[Clinical significance of regional cerebral blood volume and flow-to-volume ratio in ischemic cerebrovascular disease measured by SPECT].
Regional cerebral blood volume (rCBV) and flow-to-volume ratio (rCBF/rCBV) were evaluated for clinical significance in comparison to rCBF and findings in X-ray CT (XCT) and radionuclide (RNA) and contrast angiography (CAG). A total of 109 cases were studied within 90 days after cerebrovascular ischemic attack. CBV SPECT was performed following CBF SPECT with I-123-IMP and RNA with Tc-99m-RBC, and processed for subtraction of I-123 contamination fraction. CBF/CBV image was obtained as the count ratio of CBF to CBV image at the same slice-level. Parametric rCBV and rCBF/rCBV were estimated as the count ratio of the focus to the contralateral normal region of interest. Image findings were scored by visual judgement. Student's t-test was applied for statistical analysis with a significance level of p = 0.01. The rCBV-ratio was inversely proportional to rCBF/rCBV-ratio, and was different between the two groups with high and low score on flip-flop perfusion in RNA and among three groups with different postictal neurological course. The ratio was the highest for the group of improved course. The rCBF/rCBV-ratio was possibly correlated to rCBF-ratio, and was different between the two groups with high and low score on low density area in XCT, early perfusion in RNA and arterial stenosis in CAG. In the group of improved course, the ratio was different between the second and the third postictal week's duration. These results, therefore, suggest that rCBV-ratio reflects collateral perfusion, and is valuable for assessing postictal prognosis in cerebrovascular disease, and that rCBF/rCBV-ratio may reflect regional oxygen extraction fraction, and is valuable for speculating cerebral perfusion reserve.
Senda
K
K
Department of Radiology, National Nagoya Hospital.
Maruyama
K
K
Chujo
M
M
Yokoyama
K
K
D000328:Adult; D000368:Aged; D000662:Amphetamines; D001810:Blood Volume; D001921:Brain / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007457:Iodine Radioisotopes; D020367:Iofetamine; D008297:Male; D008875:Middle Aged; D015899:Tomography, Emission-Computed, Single-Photon
D000662:Amphetamines; D007457:Iodine Radioisotopes; D020367:Iofetamine