Japanese
Title脳血管障害における局所脳循環代謝の変化 - ポジトロンCTによる検討 -
Subtitle原著
Authors宍戸文男*, 上村和夫*, 犬上篤*, 小川敏英*, 山口龍生*, 菅野巖*, 三浦修一*, 飯田秀博*, 村上松太郎*, 高橋和弘*, 佐々木広*, 田川皓一**, 安井信之***
Authors(kana)
Organization*秋田県立脳血管研究センター放射線医学研究部, **神経内科学研究部, ***脳神経外科学研究部
Journal核医学
Volume23
Number2
Page123-134
Year/Month1986/2
Article原著
Publisher日本核医学会
Abstract「要旨」ポジトロンCTと15O標識ガスを用いて, 中大脳動脈域に脳梗塞の確認された症例および正常者の局所脳組織の血流量, 酸素摂取率, 酸素消費量, 血液量を測定した. 梗塞巣では発症直後から1週以内では"misery perfusion"を示し, その後, 1週から4週後には血流のみが回復する"luxury perfusion"の状態を呈した. 梗塞巣はこの過程を経て, 2か月以後になると血流量も酸素消費量も同程度の低下を示し, 梗塞巣として機能障害が固定してしまう, という血流代謝の経時的変化が観察された. 脳梗塞の急性期においてX線CTで低吸収域として示される領域は血流量が12ml/100ml/min以下, 酸素消費量が1.5ml/100ml/min以下であった. また中大脳動脈域の脳梗塞より対側の中大脳動脈域, 患側の視床, 対側の小脳半球, 脳幹部の血流代謝が影響を受けることも観察し得た. さらに局所の血液通過時間についても言及した.
Practice臨床医学：一般
KeywordsPositron CT, Cerebral ischemia, Regional cerebral blood flow, Regional cerebral metabolism, Diaschisis.
English
TitleCerebral Circulation and Metabolism in Cerebral Infarction of Middle Cerebral Artery Territory - A Positron CT Study with HEADTOME III and 15O Labeled Gases -
SubtitleOriginal Articles
AuthorsFumio SHISHIDO*, Kazuo UEMURA*, Atsushi INUGAMI*, Toshihide OGAWA*, Tatsuo YAMAGUCHI*, Iwao KANNO*, Shuuichi MIURA*, Hidehiro IIDA*, Matsutarou MURAKAMI*, Kazuhiro TAKAHASHI*, Hiroshi SASAKI*, Kouichi TAGAWA**, Nobuyuki YASUI***
Authors(kana)
Organization*Department of Radiology and Nuclear Medicine, **Department of Neurology, ***Department of Neurosurgery, Research Institute of Brain and Blood Vessels-Akita
JournalThe Japanese Journal of nuclear medicine
Volume23
Number2
Page123-134
Year/Month1986/2
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractRegional cerebral blood flow (rCBF), oxygen metabolism (rCMRO2), oxygen extraction fraction (rOEF) and blood volume (rCBV) were measured with a high performance positron CT (HEADTOME-III) and the 15O labeled gas steady-state method. Seven normal volunteers and 13 patients with ischemic infarction located in the territory of unilateral middle cerebral artery (MCA) were subjected to the positron CT measurement. In the present study, over estimation of rOEF and rCMRO2 were corrected by rCBV using the principle described by Lammertsma and Jones. From these paremeters we also calculated an rCBV/rCBF which meant regional blood transient time of cerebral vessels (rTT). Early ischemic lesions showed two types of uncoupling between rCBF and rCMRO2. Patients studied within the 5th day of the onset showed high rOEF with low rCBF in the infarcted forcus (misery perfusion). About a week after onset rOEF was changed into low level with decreased rCMRO2 and recovered rCBF, and the change lasted to a month after onset recovered rCBF, and the change lasted to a month after onset (luxury perfusion). Then, about two months later, the lesions gradually went to matched change of rCBF and rCMRO2 (coupled perfusion). These changes of rCBF and rCMRO2 described above will reveal the natural course of ischemic brain tissue with acute onset. It was also proved that there was positive correlation between rTT and rOEF. A parameter of rTT will be important to presume rOEF from a single photon emission CT measurement, which has not been able to study oxygen metabolism but could measure rCBF and rCBV. The threshold levels of rCBF and rCMRO2 for morphological tissue damages assessed as a low density area on a X-ray CT were clinically estimated from the present study. The thresholds evaluated in patients within a day of onset, were 12ml/100ml/min, and 1.5ml/100ml/min for rCBF and rCMRO2, respectively. In the present series about unilateral MCA infarction, significant but mild decrease of rCBF and rCMRO2 with normal rOEF were also noted in the structurelly normal brain tissues as follows ; contralateral MCA territory, ipsilateral thalamus, contralateral cerebellar hemisphere, and brainstem. These decrease were considered to be caused by the diaschisis.
PracticeClinical medicine
KeywordsPositron CT, Cerebral ischemia, Regional cerebral blood flow, Regional cerebral metabolism, Diaschisis.

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