Lord R S, Reid C V, Ramsay S C, Yeates M G
Surgical Professional Unit, St. Vincent's Hospital, Sydney. Australia.
Ann Vasc Surg. 1992 Sep;6(5):438-42. doi: 10.1007/BF02006999.
Single photon emission computed tomography (SPECT) scanning with 99TcHMPAO (Ceretec) was used to demonstrate regional cerebral blood flow (rCBF) in sixteen patients with hemodynamically significant unilateral carotid stenosis. All patients were demonstrated by cerebral computed tomography to be without cerebral infarction. When dysautoregulation was induced by intravenous acetazolamide, eight patients demonstrated a perfusion defect ipsilateral to carotid stenosis. Repeat SPECT scanning with dysautoregulation following carotid endarterectomy showed improved or normal cerebral perfusion in seven of these patients. The results suggest that a hemodynamic mechanism for cerebral ischemic events, including transient ischemic attacks (TIA) may be more common than previously suspected. Carotid disobliteration usually improves ipsilateral cerebrovascular reserve in patients with a preoperative perfusion defect.
使用99TcHMPAO（脑显肽）单光子发射计算机断层扫描（SPECT）来显示16例具有血流动力学意义的单侧颈动脉狭窄患者的局部脑血流量（rCBF）。所有患者经脑计算机断层扫描显示均无脑梗死。当通过静脉注射乙酰唑胺诱导自主调节功能障碍时，8例患者在颈动脉狭窄同侧出现灌注缺损。在颈动脉内膜切除术后重复进行伴有自主调节功能障碍的SPECT扫描显示，这些患者中有7例脑灌注得到改善或恢复正常。结果表明，包括短暂性脑缺血发作（TIA）在内的脑缺血事件的血流动力学机制可能比之前怀疑的更为常见。对于术前存在灌注缺损的患者，颈动脉再通通常可改善同侧脑血管储备。
