Pávics L, Grünwald F, Reichmann K, Séra T, Ambrus E, Horn R, Hartmann A, Menzel C, Csernay L, Biersack H J
Department of Nuclear Medicine, Albert Szent-Györgyi Medical University of Szeged, Hungary.
Nucl Med Rev Cent East Eur. 1998;1(1):13-9.
The diagnostic potential of 99mTc-HMPAO following systemic administration of the cerebral vasodilator acetazolamide (acetazolamide test) was evaluated using regional-cerebral-blood-flow (rCBF) SPECT in patients with Alzheimer's disease (AD) or with vascular-type of dementia (VD).
An initial, high-resolution SPELT study was performed with 99mTc-HMPAO, and after 2 days patients were re-evaluated with 99mTc-HMPAO following systemic administration of acetazolamide. Reconstructed SPELT slices were evaluated visually and semiquantitatively by a semiautomatic rCBF map method.
Using 99mTc-HMPAO alone, a bilateral hypoperfusion was found in the temporal and/or parietal regions in 33% (6/18) of VD patients and in 70% (23/33) of AD patients. The vascular reserve capacity, as determined with the acetazolamide test, was not impaired in 22% of the VD patients but in 76% of the AD patients. The differences in the perfusion patterns between VD and AD patients were statistically different (p < 0.01, Fischer's exact test). Of the 6 VD patients with hypoperfusion (bilateral temporal and/or parietal), 4 had a decreased vascular reserve capacity as determined in the acetazolamide test. Decreased reserve capacity was found in only 4 out of 25 patients with AD.
The acetazolamide test is helpful in rCBF SPECT to differentiate VD from AD.
在患有阿尔茨海默病（AD）或血管性痴呆（VD）的患者中，使用区域脑血流（rCBF）单光子发射计算机断层扫描（SPECT）评估了全身给予脑血管扩张剂乙酰唑胺后99mTc - HMPAO的诊断潜力（乙酰唑胺试验）。
首先用99mTc - HMPAO进行一次高分辨率SPECT研究，2天后在全身给予乙酰唑胺后，用99mTc - HMPAO对患者进行重新评估。通过半自动rCBF图方法对重建的SPECT切片进行视觉和半定量评估。
仅使用99mTc - HMPAO时，33%（6/18）的VD患者和70%（23/33）的AD患者在颞叶和/或顶叶区域发现双侧灌注不足。通过乙酰唑胺试验确定的血管储备能力，在22%的VD患者中未受损，但在76%的AD患者中受损。VD和AD患者灌注模式的差异具有统计学意义（p < 0.01，Fisher精确检验）。在6例灌注不足（双侧颞叶和/或顶叶）的VD患者中，4例在乙酰唑胺试验中确定血管储备能力下降。在25例AD患者中，只有4例发现储备能力下降。
乙酰唑胺试验有助于在rCBF SPECT中区分VD和AD。
