Momose T, Nishikawa J, Watanabe T, Ohtake T, Sasaki Y, Sasaki M, Mii K
Department of Radiology, Faculty of Medicine, University of Tokyo.
Kaku Igaku. 1992 Sep;29(9):1139-42.
In order to evaluate glucose metabolism in brain death, 18F-FDG-PET scans were performed in three patients with clinically highly suspected brain death. One case was caused by head trauma and other two cases were by subarachnoid hemorrhage. All of them were in deep coma without spontaneous breathing, whose intracranial pressure was remarkably elevated up to the level of mean arterial pressure. Nineteen frames of dynamic scan were started soon after intravenous injection of 18F-FDG for one minute per frame, followed by 10 minutes of static scan which started 40 minutes after the injection. Both in dynamic and static scan, no significant intracranial accumulation of 18F-FDG was seen in all of three cases. This finding can be interpreted as the evidence that there is no significant glucose utilization from blood in the brain. This is the first report of clinical application of 18F-FDG-PET to brain death. Our results support the clinical diagnosis of brain death and 18F-FDG-PET can be of value for the assessment of glucose metabolism in patients with suspected brain death.
为了评估脑死亡患者的葡萄糖代谢情况,对3例临床高度怀疑脑死亡的患者进行了18F-FDG-PET扫描。1例由头部外伤引起,另外2例由蛛网膜下腔出血引起。所有患者均处于深度昏迷,无自主呼吸,颅内压显著升高至平均动脉压水平。静脉注射18F-FDG后很快开始进行19帧动态扫描,每帧1分钟,注射后40分钟开始进行10分钟静态扫描。在动态和静态扫描中,3例患者均未发现颅内有明显的18F-FDG聚集。这一发现可解释为脑内不存在从血液中摄取显著葡萄糖的证据。这是18F-FDG-PET在脑死亡临床应用方面的首次报告。我们的结果支持脑死亡的临床诊断,18F-FDG-PET对于疑似脑死亡患者的葡萄糖代谢评估具有价值。