METHODS: We studied 19 patients (10 men and 9 women) with homonymous hemianopia and compared them with 34 healthy subjects (20 men and 14 women). Cerebral glucose metabolism was measured by 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), 1 to 6 months after the onset. Bilateral regions of interest (ROIs) were selected from the posterior and, anterior striate cortices, extrastriate cortex, and thalamus. Furthermore, semi-quantitative data on cerebral glucose metabolism were obtained for ROIs and compared with the data obtained for homologous regions in the contralateral hemisphere by calculating the ipsilateral/contralateral (I/C) ratio.
RESULTS: The I/C ratio for the cerebral glucose metabolism in the posterior striate cortex was high (>0.750) in 8 patients, and the central visual field of these patients improved or showed macular sparing. The I/C ratio for cerebral glucose metabolism in the anterior striate cortex was high (>0.830) in 7 patients, and the peripheral visual field of these patients improved. However, no improvement was observed in 9 patients with a low I/C ratio for cerebral glucose metabolism in both the posterior and anterior striate cortices.
CONCLUSIONS: Measurement of cerebral glucose metabolism in the striate cortex is useful for estimating visual field prognosis. Furthermore, FDG-PET is useful in predicting the prognosis of hemianopia.
方法:我们研究了19名患者(10名男性和9名女性)的同义偏盲,并将其与34名健康受试者(20名男性和14名女性)进行了比较。通过18F-氟代脱氧葡萄糖正电子发射断层扫描(FDG-PET)测量脑葡萄糖代谢,发病后1至6个月。从后部和后部选择双侧感兴趣区域(ROI),前条纹皮质,皮质外,还有丘脑.此外,通过计算同侧/对侧(I/C)比,获得了ROI的脑葡萄糖代谢半定量数据,并将其与对侧半球同源区域的数据进行了比较。
结果:8例患者的后纹状体皮质中脑葡萄糖代谢的I/C比值较高(>0.750),这些患者的中央视野改善或显示黄斑保留。7例患者前纹状体皮质脑葡萄糖代谢I/C比值较高(>0.830),这些患者的周边视野得到改善。然而,在9例I/C比值较低的患者中,前后条纹皮质的脑葡萄糖代谢均无改善.
结论:测量纹状体皮质中的脑葡萄糖代谢对于估计视野预后是有用的。此外,FDG-PET可用于预测偏盲的预后。