Subscribe to RSS
DOI: 10.1055/s-0038-1629869
Altersabhängigkeit der zerebralen Tc-99m-ECD-Verteilung zwischen Klein-und Schulkindern und Erwachsenen[*]
Age-Dependence of Local Cerebral Blood Flow -Investigations of 4 to 15 Years Old Children and Adults with Tc-99m-ECDPublication History
Eingegangen:
07 August 1996
in revidierter Form:
23 October 1996
Publication Date:
04 February 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00034924/199704/lookinside/thumbnails/10-1055-s-0038-1629869_de-1.jpg)
Zusammenfassung
Ziel: In dieser Studie wird geprüft, ob die Normwertverteilung von Hirn-perfusionsmarkern bei Erwachsenen auf Kinder in der Altersgruppe von 4 bis 15 Jahren übertragen werden kann. Methoden: Bei 23 Kindern (Gruppe I) im Alter von 4-15 Jahren (MW 11 ±3 Jahre) ohne Anhalt für hirnorganische oder zerebrovaskuläre Erkrankungen wurden SPECT-Untersuchungen mit Tc-99m-ECD durchgeführt. Als Kontrollgruppe (Gruppe II) dienten 10 Erwachsene (Alter 27-56 Jahre, MW 45 ± 10 Jahre). Die Auswertung erfolgte semiquantitativ mit Normierung der lokalen kortikalen Aktivität auf die des Zerebellums (= 100%). Ergebnisse: In Gruppe I ergab sich im Vergleich zu Gruppe II durchweg eine höhere kortikale Aktivität, die größten Unterschiede waren parietal (107,6 ± 9,8 vs. 84,1 ± 12,4%), frontal (97,7 ± 6,7 vs. 79,4 ± 8,9%), links temporal (99,7 ± 7,4 vs. 84,9 ± 10,1 %) und im zingulären Kortex (112,1 ±9,1 vs. 95,9 ± 10,1%, p<0,05) zu verzeichnen. Die zerebrale Impulsdichte (in Relation zur injizierten Aktivität und zur Aufnahmedauer) korrelierte linear mit dem Alter in der Gruppe I (r = -0,78, p <0,001), ebenso wie die relative kortikale Impulsdichte in 5 ROIs parietal (r = -0,42 bis -0,57), in 2 ROIs frontal (r = -0,48), in 7 ROIs temporal (r = -0,42 bis -0,58) und in 2 ROIs okzipital (r = -0,44). Der Vergleich der lokalen Impulsdichten in Untergruppen von 4-10 Jahren und 11-15 Jahren ergab in 14 von 69 ROIs Unterschiede. Schlußfolgerung: Die Ergebnisse zeigen, daß sich die normale Verteilung des rCBF für die Altersgruppe der Klein- und Schulkinder deutlich von der bei Erwachsenen unterscheidet. Daher sind für die Anwendung von Hirnperfusionsmarkern bei Kindern eigene rCBF-Normwerte zu definieren, wobei eine Untergliederung in Altersgruppen von 4-10 und 11-15 Jahren sinnvoll ist.
Summary
Aim: This present study deals with the question whether normal distribution of local cerebral blood flow (ICBF) agents in adults can be transferred to the age group of 4 to 15 years old children. Methods: 23 children (age: 4-15 years, mean 11 ± 3 y) (group I) and 10 adults (age: 27-56 years, mean 45 ± 10 y) (group II) without evidence of cerebrovascular disease or other brain diseases underwent Tc-99m-ECD-SPECT imaging. Counts in the cortical ROIs were related to those of cerebellar ROIs (= 100%). Results: In group I, relative cortical activity exceeded that of group II, particularly in parietal (107.6 ± 9.8 vs. 84.1 ± 12.4%), frontal (97.7 ± 6.7 vs. 79.4 ± 8.9%), left temporal areas (99.7 ± 7.4 vs. 84.9 ± 10.1%) and in the cingular cortex (112.1 ± 9.1 vs. 95.9 ± 10.1 %, p <0.05). Cerebral activity uptake/injected dose/acquisition period was linearly correlated with age in group I (r = -0.78, p <0.001). There was also a correlation of the relative local count density with age in 5 parietal ROIs (r = -0.42 to -0.57), in 2 frontal ROIs (r = -0.48), in 7 temporal ROIs (r = -0.42 to -0.58) and in 2 occipital ROIs (r = -0.44). In 14 cortical regions relative counts differed when subgroups of children aged 4-10 and 11-15 years were analysed. Conclusion: There are systematic differences between 4 to 15 years old children and adults regarding the normal distribution of ICBF. Diagnostic use of perfusion agents has to consider the respective age-adjusted normal flow maps; respective normal ranges should be determined for age groups of 4-10 and of 11 -15 years separately.
