Nonuniform distribution of microspheres in blood flowing through a medium-size artery

The history of the microsphere method for measuring blood flows with special reference to myocardial blood flow: a personal memoir

We use many types of equipment and technologies to make our measurements but give little thought to how they developed. Evolution was once described as a series of recoils from blind alleys, and this is exemplified by the gradual development of the microsphere method of measuring blood flows. The microsphere method is one of the most frequently used methods for measuring blood flow to organs and portions of organs. The method can measure myocardial blood flow with reasonable accuracy (within 10%) down to samples weighing >50 mg but probably will not do so for samples weighing 1-10 mg. Microspheres with diameters from 10 to 15 μm provide the best compromise between accurate flow measurement and retention in tissue. Radioactive labels have been almst entirely replaced by fluorescent labels, but colored microspheres and neutron-activated labels are also used.NEW & NOTEWORTHY The contributions of the various individuals who developed the microsphere method of measuring regional blood flows and how these advances took place are brought to light in this paper.

Multiple injections of coloured microspheres for islet blood flow measurements in anaesthetised rats: influence of microsphere size

We investigated if coloured microspheres could be used for repeated measurements of pancreatic islet blood flow in rats. An initial injection of 1.0-1.5 x 10(5) microspheres (black colour), with a size of 10 or 15 microm, was made into the ascending aorta, while an arterial reference sample was collected from the femoral artery. Twelve min later, 1 ml of saline or 30% D-glucose was injected intravenously. Three min after this injection a second injection of 10- or 15-microm microspheres (green colour) was given. The animals were then killed, and the pancreas and adrenals were removed and samples (150-200 mg) were secured from the duodenum, ileum, colon, right kidney and liver. The microsphere contents were determined with the aid of a freeze-thawing technique and blood flow values were calculated. Our results suggest that 10-microm microspheres, but not 15-microm microspheres, provide reproducible islet and total pancreatic blood flow measurements when repeatedly injected. Values for the blood flow to the intestines, kidney and liver were less sensitive to the size of the microspheres. We conclude that repeated administration of 15-microm microspheres induces a high risk for erroneous islet and total pancreatic blood flow measurements, whereas two such measurements can be performed if 10-microm microspheres are used.

Body temperature influences regional tissue blood flow during retrograde cerebral perfusion

OBJECTIVE

This study compared the cerebral microcirculation during retrograde cerebral perfusion with that during antegrade cardiopulmonary bypass under normothermic and hypothermic conditions.

METHODS

Brain tissue blood flow was measured with the hydrogen-clearance and colored microsphere (15 and 50 microns) methods during antegrade cardiopulmonary bypass and retrograde cerebral perfusion. Measurements were performed during normothermia (37 degrees C), moderate hypothermia (28 degrees C) and deep hypothermia (20 degrees C) in groups of mongrel dogs (n = 8).

RESULTS

During antegrade cardiopulmonary bypass, the microsphere method showed a significant decrease in cerebral blood flow as body temperature decreased (40.1 +/- 20.8 ml/min/100 gm at 37 degrees C, 16.2 +/- 18.0 ml/min/100 gm at 20 degrees C with 50 microns microspheres) At 20 degrees C, the cerebral blood flow measured with the 15 microns microspheres was significantly lower than that assessed with the hydrogen-clearance method (11.3 +/- 7.0 vs 24.8 +/- 7.0 ml/min/100 gm). During retrograde cerebral perfusion, the microsphere method also showed a significant decrease in cerebral blood flow with cooling. At 37 degrees C, the cerebral blood flow measured with the 15 microns microspheres (0.8 +/- 0.7 ml/min/100 gm) was significantly lower than that assessed with the hydrogen-clearance method (10.1 +/- 3.5 ml/min/100 gm). At both 28 degrees and 20 degrees C, the hydrogen-clearance method showed significantly higher cerebral blood flow (10.1 +/- 5.8 and 8.2 +/- 3.7 ml/min/100 gm) than did the 50 microns microspheres (1.8 +/- 0.6 and 1.0 +/- 0.8 ml/min/100 gm) and 15 microns microspheres (0.23 +/- 0.14 and 0.18 +/- 0.15 ml/min/100 gm).

CONCLUSION

(1) Cerebral blood flow that shunts to capillaries is increased during antegrade cardiopulmonary bypass under deep hypothermia. (2) During retrograde perfusion, the majority of the blood flow shunts away from brain capillaries, even under normothermic conditions, and blood flow through large venoarterial shunts increases as body temperature decreases. Although the cerebral microcirculation during retrograde perfusion is decreased, retrograde perfusion provides some degree of oxygenation to the body.

An alternative to radioactive microspheres for measuring regional myocardial blood flow, Part 1: Colored microspheres

OBJECTIVE

To compare measurements of regional myocardial blood flow between color and radioactive microspheres.

DESIGN

Prospective, randomized, controlled.

SETTING

University research laboratory.

PARTICIPANTS

Pigs.

INTERVENTIONS

Pigs underwent constriction of the left anterior descending artery, either incremental and then 0 constriction with epinephrine, 0.5 to 3 mu/kg/min (n = 5; "variable") or only 0% and 100% constriction without epinephrine (n = 4, "single"). Radioactive and color microspheres were injected simultaneously. For variable constriction, 5 colors (3 x 10(6)/mL) were tested in random order and, for single, red and yellow (6 x 10(6)/2 mL).

MEASUREMENTS AND MAIN RESULTS

Measurements of regional endocardial, epicardial, and transmural myocardial blood flow were compared by regression analysis (linear and nonlinear). With radioactive measurements as the point of reference, when regional flow was 50 to 150 mL/min/100 g, correlation was high (r = 0.85), although regression slope was low. With endocardial and epicardial flow between 30 and 100 mL/min/100 g, correlation was close (r = 0.84). Overall nonlinear correlation was higher with single than variable constriction (r = 0.72). When regional flow was less than 100 mL/min/100 g, linear correlation was r = 0.72. When transmural flow measured by color microspheres was less than 25 mL/min/100 g, correlation was high (r = 0.86) but, with endocardial or epicardial flow, low (r = 0.67). When transmural flow was greater than 100 mL/min/100 g, correlation was extremely low (r = 0.1; n = 26 data points). The overall correlations for regional endocardial and epicardial flows were also low, except in the ischemic zone.

