortex intraparenchymal microcirculation were taken. Excitation was at a wavelength of 488 nm (argon laser), and emission was collected above 515 nm. CLSM provided images of brain vessels with sufficient signal-to-noise ratio for three-dimensional reconstructions down to a depth of 250 microns beneath the surface of the brain. Compared to conventional fluorescence microscopy, CLSM has a much higher axial resolution and higher depth of penetration. Laser light-induced intravascular aggregates, irregularities of erythrocyte flow, or microvascular occlusions ("light and dye injury") were not apparent in the current experimental paradigm. CLSM is a promising new tool for in vivo visualization of the cerebral microcirculation. Future studies have to characterize the potential damage to the tissue dye mechanisms.