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Brain and Nerve No to Shinkei Volume 44, Issue 1 （January 1992）

Brain and Nerve 脳と神経 44巻1号（1992年1月発行）

Japanese English

原著

経静脈性digital subtraction angiographyを用いた脳血管床血流評価の試み—time density cuiveのパラメーターの検討 Evaluation of Cerebral Intravascular Blood Flow by Time Density Curve Study of Intravenous Digital Subtraction Angiography 今村徹 ¹ , 関根禎子 ² , 佐藤景 ² , 遠藤実 ² , 圓谷建治 ² , 小暮久也 ¹ , 星章彦 ³ Toru Imamura ¹ , Teiko Sekine ² , Kei Satoh ² , Minoru Endoh ² , Kenji Tsuburaya ² , Kyuya Kogure ¹ , Akihiko Hoshi ³ ¹東北大学医学部脳疾患研究施設神経内科 ²東北厚生年金病院神経内科 ³東北厚生年金病院放射線科 ¹Department of Neurology, Institute of Brain Diseases, Tohoku University School of Medicine ²Department of Neurology, Tohoku Kohseinenkin Hospital ³Department of Radiology, Tohoku Kohseinenkin Hospital キーワード： intravascuiar blood flow , ischemic cerebrovascuiar disease , digital subtraction angiography , time density curve , cerebral circulation Keyword: intravascuiar blood flow , ischemic cerebrovascuiar disease , digital subtraction angiography , time density curve , cerebral circulation pp.31-35

発行日 1992年1月1日 Published Date 1992/1/1

DOI https://doi.org/10.11477/mf.1406902053

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Abstract 文献概要
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　経静脈性digital subtraction angiography（IVDSA）を用いた簡易的な脳血管床血流評価法について検討した。頭部正面像で左右の中大脳動脈領域にROIをとってtime density curve（TDC）を作成し，TDCのpeak time（PT）やmodal transit time（MOTT）といったパラメーターの左右差を，症例群ごとに検討した。大血管閉塞群では，PTとMOTTの左右差は対照群より有意に延長し，SPECT上の低集積群ではMOTTの左右差が等集積群より有意に延長していた。大血管閉塞が見られるにもかかわらずSPECT上等集積であった例では，MOTTの左右差は対照群と同程度であった。以上の結果は，PT，MOTTの左右差が脳血管床血流をある程度反映し，局所脳血流の左右差の何らかの指標となる可能性を示していると思われる。このような簡便な脳循環動態評価法は，特に虚血性脳血管障害超急性期治療などの場面で有用性を発揮するかもしれない。

Time density curve (TDC) can be reconstructed from the data of intravenous digital subtraction angiography (IVDSA). We evaluated peak time (PT) and modal transit time (MOTT) of the TDC as the probable indica-tor of cerebral intravascular blood flow.

Cerebral IVDSA and single photon emission CT (SPECT) were performed on 12 patients of ischemic cerebrovascular disease, which consisted of 3 internal carotid artery (ICA) occlusions, one middle cerebral artery (MCA) occlusion, one anterior cerebral artery (ACA) branch occlusion and 7 lacunar infarctions. We classified former 4 patients as occlusion group and latter 8 as reference group. In 3 patients (2 ICA and one MCA occlusions), SPECT study revealed definite hypoac-cumulation in the MCA territory of occlusive side. Two regions of interest (ROI) were placed on the territories of right and left middle cerebral arteries in the frontal view of cerebral IVDSA. Digital data processor fitted y curve to the TDC of each ROI, and calculated PT and MOTT.

The absolute lateralities of PT and MOTT of MCA territory was significantly (p ＜0.05) larger in occlusion group than reference group. Patients with hypoac-cumulation in SPECT had significantly (p＜0.02) larger laterality of MOTT than patients with isoaccumulation One ICA occluded patient without hypoaccumulation in corresponding MCA territory had relatively small late-rality of MOTT similar to the patients of ACA branch occlusion and lacunar infarction. These results suggest that PT and MOTT are possible to detect the laterality of the intravascular blood flow in MCA territories caused by major artery occlusion. Cerebral TDC study of IVDSA may be useful in some clinical therapeutic situations such as hemodilution or intra-arterial throm-bolysis, and worth further clinical evaluation.