RELATION BETWEEN REGIONAL CEREBRAL BLOOD FLOW CHANGES AND NEUROLOGICAL SYMPTOMS IN THE ISCHEMIC CEREBRO- VASCULAR DISEASES--ON DYNAMIC CT AND COLD XENON CT-

1996 Fiscal Year Final Research Report Summary

• Project/Area Number: 07671029
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Single-year Grants
• Section: 一般
• Research Field: Radiation science
• Research Institution: TOKYO WOMEN'S MEDICAL UNIVERSITY
• Principal Investigator: ONO Yuko TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, PROFESSOR, 医学部, 教授 (50075470)
• Co-Investigator(Kenkyū-buntansha): YAMAMOTO Masaaki TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, ASSOCIATE PROFESSOR, 医学部, 助教授 (80096651) ; JIMBO Minoru TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, PROFESSOR, 医学部, 教授 (40075255) ; IWAI Eriko TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, LECTURER, 医学部, 講師 (80179473) ; UMEBARA Hiroshi TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, ASSISTANT, 医学部, 助手 (60246618) ; IDE Mitsunobu TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, ASSOCIATE PROFESSOR, 医学部, 講師 (30176317) ; NISHIMURA Yoshiko TOKYO WOMEN'S MEDICAL UNIVERSITY, SCHOOL OF MEDICINE, LECTURER (90266841)
• Project Period (FY): 1995 – 1996
• Keywords: CERBRAL VASCULAR DISEASE / ISCHEMIC / CERBRAL INFARCTION / DYNAMIC CT / XE I HALATION CT / REGIONAL CEREBRAL BLOOD FLOW(RCBF)

Research Abstract

[PURPOSE] DYNAMIC CT(DCT) AND XE INHALATION CT(XECT) WERE PERFORMED FOR THE ISCHEMIC CEREBRO-VASCULAR DISEASES TO FIND EFFECTIVENESS OF RECIRCULATION IN THE INVOLVED AREA COMPARING WITH THE NEUROLOGICAL DEFICITS, IN THE EARLY DAYS AFTER ONSET.
[MATERIALS AND METHOD] DCT(FOR 30 SECONDS) WAS PERFORMED IN 45 CASES OF CEREBRAL ISCHEMIA DURING 3 DAYS AFTER ONSET. XECT (FOR 4 MINUTES XE INHALATION) WAS PERFORMED IN 15 CASES, DURING 5-30DAYS AFTER ONSET.
[RESULTS] 10 CASES OF 25 DCT WITHOUT ABNORMALITY, OR SLIGHTLY DECREASED OR INCREASED RCBF DURING 48HOURS AFTER ONSET, PRESENTED NO INFARCTION IN THE FOLLOWING CT. IN 15 CASES OF THE SAME GROUP WITH SLIGHTLY TO MODERATELY DECREASED RCBF PRESENTED INFARCTION IN THE FOLLOWING EXAMINATION. ON DCT IN 72HOURS, 2 OF 6 CASES WITH EVIDENT DELAY AND DECREASE IN RCBF KEPT THEIR SEVERE NEUROLOGICAL DEFICITS, AND ANOTHER 1 CASE WITHOUT ABNORMALITY IN THE DCT SHOWED ONLY SLIGHTLY RECOVERED NEUROLOGICAL DEFICITS. UNRECOVERED SEVERE NEUROLOGICAL DEFICITS WERE NOTED IN THE PROMINENTLY DECREASED RCBF ON DCT, IN 14 CASES DURING 48HOURS AND IN OTHER 2 CASES DURING 72 HOURS. XECT WAS SUCCEEDED IN THE SUBACUTE STAGE, THEREFORE DECREASED RCBF VALUE IS ALMOST CORRELATIVE TO NEUROLOGICAL DEFICITS. ALL 6 CASES WITH MORE THAN 50%-DECREASED RCBF SHOWED MODERATE TO SEVERE CONTINUOUS NEUROLOGICAL DEFICITS. 1 OF 4 CASES WITH 20-50% DECREASED RCBF SHOWED MODERATE NEUROLOGICAL DEFICIT. 2 CESES WITHOUT ABNORMALITY ON XECT, BUT MODERATE TO SEVERE DELAY IN THE DCT SHOWED MODERATE TO SEVERE CONTINUOUS NEUROLOGICAL DEFICITS.
[DISCUSSION] DCT IS QUITE EFFECTIVE TO FIND THE OCCLUDED ARTERY AND COLLATERAL CIRCULATION OR RECANALIZATION JUST AFTER THE ONSET AND DURING 48HOURS AFTER ONSET, WHEN NO EXACT FOCUS OF ISCHEMIA IS DETECTED IN THE BRAIN PARENCHYMA. DCT IS PRESENTING CEREBRAL BLOOD FLOW AT THE EXAMINED TIME, BUT DCT INFORMATIONS WILL NOT BE EQUAL TO THE FINAL CIRCULATION TO THE ISCHEMIC AREA IN THE CASES WITH DEVELOPING ISCHEMIA. XECT IN SUBACUTE STAGE IS ALMOST CORRELATIVE TO THE FINAL CONDITION OF THE INVOLVED AREA, BUT THE EXAMINATION METHOD IS DIFFICULT FOR THE PATIENTS IN THE ACUTE STAGE.
[CONCLUSION] DCT IS EFFECTIVE TO KNOW CEREBRAL BLOOD FLOW CHANGE DURING 48HOURS AFTER ONSET TO SUGGEST FINAL CONDITION OF THE BRAIN AND TO SELECT THE SUITABLE THERAPEUTIC METHOD EXCEPT FOR DEVELOPING INFARCTION. XECT IS EFFECTIVE IN THE SUBACUTE STAGE TO KNOW THE FINAL CONDITION OF RCBF CHANGE.