Japanese
TitleポジトロンCTを用いたモヤモヤ病の局所脳循環代謝に関する研究
Subtitle《原著》
Authors桑原康雄*
Authors(kana)
Organization*九州大学医学部放射線科学教室
Journal核医学
Volume23
Number10
Page1381-1402
Year/Month1986/10
Article原著
Publisher日本核医学会
Abstract「要旨」: ポジトロンCTを用いてモヤモヤ病の脳循環代謝について検討した. 小児両側慢性例では小脳や線条体を除く大脳半球の広範な血流および酸素消費量の低下, 小児両側初期例では両側の前頭葉あるいは側頭葉から後頭葉での血流低下と酸素摂取率の上昇, 小児一側初期例では一側の大脳半球の広範な血流低下と酸素摂取率の上昇, 成人例では前頭葉や頭頂葉を中心とする血流と酸素消費量の低下が特徴的な所見と考えられた. 血液量の増加はいずれのグループでもみられたが, 小児例の前頭葉および線条体から視床で目立った. さらにポジトロンCTによる病期分類を試みたが, 脳血管撮影による病期分類と良く相関した. 手術前後での比較では, EC-IC bypass周囲の皮質での血流量の増加と線条体での血液量の減少がみられるものがあった. また, ポジトロンCTでは脳血流が低下し, 酸素摂取率の上昇している部位を明らかにできるため, 術前検査としても有用であると考えられた.
Practice臨床医学：一般
KeywordsMoyamoya disease, Positron emission computed tomography, Cerebral blood flow, Cerebral metabolic rate of oxgen, Cerebral blood volume.
English
TitleEvaluation of Regional Cerebral Circulation and Metabolism in Moyamoya Disease Using Positron Emission Computed Tomography
SubtitleOriginal Articles
AuthorsYasuo KUWABARA
Authors(kana)
OrganizationDepartment of Radiology, Faculty of Medicine, Kyushu University
JournalThe Japanese Journal of nuclear medicine
Volume23
Number10
Page1381-1402
Year/Month1986/10
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] : Regional cerebral blood flow, oxygen extraction fraction, metabolic rate of oxygen, blood volume and transit time were evaluated in 11 patients with moyamoya disease and 3 with suspected moyamoya disease using positron emission computed tomography. Eight of them were examined before and after EC-IC bypass surgery. Moyamoya patients were classified into four groups, namely, pediatric bilateral chronic type (over 5 years from onset) , pediatric bilateral early type (within 5 years from onset) , pediatric unilateral early type and adult type, according to age, duration of disease from onset and angiographic findings. These four groups showed different patterns on PET images ; diffusely decreased CBF and CMRO2 in pediatric bilateral chronic type, decreased CBF and increased OEF in the frontal or temporo-parietal region in pediatric bilateral early type, diffusely decreased CBF and increased OEF in the unilateral cerebral hemisphere in pediatric unilateral cerebral hemisphere in pediatric unilateral early type, and decreased CBF and CMRO2 in adult type. An increase of rCBV was demonstrated in frontal regions or basal ganglia in all groups, more prominently in pediatric patients. This was thought to be a common finding in moyamoya disease, corresponding to moyamoya vessels. Staging of moyamoya disease by PET was presented and compared to the angiographic staging. They were significantly correlated, and the stage 3 on PET image with decreased CMRO2 corresponded to the stage 3 or 4 on angiography, the most active stage of moyamoya disease. PET revealed increased CBF in the cortical area around EC-IC bypass but no remarkable changes in mean values of rCBF, OEF, CMRO2 and CBV in cerebral hemisphere. Some patients showed decreased rCBV in the basal ganglia. Development of transdural collaterals from STA seemed to be correlated with preoperative PET findings. Since PET can demonstrate area of decreased rCBF and increased rOEF, it is very useful for decision of EC-IC bypass surgery.
PracticeClinical medicine
KeywordsMoyamoya disease, Positron emission computed tomography, Cerebral blood flow, Cerebral metabolic rate of oxgen, Cerebral blood volume.

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