Japanese
Title99mTc-DTPA-HSA {テクネチウムヒト血清アルブミンD (99mTc)} の脳血管障害における臨床的応用 - 主として脳循環予備能の評価について -
Subtitle原著
Authors西澤貞彦*,†, 玉木長良*, 米倉義晴*, 藤田透*, 小西淳二*, 阿部光幸*, 福山秀直**, 三好稔彦**, 原田清**, 名村裕弘**, 山内浩**, 石川正恒***, 山形専***, 永田泉***, 菊池晴彦***
Authors(kana)
Organization*京都大学医学部放射線科・核医学科, **神経内科, ***脳神経外科, †現;天理よろづ相談所病院放射線科
Journal核医学
Volume25
Number11
Page1189-1200
Year/Month1988/11
Article原著
Publisher日本核医学会
Abstract「要旨」 脳神経疾患26例にテクネチウムヒト血清アルブミンD(99mTc)注射液(99mTc-DTPA-HSA)を用いた脳RIアンギオグラフィー(RNA)およびSPECTを行い, PETによる脳循環代謝あるいは123I-IMPによる脳血流分布と対比し, その有用性を検討した. 片側性の脳動脈主幹部閉塞症あるいは強度狭窄症では14例中13例でRNAによる閉塞の予測が可能であったが, 両側性閉塞あるいは片側性狭窄の4例では異常は描出されなかった. 脳動脈奇形, 静脈性血管腫ではSPECTで異常血管腔が明瞭に認められた. SPECTにおいて内頸動脈閉塞症あるいは強度狭窄症3例で病側大脳半球の血液量増加が見られ, これらの症例ではPETにより血流の低下, 血液量の増加および酸素摂取率の上昇が認められた. 血液量の増加が見られた中大脳動脈閉塞の1例では血流の低下はなく, 酸素摂取率にも異常を認めなかった. 脳血流に低下が見られても血液量の増加の認められない症例では酸素摂取率の上昇は見られなかった. 99mTc-DTPA-HSAはRNAによる脳動脈主幹部閉塞の非侵襲的な補助診断に加え, SPECTによる脳血液量の評価に有用で, それにより脳循環予備能の検討が可能となり, その臨床的意義は大きいものと考えられる.
Practice臨床医学：一般
Keywords99mTc-DTPA-HSA, Cerebrovascular disease, Single photon emission computed tomography, Positron emission tomography, Radionuclide angiography
English
TitleClinical Evaluation of 99mTc-DTPA-HSA in Patients with Cerebrovascular Diseases : Assessment of Perfusion Reserve with SPECT
Subtitle
AuthorsSadahiko NISHIZAWA*, Nagara TAMAKI*, Yoshiharu YONEKURA*, Tohru FUJITA*, Junji KONISHI*, Mitsuyuki ABE*, Hidenao FUKUYAMA**, Toshihiko MIYOSHI**, Kiyoshi HARADA**, Yasuhiro NAMURA**, Hiroshi YAMAUCHI**, Masatsune ISHIKAWA***, Sen YAMAGATA***, Izumi NAGATA***, Haruhiko KIKUCHI***
Authors(kana)
Organization*Department of Radiology and Nuclear Medicine, **Department of Neurology, ***Department of Neurosurgery,Kyoto University of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume25
Number11
Page1189-1200
Year/Month1988/11
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] Clinical usefulness of 99mTc-DTPA-HSA was assessed in 26 patients with cerebral diseases using radionuclide angiography (RNA) and single photon emission computed tomography (SPECT). Positron emission tomography (PET) was also done in 11 cases with occlusion of unilateral cerebral major vessel (CMV) and SPECT with N-isopropyl-[123I]p-iodoamphetamine (IMP) was performed in 19 cases. RNA detected abnormality in 13 out of 14 cases with occlusion of unilateral CMV but failed to detect in 4 cases with unilateral stenosis or bilateral occlusion of CMV. Eight cases without occlusion or stenosis of CMV showed normal RNA. All of 3 cases with arteriovenous malformation and venous angioma showed abnormality with SPECT. CBV images obtained with SPECT showed a good agreement with those of PET. In SPECT studies, 3 cases with occlusion of unilateral CMV showed increased cerebral blood volume (CBV) in the affected cerebral hemisphere with decreased cerebral blood flow (CBF). In these 3 cases, PET studies revealed increased oxygen extraction fraction (OEF) in the affected side. Cases with decreased CBF in affected hemisphere demonstrated normal OEF without CBV abnormality. One case with occlusion of CMV showed increased CBV in affected hemisphere without decreased CBF. PET demonstrated the same finding in CBF and CBV with normal OEF. In 2 cases, PET revealed increased OEF in the bilateral cerebral hemisphere which were not detected by SPECT. In cases with occlusion of unilateral CMV, increased OEF was predicted by increased CBV with decreased CBF. The combined use of CBF and CBV SPECT is a valuable tool for assessment of perfusion reserve in cerebrovascular diseases.
PracticeClinical medicine
Keywords99mTc-DTPA-HSA, Cerebrovascular disease, Single photon emission computed tomography, Positron emission tomography, Radionuclide angiography

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