Observational studyEuropean radiology experimental2026
Effect of body position on cerebral perfusion: a comparison of supine and seated positions assessed using conventional and upright CT perfusion.
Observational study in European radiology experimental, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivePostural changes influence systemic hemodynamics and may affect cerebral perfusion; however, quantitative evaluation remains limited in vivo under physiological gravitational conditions. We aimed to assess posture-dependent alterations in cerebral perfusion using upright multidetector computed tomography perfusion (CTP), with whole-brain cerebral blood flow (CBF) as the primary outcome. MATERIALS AND
methodsThis was a single-center observational study of healthy volunteers approved by the institutional review board. Eighteen volunteers underwent CTP imaging in both the supine and seated positions on the same day using two 320-row multidetector CT scanners with identical systems. Whole-brain CBF was defined as the primary endpoint. Mean transit time (MTT) and cerebral blood volume (CBV) were evaluated as secondary outcomes. Paired comparisons were performed between postures, and exploratory analyses assessed regional changes and interindividual variability.
resultsWhole-brain CTP-derived CBF was significantly higher in the seated position than in the supine position (32.9 ± 6.0 [mean ± standard deviation] versus 29.2 ± 5.6 mL/100 g/min; p = 0.010), representing a 1.15 ± 0.19-fold increase. CTP-derived MTT was significantly shorter in the seated position (4.25 ± 0.61 versus 4.63 ± 0.72 s; p = 0.035), and CTP-derived CBV showed a modest but significant increase (2.23 ± 0.16 versus 2.16 ± 0.17 mL/100 g; p = 0.044). Regional perfusion changes were consistent across brain segments with interindividual variability in postural responses.
conclusionsUpright CTP detected posture-associated differences in whole-brain CTP-derived perfusion metrics, suggesting potential utility for investigating physiological and pathological alterations in cerebral hemodynamics associated with postural change. RELEVANCE STATEMENT: Upright CTP enables physiological evaluation of posture-related cerebral hemodynamics under gravitational loading and may provide new insights into cerebral circulation in both health and disease. KEY POINTS: Whole-brain cerebral blood flow increased by 15% in the seated position compared with supine using upright CT perfusion. Mean transit time shortened by 7% and cerebral blood volume increased modestly by 4% in the seated position. Perfusion responses showed marked interindividual variability, suggesting different physiological adaptations to posture.
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