Siennicki-Lantz A, Lilja B, Elmståhl S
Department of Community Medicine, Malmö University Hospital, Lund University, Sweden.
Nucl Med Commun. 1999 Mar;20(3):219-26. doi: 10.1097/00006231-199903000-00004.
Two radiopharmaceuticals, 99Tcm-hexamethyl propylene amine oxime (99Tcm-HMPAO) and 99Tcm-ethyl cysteinate dimer (99Tcm-ECD), are currently used to determine cerebral blood flow. 99Tcm-ECD is, by virtue of its greater stability, superseding 99Tcm-HMPAO for routine examinations. Since the clinical assessment of 99Tcm-ECD images is usually based on experience with 99Tcm-HMPAO, we used both radiopharmaceuticals to compare regional cerebral blood flow in the same individuals. Eleven healthy subjects aged 67.1 +/- 6.3 years (mean +/- S.D.) underwent 99Tcm-ECD followed by 99Tcm-HMPAO single photon emission tomography. Cerebral blood flow was quantified in cortical and central regions of interest (basal ganglia, ventricles, white matter) in relation to cerebellar uptake. The intra-subject comparison of cerebral blood flow in the cortical areas revealed higher levels of perfusion in the posterior parietal, parieto-occipital and temporo-occipital areas using 99Tcm-ECD. In contrast to the cortical areas, cerebral blood flow in the central areas was greater using 99Tcm-HMPAO, especially in the centrum semiovale, basal ganglia, frontal white matter and frontal horns. This difference in cerebral blood flow when imaging healthy individuals with 99Tcm-ECD and 99Tcm-HMPAO should be taken into account in clinical practice when changing from one radiopharmaceutical to the other.
目前有两种放射性药物，锝-99m六甲基丙烯胺肟（99Tcm-HMPAO）和锝-99m乙半胱氨酸二聚体（99Tcm-ECD）用于测定脑血流量。由于99Tcm-ECD具有更高的稳定性，在常规检查中正在取代99Tcm-HMPAO。鉴于对99Tcm-ECD图像的临床评估通常基于对99Tcm-HMPAO的经验，我们使用这两种放射性药物对同一受试者的局部脑血流量进行比较。11名年龄为67.1±6.3岁（均值±标准差）的健康受试者先接受了99Tcm-ECD单光子发射断层扫描，随后又接受了99Tcm-HMPAO单光子发射断层扫描。根据小脑摄取情况，对感兴趣的皮质和中心区域（基底神经节、脑室、白质）的脑血流量进行定量分析。皮质区域脑血流量的受试者内比较显示，使用99Tcm-ECD时，顶叶后部、顶枕部和颞枕部的灌注水平较高。与皮质区域不同，使用99Tcm-HMPAO时中心区域的脑血流量更大，尤其是在半卵圆中心、基底神经节、额叶白质和额角。在临床实践中，当从一种放射性药物更换为另一种时，应考虑使用99Tcm-ECD和99Tcm-HMPAO对健康个体进行成像时脑血流量的这种差异。
