13N-NH3 PET脑血流灌注显像诊断缺血性脑血管病变

目的探讨13N-NH3 PET脑血流灌注显像对缺血性脑血管病变的诊断价值.方法对5例健康志愿者,20例缺血性脑血管病变患者静脉注射13N-NH3 740～925 MBq,3～5 min后行T+E 二维方式脑血流灌注显像.图像分析采用视图分析和脑皮质标准摄取值(SUV)半定量分析,镜像比值法测量左/右两侧相应脑区SUV比值(SUV_r).其中9例短暂性脑缺血发作(TIA)行乙酰唑胺(ACZ)脑负荷试验,观察口服ACZ前后脑区影像、SUV和SUV_r变化.结果正常左/右脑区平均SUV_r为0.99±0.15,患侧/健侧(L/N)比值<0.85为稀疏区,<0.7为缺损区.13例TIA 13 N-NH3 PET显像示7例阳性,8例行MRI 2例阳性,6例行CT 1例阳性.7例TIA13N-NH3 PET显像阳性患者发现29个缺血灶,平均SUV 1.78±0.41,低于对照组(2.51±0.52,t=8.78,P<0.05).脑梗死(CI)患者共发现13个梗死灶,平均SUV 1.05±0.23,明显低于对照组和TIA组(t=5.9,P<0.001).9例ACZ脑负荷试验,缺血灶由静息29处增至35处,检出率提高17.1%;TIA阳性率由53.8%提高到62.5%;静息平均SUV_r为0.87±0.11,口服ACZ后减低至0.77±0.07(t=6.47,P<0.05).结论 13N-NH3PET脑灌注显像安全、无创伤性,灵敏度高且病灶定位准确.口服ACZ脑负荷试验安全、简便、可靠,对评价局部脑血流储备功能有重要价值.     

潘生丁负荷试验脑灌注显像诊断缺血性脑血管病的价值

目的使用潘生丁负荷试验脑灌注显像评估缺血性脑血管疾病(CVD)患者的脑储备功能。方法正常对照组8例,CVD组66例。用99Tcm-双半胱乙酯先做脑潘生丁负荷显像按体重静脉注射潘生丁0.14mg·kg-1·min-14min,30min后行脑SPECT显像;2～5d后在同样条件下进行脑SPECT基态显像。图像行视觉及定量分析。8例患者治疗后随访。结果根据视觉及定量分析结果将脑血流对潘生丁的反应分为4型A型,潘生丁试验后原有病灶扩大,不对称指数(AI)及摄取指数(UR)均下降;B型,基态显像正常,用药后出现明显灌注低下区,AI值下降,UR由正常变为低于正常;C型,原有病灶用药后缩小或消失,AI、UR值均上升;D型,用药前后图像及AI、UR值均无差异。14例小脑交叉性失联络现象在潘生丁试验后8例恢复正常。结论潘生丁负荷试验有助于CVD的诊断、预后估测及治疗方案制定。     

橄榄桥脑小脑萎缩SPECT脑显像和MRI对比研究

目的 评价SPECT脑血流灌注显像在橄榄桥脑小脑萎缩（OPCA）诊断中的价值。方法 对20例OPCA患者行SPECT脑血流灌注显像和头颅MRI检查,并对各项检查结果进行比较。结果 OPCA患者的SPECT显像异常表现为脑局部血流低灌注,以脑干、脑小及基底节为主,也可累及大脑各叶;与MRI比较,SPECT显示病变范围更广泛;SPECT和MRI的异常率分别为95％和75％。结论 SPECT脑血流灌注显像为诊断OPCA提供了新方法,灵敏度优于MRI;SPECT与MRI相结合,有助于提高OPCA诊断的准确性。     

Alzheimer病与轻度认知功能障碍的脑SPECT显像

目的探讨脑SPECT显像对阿尔茨海默病（AD）和轻度认知功能障碍（MCI）的早期诊断及预后判定价值。方法对33例AD、17例MCI患者和12例认知正常者进行SPECT检查及随访研究。结果AD组典型表现是双侧颞顶叶低灌注，在颞叶、顶叶、额叶、丘脑和扣带回血流灌注均明显低于MCI和认知正常组（P〈0．05）；MCI组仅在颞叶血流灌注明显低于认知正常组（P〈0．05）。不稳定型MCI组扣带回血流灌注明显低于稳定型MCI组（P〈0．05）。结论SPECT显像可为早期诊断AD和MCI提供客观评定脑功能的指标，对MCI预后判定有重要价值。     

冠心病患者201Tl和99Tcm-MIBI双核素心肌灌注显像

目的探讨静息201Tl/负荷99Tcm-甲氧基异丁基异腈(MIBI)双核素心肌SPECT显像在冠心病诊断中的价值.方法对36例冠心病患者行201Tl负荷-延迟再分布心肌SPECT显像;常规潘生丁药物负荷高峰时,静脉注射201Tl 111～148 MBq,15 min后进行心肌显像.对23例冠心病患者和9例正常人行静息201Tl负荷、99Tcm-MIBI双核素心肌SPECT显像,静息状态注射201Tl 111～148 MBq,注射后5 min给予潘生丁药物负荷,高峰时注射99Tcm-MIBI 925 MBq.1 h后行双核素显像.结果 36例冠心病患者201Tl负荷-延迟再分布心肌显像的阳性率为83.33%,23例冠心病患者双核素心肌显像的阳性率为100%,两组阳性率比较差异有显著性(χ2=4.267,P=0.043).9例正常受检者均为阴性.结论双核素心肌显像对冠心病的检出率较高,省时、安全并可获得高质量图像,对冠心病诊断有较高临床价值.     

