| Japanese |
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| Title | 連続撮像法によるDiamox負荷99mTc - HMPAO SPECTにおける変化率図の有用性 |
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| Subtitle | 原著 |
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| Authors | 山本尚幸* |
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| Organization | *喜多医師会病院放射線科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 4 |
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| Page | 399-408 |
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| Year/Month | 1996/4 |
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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」連続撮像Diamox負荷99mTc-HMPAO SPECTは優れた検査法であるが, 安静時血流分布の影響, 放射化学的純度の補正等の問題がある. 本研究では本法で脳循環予備能を評価するために血流変化率を画像化する方法を考案し有用性を検討した. 変化率図は, 平均全脳カウント比で補正をした負荷後SPECTを安静時像で除して得た. 7名の患者に本法と131Xe SPECTを行い, 脳血流変化率の左右比を比較すると, 両者は強い相関を示した(r=0.89, p<0. 01). 脳血管造影と対比した慢性脳血管障害53名で, 安静時像, 減算像, 変化率図のすべてに左右差がない25名中に脳血管造影で高度狭窄を示した例はなく, 減算像, 変化率図のみで左右差を認めた7例中3例で脳主幹動脈の高度狭窄を認めた. また4例は安静時像, 減算像で左右差があるが変化率図では左右差はなく, 血流と代謝が共に低下した状態と考えられた. 変化率図は脳循環予備能評価法として簡便かつ有用であると考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | SPECT, Cerebral blood flow, 99mTc-hexamethylpropyleneamine oxime(HMPAO), Brain perfusion reserve, Acetazolamide. |
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| English |
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| Title | Usefulness of Change Ratio Map in 99mTc - HMPAO SPECT with Acetazolamide Enhancement |
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| Subtitle | Original Articles |
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| Authors | Naoyuki YAMAMOTO |
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| Authors(kana) | |
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| Organization | Department of Radiology, Kita-ishikai Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 4 |
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| Page | 399-408 |
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| Year/Month | 1996/4 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | [Summary]Although a sequential 99mTc-HMPAO SPECT technique with Diamox test(seq-SPECT)is a simple and time-saving procedure to assess brain perfusion reserve, the influence of the first dose of the tracer on the second one is not negligible. Therefore, a subtraction of the rest-SPECT from the 2nd SPECT is widely-used. However, subtracted SPECT images not only need to be corrected for the injected dose and the radiochemical purity due to inherent instability of HMPAO but also are usually degraded in quality. This study was undertaken to resolve these problems utilizing a change ratio(CR)map. The CR map was obtained by dividing 2nd SPECT by rest-SPECT. Prior to subtraction, the 2nd SPECT was normalized with the ratio of the mean whole brain counts between both SPECTs. To validate CR map, 7patients were studied with both seq-SPECT and 133Xe inhalation CBF measurement(Xe-CBF). The right to left count ratio obtained from the ROIs placed on MCA territory of CR map correlated well with that from Xe-CBF(r=0.89, p<0.01). Fifty-three patients with stroke underwent the seq-SPECT which was compared with the cerebral angiography(CAG)and classified into 4 groups according to the CR map. In 25 patients, all of the rest-, the subtracted-SPECT and the CR map did not show any difference between the affected side and the contralateral normal side. Seven patients with normal rest-SPECT showed decreased subtracted-SPECT counts and CR on the affected side. Three of them showed more than 75% stenosis on CAG. Four patients with the decreased counts both at the rest- and the sub-tracted-SPECT revealed no difference on the CR map suggesting the matched decrease of both blood flow and metabolism in the affected side. In conclusion, the CR map was a simple and useful method to evaluate the brain perfusion reserve with the seq-SPECT. |
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| Practice | Clinical medicine |
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| Keywords | SPECT, Cerebral blood flow, 99mTc-hexamethylpropyleneamine oxime(HMPAO), Brain perfusion reserve, Acetazolamide |
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