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Brain and Nerve No to Shinkei Volume 38, Issue 1 （January 1986）

Brain and Nerve 脳と神経 38巻1号（1986年1月発行）

Japanese English

原著

虚血性脳病変に対するヨードアンフェタミンによる脳循環測定 CEREBRAL BLOOD FLOW STUDIES USING N-ISOPROPYL I-123 P-IODOAMPHETAMINE IN CEREBRAL ISCHEMIC LESIONS 古林秀則 ¹ , 林実 ¹ , 河野寛一 ¹ , 半田裕二 ¹ , 兜正則 ¹ , 野口善之 ¹ , 白崎直樹 ¹ , 山本信二郎 ² , 松田博史 ³ Hidenori Kobayashi ¹ , Minoru Hayashi ¹ , Hirokazu Kawano ¹ , Yuji Handa ¹ , Masanori Kabuto ¹ , Yoshiyuki Noguchi ¹ , Naoki Shirasaki ¹ , Shinjiro Yamamoto ² , Hiroshi Matsuda ³ ¹福井医科大学脳神経外科 ²金沢大学脳神経外科 ³金沢大学核医学科 ¹Department of Neurosurgery, Fukui Medical School ²Departments of Neurosurgery, University of Kanazawa ³Departments of Nuclear Medicine, University of Kanazawa pp.75-80

発行日 1986年1月1日 Published Date 1986/1/1

DOI https://doi.org/10.11477/mf.1406205646

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Abstract 文献概要
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　抄録　虚血性脳病変の18症例についてヨードアンフェタミン（IMP）とガンマカメラ回転型emissioncomputed tomography （ECT）を用いて脳循環測定を行なった。IMP静注直後より5分間動脈採血を行なって局所脳血流の絶対値を算出した。CTスキャンを同時に検査し低吸収域の有無を観察した。8例に¹³³Xe吸入法（NOVO cerebrograph）による脳血流測定を行ない比較検討した。ECT検査では16例に局所性の低灌流域が，他の2例では全般性の低灌流域が観察された。矢状断，冠状断のECT像は低灌流域の支配動脈の同定に有用であった。CTスキャンでは9例に低吸収域は認められなかった。ECTで測定された脳表部の局所脳血流値は¹³³Xe吸入法（ISI）の対応する部位の値と近似していた。頭蓋外‐頭蓋内血管吻合術で対側半球，脳深部にも血流増加が観察された。IMP使用によるECT検査は脳虚血の早期診断，局所脳血流の三次元的測定のために今後普及すると考えられる。

Eighteen patients were studied for cerebral blood perfusion abnormalities using N-isopropyl I-123 p-iodoamphetamine (IMP) and rotating dual gamma camera emission computed tomography (ECT). All were stroke patients, 10 with cerebral vasospasm after an aneurysmal rupture, 3 with an occlusion of the middle cerebral artery, 2 with an occlusion of the internal carotid artery (IC), one with an IC stenosis, one with Moyamoya disease and one with RIND. Four patients had extracra-nial-intracranial (EC-IC) bypass operations. In three of them, CBF studies were done before and after bypass surgery.

An arterial line was placed in the left radial artery and connected to a Harvard pump. IMP (1.5-3 mCi) was injected into an arm vein while at the same time an arterial blood sample was withdrawn at a constant speed for 5 minutes.

Scanning was started 35 minutes after IMP in-jection. After a scan, multiple transverse, coronal and sagittal section images were reconstructed with a minicomputer. We determined the values of regional CBF in the regions of interest using an image. Transmission computed tomography (CT) studies were performed on the same day. In eight patients, CBF study by ¹³³Xe inhalation method (NOVO cerebrograph) was done.

ECT showed diffuse low perfusion in two pa-tients and focal low perfusion in 16 patients while CT showed abnormalities in 9 patients (50%). ECT abnormalites were more extensive than CT abnormalities. The values of rCBF in the super-ficial brain determined by ECT were similar to those examined by the inhalation method (ISI). Significant increase in rCBF was observed after the bypass operations.

ECT is a promising method of identifying zones with lesser degrees of ischemia and evaluating operative results such as either EC-IC bypass or endarterectomy.