Tamura A, Segawa H, Nakagomi T, Yoshimasu N, Kimura K, Ueda Y, Eguchi T, Sano K
No To Shinkei. 1983 Oct;35(10):975-81.
Using a new method for rCBF measurement by serial CT scanning with non-radioactive xenon enhancement, CBF was measured before and/or after microsurgical anastomosis in five cases of focal cerebral ischemia.
Studies were carried out on 2 cases of MCA occlusion, 2 of IC occlusion, and 1 of "Moyamoya" disease. CBF was measured both before and after surgery in 4 cases, and the remaining case was measured after anastomosis. Pre-operative CBF was measured 1.4 +/- 0.5 months after the onset and post-operative CBF was 2 +/- 1 months after surgery. While 50 to 70% non-radioactive xenon was inhaled for 25 min and then discontinued, serial CT scanning was carried out every 3 min. K-map (clearance rate), lambda-map (partition coefficient), and CBF-map were displayed on CRT as images of each value.
In all cases, initial pre-operative CBF decreased not only in the ipsilateral hemisphere, but also in the contralateral hemisphere. Especially in the major stroke cases, CBF reduction in the low density areas seen in CT was more than 75% of normal values. After microsurgical anastomosis, CBF increased in both hemispheres. In two cases of reversible ischemic attacks without any change in CT, the CBF markedly increased in central areas of ischemia and the CBF values became higher than normal value, that is hyperemia. On the contrary, in the central areas of the major stroke cases, that is, the low density areas in CT, CBF was still very low (under 25% of normal value) after anastomosis. However, in these cases, marked hyperemia was seen in the surrounding area of ischemic focus.
采用一种通过非放射性氙增强的连续CT扫描测量局部脑缺血患者rCBF的新方法，对5例局灶性脑缺血患者在显微外科吻合术前和/或术后测量了CBF。
对2例大脑中动脉闭塞、2例颈内动脉闭塞和1例烟雾病患者进行了研究。4例患者在手术前后均测量了CBF，其余1例在吻合术后测量。术前CBF在发病后1.4±0.5个月测量，术后CBF在手术后2±1个月测量。在吸入50%至70%的非放射性氙25分钟后停止，每3分钟进行一次连续CT扫描。K图（清除率）、λ图（分配系数）和CBF图以每个值的图像形式显示在CRT上。
所有病例中，最初术前CBF不仅在同侧半球降低，对侧半球也降低。特别是在主要中风病例中，CT上低密度区域的CBF降低超过正常值的75%。显微外科吻合术后，双侧半球的CBF均增加。在2例CT无变化的可逆性缺血性发作病例中，缺血中心区域的CBF明显增加，CBF值高于正常值，即出现充血。相反，在主要中风病例的中心区域，即CT上的低密度区域，吻合术后CBF仍然很低（低于正常值的25%）。然而，在这些病例中，缺血灶周围区域出现明显充血。
