Bestimmung der regionalen, zerebrovaskulären Perfusionsreserve (rCPR) mit der quantitativen Fluß/Volumen (F/V)-SPECT

Abstract

NPS (aphasia or neglect) are a regular concomitant symptom of cortical, and, occasionally, subcortical ischemic lesions. In 19 patients with subcortical lesions (eight with NPS, 11 without NPS), F/V-SPECT was employed to search for changes in rCPR in both, lesions and ipsilateral cortex. Results were correlated with NPS and MRI findings. Compared to the unaffected hemisphere, all subcortical lesions showed reduced regional cerebral blood flow (rCBF) (-16 to -23%), increased regional cerebral blood volume (rCBV) (+34 to +62%), and decreased or missing rCPR (-27 to -28%). Compared to MRI, there was no difference in lesion size in the thromboembolic lesions. Hemodynamic low-flow infarcts, however, were greater with SPECT than in MRI. In patients without NPS, the adjacent cortex was normal in SPECT and MRI. In addition, patients with NPS revealed reduced rCBF (-18%), increased rCBV (+19%), and decreased rCPR (-22%) in the adjacent cortex. MRI was normal in the same cortical area. These results indicate that NPS in subcortical lesions may be caused by a hemodynamic mechanism causing reduction of rCPR in the adjacent cortex.

Nuclear medicine 2000

“…In the diagnosis of renovascular hypertension, captoprit scintigraphy is of value in (radiologically proven) significant and severe stenosis but not in subcritical stenosis and occlusion, because only under these conditions are the renin-angiotensin compensation and secondary change of the renogram indicative (Sfakianakis et al 1988). in microangiopathy versus macroangiopathy, are scientific ideas that might help individual patients with neurological problems (Reiche et al 1990). We should rely on regional function and concentrate our strength.…”