Komatani A, Yamaguchi K, Sugai Y, Takanashi T, Kera M, Shinohara M, Kawakatsu S
Department of Radiology and Neuropsychiatry, Yamagata University School of Medicine, Japan.
J Nucl Med. 1988 Oct;29(10):1621-6.
We studied the potential for using dynamic single photon emission computed tomography of inhaled xenon-133 (133Xe) gas in the assessment of demented patients. An advanced ring-type single photon emission computed tomography (SPECT) "HEADTOME" with improved spatial resolution [15 mm in full width at half maximum (FWHM)] was used for tomographic measurement of regional cerebral blood flow (rCBF). All 34 patients underwent a detailed psychiatric examination and x-ray computed tomography scan, and matched research criteria for Alzheimer's disease (n = 13), senile dementia of the Alzheimer type (n = 9), or multi-infarct dementia (n = 12). In comparison with a senile control group (n = 7), mean CBF of both the whole brain and the temporo-parietal region was significantly less in the Alzheimer's disease and senile dementia Alzheimer type groups, but no significant difference was seen between the senile control group and multi-infarct dementia group. The correlation was 0.72 (p less than 0.004) between the mean CBF of the whole brain and the score of Hasegawa's Dementia Scale, and 0.94 (p less than 0.0001) between rCBF of the temporo-parietal region and the scale in Alzheimer's disease. In the senile dementia Alzheimer type group, the correlations were 0.77 (p less than 0.01) and 0.83 (p less than 0.004) respectively. No significant correlations were found in the multi-infarct dementia group. A temporo-parietal reduction in the distribution of the rCBF characteristic in the Alzheimer's disease group and a patchy whole brain reduction characteristic in the multi-infarct dementia group was detected. The ability of our improved SPECT to provide both quantitative measurement of rCBF and characteristic rCBF distribution patterns, makes it a promising tool for research or routine examination of demented patients.
我们研究了使用吸入氙 - 133（¹³³Xe）气体的动态单光子发射计算机断层扫描技术评估痴呆患者的可能性。采用具有更高空间分辨率[半高宽（FWHM）为15毫米]的先进环形单光子发射计算机断层扫描（SPECT）“HEADTOME”对局部脑血流量（rCBF）进行断层测量。所有34例患者均接受了详细的精神检查和X线计算机断层扫描，并符合阿尔茨海默病（n = 13）、阿尔茨海默型老年痴呆（n = 9）或多发梗死性痴呆（n = 12）的研究标准。与老年对照组（n = 7）相比，阿尔茨海默病组和阿尔茨海默型老年痴呆组的全脑及颞顶叶区域平均脑血流量均显著降低，但老年对照组与多发梗死性痴呆组之间未见显著差异。全脑平均脑血流量与长谷川痴呆量表评分之间的相关性为0.72（p < 0.004），阿尔茨海默病组颞顶叶区域rCBF与该量表之间的相关性为0.94（p < 0.0001）。在阿尔茨海默型老年痴呆组中，相关性分别为0.77（p < 0.01）和0.83（p < 0.004）。多发梗死性痴呆组未发现显著相关性。检测到阿尔茨海默病组rCBF特征分布的颞顶叶减少以及多发梗死性痴呆组全脑斑片状减少的特征。我们改进的SPECT能够提供rCBF的定量测量和特征性rCBF分布模式，使其成为痴呆患者研究或常规检查的有前景的工具。
