Watanabe N, Nohara S, Matsuda H, Sumiya H, Noguchi K, Shimizu M, Tsuji S, Kinuya S, Shuke N, Yokoyama K, Seto H
Department of Radiology, Toyama Medical and Pharmaceutical University, Toyama, Japan.
Nucl Med Commun. 2002 Apr;23(4):355-66. doi: 10.1097/00006231-200204000-00009.
The purpose of this retrospective study was to assess regional cerebral blood flow in patients after carbon monoxide intoxication by using brain single photon emission computed tomography and statistical parametric mapping. Eight patients with delayed neuropsychiatric sequelae and ten patients with no neuropsychiatric symptoms after carbon monoxide intoxication were studied with brain single photon emission tomography imaging with 99mTc-hexamethyl-propyleneamine oxime. Forty-four control subjects were also studied. We used the adjusted regional cerebral blood flow images in relative flow distribution (normalization of global cerebral blood flow for each subject to 50 ml x 100 g(-1) x min(-1) with proportional scaling) to compare these groups with statistical parametric mapping. Using this technique, significantly decreased regional cerebral blood flow was noted extensively in the bilateral frontal lobes as well as the bilateral insula and a part of the right temporal lobe in the patients with delayed neuropsychiatric sequelae as compared with normal volunteers (P< 0.005). In the patients with no neuropsychiatric symptoms, significantly decreased regional blood flow in the bilateral frontal lobes particularly on the left side was detected. There was a significantly decreased regional cerebral blood flow in the right frontal lobe and insula in the patients with delayed neuropsychiatric sequelae as compared to those with no neuropsychiatric sequelae. It is concluded that statistical parametric mapping is a useful technique for highlighting differences in regional cerebral blood flow in patients following carbon monoxide intoxication as compared with normal volunteers. The selectively reduced blood flow noted in this investigation supports the contention that the decrease following carbon monoxide intoxication may be prolonged and further worsen in the frontal lobe. In addition, the present study may help to clarify the characteristics of the pathophysiological alteration underlying delayed neuropsychiatric sequelae.
本回顾性研究的目的是通过脑单光子发射计算机断层扫描和统计参数映射来评估一氧化碳中毒患者的局部脑血流量。对8例一氧化碳中毒后出现迟发性神经精神后遗症的患者和10例无神经精神症状的患者进行了99mTc-六甲基丙烯胺肟脑单光子发射断层扫描成像研究。还对44名对照者进行了研究。我们使用相对血流分布中的调整后局部脑血流量图像（将每个受试者的全脑血流量按比例缩放归一化为50 ml x 100 g(-1) x min(-1)），通过统计参数映射对这些组进行比较。使用该技术，与正常志愿者相比，迟发性神经精神后遗症患者的双侧额叶、双侧岛叶以及右侧颞叶的一部分区域脑血流量显著降低（P<0.005）。在无神经精神症状的患者中，检测到双侧额叶尤其是左侧的区域血流量显著降低。与无神经精神症状患者相比，迟发性神经精神后遗症患者的右侧额叶和岛叶区域脑血流量显著降低。结论是，统计参数映射是一种有用的技术，可突出显示一氧化碳中毒患者与正常志愿者相比局部脑血流量的差异。本研究中观察到的选择性血流减少支持了这样的观点，即一氧化碳中毒后的血流减少可能会持续延长，并在额叶进一步恶化。此外，本研究可能有助于阐明迟发性神经精神后遗症潜在病理生理改变的特征。
