Japanese
Title虚血性脳血管障害における123I-iomazenil SPECTの検討 : 123I-IMP SPECTとの比較
Subtitle原著
Authors森脇博*, 松本昌泰**,***, 橋川一雄**, 奥直彦*, 石田麻里子*, 清家裕次郎**, 藤田昌宏****, 福地一樹****, 渡邊嘉之****, 寺川晴彦***, 植原敏勇*, 西村恒彦****
Authors(kana)
Organization*大阪大学医学部放射線部, **第一内科, ***神経内科, ****トレーサ情報解析
Journal核医学
Volume33
Number6
Page587-597
Year/Month1996/6
Article原著
Publisher日本核医学会
Abstract「要旨」 新しいSPECT用中枢性ベンゾジアゼピン受容体イメージング製剤である123I-iomazenilの脳血管障害に対する臨床的検討を行った. 対象は一側主幹動脈に閉塞性病変をもつ虚血性脳血管障害15例で, 123I-IMP SPECTによる安静時脳血流像やDiamox負荷にて求めた脳循環予備能と比較した. 123I-iomazenilと安静時123I-IMPの比較では, 集積低下域は視覚的にも半定量的にも123I-IMPの方が広範囲で, また程度も高度な例が多かった. crossed cerebellar diaschisisと考えられる小脳集積の左右差は, 123I-iomazenilではほとんど認めなかった. 123I-iomazenilの集積低下例の中には, 脳循環予備能の低下を認める血行力学的脳虚血例と, 予備能の低下がないにも関わらず安静時血流が低下している例があり, 後者の一部の例では脳萎縮を伴っていた. 虚血性脳血管障害において, 123I-iomazenilの分布は神経細胞密度を反映する指標となると考えられ, 123I-iomazenil SPECTは血流とは異なる情報を提供し, 病態把握に有用と考えられた.
Practice臨床医学：一般
Keywords123I-iomazenil, Benzodiazepine receptor, Cerebrovascular disease, 123I-IMP, Cerebral perfusion reserve.
English
TitleEvaluation of 123I-Iomazenil SPECT in Patients with Ischemic Cerebrovascular Disease : Comparative Study with 123I-IMP SPECT
SubtitleOriginal Articles
AuthorsHiroshi MORIWAKI*, Masayasu MATSUMOTO**,***, Kazuo HASHIKAWA**, Naohiko OKU*, Mariko ISHIDA*, Yujiro SEIKE**, Masahiro FUJITA****, Kazuki FUKUCHI****, Yoshiyuki WATANABE****, Haruhiko TERAKAWA***, Toshiisa UEHARA*, Tsunehiko NISHIMURA****
Authors(kana)
Organization*Division of Nuclear Medicine, School of Medicine, Osaka University, **First Department of Internal Medicine, School of Medicine, Osaka University, ***Department of Neurology, School of Medicine, Osaka University, ****Department of Tracer Kinetics, School of Medicine, Osaka University
JournalThe Japanese Journal of nuclear medicine
Volume33
Number6
Page587-597
Year/Month1996/6
ArticleOriginal article
PublisherTHE JAPANESE SOCIETY OF NUCLEAR MEDICINE
AbstractClinical evaluation of 123I-iomazenil, a new imaging agent for central-type benzodiazepine receptors with SPECT, was performed in patients with ischemic cerebrovascular disease. We investigated 15 patients with angiographicallyproven severe occlusive lesions (occlusion or > 70% stenosis) in the unilateral carotid system. 123I-iomazenil SPECT images were compared with cerebral blood flow (CBF) images and the cerebral perfusion reserve, which were measured using the "split dose 123I-IMP SPECT method" before and after the intravenous injection of 1g of acetazolamide. For the detection of ischemic lesions, CBF images were superior to 123I-iomazenil images based on visual analysis. Regarding the count ratio of the affected MCA territory to the non-affected (L / N), 123I-IMP was lower than 123I-iomazenil in most of the cases. In five patients showing "crossed cerebellar diaschisis" by 123I-IMP, asymmetry of the cerebellar accumulation was observed in only one patient with 123I-iomazenil, which was less prominent than with 123I-IMP. There was no significant correlation between the L / N ratio with 123I-iomazenil and the cerebral perfusion reserve in the affected MCA territory. However, in some cases showing a decreased L / N ratio (<90%) with 123I-iomazenil, a decreased CBF with normal perfusion reserve and cerebral hemi-atrophy were observed with 123I-IMP and MRI, which suggested the influence of neuronal loss due to chronic ischemia. These results indicate that 123I-iomazenil SPECT, which provides new information regarding neuronal loss due to ischemic damage to the brain, is useful for the evaluation of ischemic cerebrovascular disease.
PracticeClinical medicine
Keywords123I-iomazenil, Benzodiazepine receptor, Cerebrovascular disease, 123I-IMP, Cerebral perfusion reserve.

【全文PDF】