Lassen N A, Sperling B
Department of Clinical Physiology and Nuclear Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
J Cereb Blood Flow Metab. 1994 Jan;14 Suppl 1:S44-8.
A multicenter study was performed in seven European centers comparing 99mTc-bicisate with 133Xe as a means of evaluating bicisate as a tracer of CBF distribution in humans. The same type of single photon emission computed tomography (SPECT) instrument (Tomomatic) was used in all centers. A total of 115 cases were collected, and of these 105 were considered technically adequate, comprising 18 normal subjects, 18 senile dementia, eight epilepsy, one brain tumor, eight chronic head trauma, and 52 stroke cases. As expected, bicisate gave better spatial resolution than Xe. Agreement between the results of the two methods was noted in 98 cases, but not in the remaining 7, all belonging to the stroke group. These seven all suffered from a subacute stroke (11-23 days after onset), and the disagreement in all cases consisted of bicisate showing low count rate in the area of the infarct and Xe a normal or elevated flow (luxury perfusion) as sign of spontaneous thrombolysis with reperfusion; in fact, these seven cases comprised all the reperfusion cases in the series. The results validate bicisate as a tracer of CBF in normal humans and in chronic brain diseases. Only in a subgroup of subacute stroke cases does bicisate not follow CBF, as it fails to show reperfusion hyperemia. This suggests the usefulness of bicisate in stroke cases, particularly in the subacute phase, where other SPECT methods often present difficulties due to reflow masking the size and the severity of the lesion.
在欧洲的七个中心进行了一项多中心研究，比较了99mTc-比西酯与133Xe作为评估比西酯作为人类脑血流量（CBF）分布示踪剂的手段。所有中心均使用同类型的单光子发射计算机断层扫描（SPECT）仪器（Tomomatic）。共收集了115例病例，其中105例在技术上被认为是足够的，包括18名正常受试者、18名老年痴呆患者、8名癫痫患者、1名脑肿瘤患者、8名慢性头部创伤患者和52名中风患者。正如预期的那样，比西酯的空间分辨率优于Xe。两种方法的结果在98例中一致，但在其余7例中不一致，这7例均属于中风组。这7例均患有亚急性中风（发病后11 - 23天），所有病例中的不一致之处在于比西酯显示梗死区域计数率低，而Xe显示正常或血流增加（奢侈灌注），这是自发溶栓再灌注的迹象；事实上，这7例病例包括了该系列中的所有再灌注病例。这些结果证实了比西酯作为正常人和慢性脑部疾病中CBF示踪剂的有效性。仅在亚急性中风病例的一个亚组中，比西酯不遵循CBF，因为它未能显示再灌注充血。这表明比西酯在中风病例中，特别是在亚急性期是有用的，因为在亚急性期，其他SPECT方法常常由于再灌注掩盖病变的大小和严重程度而存在困难。
