Evaluation of regional cerebral circulation based on absolute mean transit times in radionuclide cerebral angiography

In radionuclide cerebral angiography (RCA) the analysis of the activity-time curves recorded over the hemispheres following an intravenous bolus injection of a radioactive indicator permits the evaluation of absolute cerebral mean transit times (MTTcb). The inverse of MTTcb is an index of cerebral blood flow. The bolus parts of the cerebral activity curves were fitted with gamma-variate functions. The duration of the injection bolus and its subsequent dispersion through the cardiopulmonary circulation were corrected for using the activity curve over the aortic arch. In a control material of 52 subjects MTTcb was uncorrelated with age and equal to 3.2 +/- 0.67 s (means +/- 1 SEE) for the 37 subjects younger than 60. For the fifteen subjects older than 60, mean MTTcb showed a steep increase with age. The results were in close agreement with those obtained by other researchers using either correction of cerebral curves based on a physical flow model or direct injections into the internal carotid artery. Comparison of RCA with x-ray carotid angiography in 12 subjects was satisfactory. Repeated RCA examinations in nine subjects a few days apart yielded a reproducibility of 0.7 s for MTTcb. The RCA is non-invasive, rapid, easy to perform and without risk for the patient. The RCA is recommended for quantitative evaluation of major alterations in cerebral perfusion.