Matsuda H, Higashi S, Kinuya K, Tsuji S, Nozaki J, Sumiya H, Hisada K, Yamashita J
Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
Clin Nucl Med. 1991 Aug;16(8):572-9. doi: 10.1097/00003072-199108000-00008.
This report describes a new approach to the evaluation of brain perfusion reserve using Tc-99m HMPAO SPECT. Consecutive brain Tc-99m HMPAO SPECT studies before and after acetazolamide (Diamox) administration were performed within 30 minutes on 19 patients with significant vascular occlusive lesions. Thirteen patients showed decreased perfusion reserve and four patients maintained perfusion reserve in the affected vascular territories after Diamox administration, providing additional information to baseline Tc-99m HMPAO SPECT in 17 (89%) patients. Although flow augmentation post-Diamox was underestimated, possibly due to the nonproportionality of Tc-99m HMPAO activity to true blood flow, significant changes in the brain perfusion pattern were both visually and quantitatively determined using an image subtraction technique. This consecutive Tc-99m HMPAO SPECT technique seems to be of practical use for the evaluation of brain perfusion reserve and for the improvement of the sensitivity of detecting pathologic areas.
本报告描述了一种使用锝-99m六甲基丙烯胺肟单光子发射计算机断层扫描（Tc-99m HMPAO SPECT）评估脑灌注储备的新方法。对19例患有严重血管闭塞性病变的患者在30分钟内连续进行了乙酰唑胺（醋氮酰胺）给药前后的脑Tc-99m HMPAO SPECT研究。13例患者显示灌注储备降低，4例患者在醋氮酰胺给药后受影响血管区域的灌注储备得以维持，为17例（89%）患者的基线Tc-99m HMPAO SPECT提供了额外信息。尽管醋氮酰胺给药后的血流增加可能因Tc-99m HMPAO活性与真实血流不成比例而被低估，但使用图像减法技术在视觉和定量上均确定了脑灌注模式的显著变化。这种连续的Tc-99m HMPAO SPECT技术似乎在评估脑灌注储备和提高检测病变区域的敏感性方面具有实际用途。