Schlüsselwörter
Regionaler zerebraler Blutfluß - rCBF - zerebrale Perfusion - SPECT - Altersabhängigkeit* Herrn Prof. Dr. P. Georgi zum 65. Geburtstag. (Eingegangen: 7. August 1996; in revidierter Form: 23. Oktober 1996)
-
LITERATUR
- 1 Barthel H, Kämpfer I, Dannenberg C. et al. Improvement of radiochemical properties and image quality in brain SPET by stabilization of Tc-99m-HMPAO with methylene blue (abstract). Eur J Nucl Med 1996; 23 (Suppl. 09) 1200p.
- 2 Bode H, Wais U. Age dependence of flow velocities in basal cerebral arteries. Arch Dis Child 1988; 63 (Suppl. 06) 606-11.
- 3 Brody H. Organization of the cerebral cortex. III. A study of aging in the human cerebral cortex. J Comp Neurol 1955; 102: 511-56.
- 4 Chiron C, Raynaud C, Mazière B. et al. Changes in regional cerebral blood flow during brain maturation in children and adolescents. J Nucl Med 1992; 33: 696-703.
- 5 Chugani HT, Phelps ME, Maziotta JC. Positron emission tomography study of human brain functional development. Ann Neurol 1987; 22: 487-97.
- 6 Costa DC, Jones BE, Steiner TJ. et al. Experimental studies of Tc-99m-HM-PAO with an rCBF model. Nucl Med Comm 1986; 7 (Suppl. 04) 282-3.
- 7 Crosson B, Williamson DJG, Shukla SS. et al. A technique to localize activation in the human brain with technetium-99m-HMPAO SPECT: A validation study using visual stimulation. J Nucl Med 1994; 35: 755-63.
- 8 Denays R, Tondeur M, Foulon M. et al. Regional brain flow in congenital dysphasia: studies with technetium-99m-HMPAO SPECT. J Nucl Med 1989; 30: 1825-9.
- 9 Denays R, Tondeur M, Toppet V. et al. Cerebral palsy: initial experience with Tc-99m HMPAO SPECT of the brain. Radiology 1990; 175: 111-6.
- 10 Denays R, Ham H, Tondeur M. et al. Detection of bilateral and symmetrical anomalies in Technetium-99m-HMPAO brain SPECT studies. J Nucl Med 1992; 33: 485-90.
- 11 Dingier WH. HMPAO-SPECT mit Diamox-Stimulation bei cerebrovasculären Erkrankungen. Der Nuklearmediziner 1993; 2 (Suppl. 16) 111-6.
- 12 Ell PJ, Cullum I, Costa DC. et al. A new regional cerebral blood flow mapping with Tc-99m-labelled compound. Lancet 1985; II: 50-1.
- 13 Folstein M, Folstein S, McHugh PR. Mini-mental state: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189-98.
- 14 Francesci M, Picard M, Zimmermann RE. et al. Brain washout of Tc-99m-L,L-ethyl cysteinate dimer (ECD) in normal volunteers. Eur J Nucl Med 1988; 14: 227.
- 15 Friberg L, Andersen AR, Lassen NA. et al. Retention of 99m-Tc-bicisate in the human brain after intracarotid injection. J Cereb Blood Flow Metab 1994; 14 (Suppl. 01) 19-27.
