Regional Distribution of Cerebral Blood Flow in Childhood Measured by $^{99m}Tc-HMPAO$ SPECT : Reference Values of Semiquantitative Indices and Effect of Age

$^{99m}Tc-HMPAO$ SPECT를 이용한 어린이 국소뇌혈류의 정량적 분석 : 정량적 지표들의 참고값 및 연령에 따른 변화

  • Kim, Sang-Eun (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee, Dong-Soo (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Chung, June-Key (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Lee, Myung-Chul (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Koh, Chang-Soon (Department of Internal Medicine, College of Medicine, Seoul National University) ;
  • Cho, Soo-Churl (Department of Psychiatry, College of Medicine, Seoul National University) ;
  • Hong, Seung-Bong (Department of Neurology, College of Medicine, Seoul National University) ;
  • Yoon, Byung-Woo (Department of Neurology, College of Medicine, Seoul National University) ;
  • Roh, Jae-Kyu (Department of Neurology, College of Medicine, Seoul National University) ;
  • Myung, Ho-Jin (Department of Neurology, College of Medicine, Seoul National University)
  • 김상은 (서울대학교 의과대학 내과학교실) ;
  • 이동수 (서울대학교 의과대학 내과학교실) ;
  • 정준기 (서울대학교 의과대학 내과학교실) ;
  • 이명철 (서울대학교 의과대학 내과학교실) ;
  • 고창순 (서울대학교 의과대학 내과학교실) ;
  • 조수철 (서울대학교 의과대학 정신과학교실) ;
  • 홍승봉 (서울대학교 의과대학 신경과학교실) ;
  • 윤병우 (서울대학교 의과대학 신경과학교실) ;
  • 노재규 (서울대학교 의과대학 신경과학교실) ;
  • 명호진 (서울대학교 의과대학 신경과학교실)
  • Published : 1991.05.31

Abstract

Regional cerebral blood flow (rCBF) was evaluated in 12 children ranging in age from 2.7 to 10.0 yr using $^{99m}Tc-HMPAO$ SPECT. For quantitative analysis, 13 pairs of homologous regions of interest (ROIs) were created on three attenuation-corrected 18.8 mm thick transverse slices matching the cerebral cortical regions, deep gray matter, cerebellar hemisphere, and vascular territories, and the semiquantitative indices including "right to left ratio" [(mean count/voxel of homologous right ROI) / (mean count/voxel of homologous left ROI)] and "regional index"(RI) [(mean count/voxel of a ROI)/ (mean count/voxel of all ROIs of each hemisphere)] were calculated. Mean values of right to left ratios of homologous regions ranged from 0.984 to 1.028 in children under 5 yr (group 1) and from 0.982 to 1.012 in children between 5 and 10 yr (group 2), and the mean $value{\pm}2S.D.$ for each region did not exceed 11% and 12% in group 1 and group 2, respectively. There were no statistically significant differences between the RIs of the homologous right and left regions. Significant differences of RIs were found both between vascular regions (p<0.0005 for goup 1, and p=0.0001 for goup 2) and between regions of cerebral cortices (p<0.0005 for group 1, and p<0.005 for group 2) with a relatively high value in the occipital cortex and the lower values in the cerebellum and deep gray matter among the regions of cerebral cortices in both groups. There were no significant differences between the RIs of corresponding regions of group 1 and group 2, except a significantly higher value of right deep gray matter in group 2 than in group 1(p=0.0301). The RIs of the superior frontal cortex and deep gray matter showed to be positively correlated with age (superior frontal cortex; right: rs=0.5254, p=0.0814, left : rs=0.5919, p=0.0496/deep gray matter; right: rs=0.8246, p=0.0062, left: rs=0.6266, p=0.0377). The results suggest that the rCBF pattern of children approaches that of adults in an accipito-rostral direction. This time course of rCBF changes is in agreement with behavioral, neurophysiological, and anatomical alterations known to occur in the developing brain.

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