Kosuda S, Kusano S, Aoki S, Suzuki K, Fujii H, Kawakami R, Mezaki T, Akita S, Nakamura O, Shidara N
Department of Radiology, Tokyo Metropolitan Komagome Hospital.
Kaku Igaku. 1993 Jun;30(6):613-20.
In order to assess the cerebral distribution of intracarotid chemotherapy, 17 postoperative patients with brain tumor underwent brain SPECT obtained by intraarterial infusion of 18.5 MBq of 99mTc-HMPAO. Injection methods were continuous (5.0 ml/min) or pulsatile infusion with supraor infraophthalmic catheterization. The findings obtained by brain SPECT were frequently different from those of angiography and/or DSA. In supraophthalmic catheterization with continuous infusion, only 2 of 10 studies (20%) had homogeneous distribution and 5 of them (50%) had maldistribution of 99mTc-HMPAO which appears in association with laminar flow effect. The remaining 3 studies showed localized distribution (two: tumor localization, one: healthy brain localization). On the other hand, all of 5 studies with pulsatile infusion had homogeneous distribution of 99mTc-HMPAO. In infraophthalmic catheterization, all but one of 5 studies had homogeneous distribution with continuous infusion. These results suggest that pulsatile infusion may be effective in eliminating maldistribution of 99mTc-HMPAO in supraophthalmic catheterization. In conclusion, we are convinced that 99mTc-HMPAO is a useful intraarterial agent for assessing cerebral distribution of intracarotid chemotherapy.
为了评估颈动脉内化疗的脑内分布情况，17例脑肿瘤术后患者经动脉内注入18.5 MBq的99mTc-HMPAO后接受了脑单光子发射计算机断层扫描（SPECT）。注射方法为连续注射（5.0 ml/分钟）或采用经眼上或眼下导管插入术进行脉冲式注射。脑SPECT检查结果常常与血管造影和/或数字减影血管造影（DSA）的结果不同。在经眼上导管插入术连续注射的10项研究中，只有2项（20%）显示分布均匀，其中5项（50%）出现99mTc-HMPAO分布不均，这与层流效应有关。其余3项研究显示为局部分布（2项：肿瘤定位，1项：健康脑区定位）。另一方面，5项采用脉冲式注射的研究中，所有研究的99mTc-HMPAO分布均均匀。在经眼下导管插入术时，5项研究中除1项外，其余采用连续注射时分布均均匀。这些结果表明，脉冲式注射可能有助于消除经眼上导管插入术时99mTc-HMPAO的分布不均。总之，我们确信99mTc-HMPAO是一种用于评估颈动脉内化疗脑内分布的有用的动脉内用药。
