| Japanese |
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| Title | 99mTc-ECD RNアンジオグラフィ, SPECT, 1回動脈血採血による脳血流量の測定 |
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| Subtitle | 《原著》 |
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| Authors | 井坂吉成*, 吉川卓也*, 成田昌子*, 蘆田敬一*, 今泉昌利*, 原田稔** |
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| Organization | *国立大阪病院内科, **国立大阪病院放射線科 |
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| Journal | 核医学 |
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| Volume | 33 |
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| Number | 9 |
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| Page | 965-973 |
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| Year/Month | 1996/9 |
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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」99mTc-cysteinate dimer(ECD)を用いた簡便な脳血流量測定法を考案した. 対象は, 脳梗塞4例, 本態性高血圧症2例, パーキンソン病2例, パーキンソニズム1例, 多発梗塞性痴呆1例, 脳塞栓1例, 頭位変換性めまい1例であった. トレーサを右肘静脈からボーラス注射し, 大脳と大動脈弓における時間放射能曲線を5分間収集した. RNアンジオ終了後ただちに大腿動脈から血液1mlを採り放射能を測定後, 脳SPECTを20分間収集した. 脳動態測定は3コンパートメント2パラメータモデルを考慮し, トレーサの血中から脳への移行速度定数K1, 血液中で脂溶性から水溶性に変換される速度定数(k5), 脳, 血液脂溶性トレーサ, 血液水溶性トレーサのコンパートメントを仮定した. 脳への入力関数は大動脈弓における時間放射能曲線を血液試料の放射能, トレーサ静注5分後の大動脈弓カウントからμCi/ml単位に, 脳への出力関数は大脳における時間放射能曲線とSPECT放射能からμCi/100ml単位で表し, 最小二乗法またはグラフプロット法でパラメータを算出した. 133Xe全脳血流量(Fa)を測定し, K1との相関, ECDの全脳における摂取率(extraction, E)を測定した. 本法によって求めたパラメータは, K1=0.21±0.05(ml/ml/min), k5=0.66±0.15(/min), E=0.65±0.15であった. K1とFaとの直線回帰式は, K1=0.53Fa+3.7(rs=0.91; p<0.01)で強い相関関係が認められた. 本法は, 従来の脳血流量測定法に比較して侵襲度が低く, 採血と血液試料の処理は1回で完了する. また短時間に全脳血流量の測定と局所脳血流量の算出が可能であり, 種々の脳疾患に臨床応用可能と考えられた. |
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| Practice | 臨床医学：一般 |
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| Keywords | 99mTc-ECD, Cerebral blood flow, Kinetic model, SPECT. |
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| English |
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| Title | Quantitative Measurements of Cerebral Blood Flow Using 99mTc-ECD Radionuclide Angiography, SPECT and One-Point Arterial Sampling |
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| Subtitle | - Original Articles - |
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| Authors | Yoshinari ISAKA*, Takuya YOSHIKAWA*, Masako NARITA*, Keiichi ASHIDA*, Masatoshi IMAIZUMI*, Minoru HARADA** |
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| Authors(kana) | |
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| Organization | *Department of Internal Medicine, **Department of Radiology, Osaka National Hospital |
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| Journal | The Japanese Journal of nuclear medicine |
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| Volume | 33 |
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| Number | 9 |
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| Page | 965-973 |
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| Year/Month | 1996/9 |
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| Article | Original article |
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| Publisher | THE JAPANESE SOCIETY OF NUCLEAR MEDICINE |
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| Abstract | We quantified regional cerebral blood flow using 99mTc-bicisate ethyl cysteinate dimer (ECD) radionuclide (RN) angiography, one-point arterial sampling and static SPECT in 12 patients. The tracer was injected as a bolus into the right antecubital vein, and time-activity curves over the cerebrum and the aortic arch were sequentially recorded for 300 s with 3 s intervals in a 128×128 format with a large-field of view gamma camera equipped with a low-energy collimator. Blood was obtained from the femoral artery immediately after stopping the RN angiography and the arterial concentration of 99mTc-ECD was calculated. Thereafter, the SPECT data acquisition was started with the subject's head immobilized. We applied a three-compartment kinetic model: The influx constant of 99mTc-ECD from blood to brain (K1) and the transfer of ECD from diffusible compartment to nondiffusible one in the blood (k5). The K1 value was compared with the global cerebral blood flow value (Fa) measured by the 133Xe clearance technique. From the kinetic analysis, the following parameter values could be calculated: K1=0.21+-0.05 (ml/ml/min), k5=0.66+-0.15 (/min), Fa=0.32+-0.09 (ml/ml/min) and the extraction fraction E=K1/Fa=0.65+-0.05. There was a strong correlation between K1 and Fa (Y=0.53X+3.7; rs=0.91). By combining the K1 and E values in the whole-brain, we can obtain the absolute global flow value and regional 99mTc-ECD CBF maps if the average concentration of the tracer in the whole-brain is used as a reference. Our method is less invasive and suitable for quantitation of cerebral blood flow in patients with brain disorders. |
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| Practice | Clinical medicine |
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| Keywords | 99mTc-ECD, Cerebral blood flow, Kinetic model, SPECT. |
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