Soricelli A, Mainenti P P, Leone D, Discepolo A, Romano M, Varrone A, Servillo G, Serio S, Brunetti A, Salvatore M
Chair of Nuclear Medicine, University of Naples Federico II, Italy.
Minerva Anestesiol. 1996 Jun;62(6):209-12.
Nuclear Medicine studies performed with tomographic acquisition and tracers such as Technetium-99m hexamethyl-propyleneamine oxime (99mTc-HMPAO) are able to assess cerebral blood flow. A case is reported of a patient with a large intracranial tumor, of possible pituitary origin, with a clinical and electroencephalographic suspicion of brain death. The patient had endocrinous-metabolic impairments for a history of impotence, since 18 months, and diabetes insipidus with a urine output of 350 ml/hr in the first 24 hours from the clinical suspicion of brain death. Due to the endocrinous-metabolic impairments, according to Italian law, it was necessary to confirm the diagnosis of brain death by performing a study able to assess cerebral blood flow. A single Photon Emission Tomography (SPET) scan was performed after the intravenous administration of 99mTc-HMPAO using a high resolution, brain dedicated device. No tracer uptake was evident in cerebral, cerebellar and brain stem structures. The cerebral blood flow study by SPET confirmed the diagnosis of brain death and made the organ transplant possible in a short period of time. High resolution SPET studies are useful to confirm the diagnosis of brain death when there are factors that can influence clinical and electroencephalographic signs, reducing time to authorise the organ explant.
采用断层采集技术以及锝-99m六甲基丙烯胺肟（99mTc-HMPAO）等示踪剂进行的核医学研究能够评估脑血流量。本文报告了一例患者，其颅内有一个可能起源于垂体的大型肿瘤，临床及脑电图检查怀疑脑死亡。该患者因阳痿病史已有18个月，存在内分泌代谢障碍，且自临床怀疑脑死亡起的头24小时内尿量达350毫升/小时，患有尿崩症。由于存在内分泌代谢障碍，根据意大利法律，有必要通过一项能够评估脑血流量的研究来确诊脑死亡。在静脉注射99mTc-HMPAO后，使用一台高分辨率的脑部专用设备进行了单光子发射断层扫描（SPET）。在大脑、小脑和脑干结构中均未发现明显的示踪剂摄取。通过SPET进行的脑血流量研究确诊了脑死亡，并使得在短时间内进行器官移植成为可能。当存在可能影响临床和脑电图体征的因素时，高分辨率SPET研究有助于确诊脑死亡，从而缩短批准器官摘除的时间。