CONCLUSIONS

Color and radioactive measurements correlate well during moderate and ischemic regional myocardial blood flow, ischemic blood flow requiring a higher concentration of color microspheres. A major limitation of using color microspheres is imprecision when flow is greater than 150 mL/min 100 g.

Insights into the assessment of myocardial perfusion offered by different cardiac imaging modalities

Myocardial perfusion may be very broadly defined as the tightly regulated nutrient delivery to cardiac tissue. The different components of perfusion are myocardial blood flow, oxygen delivery, myocardial oxygen consumption, and myocardial blood volume. Historically, focus has been placed mostly on the assessment of blood flow. In many instances, knowledge of flow without information about these other aspects is inadequate. This review discusses the various cardiac imaging techniques used for the assessment of myocardial perfusion that represent diverse physiologic measures of "perfusion." Their strengths and limitations are discussed as is their relevance to specific clinicopathologic conditions. Significant work still needs to be performed before all the aspects of myocardial perfusion can be precisely measured in human beings.

Regional cerebral tissue blood flow measured by the colored microsphere method during retrograde cerebral perfusion

Brain tissue blood flow was measured precisely by the colored microsphere method during retrograde cerebral perfusion in 10 normothermic mongrel dogs. The average tissue blood flow rates to the cerebral cortex, cerebral medulla, brain stem, cerebellum, and spinal cord during retrograde cerebral perfusion at 25 mm Hg of external jugular venous pressure were 10.5 +/- 10.3, 4.2 +/- 4.6, 11.1 +/- 9.8, 12.3 +/- 8.6, and 9.1 +/- 5.8 ml/min per 100 gm, respectively. The brain was perfused wholly by retrograde cerebral perfusion without lateralization. Total cerebral blood flow was calculated as the sum total rates of blood flow to each area. Total cerebral blood flow during retrograde cerebral perfusion at 25 mm Hg was 7.8 +/- 4.4 ml/min, which represented 3.5% +/- 1.9% of whole body blood flow and one third of the total cerebral blood flow (28.0 +/- 4.2 ml/min) during cardiopulmonary bypass at a flow rate of 1000 ml/min. Oxygen consumption and carbon dioxide elimination by the total cerebrum during retrograde cerebral perfusion at 25 mm Hg were 0.54 +/- 0.23 ml/min and 34 +/- 15 mumol/min, respectively, or 8.6% +/- 3.6% and 7.0% +/- 3.1% of the corresponding whole body value and represented about one third of that measured during cardiopulmonary bypass (1.21 +/- 0.39 ml/min and 96 +/- 15 mumol/min). Total cerebral blood flow, total cerebral oxygen consumption, and carbon dioxide elimination increased as the external jugular venous pressure increased from 15 to 25 mm Hg; however, no further increase occurred once the external jugular venous pressure exceeded 25 mm Hg.

Arterial microsphere concentrations in cats are not affected by changes in hematocrit

BACKGROUND AND PURPOSE

Acute anemia may lead to erroneously low arterial reference sample concentrations of radioactive microspheres, depending on the sampling rate and the size of the artery from which the reference samples are withdrawn. Because this error would lead to falsely high cerebral blood flow values in studies involving hemodilution caused by hemorrhage and fluid resuscitation, we studied the effects of hematocrit, withdrawal rate, and vessel location and size on arterial microsphere concentrations in anesthetized adult cats.

METHODS

Cats were anesthetized with ketamine, isoflurane, and nitrous oxide; both brachial arteries were cannulated with polyethylene tubing, as was the abdominal aorta through the femoral artery. Sequential left atrial microsphere injections were made using several doses of each of five isotopes. The rate of reference sample withdrawal from the three sampling catheters was randomized to 1.03 mL.min-1 or 2.06 mL.min-1. We analyzed the ratio of the number of microspheres in paired reference samples using the factors hematocrit, rate of withdrawal, and site. A ratio less than 1 indicates an underestimation of arterial microsphere concentration, which would lead to erroneously high cerebral blood flow values. The procedure was repeated after isovolemic hemodilution with 10% hetastarch to hemoglobin levels approximating 85%, 70%, 55%, and 40% of baseline.

RESULTS

No significant effects of hematocrit on ratios of microsphere concentrations existed at any withdrawal rate or site. Ratios of microsphere concentrations in reference samples withdrawn slowly (1.03 mL.min-1) from the aorta and ratios of microsphere concentrations withdrawn either rapidly (2.06 mL.min-1) or slowly from the brachial arteries were significantly (P < .001) less than 1.

CONCLUSIONS

Hemodilution did not affect microsphere concentrations in arterial reference samples at any withdrawal site or rate and therefore does not affect the accuracy of microsphere blood flow determinations. However, slow withdrawal from a large vessel may underestimate actual microsphere concentrations.

Structure-localization relationships of 11C-labeled phentermine derivatives: effect of aromatic substitution

A series of phentermine analogs, including the unsubstituted, the para-F, -Cl, -Br and -I, and the meta-CF3 derivatives, were labeled by [11C]methylation and evaluated in rats to determine the structure-localization relationships for this class of regional cerebral blood flow imaging agents. All the phentermines were well-localized in the brain; however, only the para-substituted agents were well-retained. Localization in the nontarget tissue was affected by the lipophilicity of the substituent. Comparison with the radioiodinated analogs showed virtually identical results, which suggests that the compounds were not significantly metabolized. The agent with the best biodistribution characteristics was the N-[11C]methyl-p-iodophentermine, with the p-bromo analog almost equivalent.

Regional blood flow and strontium-85 incorporation rate in the rat hindlimb skeleton

Regional distribution of radioactive microspheres and 85Sr incorporation rate in the os ilium, femur, and tibia were determined in 44 rats. In 15 additional animals, regional blood flow was measured with the reference sample technique. Highest numbers of microspheres were found in the distal femoral and proximal tibial metaphyses. Highest blood flow rates were found in the os ilium, the caput femoris, and distal femoral and proximal tibial metaphyses. The diaphyses and epiphyses of the femur and tibia had a relatively lower perfusion. The regional 85Sr incorporation rate was correlated (r = 0.67) to the regional distribution of the microspheres. The dispersion of the data was large and this was mainly due to biological variation. The results describe the regional distribution of blood flow in the rat hindlimb and demonstrate a close association between blood flow and mineral turnover in normal rat skeletal tissue as shown by the correlation between microsphere and 85Sr incorporation rate distribution.

