Marochnik S, Alexandrov A V, Anthone D, Lewin C, Caldwell C B, Pullicino P M
Department of Anesthesiology, Buffalo General Hospital, State University of New York, USA.
J Neuroimaging. 1996 Oct;6(4):243-5. doi: 10.1111/jon199664243.
Single-photon emission computed tomography (SPECT) and transcranial Doppler (TCD) ultrasonography were used to assess brain perfusion during cardiopulmonary bypass. Intravenous injections of technetium 99 m-hexamethylpropyleneamineoxime (99mTc-HMPAO) were administered before surgery and intraoperatively after the first 2 minutes in the first patient and at the end (42 minutes) of cardiopulmonary bypass in the second patient. The total middle cerebral artery territory counts were calculated using the region-of-interest method and compared to cerebellar regional counts. 99mTc-HMPAO uptake on SPECT scans was increased at the beginning and at the end of cardiopulmonary bypass, compared to baseline preoperative values (11-17%) in the presence of multiple microembolic signals on TCD (n1 = 35 and n2 = 42 for unilateral middle cerebral artery monitoring). These results indicate the feasibility of using HMPAO-SPECT to study brain perfusion changes during cardiac surgery. A combination of SPECT and TCD ultrasonography may be used to study the impact of microembolism during cardiac surgery with cardiopulmonary bypass.
单光子发射计算机断层扫描（SPECT）和经颅多普勒（TCD）超声检查用于评估体外循环期间的脑灌注情况。在手术前以及第一名患者体外循环开始2分钟后、第二名患者体外循环结束时（42分钟）静脉注射锝99m-六甲基丙烯胺肟（99mTc-HMPAO）。使用感兴趣区法计算大脑中动脉区域的总计数，并与小脑区域计数进行比较。与术前基线值相比，在TCD存在多个微栓子信号的情况下（单侧大脑中动脉监测，n1 = 35，n2 = 42），体外循环开始时和结束时SPECT扫描上的99mTc-HMPAO摄取增加（11-17%）。这些结果表明使用HMPAO-SPECT研究心脏手术期间脑灌注变化的可行性。SPECT和TCD超声检查相结合可用于研究体外循环心脏手术期间微栓塞的影响。
