Positron Emission Tomographyによる血行再建術前後の脳循環代謝の評価—4症例の報告

An Evaluation of Cerebral Blood Flow and Metabolism of Reconstructive Vascular Surgery Using Positron Emission Tomography : A Report of 4 Cases

　閉塞性脳血管障害症例4例に血行再建術を施行し，その前後にpositron emission tomography（PET）を用いて脳循環代謝諸量を計測した。症例は主幹動脈狭窄が関与するTIA 1例，minor stroke 3例であり，2例に浅側頭動脈中大脳動脈吻合術，2例に頸動脈内膜剥離術を施行した。PETでは脳血流量（CBF），脳血液量（CBV），脳酸素摂取率（OEF），脳酸素消費率（CMRO₂），CBF／CBVを健常領域，狭窄領域に分けて計測した。浅側頭動脈中大脳動脈吻合術を施行した症例では各因子に明確な改善は認めなかった。頸動脈内膜剥離術を施行した2例では各因子の改善を認めた。

Changes in cerebral hemodynamics due to recon-structive cerebral vascular surgery were evaluated using positron emission tomography (PET) . Three minor stroke cases and 1 TIA case, brought on by main trunk stenosis, were included. STA-MCA anastomoses was performed in two of the cases and carotid endarterectomy was performed in the remai-ning two cases. CBF, CBV, OEF, CMRO₂ and CBF/ CBV were investigated using PET with the ROIs fixed in both normal and stenosis areas. On the two cases of STA - MCA anastomosis, clear hemo-dynamic improvement was not demonstrated. On the two carotid endarterectomy cases, the hemo-dynamic factors showed improvement.