Measurement of regional myocardial blood flow with multiple colored microspheres

BACKGROUND

The use of radioactive microspheres (RM) for the measurement of regional myocardial blood flow (RMBF) is limited and inaccessible to many investigators due to radiation safety concerns and radioactive waste disposal problems. Therefore, a new method for the measurement of RMBF using colored microspheres (CM) was developed.

METHODS AND RESULTS

Polystyrene spheres (diameter, 15 +/- 0.1 [SD] micron; density, 1.09 g/ml) were dyed with one of five colors. With the injection of CM into the left atrium or into a coronary perfusion line, RMBF and its distribution can be determined. CM are extracted from the myocardium and blood by digestion with potassium hydroxide and subsequent microfiltration. The dyes are then recovered from the CM within a defined volume of a solvent, and their concentrations are determined by spectrophotometry. The separation of composite absorbance spectra by spectrophotometry with the CM technique was as good as the separation of energy spectra by a gamma-counter using the RM technique. Leaching of dye from the CM was less than 0.1% during a 2-month period in vitro. Significant leaching of dye from the microspheres also did not occur during 8 hours in the blood and myocardium of four anesthetized dogs in vivo. For further validation of this method, pairs of CM and RM (15.5 +/- 0.1 [SD] microns) were simultaneously injected under five different RMBF conditions (range, 0-10 ml/[min.g]) into the left anterior descending coronary artery of four anesthetized pigs, with coronary inflow as a flow reference, or into the left atrium of four anesthetized dogs using aortic blood withdrawal as a reference. The relation between RMBF determined by CM and RM was CM = 0.01 + 1.00.RM (r = 0.98, n = 1,080 data points) in the pigs, and CM = -0.19 + 0.92.RM (r = 0.97, n = 1,813 data points) in the dogs.

CONCLUSIONS

Measurement of RMBF with CM yields values very similar to those of RM. Their use is less expensive and avoids all the disadvantages related to radioactivity, thus offering an alternative method for as many as five RMBF measurements in a single experiment.

Regional cerebral blood flow in pigs estimated by microspheres

Regional cerebral blood flow in anaesthetized pigs is determined with the microsphere method. Five regions of cortical grey matter and three white subcortical areas in each hemisphere are examined together with anatomically classic structures. The validity of the biopsies was confirmed by freeze drying of the tissue. Three flow measurements in a group of six animals showed large interindividual variations whereas regions with the same structure in the particular animal showed a high degree of uniformity. Symmetrical regions in the two hemispheres were similar with a coefficient of variation between sides of less than 5%. The coefficient of variation of the particular flow measurements were 15%. The different brain structures have four discernible flow levels. White subcortical matter has three different flow values and forms together with medulla oblongata and hippocampus the low flow area. Flow in grey cortical matter is of the same magnitude as in unanaesthetized animals and constitutes together with thalamus, mesencephalon, pons and cerebellar hemispheres the intermediate flow level. The high flow areas are nucleus caudatus and lentiformis together with the cerebellar vermis. The choroid plexus, pituitary gland and pineal gland all have very high flow values and seem, in contrast to the rest of the brain, insensitive to the CO2-tension in arterial blood and global cerebral metabolism. Microsphere estimation of regional blood flow seems to be an appropriate technique for evaluating regional cerebral blood with a high degree of spatial resolution in repeated flow measurements.

Epicardial oxygen tensions during changes in arterial PO2 in pigs

Arterial hypoxemia decreased epicardial tissue PO2, measured by means of a multiwire surface electrode, as well as coronary venous PO2 and myocardial lactate extraction. Left ventricular blood flow increased, O2 delivery, O2 demand and O2 consumption of the left ventricle remained unchanged. Thus, epicardial and coronary venous PO2 indicated decreased capillary and interstitial PO2 rather than cellular hypoxia. A linear relation between mean epicardial PO2 and coronary venous PO2 proves both parameters equally effective in reflecting changes in myocardial tissue oxygenation. However, PO2 distribution curves provide additional information and epicardial PO2 is superior in models with regional changes of myocardial oxygenation.

Marked regional heterogeneity in blood flow within a single skeletal muscle at rest and during exercise hyperaemia in the rabbit

In 1985 both Pendergast et al. and Piiper et al. described a major regional heterogeneity in blood flow within single skeletal muscles both at rest and during exercise. Based on the microsphere method they described large variations in blood flow between muscle samples as large as 1 g each. The aims of the present study were: (1) To test this notion of regional heterogeneity in microsphere deposition within single skeletal muscles both at rest and during exercise. (2) To compare the distribution of microspheres with other blood flow tracers. (3) To test whether or not any heterogeneity was due to vasomotion in small arteries or arterioles. Microspheres were infused into anaesthetized rabbits over either 10, 30 or 120 s, or 10 min. Exercise was mimicked by tetanic contractions obtained by electrical stimulation of the motor nerves. Three hindleg muscles were divided into samples of 0.25 g each. Regional heterogeneity was expressed as the coefficient of variation corrected for statistical distribution of microspheres (CVc). The CVc at rest was about 0.34. The CVc was unaffected by the various infusion periods and did not change during exercise. Simultaneous infusions of microspheres and 86Rb+ or antipyrine gave high correlations between the two blood flow tracers, with all r values exceeding 0.83 (n = 18). We conclude that the microsphere method provides reliable estimates for regional blood flow within single skeletal muscles. The distribution of blood flow was markedly heterogeneous both at rest and during exercise. The heterogeneity in blood flow was apparently not a result of vasomotion.

Errors in bone blood flow measured with microspheres due to sample preparation technique

An experiment was carried out to examine the effect of boiling the carcass on the subsequent microsphere content of the skeleton. Intracardiac injections of radioactive microspheres were made in five rabbits and the animals killed humanely. The tibia and femur were then removed from one lower limb by dissection, and from the other after boiling it in a pressure cooker. The mean radioactivity in the bones was significantly less following boiling: 61% (SD 14) of the control tibia and 56% (SD 11) of the control femur. As a methodological check, the radioactivity in the bones of left and right legs was compared after both had been removed by boiling. In three animals, the mean activity (left compared with right) was 101% (SD 6) in the tibia and 100% (SD 3) in the femur. Boiling the carcass led to a substantial reduction in the microsphere content of the bones and cannot be recommended as a method of sample preparation for quantitative bone blood flow work.

