Japanese
TitleSPECTによる閉塞性脳血管障害の脳循環予備能評価 - Diamox反応性とCrossed cerebellar diaschisisの所見による判定 -
Subtitle原著
Authors菅原敬文*
Authors(kana)
Organization*愛媛大学医学部放射線医学教室
Journal核医学
Volume32
Number3
Page287-299
Year/Month1995/3
Article原著
Publisher日本核医学会
Abstract「要旨」SPECTによる閉塞性脳血管障害の脳循環予備能評価についてDiamox反応性とcrossed cerebellar diaschisis (CCD) の所見から検討した. 対象は慢性期53症例で, 局所脳血流測定は133Xe吸入法, CCDの評価には99mTc-HMPAO SPECTを用いた. Diamox反応性の低下は53例の患側65領域中32領域 (49%) でみられ, 手術例では術後にその改善がみられた. 健側でも40領域中21領域で血流低下がみられたが, 反応性は保たれていた. また, 予備能の改善に比し血流の改善は乏しかった. CCD (+) 群では患側大脳半球の脳循環予備能がCCD (-) 群に比し有意に保たれており, 負荷前後での大脳半球の血流比の変化とCCDの程度との間には有意な相関がみられた (r=-0.794, p<0.01). Diamox負荷SPECTは, 慢性閉塞性脳血管障害の脳循環予備能評価, 手術適応および効果判定に有用であった. また, CCDに注目すれば, 大脳半球の血流低下の主因が脳灌流圧の低下にあるか脳組織活性の低下にあるかを, SPECTでも推察しうることが示唆された.
Practice臨床医学：一般
KeywordsSPECT, Occlusive cerebrovascular disease, Cerebral perfusion reserve, Diamox, Crossed cerebellar diaschisis
English
TitleSPECT Evaluation of Cerebral Perfusion Reserve in Patients with Occlusive Cerebrovascular Diseases : Evaluation with Acetazolamide Test and Crossed Cerebellar Diaschisis
Subtitle
AuthorsYoshifumi SUGAWARA
Authors(kana)
OrganizationDepartment of Radiology, Ehime University School of Medicine
JournalThe Japanese Journal of nuclear medicine
Volume32
Number3
Page287-299
Year/Month1995/3
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary] In 53 patients with chronic occlusive cerebrovascular diseases, we evaluated cerebral perfusion reserve. Cerebral perfusion reserve was evaluated by the change in cerebral blood flow (CBF) at rest and the CBF after acetazolamide (Diamox) as measured by the 133Xe gas inhalation SPECT method. Crossed cerebellar diaschisis (CCD) was evaluated semiquantitatively by the count ratio of the cerebellar cortex using 99mTc-HMPAO SPECT. Thirty-two (49%) of the 65 affected lesions in 53 patients had shown a decreased response to Diamox. In the cases of decreased response to Diamox, the response improved significantly after surgery. However, CBF did not improve as much as the response. In the 40 nonaffected sides, 21 (53%) showed decreased CBF at rest but good response to Diamox. At rest, no difference of the CBF ratio (affected/contralateral nonaffected cerebral cortex) was observed between the patients with CCD (6 pts) and those without CCD (8 pts). After Diamox, however, the CBF ratio of the patients with CCD was significantly higher than that without CCD. The change of the CBF ratio before and after Diamox correlated significantly with the degree of CCD (r=-0.794, p<0.01). Diamox was useful for evaluating the cerebral perfusion reserve to indicate surgery in patients with chronic cerebrovascular diseases. Perhaps CCD could be a useful index in the differentiation of the decreased CBF caused by reduced perfusion pressure from that caused by reduced metabolic demand because CCD had a close relationship with the cerebral perfusion reserve.
PracticeClinical medicine
KeywordsSPECT, Occlusive cerebrovascular disease, Cerebral perfusion reserve, Diamox, Crossed cerebellar diaschisis

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