<原著>^<99m>Tc-HM-PAOを用いた脳血流定量測定法の検討と臨床応用
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概要
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This study investigated a new method of measuring regional cerebral blood flow (rCBF), using ^<99m>Tc-HM-PAO SPECT. Mean CBF (mCBF) was measured by the Patlak plot method and rCBF was calculated by Lassen's correction algorithm, as Matsuda et al. reported. The cerebral hemisphere was used as the reference region for Lassen's correction. The reference RI count rate was calculated from one slice at the basal ganglia level and correction factor α was fixed at 2.0. Consequently, rCBF could be measured more easily than by utilising Matsuda's method. The contribution of age, laterality and gender to the CBF of normal subjects was studied. Furthermore, CBF change was evaluated after acetazolamide injection in patients with cerebral vascular disease and during hyperventilation in patients with partial epilepsy. The mCBF value of 26 normal subjects was 53.8 ± 6.4 ml/100g/min and showed a significant correlation with advancing age (R=-0.644,p=0.0004,n=26). The mean value for rCBF of the cerebellum, frontal area, temporal area, occipital area and parietal area were 77.3±6.6ml/100g/min, 70.2±9.1 ml/100g/min, 72.3±7.5 ml/100g/min, 71.8±6.2 ml/100g/min and 77.3±6.6ml/100g/min respectively. Each of the above listed regions, except for the occipital area demonstrated a significant correlation with advancing age. The most remarkable decrease of rCBF with age was discerned in the frontal area (R=0.757,p=0.0001,n=26). There were no gender differences or laterality in mCBF or respective rCBF values. The increase in CBF after 1.0g acetazolamide administration was evaluated in 7 patients with ischemic cerebral vascular disease. The increase in mCBF on the affected side in 3 patients with unilateral occlusive vascular pathology was significantly lower than that on the unaffected side (p<0.01). In addition, reduced cerebrovascular reserve capacity was observed regionally on the affected side in those 3 patients by SPECT imaging. The decrease in CBF during hyperventilation was evaluated during interictal phase in 7 patients with partial epilepsy. During hyperventilation, CBF was reduced by 13.4±4.1 ml/100g/min (22.0±4.5%). There was no significant difference in the reduction of CBF between 4 patients with "build up" phenomenon on electroencephalogram and 3 patients without it. Under normal conditions, focal hypoperfusion on SPECT imaging was present in 4 of 7 patients, and in 6 patients during hyperventilation. These results suggest that this new method of measuring CBF in a quantitative manner is very useful for a variety of clinical studies.
- 近畿大学の論文
- 1994-03-25
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