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(Stroke. 1971;2:519.)
© 1971 American Heart Association, Inc.

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Regional Cerebral Blood Flow in Man Determined by the Initial Slope of the Clearance of Intra-arterially Injected l33Xe

THEORY OF THE METHOD, NORMAL VALUES, ERROR OF MEASUREMENT, CORRECTION FOR REMAINING RADIOACTIVITY, RELATION TO OTHER FLOW PARAMETERS AND RESPONSE TO Paco₂ CHANGES

JES OLESEN M.D.¹; OLAF B. PAULSON M.D.¹; NIELS A. LASSEN M.D.¹

¹ Department of Neurology and the Department of Clinical Physiology, Bispebjerg Hospital 2400 Copenhagen NV, Denmark

The regional cerebral blood flow can be calculated from the initial slope of the logarithmically displayed clearance curve following intra-arterial injection of ¹³³Xe (rCBF_initial). The relationship between this parameter and the values resulting from stochastic (height over area) and compartmental analyses is extensively discussed. Experimental results demonstrate the theoretically expected close relationship between rCBF_initial and flow of gray substance (rCBF_initial 20% to 30% lower than F_g). It is shown how the cerebral clearance curve (normally biexponential) with low flow values becomes gradually monoexponential. Thus only flow of gray substance changes, whereas flow of white substance is independent of CBF. CBF₁₀ was shown to overestimate CBF with about 15% independent of the flow level. Correlation between CBF_initial and CBF₁₀ was linear (r=0.98) at CBF₁₀ values above 20 ml/100 gm/min.

The CBF_initial normal value is found to be 64±9 ml/100 gm/min, and the interchannel coefficient of variation is 8.2%. A correction for remaining radioactivity from previous measurements is described. Using this, no significant difference was found between repeated resting state measurements.

The CBF_initial-Paco₂ relationship was found to be best described as exponential. In a group of patients with various intracranial diseases, 1 mm Hg change in Paco₂ resulted in 4% change of CBF_initial quite independent of the CBF_initial level.

Key Words: apoplexy • barbiturate poisoning • carbon dioxide tension • cerebral blood flow regulation • cerebral circulation • inert gas clearance • isotope clearance method • tracer kinetics

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