脳血流シンチを応用した脳血流の定量評価により心臓大血管手術後の脳梗塞発生は予測できるか
心臓大血管手術後の脳梗塞予測は困難である。今回われわれは術前の脳血流定量評価が術後脳梗塞発生予測に有用か検討した。脳血流評価での脳血流予備能が最も不良であることを示すステージIIと判断される部位の有無と術後脳梗塞発生に統計学的相関を認めなかったが，ステージIIに分類される部位が脳表面積の10%以上を占める症例では術後脳梗塞を有意に発症しやすい結果となった。本評価法は術後脳梗塞の予測に有用である可能性がある。...
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| Published in | 脈管学 Vol. 57; no. 9; pp. 125 - 133 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
日本脈管学会
10.09.2017
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0387-1126 1880-8840 |
| DOI | 10.7133/jca.16-00027 |
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| Abstract | 心臓大血管手術後の脳梗塞予測は困難である。今回われわれは術前の脳血流定量評価が術後脳梗塞発生予測に有用か検討した。脳血流評価での脳血流予備能が最も不良であることを示すステージIIと判断される部位の有無と術後脳梗塞発生に統計学的相関を認めなかったが，ステージIIに分類される部位が脳表面積の10%以上を占める症例では術後脳梗塞を有意に発症しやすい結果となった。本評価法は術後脳梗塞の予測に有用である可能性がある。 |
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| AbstractList | 心臓大血管手術後の脳梗塞予測は困難である。今回われわれは術前の脳血流定量評価が術後脳梗塞発生予測に有用か検討した。脳血流評価での脳血流予備能が最も不良であることを示すステージIIと判断される部位の有無と術後脳梗塞発生に統計学的相関を認めなかったが，ステージIIに分類される部位が脳表面積の10%以上を占める症例では術後脳梗塞を有意に発症しやすい結果となった。本評価法は術後脳梗塞の予測に有用である可能性がある。 |
| Author | 三笠, 圭太 友枝, 博 田中, 啓之 澤田, 健太郎 千原, 新吾 |
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| References | 6) Hirose H, Amano A, Takahashi A, et al: Off-pump total arterial bypass grafting using bilateral mammary, gastroepipioic, and radial artery. Ann Thorac Cardiovasc Surg 2000; 6: 405–407 2) 中川原譲二：脳虚血の臨床画像診断．脳と神経1999; 51: 502–513 8) Grubb RL Jr., Derdeyn CP, Fritsch SM, et al: Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 1998; 280: 1055–1060 9) Kuroda S, Houkin K, Kamiyama H, et al: Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion: can acetazolamide test predict it? Stroke 2001; 32: 2110–2116 13) Matsumoto Y, Ogasawara K, Saito H, et al: Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging. Eur J Nucl Med Mol Imaging 2013; 40: 1573–1581 4) 中井完治，長田秀夫，藤井和也，他：症候性頭蓋内動脈狭窄に対するシロスタゾールの使用経験．Progress in Medicine 2010; 30: 1773–1776 1) JET Study Group: Japanese EC-IC Bypass Trial (JET Study): study designと中間解析．脳卒中の外科2002; 30: 97–100 11) Widder B, Kleiser B, Krapf H: Course of cerebrovascular reactivity in patients with carotid artery occlusions. Stroke 1994; 25: 1963–1967 7) Derdeyn CP, Grubb RL Jr, Powers WJ: Cerebral hemodynamic impairment: methods of measurement and association with stroke risk. Neurology 1999; 53: 251–259 5) Bergman P, Hadjinikolaou L, Dellgren G, et al: A policy to reduce stroke in patients with extensive atherosclerosis of the ascending aorta undergoing coronary surgery. Interact Cardiovasc Thorac Surg 2004; 3: 28–32 12) Yamauchi H, Fukuyama H, Nagahama Y, et al: Evidence of misery perfusion and risk for recurrent stroke in major cerebral arterial occlusive diseases from PET. J Neurol Neurosurg Psychiatry 1996; 61: 18–25 10) Webster MW, Makaroun MS, Steed DL, et al: Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease. J Vasc Surg 1995; 21: 338–344; discussion, 344–345 3) Kanda Y: Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 2013; 48: 452–458 |
| References_xml | – reference: 12) Yamauchi H, Fukuyama H, Nagahama Y, et al: Evidence of misery perfusion and risk for recurrent stroke in major cerebral arterial occlusive diseases from PET. J Neurol Neurosurg Psychiatry 1996; 61: 18–25 – reference: 7) Derdeyn CP, Grubb RL Jr, Powers WJ: Cerebral hemodynamic impairment: methods of measurement and association with stroke risk. Neurology 1999; 53: 251–259 – reference: 3) Kanda Y: Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant 2013; 48: 452–458 – reference: 4) 中井完治，長田秀夫，藤井和也，他：症候性頭蓋内動脈狭窄に対するシロスタゾールの使用経験．Progress in Medicine 2010; 30: 1773–1776 – reference: 1) JET Study Group: Japanese EC-IC Bypass Trial (JET Study): study designと中間解析．脳卒中の外科2002; 30: 97–100 – reference: 6) Hirose H, Amano A, Takahashi A, et al: Off-pump total arterial bypass grafting using bilateral mammary, gastroepipioic, and radial artery. Ann Thorac Cardiovasc Surg 2000; 6: 405–407 – reference: 11) Widder B, Kleiser B, Krapf H: Course of cerebrovascular reactivity in patients with carotid artery occlusions. Stroke 1994; 25: 1963–1967 – reference: 13) Matsumoto Y, Ogasawara K, Saito H, et al: Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging. Eur J Nucl Med Mol Imaging 2013; 40: 1573–1581 – reference: 5) Bergman P, Hadjinikolaou L, Dellgren G, et al: A policy to reduce stroke in patients with extensive atherosclerosis of the ascending aorta undergoing coronary surgery. Interact Cardiovasc Thorac Surg 2004; 3: 28–32 – reference: 9) Kuroda S, Houkin K, Kamiyama H, et al: Long-term prognosis of medically treated patients with internal carotid or middle cerebral artery occlusion: can acetazolamide test predict it? Stroke 2001; 32: 2110–2116 – reference: 2) 中川原譲二：脳虚血の臨床画像診断．脳と神経1999; 51: 502–513 – reference: 10) Webster MW, Makaroun MS, Steed DL, et al: Compromised cerebral blood flow reactivity is a predictor of stroke in patients with symptomatic carotid artery occlusive disease. J Vasc Surg 1995; 21: 338–344; discussion, 344–345 – reference: 8) Grubb RL Jr., Derdeyn CP, Fritsch SM, et al: Importance of hemodynamic factors in the prognosis of symptomatic carotid occlusion. JAMA 1998; 280: 1055–1060 |
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| Snippet | 心臓大血管手術後の脳梗塞予測は困難である。今回われわれは術前の脳血流定量評価が術後脳梗塞発生予測に有用か検討した。脳血流評価での脳血流予備能が最も不... |
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| Title | 脳血流シンチを応用した脳血流の定量評価により心臓大血管手術後の脳梗塞発生は予測できるか |
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