用碘-123-异丁基苄胍放射自显影术测量局部脑血流量：正常值、可重复性及对灌注不足的敏感性
Regional cerebral blood flow measurement with iodine-123-IMP autoradiography: normal values, reproducibility and sensitivity to hypoperfusion.
作者信息
Hatazawa J, Iida H, Shimosegawa E, Sato T, Murakami M, Miura Y
机构信息
Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Japan.
出版信息
J Nucl Med. 1997 Jul;38(7):1102-8.
UNLABELLED
We recently proposed a simplified technique for measuring regional cerebral blood flow (rCBF) using the [123I]N-isopropyl-p-iodoamphetamine (IMP) autoradiographic (ARG) method with SPECT (the IMP-ARG method). We examined normal values of rCBF and the reproducibility and sensitivity to hypoperfusion in stroke patients using this method.
METHODS
By using a standard arterial input, a single static scan, a fixed distribution volume (Vd) and one-point arterial blood sampling, we measured rCBF in 39 normal volunteers (19 men and 20 women; mean ages 61 +/- 11 yr for the men and 60 +/- 12 yr for the women). Eighteen neurologically stable patients with prior stroke (mean age = 65 +/- 11 yr) were studied twice at a mean interval of 97 days. In 16 patients (7 men and 9 women, mean age = 63 +/- 5 yr) with subarachnoid hemorrhage, rCBF was measured 1-2 wk after onset. Cerebral vasospasm was evaluated by repeated angiography. The mean rCBF in the vasospastic area was compared with that in a nonvasospastic area.
RESULTS
The mean rCBFs of the cerebral cortex and centrum semiovale in the volunteers were 33.0 +/- 5.1 ml/100 g/min and 25.0 +/- 4.5 ml/100 g/min, respectively. There was no age-dependent change in rCBF, but the women showed significantly higher cortical rCBF than the men (p < 0.05). In the stroke patients, the whole-brain CBF values showed high reproducibility, with high correlations between those obtained at the first and second studies (y = -3.5 + 1.03x; r = 0.90; p < 0.001). In the subarachnoid hemorrhage patients, the vasospastic area showed significantly lower rCBF than the normal cortical rCBF (p < 0.01) and the nonvasospastic area (p < 0.01). Brain regions with rCBF levels below 20 ml/100 g/min showed infarction on the follow-up CT scan.
CONCLUSION
The IMP-ARG method is reproducible, sensitive to hypoperfusion and feasible for the quantitative evaluation of rCBF in routine clinical practice.
未标注
我们最近提出了一种使用[123I]N-异丙基-p-碘安非他明（IMP）放射自显影（ARG）法结合单光子发射计算机断层扫描（SPECT）（IMP-ARG法）测量局部脑血流量（rCBF）的简化技术。我们使用该方法研究了rCBF的正常值以及中风患者对灌注不足的可重复性和敏感性。
方法
通过使用标准动脉输入、单次静态扫描、固定分布容积（Vd）和单点动脉血样采集，我们测量了39名正常志愿者（19名男性和20名女性；男性平均年龄61±11岁，女性平均年龄60±12岁）的rCBF。18名既往有中风且神经功能稳定（平均年龄 = 65±11岁）的患者平均间隔97天进行了两次研究。在16名蛛网膜下腔出血患者（7名男性和9名女性，平均年龄 = 63±5岁）中，发病后1 - 2周测量rCBF。通过重复血管造影评估脑血管痉挛。比较痉挛区域的平均rCBF与非痉挛区域的平均rCBF。
结果
志愿者大脑皮质和半卵圆中心的平均rCBF分别为33.0±5.1 ml/100 g/min和25.0±4.5 ml/100 g/min。rCBF没有年龄依赖性变化，但女性的皮质rCBF显著高于男性（p < 0.05）。在中风患者中，全脑CBF值显示出高可重复性，首次和第二次研究获得的值之间具有高度相关性（y = -3.5 + 1.03x；r = 0.90；p < 0.001）。在蛛网膜下腔出血患者中，痉挛区域的rCBF显著低于正常皮质rCBF（p < 0.01）和非痉挛区域（p < 0.01）。rCBF水平低于20 ml/100 g/min的脑区在后续CT扫描中显示梗死。
结论
IMP-ARG法具有可重复性，对灌注不足敏感，在常规临床实践中对rCBF进行定量评估是可行的。
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