Central Benzodiazepine Receptor Binding Potential and CBF Images on SPECT Correlate with Oxygen Extraction Fraction Images on PET in the Cerebral Cortex with Unilateral Major Cerebral Artery Occlusive Disease
Central Benzodiazepine Receptor Binding Potential and CBF Images on SPECT Correlate with Oxygen Extraction Fraction Images on PET in the Cerebral Cortex with Unilateral Major Cerebral Artery Occlusive Disease
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DOI：
10.2967/jnumed.110.084186
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发表时间：
2011-04-01
影响因子：
9.3
通讯作者：
Ogawa, Akira
中科院分区：
文献类型：
--
作者：
Chida, Kohei;Ogasawara, Kuniaki;Ogawa, Akira
氧摄取分数（OEF）是有症状的主要脑动脉闭塞性疾病患者卒中复发的关键预测因子。本研究的目的是比较慢性单侧大脑中动脉（MCA）或颈内动脉（伊卡）闭塞性疾病患者的SPECT与PET OEF图像的中枢苯二氮卓类受体结合电位（BRBP）和脑血流（CBF）图像。研究方法：在20名健康受试者和34名单侧MCA或伊卡闭塞性疾病患者中，分别使用O-15 PET和N-异丙基-p-I-123-iodoamphetamine和I-123-iomazenil SPECT评估OEF、CBF和BRBP。所有图像通过线性和非线性变换转换为标准的脑大小和形状，使用统计参数映射进行解剖标准化。使用三维立体定向感兴趣区（ROI）模板根据动脉供应自动放置感兴趣区（ROI），并计算每幅图像中患侧与对侧的值之比。结果如下：在闭塞性疾病患者中，在3个大脑皮质区域观察到PET OEF与SPECT BRBP/CBF比值之间的显著正相关大脑前动脉（ACA）ROI与大脑中动脉（MCA）ROI的相关系数分别为0.851和0.807，P < 0.0001;大脑后动脉ROI的相关系数r = 0.774，P < 0.0001），但基底节和小脑的两个参数之间无相关性。当PET OEF比值异常升高定义为大于健康受试者中获得的平均垂直条2 SD时，SPECT BRBP/CBF比值检测PET OEF比值异常升高的灵敏度和特异性分别为ACA ROI 100%和96%，MCA ROI 100%和89%，PCA ROI 100%和93%。结论：在特定的临床环境中，SPECT上的BRBP/CBF图像与PET上的OEF图像相关，即在慢性单侧MCA或伊卡闭塞性疾病患者的大脑皮层中。
Oxygen extraction fraction (OEF) is a key predictor of stroke recurrence in patients with symptomatic major cerebral arterial occlusive disease. The purpose of the present study was to compare central benzodiazepine receptor binding potential (BRBP) and cerebral blood flow (CBF) images on SPECT with OEF images on PET in patients with chronic unilateral middle cerebral artery (MCA) or internal carotid artery (ICA) occlusive disease. Methods: OEF, CBF, and BRBP were assessed using O-15 PET and N-isopropyl-p-I-123-iodoamphetamine and I-123-iomazenil SPECT, respectively, in 20 healthy subjects and in 34 patients with unilateral MCA or ICA occlusive disease. All images were transformed into the standard brain size and shape by linear and nonlinear transformation using statistical parametric mapping for anatomic standardization. A region of interest (ROI) was automatically placed according to the arterial supply using a 3-dimensional stereotactic ROI template, and the ratio of the value in the affected side to that in the contralateral side was calculated in each image. Results: Among patients with occlusive disease, a significant positive correlation was observed between PET OEF and SPECT BRBP/CBF ratios in 3 cerebral cortical regions (r = 0.851, P < 0.0001, for anterior cerebral artery [ACA] ROI; r = 0.807, P < 0.0001, for MCA ROI; and r = 0.774, P < 0.0001, for posterior cerebral artery [PCA] ROI), but there were no correlations between these 2 parameters in the basal ganglia or the cerebellum. When an abnormally elevated PET OEF ratio was defined as a value greater than the mean vertical bar 2 SDs obtained in healthy subjects, sensitivity and specificity were, respectively, 100% and 96% for the ACA ROI, 100% and 89% for the MCA ROI, and 100% and 93% for the PCA ROI for the SPECT BRBP/CBF ratio for detecting an abnormally elevated PET OEF ratio. Conclusion: BRBP/CBF images on SPECT correlate with OEF images on PET in a specific clinical setting-that is, in the cerebral cortex of patients with chronic unilateral MCA or ICA occlusive disease.