Fåhraeus-Vejlens effect: margination of platelets and leukocytes in blood flow through branches

The distribution of platelets and leukocytes was studied in tube flow at T-junctions. The diameters were 200 microns for the main channel and 100 microns for the side branch, or 100 microns and 80 microns, respectively. The concentrations of platelets and leukocytes in the blood collected from the side branch and in the blood from the reservoir were measured using blood samples with different levels of fibrinogen. The concentration of platelets in the blood from the side branch was found to be about 1.2-1.5 times higher than in the reservoir. This ratio was found dependent on the feed hematocrit and fibrinogen concentration. The concentration of leukocytes in the blood from the side branch was about 0.9-1.4 times the value of the blood in the reservoir depending slightly on the fibrinogen concentration.

Experimental methods in the pathogenesis of limb ischemia

Ischemia of extremities is responsible for considerable morbidity and mortality and the pathophysiology of this condition warrants further study. The purpose of this review is to discuss techniques used in the evaluation of limb ischemia and reperfusion. It is of critical importance to study limb blood flow distribution to the microcirculation where nutritive exchange occurs. Skeletal muscle ischemia progresses to infarction when critical deficits of cellular metabolites develop, which mandates that studies be focused at the cellular level. It is clear that the adverse effects of ischemia can be exacerbated by a reperfusion injury to the endothelium of the microvasculature. Investigators wishing to study limb ischemia have a wide spectrum of methodology and established models available to use in improving the understanding of the complex events of ischemic injury.

Cochlea and heart as end-organs in small vessel disease

Many studies have been done recently to determine the role of various stresses on the heart and peripheral vasculature. Although damage to coronary arteries and renal vessels has been well described, the ear as an end-organ in small vessel disease has been largely neglected. In a previous study, we examined the effects of noise, hypertension, and an atherogenic diet on the microvasculature of the cochleas in rats. The present study examines the effects of these stresses on the hearts of the same rats. The technique used to examine microvascular blood flow was the injection of unlabeled microspheres prior to killing. We found that the blood flow in the cochleas was reduced significantly in hypertensive animals exposed to noise or an atherogenic diet compared to that of normotensive or hypertensive control animals. The hearts of such animals, however, showed decreased myocardial blood flow only when compared to those of normotensive control animals, not when compared to those of hypertensive control animals.

Impaired adrenal vascular response to hemorrhagic hypotension by an adreno-femoral venous shunt

We studied the influence of an adreno-femoral venous shunt on the regional blood flow in the dog adrenal gland during hemorrhagic hypotension. An adreno-femoral venous shunt was placed transperitoneally in the left adrenal gland while the animal was under pentobarbital anesthesia. The right adrenal gland was left intact. Hemorrhagic hypotension was induced at 50 mm Hg mean arterial blood pressure for 1 hr in six dogs and the other six dogs served as normotensive controls. Nonradioactive microspheres (2 X 10(6), 15 +/- 2 micron) were injected into the ventricle. The adrenal cortical and medullary blood flows were estimated by microscopic counting of the microspheres in the serially sectioned adrenal gland. The total adrenal blood flow (sum of the cortical and medullary blood flows) of two methods was compared; the microsphere method vs timed venous sampling through the shunt. In the intact right adrenal gland, the cortical blood flow was significantly decreased, but the medullary blood flow remained unchanged during hemorrhagic hypotension. Subsequently the total adrenal blood flow was not significantly decreased. In the cannulated left adrenal gland, both the cortical and medullary blood flows were significantly decreased and adrenal vascular autoregulation was inhibited. The total adrenal blood flow calculated by the microsphere method showed a significant correlation with that by timed venous sampling through the shunt. These results indicate that the adrenal medullary vasculature autoregulates during hemorrhagic hypotension and that an adreno-femoral venous shunt abolishes this vascular response.

Overall hemodynamic pattern in coarctation of the abdominal aorta in conscious rats

This study was designed to examine the total body hemodynamics of abdominal aortic coarctation hypertension. The study quantitates both regional and organ blood flow and resistance in conscious rats both above and below an experimentally produced coarctation. The experimental group consisted of 10 male Sprague-Dawley rats with a mean pressure gradient of 68 mm Hg across the coarctation. This experimental group was compared with a group of eight control rats with no pressure gradient. Flow measurements were made with radioactively labeled microspheres 4 weeks after aortic constriction. This aortic coarctation produced an increase in cardiac index (22%) and total peripheral resistance (19%). Blood flow through tissues proximal to the coarctation was not different from control; vascular resistance was increased (31%). Flow through the tissues distal to the coarctation was increased (16%); vascular resistance was decreased (-22%). The upper carcass, diaphragm, and brain were the tissues most representative of flow above the coarctation, and the lower carcass and large intestine were the tissues most representative of flow below the coarctation. Coarctation of the aorta produced cardiac hypertrophy and increased microsphere shunting to the lungs.

Comparison of thermal clearance measurement of regional cerebral blood flow with radiolabelled microspheres

A thermal clearance technique for measuring cerebral blood flow is described and compared with the radiolabelled microsphere technique. The thermal technique involves measurement of the rewarming curve generated after bolus infusion of 4-5 ml of ice-cold saline into the common carotid artery with a subdural thermistor placed on the parietal cortex. Evaluation of the biexponential decay curves obtained with this technique demonstrated a close correlation with total hemispheric, parietal, and parietal gray blood flow determined by simultaneous microsphere measurement. Despite significant correlations (p less than 0.001), scatter in the data produced a broad 95% confidence interval, thus making interpretation of blood flow with the thermal clearance technique impossible. Furthermore, instrumentation with the thermal probe, which required opening of the dura, blunted the cerebral blood flow response to hypercapnia. We conclude that the major limitations of the thermal clearance technique include: nonhomogeneous clearance function, significant variability, and depression of CO2 reactivity. These limitations must be addressed before this technique can be used reliably in the laboratory.

