Cerebral distribution of 133-Xe and blood flow measured with high purity germanium.

Distribution of cerebral blood flow was measured with an array of 200 ultra-pure germanium radiation detectors and 133-Xe by inhalation. The array "sees" the head as a composite of different subvolumes and enables measurement of the concentration history of tracer every 1-10 sec in each subvolume simultaneously. Subvolume mean flows, (fm), and partition coefficients, lambda m, are derived by compartmental analysis of tissue concentration washout curves. Errors from "cross talk," scalp radiation, "look through," and assumed partition coefficients are eliminated. Average fm adjusted for 40 mm Hg PACO2 in 14 cortical subvolumes (7 right, 7 left) of four normal 21-24 year old controls ranged from 50 to 60 ml/100 cc tissue/min, and lambda m ranged from 0.97 to 1.14. Average fm and lambda m in white matter was 24 ml/100 cc/min and 1.42 - 1.14 respectively. During CO2 inhalation, right and left hemispheric fm increased 6.4% and 5.7%/mm Hg respectively, whereas white matter fm increased 2.2% and 3.4% mm Hg respectively. There was no systematic difference between front and back or dominant vs non-dominant sides. Three 73-84 year old controls had reduced fm and CO2 reactivity in all subvolumes, lambda m was in the same range as in younger controls. Two patients with intracranial cerebrovascular disease showed excellent localization of ischemic subvolumes. One patient with asymptomatic unilateral 98% stenosis of the internal carotid artery had a similar distribution of blood flow in both hemispheres.