Lin W Y, Kao C H, Wang P Y, Changlai S P, Wang S J
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Nucl Med Commun. 1996 Mar;17(3):208-11. doi: 10.1097/00006231-199603000-00006.
Luxury perfusion is a well-known phenomenon that can mask ischaemic lesions in patients with cerebral infarction, thus making diagnosis difficult. In this study, we evaluated the incidence of luxury perfusion over a 3-week period following a stroke episode. The usefulness of crossed cerebellar diaschisis (CCD) as a complementary feature in the diagnosis of cerebral infarction was also evaluated using 99Tcm-hexamethylpropyleneamine oxime (99TcmHMPAO) brain single photon emission tomography (SPET). Twelve patients diagnosed as having a hemispheric ischaemic stroke of the middle cerebral arterial territory were enrolled in the study. Each patient underwent a total of four 99Tcm-HMPAO brain SPET examinations, 1 day, 1 week, 2 weeks and 3 weeks following the stroke episode. Our results show that the incidence of luxury perfusion was 67% (8/12) after 1 week, 75% (9/12) after 2 weeks and 83% (10/12) after 3 weeks. The incidence of CCD was 33% (4/12) after 1 day, 50% (6/12) after 1 week, 42% (5/12) after 2 weeks and 33% (4/12) after 3 weeks. We conclude that the detection of cerebral infarction is difficult 2 weeks or more after a stroke episode. The interval between the stroke episode and examination must be considered when reading the 99Tcm-HMPAO image. In addition, CCD may be helpful for the diagnosis of cerebral infarction within the first week after a stroke episode, especially in cases of an unidentified ischaemic region on the 99Tcm-HMPAO hemispheric image. However, the value of CCD is limited 2 weeks or more following the stroke episode.
过度灌注是一种众所周知的现象，它可掩盖脑梗死患者的缺血性病变，从而使诊断变得困难。在本研究中，我们评估了卒中发作后3周内过度灌注的发生率。还使用99锝-六甲基丙烯胺肟（99TcmHMPAO）脑单光子发射断层扫描（SPET）评估了交叉性小脑失联络（CCD）作为脑梗死诊断补充特征的有用性。12例被诊断为大脑中动脉区域半球缺血性卒中的患者纳入了本研究。每位患者在卒中发作后的第1天、第1周、第2周和第3周总共接受4次99Tcm-HMPAO脑SPET检查。我们的结果显示，过度灌注的发生率在1周后为67%（8/12），2周后为75%（9/12），3周后为83%（10/12）。CCD的发生率在第1天为33%（4/12），第1周为50%（6/12），第2周为42%（5/12），第3周为33%（4/12）。我们得出结论，卒中发作后2周或更长时间难以检测到脑梗死。在解读99Tcm-HMPAO图像时必须考虑卒中发作与检查之间的间隔时间。此外，CCD可能有助于卒中发作后第一周内脑梗死的诊断，尤其是在99Tcm-HMPAO半球图像上缺血区域不明确的情况下。然而，卒中发作后2周或更长时间CCD的价值有限。