Distribution of different sized microspheres in experimental hepatic tumours

The extent of embolization of different sized radioactive microspheres in experimental tumours and the homogeneity of their distribution in normal liver was examined in 25 rats. The ratio of arterially introduced microspheres lodging in tumour tissue compared to the surrounding normal hepatic parenchyma was measured for 15, 32.5 and 50 microns diameter tracer microspheres. The mean tumour to liver arterial perfusion ratio (T/L) for 15 and 32.5 microns spheres was approximately 3:1 in both cases and there was no significant difference between these values (P greater than 0.05). However, 50 microns microspheres did not preferentially lodge in malignant tissue (mean T/L ratio 1:1). The homogeneity of distribution of microspheres embolizing in the normal liver tissue was assessed for each microsphere size. As microsphere diameter increased from 15 to 50 microns, microspheres lodged more evenly throughout the liver substance. For 15 microns microspheres the coefficient of variation was 55.5% +/- 8.3 and 32.5 microns microspheres distributed with a coefficient of 35% +/- 16.8 while 50 microns spheres distributed most evenly with a coefficient of 19.7% +/- 6.8.

Myocardial extraction and retention of 2-iododesmethylimipramine: a novel flow marker

An ideal deposition marker for measuring regional flow is completely extracted during transcapillary passage and permanently retained. beta-Labeled desmethylimipramine ([3H]DMI) is a nearly ideal flow marker. To obtain gamma- and positron-emitting markers, DMI was iodinated to form 2-iododesmethylimipramine (IDMI). IDMI was more lipophilic than DMI. In isolated saline-perfused rabbit hearts its transorgan extraction was greater than 99%; and retention was greater than 98% at 5 min at mean flows of up to 3.5 ml X g-1 X min-1. During washout, the fractional escape rate was less than 0.1% X min-1 and was independent of flow. In isolated blood-perfused rabbit hearts, extraction was still 98%, but retention was as low as 86% after 5 min at a flow of 1.6 ml X g-1 X min-1. The fractional escape rate was up to 2% X min-1 but independent of flow. Despite this relatively rapid loss, regional IDMI deposition remains proportional to regional flow for many minutes. Therefore IDMI is useful as an externally detectable "molecular microsphere" for myocardial flow imaging in vivo.

Effects of fluid-percussion brain injury on regional cerebral blood flow and pial arteriolar diameter

The effects of two levels of fluid-percussion brain injury on cerebral blood flow (CBF) and pial arteriolar diameter were investigated in cats. Regional CBF was measured using the radioactive microsphere technique. Experimental brain injury resulted in changes in arterial blood pressure, CBF, and pial arteriolar diameter that were related to the severity of the injury. Low-level injury (1.88 +/- 0.11 atm, mean +/- standard error of the mean) resulted in a slight transient increase in CBF which had returned to preinjury levels by 30 minutes. High-level injury (2.68 +/- 0.19 atm) resulted in larger, statistically significant (p less than 0.01) increases in whole-brain CBF, decreases in cerebrovascular resistance, and increases in pial arteriolar diameter 1 minute postinjury. One hour after injury, CBF had returned to preinjury levels while cerebral perfusion pressure was significantly (p less than 0.01) reduced. There was no evidence of reduced CBF in any region studied. Pial arterioles dilated during the posttraumatic hypertensive period and then returned to control diameters within 1 hour after injury. Changes in the diameter of pial arterioles were significantly correlated with posttraumatic changes in CBF.

A comparison between regional cerebral blood flow measurements obtained in human subjects using 11C-methylalbumin microspheres, the C15O2 steady-state method, and positron emission tomography

Regional cerebral blood flow (rCBF) values were measured in nine normotensive subjects with known previous myocardial infarctions using 15 mu 11C-methylalbumin microspheres and positron emission tomography (PET). Microspheres were injected directly into the left ventricle of each subject during routine cardiac angiography and blood flow calibrated using the reference sample technique. rCBF values were compared with those obtained for a group of fifteen age-matched normal controls using the C15O2 steady-state inhalation technique. Using 1 cm radius circular regions of interest, the 11C-microspheres approach yielded mean blood flow values of 51 ml/100 ml/min and 48 ml/100 ml/min for regions of interest dominated by temporal and frontal cortical grey matter respectively. An rCBF value of 32 ml/100 ml/min was obtained for regions of interest dominated by frontal white matter. Mean rCBF values obtained for these regions using the C15O2 method were not significantly different (52 ml/100 ml/min, 44 ml/100 ml/min, and 28 ml/100 ml/min respectively), but the C15O2 approach gave a significantly lower rCBF value than the 11C-microspheresfor regions of interest dominated by occipital grey matter. Although the two groups of subjects studied were not strictly equivalent, the good agreement between blood flow values obtained using the 11C-microspheres and the C15O2 techniques is of interest, and suggests that the assumptions of the C15O2 steady-state approach do not lead to large errors in practice.

Hypoxia results in an increase in total systemic shunt flow in dogs

There is considerable evidence to indicate that blood flow to many organs changes in response to hypoxia. However, since blood may traverse nutrient capillaries or be shunted through precapillary arteriovenous channels, measurements of total organ blood flow alone may not accurately reflect microcirculatory adaptations to hypoxia. To test this hypothesis, we determined the effect of controlled normoxic ventilation (PO2 = 86.4 +/- 2.8 Torr; N = 10) and controlled hypoxic ventilation (PO2 = 45.9 +/- 1.0 Torr; N = 5) on cardiac output, nutrient blood flow and total systemic shunt flow in dogs using radiolabelled 15 micrometers microspheres. The microspheres were injected from left heart catheters in each animal and total systemic shunt flow was estimated from the radioactivity present in pulmonary artery reference samples. Cardiac output, as well as nutrient blood flow to the heart and brain, was similar in both hypoxic animals and normoxic controls. Although we could detect no significant changes in nutrient blood flow to the remaining organs in response to hypoxia, total systemic shunt flow increased from a baseline value of 4.4% of cardiac output to a maximum value of 7.9% of cardiac output in hypoxic animals compared to 2.3% of cardiac output in normoxic animals at a similar time point (P less than 0.01). This hypoxia-induced increase in total systemic shunt flow may contribute to the overall decline in organ function often observed in this setting.

