Chang C C, Kuwana N, Noji M, Tanabe Y, Koike Y, Ikegami T
Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Japan.
Nucl Med Commun. 1999 Feb;20(2):167-9. doi: 10.1097/00006231-199902000-00009.
Mean cerebral blood flow (CBF) of the whole brain was measured in 48 patients who underwent cerebrospinal fluid shunt surgery for normal pressure hydrocephalus (NPH) by performing first-pass radionuclide angiography using 99Tcm-hexamethylpropylene amine oxime. Patients were divided according to outcome into an 'excellent' improvement group, a 'good' improvement group, a 'fair' improvement group and a 'poor' improvement group. Patients with excellent and good improvement had a preoperative mean CBF of 40.4 +/- 3.9 ml.100 g-1.min-1 and 37.1 +/- 5.5 ml.100 g-1.min-1, respectively, both of which were significantly (P < 0.005) higher than that in 11 patients who showed fair improvement (30.8 +/- 3.2 ml.100 g-1.min-1) and six patients who showed poor improvement (31.8 +/- 2.5 ml.100 g-1.min-1). Patients with a clinical improvement after shunting had an increased postoperative mean CBF. We conclude that patients with a preoperative mean CBF of over 35 ml.100 g-1.min-1 can show favourable improvement after a shunting procedure, and that the preoperative mean CBF of 32 ml.100 g-1.min-1 can be considered the critical level for treatment.
对48例因正常压力脑积水（NPH）接受脑脊液分流手术的患者，使用99Tcm - 六甲基丙烯胺肟进行首次通过放射性核素血管造影，测量全脑平均脑血流量（CBF）。根据结果将患者分为“优”改善组、“良”改善组、“中”改善组和“差”改善组。改善为优和良的患者术前平均CBF分别为40.4±3.9ml·100g-1·min-1和37.1±5.5ml·100g-1·min-1，两者均显著（P<0.005）高于11例改善为中的患者（30.8±3.2ml·100g-1·min-1）和6例改善为差的患者（31.8±2.5ml·100g-1·min-1）。分流后临床改善的患者术后平均CBF增加。我们得出结论，术前平均CBF超过35ml·100g-1·min-1的患者在分流手术后可显示良好改善，术前平均CBF为32ml·100g-1·min-1可被视为治疗的临界水平。
