Computed tomographic measurement of local cerebral blood flow by xenon enhancement

The present technique was developed to overcome some of the disadvantages of measuring cerebral blood flow by radionuclide methods, such as poor localization of flow values and errors that result if the brain is pathological and local partition coefficients are altered. Serial CT scanning in humans was carried out during and after inhalation of 50 to 70% non-radioactive xenon. This diffusible gas with high atomic number enhanced gray matter first by 19 +/- 4 Hounsfield Units (HU) and later white matter by 24 +/- 4 HU. The regionality of flow values were cursored on CT pictures with a high spatial resolution of 4 X 4 mm (64 pixels) or 0.16cm2 X 0.5cm. In seven normal subjects, blood flow in gray matter was 82 +/- 11 ml/100gm/min and that in white matter 24 +/- 5ml/100gm/min. The partition coefficient (lambda), which is not obtainable in vivo by radionuclide scanning, was 0.9 +/- 0.1 for normal gray matter, 1.4 +/- 0.2 for normal white matter. Reduced flow, 13% in gray matter and 46% in white matter, was found in a large infarct secondary to complete occlusion of middle cerebral artery. In edematous tissue, blood flow was not significantly impaired in gray matter but was reduced to 29 to 54% in white matter. Local lambda values were reduced to 0.6-0.9 in edematous tissue, and 0.3-0.7 in infarction. This method appears to have several advantages over conventional isotope methods of measuring cerebral blood flow and provides useful clinical and research information.