The microsphere method facilitates statistical assessment of regional blood flow

When microspheres are injected into the circulation, they are trapped in the arteriolar or capillary system within various organs. It has been confirmed in animal experiments that the number of microspheres in a myocardial sample approximately follows a Poisson distribution, under adequate experimental conditions. On the basis of this result, we arrived at the following hypothesis: When regional blood flow is measured under a steady state by the reference sample method, the 95% relative error can be approximated by +/- 196 square root 1/v + 1/w, where v and w represent the number of microspheres in blood sample and myocardial sample, respectively. The equation is valid if v and w are greater than 400 and 49, respectively. We obtained an expression of the relation among the percent of increase or decrease in regional blood flow being verified, the probability of increase or decrease, as a statistically significant variation and the number of microspheres in a myocardial sample. An investigator can work out an approximate experimental design using this expression. For instance, when the increase in regional blood flow required for verification is expected to be 20% and he wants this increase to be verified by 90%-probability and as a statistically significant increase, he can predict from this expression that the number of microspheres in a myocardial sample should be 472 and 567 before and after the experimental intervention on the coronary circulation, respectively. The expression is useful as index for experiments involving use of the microsphere method.

Radial distribution of white cells during blood flow in small tubes

The radial distribution of white blood cells (WBC) in blood flowing through glass tubes (i.d. 69 micron) was studied as a function of wall shear stress (range 0.1-2.5 Pa) and suspending medium (plasma, buffered saline, high-molecular-weight dextran solution). It was found that, irrespective of the choice of suspending medium, the highest leukocyte flux at high shear stresses was found in the tube center. WBC redistribution was seen upon lowering the shear stresses: A significant shift of WBC flux toward the marginal fluid layers occurred at the expense of the axial region. After replacement of plasma by other media the flow-dependent redistribution of WBCs was qualitatively unaffected. However, suspension of cells in dextran solution (inducing strong red cell aggregation) resulted in enhanced WBC margination, while in saline (no red cell aggregation) axial accumulation was accentuated. The results support the concept of size-dependent radial distribution of particles in flow of mixed suspensions. If applied to the living microcirculation, the data serve to explain WBC margination in microvessels (the first step in the series of events leading to emigration) in terms of a hydrodynamic phenomenon resulting from red cell/white cell interaction. The pronounced flow dependence of WBC margination results primarily from the effect of shear on red cell aggregation which leads to an alteration of the effective particle size distribution in the flowing blood.

Tissue blood flow and localization of arteriovenous anastomoses in pigs with microspheres of four different sizes

Using microspheres of 10, 15, 25 and 35 micron diameters we have compared blood flows to a large number of tissues and the complete distribution of common carotid arterial blood in an attempt to localize the site of arteriovenous shunting in anaesthetized pigs. Blood flow values obtained with the spheres of the four sizes were similar in the brain, heart, kidneys, skeletal muscles, stomach, small and large intestines, spleen, adrenals, liver, bones, fat and salivary glands. In the ears and skin from several regions, blood flow measured with 35 micron spheres was substantially higher than those measured with smaller spheres. Blood flow pattern in the eye and tongue was such that 10 micron flow value was moderately less and the 25 and 35 micron values were only slightly higher than the corresponding 15 micron value. These data indicate that a considerable number of arteriovenous anastomoses, large enough to let microspheres of up to 25 micron pass through, are present in the ears and skin. Only smaller arteriovenous anastomoses may be present in the eyes and tongue. This conclusion is supported by the observation that 5-hydroxytryptamine, which causes constriction of arteriovenous anastomoses, negated the difference in the blood flows measured with 15 and 35 micron spheres in the ears and skin.

The radiolabeled microsphere technique in gut blood flow measurement--current practice

Measurement of blood flow to the gut has become an integral part of the physiologic study of the gastrointestinal tract. While many methods have been utilized in measuring tissue blood flow, the one most often practiced today is dependent on injection of radioactively labeled microspheres. The theoretical basis of the microsphere technique is analogous to that of the indicator-dilution method. A bolus of microspheres suspended in a suitable vehicle is injected into the left atrium or left ventricle where they mix uniformly with the oxygenated blood. They are then distributed via aortic blood flow to the capillary beds within each organ in proportion to the volume of microsphere-containing blood. Technical aspects of tissue processing, gamma energy detection, and gamma spectrum analysis are reviewed. Sources of experimental error and techniques for their reduction are also discussed.

Interscapular brown adipose tissue blood flow in the rat. Determination with 133xenon clearance compared to the microsphere method

The xenon clearance method was adapted to continuous measurement of interscapular brown adipose tissue (ISBAT) blood flow in anesthetized rats. The ISBAT-blood partition coefficient for xenon was determined to 3.6 ml X g-1. The blood flow values obtained by Xe clearance were compared with flow values obtained concomitantly by the microsphere technique in 17 cold acclimated rats, at ISBAT blood flows between 0.1 and 6 ml X g-1 X min-1. Variations in blood flows were obtained by infusion of noradrenaline at different rates. The blood flow values obtained from the xenon clearance method showed a close correlation to the blood flow values determined with microspheres. Y = 0.98. X + 0.15 (r = 0.96, P less than 0.001). The Xe clearance method has the advantages compared to the microsphere technique that it permits continuous monitoring of the blood flow and does not require the sacrifice of the animal.

Measurement of cochlear blood flow--new technique

A newly-developed procedure which combines the microsphere method with surface preparation dissection was employed in an investigation of blood flow in cochleas of anesthetized gerbils. In these experiments, 10.1 +/- 0.9 microns carbon-coated microspheres were injected into the left auricle of the heart and a reference blood sample withdrawn at 0.165 ml/min from the iliac artery. The blood flow in the lateral portion (stria vascularis, ligamentum spirale, and suprastria) was calculated to be 337.20, 184.00 and 24.75 nl/min; in the spiral portion (basilar membrane, lamina spiralis ossea, and limbus spiralis) it was found to be 85.40, 39.55 and 6.10 nl/min; and in the central portion (modiolus) it was found to be 256.55, 43.60 and 2.45 nl/min in the first, second and third turns, respectively. The total blood flow in the left and right membranous cochleas was 1062.70 and 896.60 nl/min, respectively. Averaged total blood flow in both ears was 979.60 nl/min. This is a first attempt to measure blood flow in the very small, functionally different areas of the cochlea. This work has shown that it is possible to measure and compare blood flow between the turns and between different functional parts within the turns.

