[Cerebral blood flow measurement using H2(15)O intravenous injection and positron emission tomography: description of implementation and applications to cerebrovascular reactivity measurement].

The method for cerebral blood flow (CBF) measurement using an H215O intravenous injection and positron emission tomography (PET) was implemented, examined and applied to measure cerebrovascular reactivity to PaCO2(VRCO2) and to MABP (VRBP) in normal brain and in ischemic brain. Immediately after bolus intravenous injection of 30-40 mCi H2(15)O, a time-activity curve of H2(15)O concentration in the arterial blood and in the brain were measured for 60 sec by a beta detector and a PET, respectively. The PET was HEADTOME III and measured five planes. CBF was determined by the table-look up method based on the autoradiographic principle. Six volunteers were studied to examine region of VRCO2, and a moyamoya patient and a stroke patient with a bilateral-intracarotid circulation defect were studied to examine VRCO2 and VRBP in ischemic brain. The studies were carried out so as to be followed two or three H2(15)O CBF measurements with changing PaCO2 or MABP after control study at rest condition. In addition, prior to the H2(15)O study O15 gas steady state study was performed on all subjects. Validity of the method examined by simulation studies showed 3% error per 1 sec time shift of the artery curve for 60 sec PET scan duration and the error was rapidly increased to the shorter scan duration. Inhomogeneity of a brain tissue gave mild under-estimation by 5% for 60 sec PET scan duration. VRCO2 in normal brain was revealed to be almost uniform except that the infratentorium area showed a slight higher VRCO2 than the supratentorium area. The ischemic brain showed a negative correlation between VRCO2 and oxygen extraction fraction (OEF), and a positive correlation between VRBP and OEF.