| Japanese |
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| Title | Diamox負荷99mTc - ECD脳血流SPECTによる心臓大血管手術患者の脳循環予備能の検討 |
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| Subtitle | 原著 |
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| Authors | 松村要*, 中島弘道*, 田中國義**, 北野外紀雄*, 村嶋秀市*, 竹田寛*, 湯浅浩**, 矢田公**, 中川毅* |
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| Authors(kana) | |
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| Organization | *三重大学医学部放射線科, **胸部外科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 3 |
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| Page | 223-231 |
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| Year/Month | 1996/3 |
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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」体外循環を用いた心臓大血管手術予定患者の術前検査として99mTc-ECDによるdiamox負荷脳血流SPECTを施行し, 術中脳合併症の高リスク患者の検出の可能性について検討した. 冠動脈疾患, 大動脈瘤等の患者18人に99mTc-ECD静注後baseline SPECTを行い, 続いてdiamox静注後, 再度99mTc-ECDを投与し, 負荷後SPECTを行った. 負荷前後SPECT画像より求めた局所カウントより, カウント変化率を計算し, 脳循環予備能を推定した. 18例中3例に術後脳梗塞が見られたが, それらの術前脳循環予備能は低下していた. この経験より, その後の本検査により脳循環予備能の低下が示された3例にて体外循環中の脳灌流圧の高値維持などの積極的な脳保護を行ったところ, 脳合併症は見られなかった. 本法は心臓大血管手術時の脳合併症高リスク患者の術前検出に簡便, 実用的で, 有用な方法であると思われた. |
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| Practice | 臨床医学：一般 |
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| Keywords | 99mTc-ECD SPECT, Cardiopulmonary bypass, Cerebral damage, Cerebral perfusion reserve, Diamox. |
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| English |
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| Title | Presurgical Evaluation of Cerebral Perfusion Reserve in Patients for Cardiovascular Surgery Using 99mTc - ECD SPECT with Diamox Enhancement |
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| Subtitle | Original Articles |
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| Authors | Kaname MATSUMURA*, Hiromichi NAKASHIMA*, Kuniyoshi TANAKA**, Tokio KITANO*, Shuichi MURASHIMA*, Kan TAKEDA*, Hiroshi YUASA**, Isao YADA**, Tsuyoshi NAKAGAWA* |
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| Authors(kana) | |
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| Organization | *Department of Radiology, **Department of Thoracic Surgery, Mie University School of Medicine |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 3 |
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| Page | 223-231 |
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| Year/Month | 1996/3 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative 99mTc-ethyl cysteinate dimer(ECD)SPECT and acetazolamide(diamox)enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox(1g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures. |
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| Practice | Clinical medicine |
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| Keywords | 99mTc-ECD SPECT, Cardiopulmonary bypass, Cerebral damage, Cerebral perfusion reserve, Diamox. |
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