Gibbs J M, Leenders K L, Wise R J, Jones T
Lancet. 1984 Jan 28;1(8370):182-6. doi: 10.1016/s0140-6736(84)92110-x.
Regional cerebral blood flow, oxygen utilisation, fractional oxygen extraction, and cerebral blood volume were measured by positron emission tomography in thirty-two patients with internal-carotid-artery occlusion. In most cases, any reduction in cerebral blood flow in the territory distal to an occluded carotid artery was matched to diminished cerebral metabolic demands. Cerebral blood flow was inappropriately low in only six patients, in whom regional oxygen utilisation was maintained by a compensatory rise in oxygen extraction ratio. The frequent finding of high cerebral blood volume distal to occluded vessels was consistent with a state of focal vasodilatation in response to diminished cerebral perfusion pressure. Analysis of the relation between cerebral blood flow, blood volume, and oxygen extraction ratio suggested that the reduction in cerebral perfusion pressure, and hence circulatory reserve, could be most reliably predicted by the ratio of cerebral blood flow to blood volume. By identifying those patients with carotid occlusion who are most compromised on haemodynamic grounds, combined measurement of cerebral blood flow and blood volume should be valuable in selection of candidates for extracranial-intracranial bypass surgery.
采用正电子发射断层扫描技术，对32例颈内动脉闭塞患者的局部脑血流量、氧利用率、氧摄取分数和脑血容量进行了测量。在大多数情况下，闭塞颈动脉远端区域的脑血流量减少与脑代谢需求降低相匹配。仅6例患者的脑血流量过低，这些患者通过氧摄取率的代偿性升高维持局部氧利用率。闭塞血管远端经常出现高脑血容量，这与因脑灌注压降低而导致的局部血管扩张状态一致。对脑血流量、血容量和氧摄取率之间关系的分析表明，脑灌注压的降低以及循环储备，最可靠地可通过脑血流量与血容量的比值来预测。通过识别那些因血流动力学因素而最受影响的颈动脉闭塞患者，联合测量脑血流量和血容量对于选择颅外-颅内旁路手术的候选者应具有重要价值。
