15. 脳血管攣縮時のsingle photon emission tomography によるクリプトンイメージ

概要

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Three dimensional analyses of local carebral blood flow were made in patients with cerebral vasospasm. The instrument used was single photon emission tomography (PHO/GAMMA LFOV, E Shimazu Co. Ltd. Japan) and an on-line data processing system (Scintipac 1200). The cases comprised seven patients with cerebral vasospasm after aneurysmal surgery. 81mKr in 5% glucose was continuously infused just above the aortic valve by means of a 81Rb-81mKr generator. The results were as follow : 1) Local hypoperfusions were recognized in six patients, who revealed a low density area in the affected region by follow-up XCT. 2) Local hyperemia was noticed in only one patient, who revealed hemorrhagic infarction in the identical cerebral region. 3) After hypervolemic and hypertensive therapy, overall 81mKr activities were increased. However, local hypoperfusion was not specifically improved. 4) After hyperventilation, three dimensional display of cerebral blood flow revealed a decrease in relation to hypocarbia. Three dimensional analysis of cerebral blood flow is useful to grasp the pathophysiology and to decide effective therapeutic principles in patients with cerebral vasospasm.