Hayashida K, Nishimura T, Hirose Y, Kaminaga T, Imakita S, Uehara T
Department of Radiology, National Cardiovascular Center, Osaka, Japan.
Eur J Nucl Med. 1992;19(11):987-9. doi: 10.1007/BF00175866.
A case of Takayasu's disease in a 22-year-old woman who complained of severe fainting attacks is presented. Bilateral obstruction of the cervical arteries was confirmed by digital subtraction angiography. Preoperative technetium-99m hexamethylpropylene amine oxime brain SPET in the sitting position showed bilateral hypoactivity in the temporoparietal areas. Subtraction brain SPET showed slightly increased activity in the lying position. The patient has had no fainting attacks since bypass surgery. Postoperative 99mTc-HMPAO brain SPET in the sitting position showed normal activity except in the right temporoparietal area. This area was filled in the lying position. 99mTc-HMPAO brain SPET is the only technique that can visualize the cerebral blood flow in any position, this capability deriving on the fact that the distribution of 99mTc-HMPAO in the brain is fixed in the first 2-3 min following injection. The use of both sitting and lying 99mTc-HMPAO brain SPET is very useful for detecting an abnormality (i.e. an inhomogeneous response due to the fall in perfusion pressure) that could not be seen if the cerebral blood flow were to be assessed only in the lying position.
本文报告了一例22岁女性的高安氏病，该患者主诉有严重的昏厥发作。数字减影血管造影证实双侧颈动脉阻塞。术前坐位的锝-99m六甲基丙烯胺肟脑单光子发射计算机断层扫描显示双侧颞顶叶区域放射性减低。减影脑单光子发射计算机断层扫描显示卧位时放射性略有增加。自搭桥手术后，患者未再出现昏厥发作。术后坐位的99m锝-六甲基丙烯胺肟脑单光子发射计算机断层扫描显示除右侧颞顶叶区域外活动正常。该区域在卧位时填充。99m锝-六甲基丙烯胺肟脑单光子发射计算机断层扫描是唯一能在任何体位显示脑血流的技术，这一能力源于99m锝-六甲基丙烯胺肟在脑内的分布在注射后的最初2至3分钟内是固定的。同时使用坐位和卧位的99m锝-六甲基丙烯胺肟脑单光子发射计算机断层扫描对于检测仅在卧位评估脑血流时无法发现的异常（即由于灌注压下降导致的不均匀反应）非常有用。
