Shih Wei-Jen, Huang Wen-Sheng, Milan Primo P
Nuclear Medicine Service, Lexington VA Medical Center, KY, USA.
Clin Nucl Med. 2006 May;31(5):259-61. doi: 10.1097/01.rlu.0000210526.50300.f7.
Stroke produces an area of focal damage and distant areas of reduced blood blow and metabolism termed diaschisis. Tc-99m ECD and HMPAO brain SPECT have demonstrated crossed cerebellar diaschisis (CCD) in patients with cerebral cortical infarct. SPECT findings reflect abnormal cerebral blood flow. CCD as shown on F-18 FDG PET reflects abnormal reflects glucose metabolism. We present the case of a patient with laryngeal cancer who also had a stroke in the left cerebral hemisphere involving the territory of the middle cerebral artery 20 years ago. This patient underwent PET, including the head and neck. A current brain F-18 FDG PET exhibited hypometabolism in the contralateral cerebellum (CCD) as well as hypometabolism of the primary insult in the left cerebral hemisphere. These findings reflect partial impairment or diminished glucose metabolism in the primary insult to the cerebrum and contralateral cerebellum. In addition, this patient illustrates that on PET imaging, CCD could be demonstrated 20 years after a stroke.
中风会产生一个局灶性损伤区域以及远处血流和代谢降低的区域，即交叉性小脑机能联系障碍。锝-99m依替菲宁和六甲基丙二胺肟脑单光子发射计算机断层扫描（SPECT）已证实，大脑皮质梗死患者存在交叉性小脑机能联系障碍（CCD）。SPECT检查结果反映了脑血流异常。F-18氟代脱氧葡萄糖正电子发射断层扫描（PET）显示的CCD反映了葡萄糖代谢异常。我们报告一例喉癌患者，该患者20年前曾在左侧大脑半球发生中风，累及大脑中动脉供血区域。该患者接受了包括头部和颈部的PET检查。目前的脑部F-18氟代脱氧葡萄糖PET显示，对侧小脑存在代谢减低（CCD），左侧大脑半球的原发性损伤部位也存在代谢减低。这些结果反映了大脑原发性损伤部位和对侧小脑的葡萄糖代谢部分受损或降低。此外，该患者表明，在PET成像上，中风20年后仍可显示CCD。
