title: Combined SPECT imaging of regional cerebral blood flow (99mTc-hexamethyl-propyleneamine oxime, HMPAO) and blood volume (99mTc-RBC) to assess regional cerebral perfusion reserve in patients with cerebrovascular disease.
abstract: In 53 patients with cerebrovascular disease (CVD), regional cerebral blood flow (CBF) and blood volume (CBV) were imaged by SPECT within one session. Slice division (CBF: CBV) yielded distribution of regional cerebral perfusion reserve (CPR). Semiquantitative evaluation was obtained from manually set ROIs by interhemispherical ratios (for CBF, CBV and CPR), using 2 SD from a normal group (n = 10) as a threshold. Sensitivities were 59% for CBF, 94% for CBV and 83% for CPR. Combined sensitivity was 98%. Establishing three constellations for CBF, CBV and CPR, regionally normal CBFs but quantitatively increased CBVs (+69%) and decreased CPRs (-31%) were found in relatively early stages of CVD. Very advanced cases showed decreased CBFs (-65%), CBVs (-40%), CPRs (-49%) and a surrounding penumbra. In 87% (46/53 patients), such rheologically postulated constellations could be demonstrated. We conclude that combined CBF and CBV SPECT, assisted by CPR images, is a promising tool to detect CVD and to assess its individual regional severity.
authors.affiliation: Department of Nuclear Medicine, Technical University, Aachen, FRG.
authors.forename: U
authors.initials: U
authors.lastname: Buell
authors.forename: H
authors.initials: H
authors.lastname: Braun
authors.forename: A
authors.initials: A
authors.lastname: Ferbert
authors.forename: H
authors.initials: H
authors.lastname: Stirner
authors.forename: C
authors.initials: C
authors.lastname: Weiller
authors.forename: E B
authors.initials: EB
authors.lastname: Ringelstein
mesh_terms: D000368:Aged; D001810:Blood Volume; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D004912:Erythrocytes; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D010091:Oximes; D010477:Perfusion; D013667:Technetium; D019690:Technetium Tc 99m Exametazime; D014055:Tomography, Emission-Computed
chemical_list: D009942:Organometallic Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime; D013667:Technetium