Imamura T, Sekine T, Satoh K, Endoh M, Tsuburaya K, Kogure K, Hoshi A
Department of Neurology, Tohoku University School of Medicine, Sendai, Japan.
No To Shinkei. 1992 Jan;44(1):31-5.
Time density curve (TDC) can be reconstructed from the data of intravenous digital subtraction angiography (IVDSA). We evaluated peak time (PT) and modal transit time (MOTT) of the TDC as the probable indicator of cerebral intravascular blood flow. Cerebral IVDSA and single photon emission CT (SPECT) were performed on 12 patients of ischemic cerebrovascular disease, which consisted of 3 internal carotid artery (ICA) occlusions, one middle cerebral artery (MCA) occlusion, one anterior cerebral artery (ACA) branch occlusion and 7 lacunar infarctions. We classified former 4 patients as occlusion group and latter 8 as reference group. In 3 patients (2 ICA and one MCA occlusions), SPECT study revealed definite hypoaccumulation in the MCA territory of occlusive side. Two regions of interest (ROI) were placed on the territories of right and left middle cerebral arteries in the frontal view of cerebral IVDSA. Digital data processor fitted gamma curve to the TDC of each ROI, and calculated PT and MOTT. The absolute lateralities of PT and MOTT of MCA territory was significantly (p less than 0.05) larger in occlusion group than reference group. Patients with hypoaccumulation in SPECT had significantly (p less than 0.02) larger laterality of MOTT than patients with isoaccumulation. One ICA occluded patient without hypoaccumulation in corresponding MCA territory had relatively small laterality of MOTT similar to the patients of ACA branch occlusion and lacunar infarction. These results suggest that PT and MOTT are possible to detect the laterality of the intravascular blood flow in MCA territories caused by major artery occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)
时间密度曲线(TDC)可从静脉数字减影血管造影(IVDSA)数据重建。我们评估了TDC的峰值时间(PT)和模态通过时间(MOTT)作为脑内血管血流的可能指标。对12例缺血性脑血管病患者进行了脑IVDSA和单光子发射计算机断层扫描(SPECT),其中包括3例颈内动脉(ICA)闭塞、1例大脑中动脉(MCA)闭塞、1例大脑前动脉(ACA)分支闭塞和7例腔隙性梗死。我们将前4例患者归为闭塞组,后8例归为参照组。在3例患者(2例ICA闭塞和1例MCA闭塞)中,SPECT研究显示闭塞侧MCA区域有明确的放射性减低。在脑IVDSA的额位视图中,在左右大脑中动脉区域放置两个感兴趣区(ROI)。数字数据处理器将伽马曲线拟合到每个ROI的TDC,并计算PT和MOTT。闭塞组MCA区域PT和MOTT的绝对侧别显著大于参照组(p<0.05)。SPECT显示放射性减低的患者MOTT的侧别显著大于放射性相等的患者(p<0.02)。1例ICA闭塞患者在相应MCA区域无放射性减低,其MOTT侧别相对较小,类似于ACA分支闭塞和腔隙性梗死患者。这些结果表明,PT和MOTT有可能检测由主要动脉闭塞引起的MCA区域血管内血流的侧别。(摘要截短于250字)