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Brain and Nerve No to Shinkei Volume 40, Issue 12 （December 1988）

Brain and Nerve 脳と神経 40巻12号（1988年12月発行）

Japanese English

原著

¹³³Xe吸入法single photon emission CTによる正常例の脳血流に関する検討 MEASUREMENT OF CEREBRAL BLOOD FLOW IN NORMAL SUBJECTS BY 133XENON INHALATION AND SINGLE PHOTON EMISSION COMPUTERIZED TOMOGRAPHY 今尾幸則 ¹ , 荒木有三 ¹ , 清水言行 ¹ , 安藤隆 ¹ , 坂井昇 ¹ , 山田弘 ¹ Yukinori Imao ¹ , Yuzo Araki ¹ , Kotoyuki Shimizu ¹ , Takashi Ando ¹ , Noboru Sakai ¹ , Hiromu Yamada ¹ ¹岐阜大学医学部脳神経外科 ¹Department of Neurosurgery, Gifu University School of Medicine pp.1143-1150

発行日 1988年12月1日 Published Date 1988/12/1

DOI https://doi.org/10.11477/mf.1406206220

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Abstract 文献概要
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　抄録　¹³³Xe吸入法によるsingle photon emission CT （SPECT）を25〜82歳までの健常成人40例に計51回施行し脳血流の半球間左右差，加齢による影響などについて検討した。40例中5例には1回目より1時間以内に2回目のSPECTを（group I），別の6例には7〜26日後に2回目のSPECT （group II）を施行しそれぞれの再現性をみた。また5例では¹²³I-IMP静注によるSPECTを同時に行ない¹³³Xe SPECTとの比較を行った。使用したSPECT装置はTomomatic 564（Medimatic Inc．　Denmark）でスライス幅2cmの連続した断層画像が同時に5スライス撮像できる。¹²³I-IMP SPECTに比べて¹³³Xe SPECTでは小脳および白質の血流が過大評価される傾向にあった。大脳半球平均血流量は右側で有意に高く局所的には前大脳動脈，中大脳動脈領域で有意差（右＞左）を認めた。脳血流は加齢と共に低下しとくに中大脳動脈領域でその傾向が強かった。group Iおよびgroup IIともに再現性は比較的良好であった。しかしどちらも2回目の測定値は1回目の測定値に比べて有意ではないが低下する傾向にあり，両測定間での被検者の精神的緊張度の違いにより脳血流が変化したものと思われた。

Cerebral blood flow (CBF) was studied tomo-graphically in 40 normal volunteers between 25 and 82 years of age in the resting state by single photon emission computerized tomography (Tomo-matic 564) accompanied by inhalation of ¹³³Xenon. In order to investigate the reproducibility, five of these reci eyed a second examination within 1 hour of the first (group I). Six others received a second examination 7 to 26 days after the first examination (group II). In addition, ¹²³I-IMPSPECT was performed in five out of 40 subjects to compare the di fference between ¹²³I-IMP SPECT and ¹³³Xe SPECT. The Tomomatic 564 (Medimatic Inc. Denmark) gives 5 slices of 2 cm thickness simultaneously and its spatial resolution (full width at half maximum, FWHM) as measured with a ¹³³Xenon line source in water was 1.6 cm in the center of each slice. CBF was calculated accord-ing to the early picture method and the sequence of picture method described by Kanno and Lassen. Subjects were positioned in the tomograph so that the five transverse sections were located at 1, 3, 5, 7 and 9 cm above and parallel to the or-bito-meatal line (OML). Cerebellar flows were obtained from a slice 1 cm above the OML (slice 1) and mean hemispheric flows were obtained from slices 3 cm (slice 2), 5 cm (slice 3), 7cm (slice 4) and 9 cm (slice 5) above the OML. The supra-tentorial regional CBF (anterior-, middle-, posterior cerebral artery and basal ganglia) was obtainedfrom slice 3 and 4 according to the CT vascular territories described by Berman et al and res-pective values were represented by an average of both values.

The following results were obtained.

1) The mean CBF derived from slice 2 was significantly higher than that derived form slice 3 while the mean CBF derived from slice 4 and slice 5 was significantly lower.

2) The CBF values in the region of the cere-bellum and white matter obtained from '33Xe SPECT tended to be greater than the 123I-IMP SPECT values.

3) The right-sided regional CBF values were slightly higher than the left in anterior and mid-dle cerebral artery territories, whereas no asym-metries were obtained in the posterior cerebral artery territory, basal ganglia or the cerebellum.

4) CBF showed significant negative correlation with advancing age and a reduction of CBF values with advancing age was greater in the middle cerebral artery territories bilaterally com-pared with other regions.

5) Both group I and group If showed a good reproducibility, although the CBF values obtained in the second examination were slightly lower than that obtained in the first.