Komatani A, Akutsu T, Onodera Y, Yamaguchi K
Department of Radiology, Yamagata University School of Medicine.
Kaku Igaku. 1995 Sep;32(9):989-96.
To investigate the discrepancy between 99mTc-hexamethylpropyleneamine oxime (HMPAO) and 133Xe rCBF SPECT, the findings of thirty patients with reasonable rCBF reduction on 133Xe SPECT were compared with HMPAO SPECT and X-ray CT. The subjects did not include the cases of acute and subacute CVD. Both SPECT were performed within two weeks by ring-type dynamic SPECT (HEADTOME, Simadzu, Japan). In comparison between the SPECT findings by 133Xe and 99mTc-HMPAO, the subjects were classified into three groups as follow. Group A: Similar findings in the both SPECT were noted in 6 cases (20%). Group B: Smaller findings on HMPAO SPECT than that by 133Xe were in 11 cases (37%). Group C: No findings of rCBF reduction on HMPAO SPECT were in 13 cases (43%). The rCBF of the lesion measured by 133Xe SPECT in the group C was 24-35 ml/100 g/min. The density of HMPAO in the lesion did not correlate with the rCBF value. Only the severity of CT findings tend to correlate with the density of HMPAO. These results suggest that the reduction of HMPAO density depends directly on some kind of neural injury rather than the rCBF value. The injury may be caused by the flow reduction under the threshold of each neural cell. So the correlation between HMPAO density and actual rCBF might show like sigmoid curve. Then the HMPAO SPECT might directly reflect the regional extraction and fixation ratio, and the reduction of blood flow cause the minute neural-injury in the lesion of moderately reduced rCBF.
为研究99mTc-六甲基丙烯胺肟（HMPAO）与133Xe脑血流灌注单光子发射计算机断层扫描（rCBF SPECT）之间的差异，将30例经133Xe SPECT检查显示脑血流灌注合理降低的患者的检查结果与HMPAO SPECT及X线计算机断层扫描（CT）结果进行比较。研究对象不包括急性和亚急性心血管疾病患者。两种SPECT均采用环形动态SPECT（日本岛津公司的HEADTOME）在两周内完成检查。在比较133Xe和99mTc-HMPAO的SPECT检查结果时，将研究对象分为以下三组。A组：6例（20%）患者的两种SPECT检查结果相似。B组：11例（37%）患者的HMPAO SPECT检查结果小于133Xe SPECT检查结果。C组：13例（43%）患者的HMPAO SPECT检查未发现脑血流灌注降低。C组中经133Xe SPECT测量的病变部位脑血流灌注为24 - 35 ml/100 g/min。病变部位HMPAO的摄取量与脑血流灌注值无相关性。仅CT检查结果的严重程度与HMPAO摄取量有一定相关性。这些结果表明，HMPAO摄取量的降低直接取决于某种神经损伤，而非脑血流灌注值。这种损伤可能是由每个神经细胞阈值以下的血流减少所致。因此，HMPAO摄取量与实际脑血流灌注之间的相关性可能呈S形曲线。那么，HMPAO SPECT可能直接反映局部摄取和固定率，血流减少会导致脑血流灌注中度降低病变部位出现微小神经损伤。
