Japanese
TitleH215O持続注入システムの開発およびそれによる局所脳血流測定 - 脳血管のCO2反応性を中心に -
Subtitle《原著》
Authors和田誠*
Authors(kana)
Organization*九州大学医学部放射線科学教室
Journal核医学
Volume23
Number10
Page1435-1453
Year/Month1986/10
Article原著
Publisher日本核医学会
Abstract「要旨」: 定量性, 再現性に優れ, 被曝線量が低く, 患者の負担も少ない局所脳血流測定のためのH215O持続注入システムを開発し, H215O注射液の医薬品としての検討, 臨床応用における使用条件の設定を行った. 本システムを用いた局所脳血流最測定における頭部, 動脈血中の放射能の平均変動係数はそれぞれ2.2%, 4.6%とC15O2持続吸入法, 15O2持続吸入法に比し小さかった. 大脳半球血流量の2回の測定における差異は, 短期間隔では3.4%, 長期間隔では6.8%であり, 再現性は良好であった. 13名の正常ボランティアにおける局所脳血流量を示した. 本システムによる脳血流測定は, 刺激試験を行うのに非常に有用であるので, 健常ボランティア3名, モヤモヤ病8名 (術後7名, 術前1名) の計11名にCO2負荷を行い, 脳血管のCO2反応性を検討し, 以下のような興味ある所見を得た. 健常ボランティアではpCO2 1mmHgの上昇につき皮質で5.4%, 白質で3.8%, 大脳半球平均で5.3%の血流増加が認められた. CO2反応性と安静時局所脳血流量 (rCBF) との間には正の相関があった. モヤモヤ病では, CO2反応性は低下しており, ことに成人例では, 小児例より低下していた. 部位別では健常部, 血流低下部周辺, 血流低下部, 梗塞部の順に低下していた. 大脳深部のモヤモヤ血管のCO2反応性はほぼ保たれていたが, 脳表部のモヤモヤ血管とEC-IC bypass surgeryより生じたtransdural collateralsのCO2反応性は低かった. rCBF, 局所脳酸素消費量 (rCMRO2) はCO2反応性と正の相関を, 局所脳酸素摂取率 (rOEF) , 局所脳血液量 (rCBV) は負の相関を示した.
Practice臨床医学：一般
KeywordsH215O, Cerebral blood flow, CO2 response, Moyamoya disease.
English
TitleDevelopment of the H215O Continuous Infusion System and its Clinical Application for the Measurement of Regional Cerebral Blood Flow with Special Concerns on the Cerebral Blood Flow Reactivity to Hypercapnia
SubtitleOriginal Articles
AuthorsMakoto WADA
Authors(kana)
OrganizationDepartment of Radiology, School of Medicine, Kyushu University
JournalThe Japanese Journal of nuclear medicine
Volume23
Number10
Page1435-1453
Year/Month1986/10
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] : A H215O continuous infusion system was developed, in order to measure regional cerebral blood flow (rCBF) . The quality of the H215O produced by this system was in conformity with the Kyushu University cyclotron-produced radiopharmaceutical standards and in clinical use, no side effect was observed. The working condition of this system was settled by examining the effect of cyclotron beam currents, 15O2/N2 gas bubbling rate, the saline volume in the trap vial on the H215O production, the relationship between infusion rate and infused radioactivity. The variance of the radioactivity of the subject's head and arterial blood samples using this system was smaller than that of C15O2 and 15O2 inhalation studies. The acute and long term reproducibility of measurements showed a variation of 3.4% and 6.8%, respectively. The rCBF was studied in 13 normal volunteers and patients with Moyamoya disease. The rCBF reactivity to hypercapnia was investigated in all patients with Moyamoya disease and in 3 normal volunteers, as the rCBF measurement using this system was thought to be suitable for the stimulation study, because it was accurate and reproducible, and also lightened the burden on the patients. The rCBF of normal volunteers increased 5.4% in the gray matter, 3.8% in the white matter and 5.3% in the cerebral hemisphere per 1 mmHg increase in pCO2. A positive correlation was observed between CO2 response and the rCBF at rest in each volunteer. A reduced CO2 response was observed in the cases of Moyamoya disease. This reduction was prominent in the adult patients than in the juvenile cases. CO2 response was reduced according to the order of normal area, low CBF area, border of low CBF area and area of infarction. CO2 response was severely reduced in Moyamoya vessels on the surface area of the brain and post-operative transdural collaterals, originating mainly from extra-cerebral arteries. In contrast, CO2 response was preserved in Moyamoya vessels in the deep area of the brain, originating mainly from intra-cerebral arteries. rCBF and regional cerebral metabolic rate of oxygen (rCMRO2) were found to be correlated positively and regional oxygen extraction fraction (rOEF) and regional cerebral blood volume (rCBV) negatively with CO2 response.
PracticeClinical medicine
KeywordsH215O, Cerebral blood flow, CO2 response, Moyamoya disease.

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