Hirata Yuko, Hamano Shin-Ichiro, Ikemoto Satoru, Oba Atsuko, Matsuura Ryuki
Division of Neurology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama-city, Saitama 330-8777, Japan; Department of Pediatrics, The Jikei University School of Medicine, 3-19-18 Nishi-shinbashi, Minato-ku, Tokyo 105-8461, Japan.
Division of Neurology, Saitama Children's Medical Center, 1-2 Shintoshin, Chuo-ku, Saitama-city, Saitama 330-8777, Japan.
Brain Dev. 2018 Nov;40(10):841-849. doi: 10.1016/j.braindev.2018.06.008. Epub 2018 Jun 29.
To quantitatively evaluate regional cerebral blood flow (rCBF) and regional developmental changes during childhood using I-N-isopropyl-iodoamphetamine single-photon emission computed tomography (SPECT) and autoradiography.
We retrospectively analyzed quantitative values of rCBF in 75 children (29 girls) aged between 16 days and 178 months (median: 12 months), whose brain images, including magnetic resonance imaging and SPECT data, were normal under visual inspection at Saitama Children's Medical Center between 2005 and 2015. The subjects had normal psychomotor development, no focal neurological abnormalities, and neither respiratory nor cardiac disease at the time of examination. Regions of interest were placed automatically using a three-dimensional stereotactic template.
rCBF was lowest in neonates, who had greater rCBF in the lenticular nucleus, thalamus, and cerebellum than the cerebral cortices. rCBF increased rapidly during the first year of life, reaching approximately twice the adult levels at 8 years, and then fell to approximately adult levels in the late teenage years. Cerebral cortex rCBF sequentially increased in the posterior, central, parietal, temporal, and callosomarginal regions during infancy and childhood.
rCBF changed dramatically throughout childhood and ranged from lower than adult values to approximately two times higher than adult values. It had different trajectories in each region during brain development. Understanding this dynamic developmental change is necessary for SPECT image evaluation in children.
使用I-N-异丙基碘安非他明单光子发射计算机断层扫描（SPECT）和放射自显影技术定量评估儿童期的局部脑血流量（rCBF）及局部发育变化。
我们回顾性分析了2005年至2015年间在埼玉儿童医疗中心接受检查的75名儿童（29名女孩）的rCBF定量值，这些儿童年龄在16天至178个月（中位数：12个月）之间，其脑部图像（包括磁共振成像和SPECT数据）在视觉检查下均正常。受试者在检查时精神运动发育正常，无局灶性神经异常，无呼吸及心脏疾病。使用三维立体定向模板自动放置感兴趣区域。
新生儿的rCBF最低，其豆状核、丘脑和小脑的rCBF高于大脑皮质。rCBF在生命的第一年迅速增加，8岁时达到成人水平的约两倍，然后在青少年后期降至约成人水平。婴儿期和儿童期，大脑皮质rCBF在后部、中央、顶叶、颞叶和胼胝体边缘区域依次增加。
rCBF在整个儿童期变化显著，范围从低于成人值到高于成人值约两倍。在大脑发育过程中，每个区域的rCBF变化轨迹不同。了解这种动态发育变化对于儿童SPECT图像评估是必要的。