- 16 George MS, Ring HA, Costa DC. et al. Neuroactivation and Neuroimaging with SPET. London, Berlin: Springer; 1991
- 17 Hellbrügge T. Physiologie und Pathologie der kindlichen Sozielentwicklung aus kinderärztlicher Sicht. Monatsschr Kinder-heilkd 1985; 133 (Suppl. 06) 429-36.
- 18 Holm S. A simple sequentially rejective multiple test procedure. Scand J Statist 1979; 6: 65-70.
- 19 Holman BL, Carvalho PA, Zimmermann RE. et al. Brain perfusion SPECT using annular single cristal camera: initial clinical experience. J Nucl Med 1990; 31: 1456-561.
- 20 Horiuchi I, Sanada S, Ohtahara S. Developmental and psychologic changes in cerebral blood flow velocity. Pediatr Res 1993; 34 (Suppl. 03) 385-8.
- 21 Houston AS, Kemp PM, Macleod MA. A Method for assessing the significance of abnormalities in HMPAO brain SPECT images. J Nucl Med 1994; 35: 239-44.
- 22 Levéillé J, Demonceau G, Rigo P. et al. Brain tomographic imaging with Tc-99m-ethyl cysteinate dimer (Tc-ECD): a new stable brain perfusion agent (abstract). J Nucl Med 1988; 29: 758.
- 23 Levéillé J, Demonceau G, De Roo M. et al. Characterization of technetium-99m-L, L-ECD for brain perfusion imaging, part 2. Biodistribution and brain imaging in humans. J Nucl Med 1989; 30: 1902-10.
- 24 Lou HC, Henriksen L, Bruhn P. Focal cerebral dysfunction in developmental learning disabilities. Lancet 1990; 335: 8-11.
- 25 Lou H, Henriksen L, Greisen G, Schneider S. Redistribution of cerebral activity during childhood. Brain Dev 1990; 12: 301-5.
- 26 Milner E. Human neural and behavioral development. A relational inquiry, with implications for personality. Springfild, Illinois: Charles C Thomas; 1967. pp. 167-289.
- 27 Moretti JM, Tamgac F, Weinmann P. et al. Early and delayed brain SPECT with Tech-netium-99m-ECD and Iodine-123-IMP in subacute strokes. J Nucl Med 1994; 35 (Suppl. 09) 1444-9.
- 28 Ogawa A, Sakurai Y, Kayama T, Yoshimoto T. Regional cerebral blood flow with age: changes in rCBF in childhood. Neurol Res 1989; 11: 173-6.
- 29 Pävics L. SPECT bei zerebrovaskulären Erkrankungen. In: Single-Photon-EmissionsComputertomographie (SPECT) des Gehirns. Wieler HJ. (Hrsg). Berlin, Heidelberg: Springer; 1995
- 30 Podreka I, Goldenberg G, Baumgartner C. et al. HMPAO brain uptake in young normal subjects: gender differences and hemispheric asymmetries. J Cereb Blood Flow Metab 1989; 9 (Suppl. 01) 202.
- 31 Rubinstein M, Denays R, Ham HR. et al. Functional imaging of brain maturation in human using iodine-123-iodoamphetamine and SPECT. J Nucl Med 1989; 30: 1982-5.
- 32 Sherman M, Nass R, Shapiro T. Regional cerebral blood flow in infantile autism. J Autism Dev Dis 1984; 4: 438-40.
- 33 Sokoloff L. Localization of functional activity in the central nervous system by measurement of glucose utilization with radioactive deoxyglucose. J Cereb Blood Flow Metab 1981; 1: 7-36.
- 34 Talairach J, Tournoux P. Co-planar stereotaxic atlas of the human brain. Stuttgart, New York: Thieme; 1988
- 35 Yonekura Y, Tsuchida T, Sadato N. et al. Brain perfusion SPECT with 99m-Tc-bici-sate: comparison with PET measurement and linearization based on permeability-surface area product model. J Cereb Blood Flow Metab 1994; 14 (Suppl. 01) 58-65.