| Japanese |
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| Title | Tc-99m-d, l-HMPAOを用いた脳血流SPECTの検討 |
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| Subtitle | 原著 |
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| Authors | 西澤貞彦*, 米倉義晴*, 藤田透*, 千田道雄*, 小西淳二*, 石川正恒**, 福山秀直*** |
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| Authors(kana) | |
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| Organization | *京都大学医学部放射線科・核医学科, **脳外科, ***神経内科 |
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| Journal | 核医学 |
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| Volume | 24 |
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| Number | 10 |
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| Page | 1521-1528 |
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| Year/Month | 1987/10 |
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| Article | 原著 |
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| Publisher | 日本核医学会 |
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| Abstract | 「要旨」 Tc-99m-d, l-hexamethylpropyleneamine oxime (HMPAO) の臨床的有用性を検討するために, 高分解能リング型SPECT装置を用い, 各種脳疾患23例に24回のHMPAO脳血流スキャンを行い, 5時間にわたる経時的変化を観察するとともに, 同一症例においてポジトロンCTを用いた脳血流測定, あるいはIMPを用いた脳血流スキャンと比較した. HMPAOは静注後2.5分以内にほぼピークに達し, その後約1時間はごくわずかな増加を示し, 以後緩徐に減少し, 5時間後には約4%の減少を認めた. 分布パターンにはほとんど変化を認めなかった. 片側の軽度血流低下を認めた症例において, ポジトロンCT, あるいはIMPと比較したところ, HMPAOでは病変部の描出が悪く, 10-20%の血流低下を示す病変部では左右差の不明瞭な症例も認められた. 同じSPECT装置を用いて行ったIMP脳血流スキャンと比べても, 病変部と正常部, あるいは皮質と白質のコントラストは不良であった. Tc-99m-d, l-HMPAOを用いた脳血流スキャンは経時的変化がなく, 良好な画像を示し, 随時使用可能という面からは非常に有用な脳血流スキャン製剤であるが, 軽度の血流低下を示す病変部の描出性は悪く, このような症例では注意を要する. |
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| Practice | 臨床医学：一般 |
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| Keywords | Single photon emission computed tomography, Technetium-99m-d, l-hexamethyl- propyleneamine oxime, N-isopropyl-[I-123]p-iodoamphetamine, Positron computed tomography, Regional cerebral blood flow |
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| English |
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| Title | Cerebral Perfusion SPECT Using Tc-99m-d, l-HMPAO : Comparative Study with I-123 IMP and CBF Measured by PET |
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| Subtitle | Original Articles |
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| Authors | Sadahiko NISHIZAWA*, Yoshiharu YONEKURA*, Tohru FUJITA*, Michio SENDA*, Junji KONISHI*, Masatsune ISHIKAWA**, Hidenao FUKUYAMA*** |
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| Authors(kana) | |
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| Organization | *Department of Radiology and Nuclear Medicine, **Department of Neurosurgery, ***Department of Neurology, Kyoto University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 24 |
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| Number | 10 |
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| Page | 1521-1528 |
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| Year/Month | 1987/10 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary] To evaluate clinical usefulness of technetium-99m-d, l-hexamethylpropyleneamine oxime (HM-PAO) as cerebral perfusion agent for SPECT, we compared the distribution of HMPAO with that of N-isopropyl-[I-123]p-iodoamphetamine (IMP) and regional cerebral blood flow (rCBF) measured by PET. In HMPAO study, we performed serial SPECT scans until 5 hr in 7 cases, and single SPECT scan at 5 min after the injection in the other 17 cases. Among 24 cases, IMP-SPECT was performed in 9 cases and PET was done in 17 cases. All SPECT scans were performed with multi-detecter SPECT scanner. The regional distribution of HMPAO in the brain did not show major changes visually except the lesions of meningioma and arteriovenous malformation, and the regional activity showed 1% increase at 45 min and 4% decrease at 5 hr compared with the activity at 5 min. In cases with cerebral infarction, major discrepancy was not observed among 3 studies. However, in cases having mild regional hypoperfusion of less than 30% decrease in rCBF compared with the non-affected area, reduced perfusion was not clearly visualized in the HMPAO-SPECT while IMP-SPECT demonstrated the ischemic lesion with better contrast. Although HMPAO is useful to assess rCBF using SPECT with the advantage of its availability at any time, the present study raised a question about the limitation of the detectability in mild ischemia. |
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| Practice | Clinical medicine |
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| Keywords | Single photon emission computed tomography, Technetium-99m-d, l-hexamethyl- propyleneamine oxime, N-isopropyl-[I-123]p-iodoamphetamine, Positron computed tomography, Regional cerebral blood flow |
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