Koshi Y, Kitamura S, Nagazumi A, Tsuganesawa T, Terashi A
Second Department of Internal Medicine, Nippon Medical School, First Hospital]
Rinsho Shinkeigaku. 1996 Jun;36(6):746-51.
In order to investigate relationship between regional cerebral blood flow (rCBF) and the white matter lesions on MRI in silent cerebral infarction, we quantitatively measured rCBF by 123I-IMP autoradiography method (IMP ARG method) and single photon emission tomography (SPECT) in 36 patients with silent cerebral infarction (SCI group), 22 patients with multi-infarct dementia (MID group), and 16 control subjects without periventricular hyperintensity (PVH) and lacunar infarction on MRI (CL group). Regions of interest (ROIs) on rCBF images were set in the frontal (F), temporal (T), parietal (P), occipital (O) cortex, and the cerebral white matter (W). The severity of PVH on MRI T2-weighted image was divided into four grades (grade 0-3). Our results: 1) Though the frequency of hypertension was significantly higher in SCI group and MID group compared with CL group, no significant difference was seen in the mean age among these three groups. 2) rCBF in the white matter and cerebral cortices except the occipital cortex in SCI group was significantly low compared with CL group (gamma CBFSCI/gamma CBFCL: W 0.87, F 0.87, P 0.88, O 0.92). 3) rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex, in MID group was significantly low compared with SCI group (gamma CBFMID/gamma CBFCL: W 0.69, F 0.71, T 0.74, P 0.75, O 0.81). 4) The mean grade of PVH in MID group was significantly higher that that in SCI group (SCI 1.1 vs MID 2.5). 5) The severity of PVH was significantly correlated with each rCBF in the white matter and cerebral cortices, especially in the white matter and frontal cortex. Our findings suggest that the quantitative measurement of rCBF by IMP ARG method is useful for the follow-up study in the patients with silent cerebral infarction as well as the evaluation of the severity of PVH on MRI.
为了研究无症状性脑梗死患者局部脑血流量（rCBF）与MRI上白质病变之间的关系，我们采用¹²³I-异丁基安非他明自体放射造影法（IMP ARG法）和单光子发射断层扫描（SPECT）对36例无症状性脑梗死患者（SCI组）、22例多发梗死性痴呆患者（MID组）以及16例MRI上无脑室周围高信号（PVH）和腔隙性梗死的对照者（CL组）的rCBF进行了定量测量。在rCBF图像上，将感兴趣区（ROI）设置在额叶（F）、颞叶（T）、顶叶（P）、枕叶（O）皮质以及脑白质（W）。根据MRI T2加权图像将PVH的严重程度分为四级（0 - 3级）。我们的结果如下：1）尽管SCI组和MID组的高血压发生率显著高于CL组，但三组的平均年龄无显著差异。2）SCI组脑白质及除枕叶皮质外的大脑皮质的rCBF显著低于CL组（γCBFSCI/γCBFCL：W 0.87，F 0.87，P 0.88，O 0.92）。3）MID组脑白质及大脑皮质，尤其是脑白质和额叶皮质的rCBF显著低于SCI组（γCBFMID/γCBFCL：W 0.69，F 0.71，T 0.74，P 0.75，O 0.81）。4）MID组PVH的平均分级显著高于SCI组（SCI为1.1，MID为2.5）。5）PVH的严重程度与脑白质及大脑皮质，尤其是脑白质和额叶皮质的各rCBF显著相关。我们的研究结果表明，IMP ARG法对rCBF进行定量测量，对于无症状性脑梗死患者的随访研究以及MRI上PVH严重程度的评估均有帮助。
