通过乙酰唑胺激发试验测量慢性脑缺血中的血管储备：与正电子发射断层扫描的比较
Vascular reserve in chronic cerebral ischemia measured by the acetazolamide challenge test: comparison with positron emission tomography.
作者信息
Nariai T, Suzuki R, Hirakawa K, Maehara T, Ishii K, Senda M
机构信息
Department of Neurosurgery, Tokyo Medical and Dental University, Japan.
出版信息
AJNR Am J Neuroradiol. 1995 Mar;16(3):563-70.
PURPOSE
To determine the value of the acetazolamide challenge test with stable xenon-enhanced CT (Xe CT) for making therapeutic decisions in patients with chronic cerebrovascular disease.
METHODS
We compared the Xe CT-measured acetazolamide response with various measures obtained by positron emission tomography. We performed both a positron emission tomographic scan and a Xe CT study in 11 patients with chronic cerebral ischemic diseases within a 1-week interval. An increase of cerebral blood flow after injection of acetazolamide was expressed as delta AT. Regional cerebral blood flow, cerebral oxygen metabolism, oxygen extraction fraction, and cerebral blood volume were measured with oxygen-15-labeled gases by positron emission tomography.
RESULTS
In low-cerebral blood flow regions, decreased delta AT was accompanied by a significant elevation of oxygen extraction fraction and cerebral blood volume, compared with oxygen extraction fraction and cerebral blood volume in regions of normal delta AT. Plotting of regional data indicated that delta was significantly dependent on oxygen extraction fraction and cerebral blood volume. The area of decreased vascular reserve determined by the Xe CT image corresponded to the area of "misery perfusion" determined by positron emission tomography.
CONCLUSION
The acetazolamide challenge test with Xe CT may offer an alternative to positron-emission tomography in detecting lesions with elevated oxygen extraction fraction and cerebral blood volume (misery perfusion) that result from chronic hemodynamic stress.
目的
确定使用稳定氙增强CT（Xe CT）进行乙酰唑胺激发试验在慢性脑血管疾病患者治疗决策中的价值。
方法
我们将Xe CT测量的乙酰唑胺反应与正电子发射断层扫描获得的各种测量结果进行了比较。我们在1周内对11例慢性脑缺血疾病患者进行了正电子发射断层扫描和Xe CT研究。注射乙酰唑胺后脑血流量的增加表示为δAT。使用氧-15标记气体通过正电子发射断层扫描测量局部脑血流量、脑氧代谢、氧摄取分数和脑血容量。
结果
在低脑血流量区域，与正常δAT区域的氧摄取分数和脑血容量相比，δAT降低伴随着氧摄取分数和脑血容量的显著升高。区域数据绘图表明，δ与氧摄取分数和脑血容量显著相关。Xe CT图像确定的血管储备降低区域与正电子发射断层扫描确定的“灌注不良”区域相对应。
结论
对于检测因慢性血流动力学应激导致氧摄取分数和脑血容量升高（灌注不良）的病变，使用Xe CT进行乙酰唑胺激发试验可能是正电子发射断层扫描的一种替代方法。
Zotero 插件