Kurokawa H, Iino K, Kojima H, Saito H, Suzuki M, Watanabe K, Kato T
No To Shinkei. 1987 May;39(5):437-46.
The papers about cerebral blood flow (CBF) in patients with cerebrovascular diseases have been already reported by positron emission computerized tomography (PET), single photon emission computerized tomography (SPECT), Xray CT (CT) using cold Xe, and so on. However the literature about the CBF changes in acute stage is few. We studied CBF in 68 patients with ischemic cerebrovascular disease within 48 hours after the onsets from February 1984 through February 1985. CBF was measured by a rapidly rotating single photon emission computerized tomography (SPECT) using non-invasive Xenon-133 inhalation method. Our subjects included 51 cases with cerebral infarction (male 37, female 14, average 62.9 years) and 17 cases with TIA (male 13, female 4, average 60.5 years), the patients who had a past history of stroke were excluded from the subjects. The SPECT was performed with use of Tomomatic 64 developed by Dr. Lassen, et al, SPECT and carotid arteriography were simultaneously performed within 48 hours in all cases. CT we used were GE CT 9800 scanner and Hitachi HF CT. The following results have been obtained: 1) SPECT clearly showed an ischemic focus correlated with clinical symptom after the attack rather than CT, the positive finding by SPECT was 92.2% and that by CT was 62.7% within 48 hours after the onset. 2) The remote effect phenomenon so-called crossed cerebellar diaschisis was demonstrated in 7 of 14 cases (50%) with cerebral infarction due to internal carotid artery occlusion and in 9 of 26 cases (34.6%) with that due to middle cerebral artery occlusion. 3) SPECT and CT were performed within 8 hours after the onset in 20 cases with cerebral infarction. SPECT showed decreased CBF in all cases whereas the positive finding by CT was 40.0%. The area of decreased CBF was always larger than the low density area that CT demonstrated. Mean CBF value of the cerebral hemisphere in the cases with ICA occlusion within 8 hours after the onsets was 31.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min), and that of MCA occlusion was 36.0 (ml/100 g/min). 4) The positive finding by SPECT on TIA cases was 47% and that by CT was 41.1%, SPECT usually did not demonstrate a small ischemic focus especially at the deep region (ie, basal ganglia region). 5) SPECT using Xe-123 inhalation was useful and non-invasive method for the diagnosis in acute stage with ischemic cerebrovascular disease.(ABSTRACT TRUNCATED AT 400 WORDS)
关于脑血管疾病患者脑血流量（CBF）的研究报告已有正电子发射计算机断层扫描（PET）、单光子发射计算机断层扫描（SPECT）、使用冷氙的X射线CT（CT）等。然而，关于急性期CBF变化的文献较少。我们于1984年2月至1985年2月对68例缺血性脑血管疾病患者在发病后48小时内的CBF进行了研究。通过使用无创性氙-133吸入法的快速旋转单光子发射计算机断层扫描（SPECT）测量CBF。我们的研究对象包括51例脑梗死患者（男性37例，女性14例，平均62.9岁）和17例短暂性脑缺血发作（TIA）患者（男性13例，女性4例，平均60.5岁），有中风病史的患者被排除在研究对象之外。使用Lassen博士等人开发的Tomomatic 64进行SPECT检查，所有病例均在48小时内同时进行SPECT和颈动脉造影。我们使用的CT是GE CT 9800扫描仪和日立HF CT。获得了以下结果：1）SPECT比CT更清楚地显示出与发作后临床症状相关的缺血灶，发病后48小时内SPECT的阳性发现率为92.2%，CT为62.7%。2）在14例因颈内动脉闭塞导致脑梗死的患者中有7例（50%）以及26例因大脑中动脉闭塞导致脑梗死的患者中有9例（34.6%）出现了所谓的交叉小脑失联络现象。3）对20例脑梗死患者在发病后8小时内进行SPECT和CT检查。SPECT显示所有病例的CBF均降低，而CT的阳性发现率为40.0%。CBF降低的区域总是大于CT显示的低密度区域。发病后8小时内颈内动脉闭塞病例的大脑半球平均CBF值为31.0（ml/100 g/min），大脑中动脉闭塞病例为36.0（ml/100 g/min）。4）TIA病例中SPECT的阳性发现率为47%，CT为41.1%，SPECT通常不能显示小的缺血灶，尤其是在深部区域（即基底节区）。5）使用氙-123吸入的SPECT是诊断缺血性脑血管疾病急性期的一种有用且无创的方法。（摘要截断于400字）
