Regional cerebral blood flow by 133xenon inhalation

Abstract

Repeated measurements of regional cerebral blood flow (rCBF) were made by the short (ten minutes) 133Xenon inhalation technique and bicompartmental analysis in 11 patients with cerebrovascular disorders, mainly acute cerebral infarction. rCBF was measured 3 to 11 times during one to two weeks. The blood flow of the fast compartment (f1) was calculated as well as the relative weight of this compartment (w1, assumed to correspond to gray matter). In addition a new flow index, the Initial Slope Index (ISI) modified for the inhalation technique, was used. This index of predominantly gray matter flow was calculated from a one-minute epoch of the early part of the clearance curve corrected for recirculation. In three of the patients the f1 and ISI varied in parallel and the w1 showed generally only minor variations from one measurement to the other. However, in the other eight patients fluctuation of the w1 and f1 values were seen which often showed no meaningful relation to the clinical course. The observed w1 changes indicated that some tissues (slowly perfused gray matter and/or rapidly perfused white extracerebral tissues) fluctuate between the fast and the slow compartment. In such cases the f1 values obtained cannot be used for comparison between measurements, since they represent flow rates of varying tissues and do not always represent a true gray matter blood flow. In these patients the ISI, which is independent of such weight changes, showed moderate and clinically likely variations.