雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Brain and Nerve No to Shinkei Volume 43, Issue 7 （July 1991）

Brain and Nerve 脳と神経 43巻7号（1991年7月発行）

Japanese English

原著

糖尿病患者における¹²³I-IMP SPECTの検討 Study of ¹²³I-IMP SPECT on Diabetic Patients 木下郁夫 ¹ , 竹尾剛 ¹ , 岩永圭介 ¹ , 魚谷茂雄 ¹ , 中村稔 ¹ , 早田正典 ¹ , 大江春人 ¹ , 利光孝 ² , 大江宣春 ² Ikuo Kinoshita ¹ , Goh Takeo ¹ , Keisuke Iwanaga ¹ , Shigeo Uotani ¹ , Minoru Nakamura ¹ , Masanori Sohda ¹ , Haruto Ohe ¹ , Takashi Toshimitsu ² , Nobuharu Ohe ² ¹北九州市立八幡病院内科 ²北九州市立八幡病院放射線科 ¹Department of Internal Medicine, Yahata City Hospital ²Department of Internal Radiology, Yahata City Hospital キーワード： ¹²³I-IMP SPECT , diabetes mellitus , diabetic central neuropathy , washout rate Keyword: ¹²³I-IMP SPECT , diabetes mellitus , diabetic central neuropathy , washout rate pp.671-676

発行日 1991年7月1日 Published Date 1991/7/1

DOI https://doi.org/10.11477/mf.1406900224

PDF(9098KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　近年各種大脳誘発電位検査より糖尿病（DM）性中枢神経障害の存在が指摘されている。今回¹²³I-IMP（IMP）SPECTを用いてwashout rate（W．R）の画像を作製し，40歳代以下のDM患者（23名，平均43.3歳）と健康成人（19名，平均44.3歳）のW．Rを比較し，W．R index（W．R．I）として画像およびヒストグラム表示をした。23名のDM患者において，W．R．I上7名がborder lineで16名がabnormalで全例異常が認められた。また，この異常は罹病期間や3大合併症の有無とも明らかな相関はみられなかった。このように明らかな脳血管障害の認められないDM患者においてもIMP SPECT上脳代謝機能の異常が認められ，潜在性の中枢神経障害が示唆された。また，この方法は正常群からのW．Rのバラツキが相対的に評価でき得る可能性が示唆された。

The involvement of peripheral nerves and nerve roots often leads to neurological manifestations which have frequently been described in association with diabetes mellitus. Whether there is any specific involvement of the central nervous system in this process has yet to be determined. Recently, many reports have suggested that significant neurophysiologic abnormalities in the central nervous system can sometimes be found in diabetic patients.

In order to accurately examine the existence of cen-tral nervous system involvement in patients with diabetes mellitus, comparisons of ¹²³I-IMP (IMP) wash-out rates were made between normal adults (n=19, average age 43.3years) and diabetic patients (n=23,average age 43.3 years) , and these results were graphi-cally demonstrated by color images. Early images were obtained 30 minutes after intravenous injection, while delayed images were made 4 hours after injection. The IMP washout rate was obtained by subtracting the values of the delayed image with the early image. The standard deviation (SD) of the IMP washout rate for each patient was compared to the averaged SD obtained from healthy adults. After calculating the deviation from SD levels of healthy adults, we made an image of the patient's IMP washout rates. These images were divided into seven degrees (I, II : normal, III, IV : borderline, V~VII: abnormal) and the ratio of each degree was expressed by a histogram in each cerebral hemisphere as the washout rate index. In 23 diabetic subjects, seven patients were found to be borderline while sixteen patients were abnormal. These impair-ments were not related either to the presence of diabetic triopathy or the duration of disease. By utilising such a noninvasive method, we were able to accurately evalu-ate the extent of diabetic central neuropathy. Therefore this subtraction method, which uses the specificity of IMP SPECT, is thus considered to be highly useful for broad clinical application.