Japanese
Title虚血性脳血管障害における99mTc - HM - PAOの静注後超早期ダイナミックSPECTの臨床的有用性の検討 - 低灌流病変および高灌流病変の検出について -
Subtitle原著
Authors外山宏*, 竹下元*, 柴田香織*, 野村昌代*, 藤原寿照*, 石川恵美子*, 藤原道明*, 藤井直子*, 江尻和隆*, 前田寿登*, 片田和廣*, 竹内昭*, 古賀佑彦*
Authors(kana)
Organization*藤田保健衛生大学医学部放射線医学教室
Journal核医学
Volume33
Number5
Page521-529
Year/Month1996/5
Article原著
Publisher日本核医学会
Abstract「要旨」虚血性脳血管障害を対象として, 99mTc-HM-PAOの脳内分布が決定する前の静注後超早期にダイナミックSPECTを行い, 低灌流病変や, 高灌流病変の診断上の有用性について検討した. 99mTc-HM-PAO925〜1,480 MBqを約1分間にて定速静注し, 静注開始30秒後, 12秒1フレームで2分間のダイナミックSPECT, 静注10分後にスタティックSPECTを施行し, 健側と比較した. 6例の慢性期一側性主幹部脳動脈閉塞症ではスタティック画像よりもダイナミック画像の方が全例患側の低灌流のコントラストが良好であった. スタティック画像で高集積を認めた5例の亜急性期脳梗塞では, ダイナミック画像で3例が高集積(高灌流), 2例が低〜等集積(低〜等灌流)を示し, いずれもスタティック画像においてhyperfixationが認められた. 静注後超早期ダイナミックSPECTは, 脳からの逆拡散や亜急性期脳梗塞巣への水溶性物質の蓄積の影響が少ない真の脳血流に近い画像として有用と考えられた.
Practice臨床医学：一般
Keywords99mTc-d, 1-hexamethyl-propyleneamine oxime(99mTc-HM-PAO), Single photon emission computed tomography(SPECT), Dynamic SPECT, Hyperfixation, Luxury perfusion.
English
TitleEvaluation of the Clinical Usefulness of Super Dynamic 99mTc - HM - PAO SPECT in Ischemic Cerebrovascular Disease - Detection of Hypo - and Hyperperfusion Area -
SubtitleOriginal Articles
AuthorsHiroshi TOYAMA, Gen TAKESHITA, Kaori SHIBATA, Masayo NOMURA, Toshiteru FUJIWARA, Emiko ISHIKAWA, Michiaki FUJIWARA, Naoko FUJII, Kazutaka EJIRI, Hisato MAEDA, Kazuhiro KATADA, Akira TAKEUCHI, Sukehiko KOGA
Authors(kana)
OrganizationDepartment of Radiology, Fujita Health University
JournalThe Japanese Journal of nuclear medicine
Volume33
Number5
Page521-529
Year/Month1996/5
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
Abstract[Summary]The purpose of this study is to assess the clinical usefulness of super dynamic SPECT of 99mTc-HM-PAO. Six patients with unilateral occlusion of middle cerebral artery(MCA)or internal carotid artery(ICA)in the chronic phase, and 5 patients with subacute cerebral infarction were studied. We used a ring-type SPECT "HEADTOME. " Two types of collimator were used : a high sensitivity(HS)collimator for super dynamic scan and a high resolution(HR)collimator for static scan. First, the intravenous constant infusion of 99mTc-HM-PAO(925-1480 MBq)for 1 minute was started. After 30 seconds from the beginning of the injection, we performed the 12 seconds/frame super dynamic SPECT for 2 minutes. Then, the static SPECT for 10minutes was done. For semiquantitative analyses, differential percentage of regional activity between affected and non-affected hemispheres was calculated in the 6th frame image of super dynamic SPECT and static SPECT image. In all 6 patients with unilateral occlusion of MCA and ICA, super dynamic SPECT images showed the better contrast of low perfusion areas in comparison with the static SPECT images. In 5 patients with subacute cerebral infarction who showed focal hyperactivities on static SPECT, focal hyperactivities(hyperperfusion or hyperemia) were displayed in 3 cases, whereas, focal hypo-or isoactivities(hypo-or isoperfusion)were shown in 2 cases on super dynamic SPECT. However, all patients with subacute cerebral infarction showed hyperfixation on static SPECT as compared with super dynamic SPECT. Although the image quality on super dynamic SPECT is not as high as that on static SPECT, cerebral hemodynamics would be detected with less backdiffusion of 99mTc-HM-PAO from the brain to blood, and with less accumulation of hydrophilic components in subacute infarct region. In conclusion, super dynamic SPECT in early distribution of 99mTc-HM-PAO using dedicated SPECT device might be helpful to detect cerebral perfusion close to true cerebral blood flow distribution.
PracticeClinical medicine
Keywords99mTc-d, 1-hexamethyl-propyleneamine oxime(99mTc-HM-PAO), Single photon emission computed tomography(SPECT), Dynamic SPECT, Hyperfixation, Luxury perfusion.

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