Miyazawa N, Koizumi K, Mitsuka S, Nukui H
Department of Neurosurgery, Yamanashi Medical University, Japan.
Clin Nucl Med. 1998 Oct;23(10):686-90. doi: 10.1097/00003072-199810000-00008.
Discrepancies have been reported between the findings of Tc-99m HMPAO and Tc-99m ECD brain perfusion SPECT imaging. This study investigated the discrepancies in the accumulation of these tracers using dynamic SPECT to detect the super early phase of distribution. Thirteen patients with luxury perfusion or high flow states were studied with both dynamic and standard SPECT using Tc-99m HMPAO and Tc-99m ECD within 1-3 days. Standard SPECT showed discrepancies in 6 of 13 patients. Patients with meningioma and cerebral thrombosis had increased accumulation of Tc-99m HMPAO and decreased uptake of Tc-99m ECD. Patients with arteriovenous malformation, subarachnoid hemorrhage, and cavernous angioma had decreased accumulation of both tracers, but to different degrees. Dynamic SPECT showed increased or normal accumulation (i.e., essentially no discrepancy) in the first few minutes. However, Tc-99m HMPAO had a longer retention time than Tc-99m ECD in the ensuing 5-10 minutes. Dynamic SPECT revealed a similar accumulation pattern but different washout rates for the two tracers. Tc-99m HMPAO might be a more suitable tracer to detect high flow states or luxury perfusion because the findings on standard SPECT were more in agreement with those of dynamic SPECT using this tracer.
据报道，锝-99m六甲基丙烯胺肟（Tc-99m HMPAO）和锝-99m双半胱乙酯（Tc-99m ECD）脑灌注单光子发射计算机断层扫描（SPECT）成像的结果存在差异。本研究使用动态SPECT检测分布的超早期阶段，以调查这些示踪剂在蓄积方面的差异。对13例存在过度灌注或高血流状态的患者在1至3天内使用Tc-99m HMPAO和Tc-99m ECD进行了动态和标准SPECT研究。标准SPECT显示13例患者中有6例存在差异。患有脑膜瘤和脑血栓形成的患者，Tc-99m HMPAO蓄积增加而Tc-99m ECD摄取减少。患有动静脉畸形、蛛网膜下腔出血和海绵状血管瘤的患者，两种示踪剂的蓄积均减少，但程度不同。动态SPECT显示在最初几分钟内蓄积增加或正常（即基本无差异）。然而，在随后的5至10分钟内，Tc-99m HMPAO的滞留时间比Tc-99m ECD长。动态SPECT显示两种示踪剂的蓄积模式相似但洗脱率不同。Tc-99m HMPAO可能是检测高血流状态或过度灌注更合适的示踪剂，因为标准SPECT的结果与使用该示踪剂的动态SPECT结果更一致。
