Nuclear Medicine and Molecular Imaging

The Korean Society of Nuclear Medicine (대한핵의학회)
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Ipsilateral Cerebral and Contralateral Cerebellar Hyperperfusion in Patients with Unilateral Cerebral Infarction; SPM Analysis

일측 뇌경색 환자에서 반대측 뇌의 보상성 뇌관류 증가에 대한 SPM 분석

  • Hong, Sun-Pyo (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine) ;
  • Yoon, Joon-Kee (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine) ;
  • Choi, Bong-Hoi (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine) ;
  • Joo, In-Soo (Department of Neurology, Ajou University School of Medicine) ;
  • Yoon, Seok-Nam (Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine)
  • 홍선표 (아주대학교 의과대학 핵의학교실) ;
  • 윤준기 (아주대학교 의과대학 핵의학교실) ;
  • 최봉회 (아주대학교 의과대학 핵의학교실) ;
  • 주인수 (아주대학교 의과대학 신경과학교실) ;
  • 윤석남 (아주대학교 의과대학 핵의학교실)
  • Published : 2008.10.31
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Abstract

Purpose: Cortical reorganization has an important role in the recovery of stroke. We analyzed the compensatory cerebral and cerebellar perfusion change in patients with unilateral cerebral infarction using statistical parametric mapping (SPM). Materials and Methods: Fifty seven $^{99m}TC-Ethylene$ Cystein Diethylester (ECD) cerebral perfusion SPECT images of 57 patients (male/female=38/19, mean age=$56{\pm}17\;years$) with unilateral cerebral infarction were evaluated retrospectively. Patients were divided into subgroups according to the location (left, right) and the onset (acute, chronic) of infarction. Each subgroup was compared with normal controls (male/female=11/1, mean age=$36{\pm}10\;years$) in a voxel-by-voxel manner (two sample t-test, p<0.001) using SPM. Results: All 4 subgroups showed hyperperfusion in the ipsilateral cerebral cortex, but not in the contralateral cerebral cortex. Chronic left and right infarction groups revealed hyperperfusion in the ipsilateral primary sensorimotor cortex, meanwhile, acute subgroups did not. Contralateral cerebellar hyperperfusion was also demonstrated in the chronic left infarction group. Conclusion: Using $^{99m}Tc-ECD$ SPECT, we observed ipsilateral cerebral and contralateral cerebeller hyperperfusion in patients with cerebral infarction. However, whether these findings are related to the recovery of cerebral functions should be further evaluated.

목적: 본 연구는 일측 뇌관류결손이 있는 뇌경색 환자들에서 $^{99m}Tc-ECD$ 단일 광자방출단층촬영술을 이용하여 반대측 국소 뇌관류의 변화를 관찰하고자 하였다. 대상 및 방법 : 뇌관류결손이 있는 뇌경색 환자 57명이 대조군에 포함되었으며, 좌측과 우측 뇌경색 환자군으로 구분하였으며, 이들은 발병 시기에 따라 6개월을 기준으로 급성 뇌경색 환자군, 만성뇌경색 환자군으로 구분하였다. 대조군들 모두 국소 뇌관류를 측정하고자 SPM분석을 이용한 $^{99m}Tc-ECD$ 단일 광자방출단층촬영술을 실시하였다. 모든 대조군의 결과를 정상 대조군과 비교하였다. 결과: 모든 대조군에서 뇌경색 반대측 대뇌피질에서 뇌관류 증가가 관찰되었으며, 뇌경색 대뇌측에서의 뇌관류 증가는 관찰되지 않았다. 만성 뇌경색 대조군에서는 뇌병변 반대측 일차 감각운동피질에서의 뇌관류 증가가 관찰되었으나, 급성 뇌경색 대조군에서는 관찰되지 않았다. 만성 좌측 뇌경색 대조군에서는 우측 소뇌 뇌관류 증가가 관찰되었다. 결론: 뇌혈류 SPECT의 SPM분석에서 일측성 뇌경색 환자에서 뇌경색 반대측 대뇌의 혈류가 증가하고, 일부 환자군에서는 뇌경색 동측 소뇌의 혈류도 증가함을 관찰하였다. 그러나 이러한 소견이 뇌기능의 회복 기전과 직접적으로 연관성이 있는지 증명하기 위해서는 추가적인 연구가 필요하다.

Keywords

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