Plasma-soluble marker for intraorgan regional flows

Measurement of regional plasma flow is needed to quantitate the delivery of substrates and drugs to cells. For estimating regional plasma flows an ideal deposition marker should be 100% extracted during transorgan passage and retained until local tissue concentrations can be measured. To escape quickly, the tracer must penetrate capillary endothelial cells rapidly. To be retained, it must bind or be transformed or accumulated by cells. Desmethylimipramine (DMI, mol wt 266.3), a norepinephrine reuptake inhibitor, is suitable. On injection of [3H]DMI and 131I-albumin simultaneously into the coronary artery inflow of isolated Ringer-perfused rabbit hearts at 37 degrees C, extractions were greater than 99% at plasma flows (Fs) up to 2.3 ml X g-1 X min-1 and greater than 94% with Fs up to 5.1. Retention at Fs less than 2.3 averaged 99.0 +/- 0.55% (SD, n = 6) at 0.5 min, 98.4 +/- 0.5% at 1 min, and 96.6 +/- 1.1% or greater than 95% at 3 min. Retentions were similar in two dog hearts in situ. With Fs greater than 3 ml X g-1 X min-1, there was greater escape, 4.2 +/- 2.7% at 1 min and 6.8 +/- 4.2% at 3 min. The fractional escape rates of loss at 2 min or more were about 1%/min at all flows, suggesting that the spatial profiles of deposition did not change thereafter. Thus DMI is nearly ideal as a "molecular microsphere."

Stimulation by glucose of the blood flow to the pancreatic islets of the rat

Blood flow to the pancreatic islets of the rat was estimated with the microsphere technique. Experiments with microspheres of different sizes (diameter 10, 15 or 50 micron) showed that optimal results were obtained with 10-micron spheres. Localization of microspheres either within or outside the islets was accomplished by freeze-thawing of the pancreas, making it transparent, so that both islets and microspheres could be distinguished in dark field illumination. Thus, microscopic examination of the freeze-thawed pancreas allowed the microspheres to be counted separately in both the endocrine and exocrine parenchyma. Under basal conditions, pancreatic blood flow was calculated as 0.60 ml X min-1 X g-1 (w/w). The islets accounted for about 10% of the total pancreatic blood flow, corresponding to 0.069 ml/min per whole pancreas. A bolus dose of glucose increased pancreatic blood flow to 0.75 ml X min-1 X g-1 (p less than 0.05), while the fractional islet blood flow rose to 15.1% (p less than 0.001) corresponding to 0.125 ml X min-1 X pancreas-1 (p less than 0.001). The glucose-induced increase in pancreatic blood flow mainly resulted from increased flow to the pancreatic tail, while the corresponding increase in islet blood flow was uniformly distributed throughout the pancreas. Injection of the non-metabolizable glucose-derivate. 3-0-methyl-D-glucose, affected neither the pancreatic nor the islet blood flow. The data indicate that the islets receive more of the pancreatic blood flow than would be accounted for by their relative volume and that glucose preferentially stimulates blood flow to the islets.

A simple cutter for fresh tissue to facilitate the investigation of intramyocardial blood flow with tracer microspheres in cats and rabbits

Tracer microspheres (TM) allow the measurement of regional tissue blood flow. For this purpose the tissue must be cut into the regions selected for measurements. We describe a simple tissue cutter, that greatly facilitates accurate and reproducible cutting of fresh tissue. We have demonstrated its usefulness for obtaining measurements of myocardial blood flow in different layers of the left ventricular free wall of hearts of anesthetized cats and conscious rabbits. Since complete trapping of the TM is essential for blood flow measurements by this method, we investigated the minimal TM size needed by comparing results obtained with different size microspheres. 25 and 15 micrometer TM were trapped equally well by all layers of the left ventricle, but TM smaller than 15 micrometers were not trapped completely. From the size distribution of the 7-10 micrometer TM, we estimated that the functional diameter of the largest capillaries was somewhat smaller (about 7.6 micrometer) in the subepicardial (epi) than in the subendocardial (endo) layer (7.9 micrometer) in both species. When measured with 15 micrometer TM, intramyocardial distribution of blood flow was comparable to that reported for dogs and sheep. In open chest cats, the endo/epi ratio was 1.25 and 1.28, and in conscious rabbits it was 1.35. We conclude that TM with diameters between 10 and 15 micrometers are suitable for measuring intramyocardial blood flow in cats' and rabbits' hearts, and that unlike in dogs and sheep, 7-10 micrometer TM cannot be used.

Blood flow rates in canine cortical and cancellous bone measured with 99Tcm-labelled human albumin microspheres

Regional differences in bone blood flow rates in the femur and the tibia of dogs were measured with 99Tcm-labelled microspheres. The measurements show an average flow rate of 3.7 ml (100 g)-1 x min-1 in cortical bone. A more rapid pace was found in red marrow containing areas, with an average flow rate in the femoral head of 19.7 ml blood (100g)-1 x min-1, and in the femoral neck of 50.3 ml blood (100 g)-1 x min-1. In the calcar femorale the average flow rate was 9.0 ml (100 g)-1 x min-1, and compared to cortical flow a positive correlation between strain and perfusion seems obvious. No difference between cortical bone in tibia and femur was found. The flow rates in the red marrow of the femoral neck are remarkably high, but the flow in the cortical bone is relatively low. It is concluded that handling of fragments of cortical bone and the associated soft tissue is presumably critical, and that the surgical technique has to be quite gentle to obtain optimal conditions for fracture healing.

