Yamauchi Hiroshi, Kagawa Shinya, Kishibe Yoshihiko, Takahashi Masaaki, Nishii Ryuichi, Mizuma Hiroshi, Takahashi Kazuhiro, Onoe Hirotaka, Higashi Tatsuya
From the Division of PET Imaging, Shiga Medical Centre Research Institute, Moriyama, Japan (H.Y., S.K., Y.K., M.T., T.H.); Department of Radiology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan (R.N.); and Bio-Function Imaging Team (H.M., H.O.) and Clinical Application Unit (K.T.), RIKEN Center for Life Science Technologies, Kobe, Japan.
Stroke. 2015 Sep;46(9):2669-72. doi: 10.1161/STROKEAHA.115.010080. Epub 2015 Jul 30.
[18F]-fluoroacetate ((18)F-FACE) can be used for evaluating glial cell metabolism. Experimental studies have shown an increase in (18)F-FACE uptake in rodent models of cerebral ischemia. The aim of this study was to determine whether (18)F-FACE uptake is increased in the noninfarcted cerebral cortex in patients with hemodynamic ischemia owing to atherosclerotic internal carotid artery or middle cerebral artery disease.
We evaluated 9 symptomatic patients with unilateral atherosclerotic internal carotid artery or middle cerebral artery disease and no cortical infarction using positron emission tomography with (18)F-FACE and (15)O-gases. (18)F-FACE uptake during 40 to 60 minutes after injection was compared with the cerebral blood flow, cerebral metabolic rate of oxygen, oxygen extraction fraction, and cerebral blood volume in the middle cerebral artery distributions.
Significant decreases of cerebral blood flow and cerebral metabolic rate of oxygen and increases of oxygen extraction fraction and cerebral blood volume were found in the hemisphere ipsilateral to the arterial lesion, and (18)F-FACE uptake in this region was greater than that in the contralateral hemisphere. The relative (18)F-FACE uptake (ipsilateral/contralateral ratio) was negatively correlated with cerebral blood flow or cerebral metabolic rate of oxygen values and was positively correlated with oxygen extraction fraction values. Multivariate analysis showed that the ipsilateral/contralateral (18)F-FACE uptake ratio was independently correlated with the cerebral blood flow (or oxygen extraction fraction) and cerebral metabolic rate of oxygen values.
In patients with atherosclerotic internal carotid artery or middle cerebral artery disease, (18)F-FACE uptake is increased in the noninfarcted cerebral cortex with chronic hemodynamic ischemia characterized by misery perfusion with decreased oxygen metabolism. Increased (18)F-FACE uptake may indicate the cortical regions that are at particular risk for ischemic damage.
[18F]-氟乙酸盐（(18)F-FACE）可用于评估神经胶质细胞代谢。实验研究表明，在脑缺血的啮齿动物模型中，(18)F-FACE摄取增加。本研究的目的是确定在因动脉粥样硬化性颈内动脉或大脑中动脉疾病导致血流动力学缺血的患者中，非梗死性大脑皮质的(18)F-FACE摄取是否增加。
我们使用(18)F-FACE和(15)O气体的正电子发射断层扫描技术评估了9例有症状的单侧动脉粥样硬化性颈内动脉或大脑中动脉疾病且无皮质梗死的患者。将注射后40至60分钟内的(18)F-FACE摄取与大脑中动脉分布区域的脑血流量、脑氧代谢率、氧摄取分数和脑血容量进行比较。
在动脉病变同侧的半球中发现脑血流量和脑氧代谢率显著降低，氧摄取分数和脑血容量增加，且该区域的(18)F-FACE摄取大于对侧半球。相对(18)F-FACE摄取（同侧/对侧比值）与脑血流量或脑氧代谢率值呈负相关，与氧摄取分数值呈正相关。多变量分析表明，同侧/对侧(18)F-FACE摄取比值与脑血流量（或氧摄取分数）和脑氧代谢率值独立相关。
在动脉粥样硬化性颈内动脉或大脑中动脉疾病患者中，非梗死性大脑皮质的(18)F-FACE摄取增加，其特征为以氧代谢降低的灌注不足为特点的慢性血流动力学缺血。(18)F-FACE摄取增加可能表明皮质区域有缺血损伤的特别风险。
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