Shiina G, Onuma T, Kameyama M, Shimosegawa Y, Ishii K, Shirane R, Yoshimoto T
Department of Neurosurgery, Sendai City Hospital, Japan.
AJNR Am J Neuroradiol. 1998 Feb;19(2):297-302.
Our goal was to elucidate the temporal profile of cerebral circulation and its relationship to prognosis in patients with diffuse brain injury by using single-photon emission CT (SPECT) and 123I-iodoamphetamine (IMP).
A total of 67 assessments were made in 26 patients with diffuse brain injury (Glasgow Coma Scale score < or = 8). The microsphere method was used for quantifying cerebral blood flow (CBF). The hemispheric CBF was defined as a mean regional CBF (rCBF), and the total cerebral hemispheric CBF (tCBF) as a mean of the bilateral hemispheric CBF. The relationship between patient outcome and tCBF was investigated.
The rCBF in patients with diffuse brain injury showed dynamic and global changes with little regional differences. The tCBF values increased in 1 to 3 days, and they were higher in the poor-outcome group than in the good-outcome group. During the period of 14 to 42 days, the tCBF values stayed within normal range in the good-outcome group, whereas they were below normal range in the poor-outcome group.
Our results revealed a good correlation between patient outcome and CBF values. Quantitative and sequential CBF studies with IMP SPECT are promising for helping to determine the prognosis for patients with diffuse brain injury.
我们的目标是通过使用单光子发射计算机断层扫描（SPECT）和123I-碘安非他明（IMP）来阐明弥漫性脑损伤患者脑循环的时间特征及其与预后的关系。
对26例弥漫性脑损伤患者（格拉斯哥昏迷量表评分≤8分）进行了共67次评估。采用微球法量化脑血流量（CBF）。半球CBF定义为平均局部脑血流量（rCBF），全脑半球CBF（tCBF）定义为双侧半球CBF的平均值。研究了患者预后与tCBF之间的关系。
弥漫性脑损伤患者的rCBF表现出动态的整体变化，区域差异较小。tCBF值在1至3天内升高，预后不良组高于预后良好组。在14至42天期间，预后良好组的tCBF值保持在正常范围内，而预后不良组则低于正常范围。
我们的结果显示患者预后与CBF值之间具有良好的相关性。使用IMP SPECT进行定量和连续的CBF研究有望有助于确定弥漫性脑损伤患者的预后。