Distribution of blood flow in the dog kidney. III. Local uptake of 10 mum and 15 mum microspheres during renal vasodilation and constriction

Recent studies indicate that intrarenal distribution of blood flow measured with microspheres (Ms) during control conditions depends on Ms size. We therefore compared local flow in outer and middle cortex (C1 and C2) and inner cortex plus the medulla (C3M) using 10.5-12.0 and 13.9-15.0 mum Ms (Ms 10 and Ms 15). One pair of Ms 10 and Ms 15 was injected during control and a second pair at 80% increased or 50% decreased total renal vascular conductance (RVC), as induced by infusion of acetylcholine (Ach) and angiotensin II (Ang) or noradrenaline (NA). All zones participated in dilation and constriction, as indicated by both Ms sizes. Ms 15 underestimated C3M flow as compared to Ms 10, by 19% during control or Ang, and by 3% during Ach (P less than 0.02). The C3M flow fractions increased during Ach and decreased during Ang, whereas NA gave greatly variable results, on average no change. Renal Ms extraction averaged 97.0 +/- 3% for Ms 10, 98.6 +/- 2.4% (S.D.) for Ms 15. About 8% of Ms 10 and less than 1% of Ms 15 were located in peritubular capillaries in each cortical zone. Neither total Ms extraction nor zonal extraglomerular Ms fraction changed over the present RVC range. Thus, the Ms 10 to Ms 15 differences as well as the observed redistribution must be due to differences in local entry of Ms into the afferent arterioles. However, steric restriction of Ms at arteriolar inlets did not play a significant role. The measured redistribution of fractional flow could in part be due to skimming of Ms at arteriolar inlets along the interlobular arteries (i.l.a.), depending on the C3M flow fraction, Ms size and i.l.a. diameter. If the observed fractional flow redistributions were solely due to variable Ms skimming, Ms 15 underestimated C3M flow by 53%, Ms 10 by 43%, during Ang as compared to Ach. Although Ms 10 and Ms 15 may correctly indicate the direction of fractional glomerular flow redistribution, at least Ms 15 overestimates this phenomenon quantitatively.

Blood flow distribution in the left ventricular free wall in open-chest dogs

The distribution of blood flow in various layers of the normally perfused left ventricular free wall was studied in open-chest dogs, using 15-micrometer radioactive microspheres. The most pronounced variations were found in epicardial blood flow, which was higher near the apex than near the base and lower along the marginal branch of the left circumflex coronary artery than along the left interventricular coronary artery. The variations in endocardial blood flow were less pronounced, while blood flow in the middle layers was about equally distributed. Consequently the endo/epicardial blood flow ratios varied over the left ventricular free wall. Possible causes of the inhomogeneities in blood flow distribution are discussed.

The effect of a xanthine derivative, 1-(5' oxohexyl)-3-methyl-7-propylxanthine (HWA 285), on heart performance and regional blood flow in dogs and rabbits

1. The effect of a new xanthine derivate 1-5' oxohexyl-3-methyl-7-propylxanthine (HWA 285) was studied on heart performance in dogs and rabbits and on regional blood flow in rabbits. 2. Heart performance (cardiac output and dP/dt max) in dogs was increased. Cardiac work (calculated as CO x mean BP) was not changed in dogs and did not change or was slightly decreased in rabbits. Heart rate was increased in dogs and unchanged in rabbits. 3. Blood pressure decreased slightly in dogs, and more markedly in rabbits. Total peripheral resistance was decreased in both species. 4. Regional blood flow (studied by use of 15 micrometers labelled microspheres) was increased in the heart, brain and skeletal muscle; the increase was dose-dependent in the range 0.3, 1.0 and 3.0 mg HWA 285 per kg intravenously. The highest dose produced a 2 fold decrease in the peripheral resistance in the brain, a 2.5 fold decrease in the heart and 4 fold decrease in skeletal muscle. 5. The drugs preferentially dilated small (7 to 10 micrometers) rather than larger (12 to 17 micrometers) arterioles; 9 micrometers microspheres were found in the outflowing blood after application of the drug, and the calculated blood flow increases were smaller, or absent, as compared with values obtained with 15 micrometer microspheres.

Effects of hypothermia, hemodilution, and pump oxygenation on organ water content, blood flow and oxygen delivery, and renal function

Hypothermia, hemodilution, and the pump-oxygenator each contribute important effects during cardiopulmonary bypass. We studied their separate effects with a 2(3) factorial, completely fixed experimental design in 16 adult male mongrel dogs. Animals undergoing hypothermia were cooled to 25 degrees +/- 1 degree C. In dogs having hemodilution, hematocrit was adjusted to 25 +/- 2%. An analysis of variance was used to determine the effects of hypothermia, hemodilution, and pump oxygenation. The experiments show that hemodilution produces increased water content in tissue and that edema is greatest in heart and gastrointestinal organs. The pump-oxygenator decreased flow to the subendocardium, whereas hemodilution increased subendocardial flow. Both hypothermia and pump oxygenation diminished flow to the outer kidney cortex, and hemodilution augmented flow to this region. Hypothermia and pump oxygenation decreased and hemodilution raised renal free-water clearance. Although none affected glomerular filtration rate, hypothermia increased filtration fraction while hemodilution diminished it. Hypothermia lessened cerebral cortical flow, an effect opposite that of hemodilution. Thus, hemodilution opposes the adverse effect of hypothermia or pump oxygenation on blood flow, oxygen delivery, or renal function. Increased water content in gastrointestinal organs and myocardium accompanies the beneficial vascular and renal effects of hemodilution.

Indirect evidence against a role of the kinin system in the renal hemodynamic effect of captopril in the rat

The effects of acute saralasin (SAR) and captopril (SQ) administration on arterial pressure (AP), plasma renin activity (PRA), urinary excretion of water and electrolytes, glomerular filtration rate (GFR), renal blood flow (RBF), and glomerular blood flow (GBF) distribution (microsphere technique) were assessed in rats with activation of the renal renin and kallikrein systems (that is, chronic sodium depletion). In both groups AP decreased, and PRA and RBF increased markedly. Blood flow to outermost (C1) glomeruli was (in nl/min/g of kidney wt) 270 +/- 35 in SAR and 219 +/- 20 in the SQ group (NS when compared to 208 +/- 9 in control chronically sodium-depleted rats). Blood flow to innermost glomeruli (C4) strikingly increased from 95 +/- 10 (control) to 216 +/- 21 (SAR) and 180 +/- 13 (SQ group). Hence, preferential vasodilatation of innermost glomeruli occurred (C1/C4 ratio of 2.18 +/- 0.27 in control, 1.26 +/- 0.11 in SAR, and 1.25 +/- 0.07 in SQ rats). Chronic (6 days) administration of SQ was associated with a rapid and marked increase in water and sodium excretion. At the end of the study, RBF was higher than control, and GBF distribution was similar to that observed in acutely treated rats (C1/C4 ratio of 1.16 +/- 0.10). These results suggest that angiotensin plays a significant role in the systemic and renal hemodynamic changes associated with chronic sodium depletion. The similarity of the changes induced by SAR and SQ provides an indirect evidence against an effective role of the renal kallikrein system in the effect of captopril.