Japanese
Title99mTc-ECDの動脈血中挙動および脳集積と脳血流量との関係
Subtitle原著
Authors宍戸文男*, 上村和夫*, 村上松太郎*, 犬上篤*, 小川敏英*, 日向野修一*, 藤田英明*, 下瀬川恵久*, 菅野巖*, 相沢康夫*, 長田乾**, 小野幸彦***
Authors(kana)
Organization*秋田県立脳血管研究センター放射線科, **神経内科, ***内科
Journal核医学
Volume29
Number1
Page27-35
Year/Month1992/1
Article原著
Publisher日本核医学会
Abstract「要旨」99mTc標識局所脳血流分布診断薬として, 99mTc-HM-PAOが臨床に利用されている. これに対して, 標識の安定性, 軟部組織への取り込み, 血中クリアランスなどの点で優れた薬剤として, 99mTc-ECDが開発され, 第2相臨床治験が行われた, 今回, 15O-steady state法による脳血流量・酸素消費量の測定と, 99mTc-ECDによるSPECTが同時に可能であった脳血管障害の9症例を対象に, 99mTc-ECDの動脈血中挙動および99mTc-ECDの脳集積と脳血流量との関係を検討した. その結果, 99mTc-ECDの動脈血中からの消失は速やかであること, 動脈血中の99mTc-ECDの酢酸エチル抽出分画は急速に減少すること, 脳組織の5-32分後と60-87分後の99mTc-ECD集積の比は脳血流量と無関係であり, 大脳皮質の領域による差異もみられないこと, 99mTc-ECD集積と脳血流量とは相関があるものの直線関係とはなっていないこと, 99mTc-HM-PAOと同様な考えで, 99mTc-ECD集積を血流量と直線的な関係になるような補正が可能であること, などが明らかとなった. しかし, luxury perfusionを示す症例では99mTc-ECDイメージがPETによる脳血流量イメージよりも酸素消費量イメージに類似していた. 以上の結果から99mTc-ECD集積と脳血流量とは関連が強く, 脳血管障害ばかりでなく, 広く脳疾患の脳血流分布の診断に臨床上有用な薬剤と考えられた. しかし, 脳血管障害の一部の病態では脳血流量よりも脳代謝を直接的に表現する可能性があり, 本薬剤の集積メカニズムと病態および脳血流代謝量との関連についての検討がさらに必要と考えられた.
Practice臨床医学：一般
KeywordsTc-99m ECD, SPECT, PET, CBF, CMRO2.
English
TitleArterial Clearance and Cerebral Uptake of Tc-99m ECD in Patients with Cerebrovascular Disease Compared with PET
SubtitleOriginal Articles
AuthorsFumio SHISHIDO*, Kazuo UEMURA*, Matsutaro MURAKAMI*, Atsushi INUGAMI*, Toshihide OGAWA*, Shuichi HIGANO*, Hideaki FUJITA*, Eku SHIMOSEGAWA*, Iwao KANNO*, Yasuo AIZAWA*, Ken NAGATA**, Yukihiko ONO***
Authors(kana)
Organization*Department of Radiology and Nuclear Medicine, **Department of Neurology, ***Department of Internal Medicine, Research Institute for Brain and Blood Vessels-Akita
JournalThe Japanese Journal of nuclear medicine
Volume29
Number1
Page27-35
Year/Month1992/1
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]Technetium-99m ethyl cysteinate dimer (ECD) has recently developed for SPECT imaging in assessment of cerebral perfusion. We evaluated the arterial blood clearance and the regional brain uptake of Tc-99m ECD compared with the regional CBF measured by PET in patients with cerebrovascular disease. Nine patients with diagnosis of cerebral ischemic disorders (N=7) and cerebral hemorrhage (N=2) were studied. PET study was performed with HEADTOME IV by O-15 steady state inhalation method. Immediately after the PET study, 555-740 MBq (5-20 mCi) of Tc-99m ECD was injected intravenously. After injection arterial blood sampling was performed sequentially, and we separated lipophilic fraction from whole blood using ethyl acetate in two cases. The SPECT imaging with Tc-99m ECD (ECD-SPECT) was started 5 min (first imaging) and 60 min (second imaging) after the administration using a high resolution ring type SPECT system (HEADTOME II). Several ROIs were placed on practically the same anatomical location on both SPECT and PET images. Clearance of the tracer in arterial whole blood and lipophilic fraction was rapid. Concerning to the distribution pattern of ECD-SPECT images there was no differences between the 1st imaging and the 2nd imaging, although about 15% of diffuse decrease of Tc-99m ECD uptake was shown in the 2nd images. The brain distribution of ECD-SPECT was comparable to the pattern of CBF image by PET. The regional relative counts of ECD-SPECT corresponded closely to the CBF value by PET, but it was no linear correlation between brain uptake of ECD-SPECT and PET-CBF. This non-linear correlation was similar to the relation between the brain uptake of Tc-99m HM-PAO and PET-CBF. In a patient with subacute cerebral infarction ECD-SPECT image was similar to CMRO2 image rather than CBF image.
PracticeClinical medicine
KeywordsTc-99m ECD, SPECT, PET, CBF, CMRO2.

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