Japanese
Title99mTc-HMPAO SPECTによる局所脳血流量測定の試み : 133Xe全脳血流量の併用
Subtitle原著
Authors井坂吉成*,**, 飯地理**, 今泉昌利**, 芦田敬一**, 糸井良仁*
Authors(kana)
Organization*国立大阪病院画像診断部, **総合内科
Journal核医学
Volume29
Number12
Page1463-1473
Year/Month1992/12
Article原著
Publisher日本核医学会
Abstract「要旨」無症候7例, 虚血性脳血管障害12例において, 133Xe静注法による大脳平均血流量と99mTc-HMPAO SPECTによる大脳平均カウントから局所脳血流量 (regional cerebral blood flow, rCBF) を算出した. SPECT-CBFと133Xe-CBFの相関は大脳半球 (r=0.993;p<0.001), 小脳半球 (r=0.901;p<0.001) のいずれにおいても非常に高かった. Lassenの3コンパートメントモデルにより, HMPAOの逆拡散を補正した場合は, 補正なしの場合と比較して, 大脳半球SPECT-CBFの133Xe-CBFとの相関は有意差は認めなかったが (r=0.978;p<0.001), 小脳半球における相関は低下した (r=0.726;p<0.001). 11例における左右前頭葉, 側頭葉, 後頭葉, 基底核, 視床血流量の再現性の検討では, 2回目測定と1回目測定の相関係数の平均は0.834 (0.757〜0.910), 変動平均は-1.4% (-3.4〜1.1%) であった. 局所脳血流量は, 基底核, 視床, 前頭葉, 側頭葉の順に高かった. Lassenの補正式を用いた場合, 局所脳血流は補正なしの場合と比較して約20%増しであったが, CBF値の相関係数, 変動程度はほぼ同様であった. 本法は, 方法が簡便なこと, 測定時間が短いこと, 非侵襲的で133Xe-CBFとの相関が非常に高く再現性も良好なことから, HMPAO-SPECTの前に大脳CBF測定が行える施設であれば, 広く臨床応用が可能と考えられた.
Practice臨床医学：一般
KeywordsCerebral blood flow, 99mTc-HMPAO, 133Xe, ISI, SPECT.
English
TitleQuantification of Regional Cerebral Blood Flow Using 99mTc-HMPAO SPECT and intravenous 133Xe Injection Method
SubtitleOriginal Articles
AuthorsYoshinari ISAKA*,**, Osamu IIJI**, Masatoshi IMAIZUMI**, Keiichi ASHIDA**, Yoshihito ITOI*
Authors(kana)
Organization*Department of Diagnostic Radiology, **Department of Internal Medicine, National Osaka Hospital
JournalThe Japanese Journal of nuclear medicine
Volume29
Number12
Page1463-1473
Year/Month1992/12
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]We converted an absolute value of 133Xe-CBF (initial slope index, ISI) to the three dimensional CBF-SPECT using the intravenous 133Xe injection technique and 99mTc-HMPAO SPECT according to the microsphere model (method A), and the three compartment model described by Lassen et al. (method B): f/fr=(C/Cr) (A) f/fr=α・(C/Cr)/[1+α-(C/Cr)] (B) where f=flow in the region of interest (ROI), fr=flow in the reference region, C=count density of 99mTc-HMPAO SPECT in the ROI, Cr=count density of 99mTc-HMPAO SPECT in the reference region, and α=conversion to clearance ratio of HMPAO. We used α value of 1.5, and the whole cerebrum as a reference region. Four asymptomatic subjects and 15 patients with ischemic cerebrovascular disease were entered the study. In method A, excellent correlation was seen between ISI and SPECT-CBF in both of the cerebral hemisphere (r=0.993; p<0.001, n=38) and the cerebellar hemisphere (r=0.901; p<0.001, n=38). When back diffusion of HMPAO was corrected by method B, correlation coefficient of SPECT-CBF with ISI was equivalent to that in method A in the cerebrum (r=0.978; p<0.001, n=38), while the correlation coefficient ih the cerebellum was lowered (r=0.726; p<0.001, n=38) although high flow to low flow ratio was increased. Reproducibility of rCBF assessed 1 week apart from the first CBF-SPECT was highly reproducible in all of the brain regions; correlation coefficient ranged from 0.757 to 0.910 with a mean correlation coefficient of 0.834 (n=11). The slope and intercept of the linear regression line between 2nd rCBF versus 1st CBF were 0.889 (range, 0.791-1.141) and 5.5 (range, -9.1-13.4), respectively. Regional CBF measured by method B was approximately 20% increase from that measured by method A. However, there was no significant difference in the reproducibility of rCBF between the two methods. Our results indicate that rCBF can be simply and noninvasively quantified using 99mTc-HMPAO SPECT and absolute unit of CBF measured by 133Xe injection technique. SPECT-CBF offers high resolution images and may be applicable for various cerebrovascular disorders in routine clinical use.
PracticeClinical medicine
KeywordsCerebral blood flow, 99mTc-HMPAO, 133Xe, ISI, SPECT.

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