乙酰唑胺负荷MR灌注成像对脑血管储备功能的评估

目的探讨乙酰唑胺(ACZ)负荷MR灌注成像对评估脑血管储备功能的价值。方法运用磁共振灌注成像(perfusion-weighted imaging,PWI)对7例脑梗死患者口服ACZ前后分别进行对比剂首过期成像,分析PWI所得参数,包括脑血容量(regionalcerebral blood volume,rCBV)及血流平均通过时间(regional mean transit time,rMTT),以此评估脑血管储备功能(cerebrovascular re-serve capacity,CRC)。结果7例患者口服ACZ前后的rMTT图均发现视觉异常区,仅5例患者有rCBV异常区,并且rMTT异常的区域大于rCBV异常区;口服ACZ后rMTT图和rCBV图的异常区要小于口服ACZ前;rMTT异常区为rMTT延长,rCBV异常区则包括rCBV增加和rCBV减少2类。结论ACZ负荷磁共振PWI在脑血管储备功能研究中有重要价值。     

ACZ负荷MR灌注成像对高血压患者脑血管储备功能的初步研究

目的 探讨MR灌注成像结合乙酰唑胺(ACZ)负荷试验,评估出现症状性脑梗死前高血压患者的脑血管储备功能. 资料与方法 对13例高血压患者和12例正常对照在口服ACZ前后进行2次MR PWI检查,选取双侧尾状核头部、豆状核、丘脑、额上回、颞上回及楔叶作为兴趣区(ROI),测量其局部脑血容量(rCBV)、平均通过时间(rMTT)并根据公式局部脑血流量(rCBF)= rCBV / rMTT、脑血管储备(%)= [(ACZ后rCBF ACZ前rCBF)/ ACZ前rCBF]×100%计算脑血管储备. 结果 (1)高血压组各ROI的rMTT、rCBV和rCBF在ACZ负荷前后无统计学意义(P＞0.05);对照组各ROI的rMTT在ACZ负荷后缩短(P＜0.05),rCBV和rCBF在ACZ后增加(P＜0.05);(2)高血压组各ROI的脑血管储备(5.5%～27.8%)较对照组相应ROI的脑血管储备(34.0%～56.1%)明显降低(P＜0.05). 结论 在出现症状性脑梗死之前,高血压患者的脑血管储备较同年龄组正常血压者下降,处于亚临床缺血的状态.     

扩张型心肌病患者双嘧达莫负荷心肌^201Tl SPECT显像分析

目的 观察扩张型心肌病患者的双嘧达莫负荷心肌201Tl SPECT显像表现.方法 2008年8月至2009年12月临床符合扩张型心肌病诊断标准的住院患者30例,按体质量0.56 mg/kg给予其双嘧达莫,于4 min内静脉注射,2 min后注射201Tl,注射完后10及240 min分别进行双嘧达莫负荷心肌201Tl SPECT显像,图像经三维重建后由2位以上有经验的核医学科医师进行分析.结果 27例（90.00%）患者的双嘧达莫负荷201Tl图像（10 min）显示左心室心肌放射性分布异常.延迟（240 min）显像时所有患者均出现左室心肌放射性分布异常,其中6例患者出现＂反向再分布＂.结论 双嘧达莫负荷心肌201Tl SPECT显像对指导扩张型心肌病的诊治具有一定的临床意义.     

冠心病患者~(201)Tl和~(99)Tc~m-MIBI双核素心肌灌注显像

目的　探讨静息2 0 1 Tl 负荷99Tcm 甲氧基异丁基异腈 (MIBI)双核素心肌SPECT显像在冠心病诊断中的价值。方法　对 36例冠心病患者行2 0 1 Tl负荷 延迟再分布心肌SPECT显像 ;常规潘生丁药物负荷高峰时 ,静脉注射2 0 1 Tl111～ 14 8MBq ,15min后进行心肌显像。对 2 3例冠心病患者和 9例正常人行静息2 0 1 Tl负荷、99Tcm MIBI双核素心肌SPECT显像 ,静息状态注射2 0 1 Tl111～ 14 8MBq ,注射后5min给予潘生丁药物负荷 ,高峰时注射99Tcm MIBI 92 5MBq。 1h后行双核素显像。结果　 36例冠心病患者2 0 1 Tl负荷 延迟再分布心肌显像的阳性率为 83 33% ,2 3例冠心病患者双核素心肌显像的阳性率为 10 0 % ,两组阳性率比较差异有显著性 (χ2 =4 2 6 7,P =0 0 4 3)。 9例正常受检者均为阴性。结论双核素心肌显像对冠心病的检出率较高 ,省时、安全并可获得高质量图像 ,对冠心病诊断有较高临床价值。     

SPECT／CT显像诊断转移性骨肿瘤的临床意义

目的探讨SPECT／CT显像在肿瘤骨转移诊断中的临床价值。方法选择237例可疑肿瘤骨转移和不明原因骨痛的患者,注射99Tcm亚甲基二膦酸盐（MDP）后180min行全身骨显像,对发现的可疑病灶立即行同机CT扫描,再行图像融合和分析。对患者资料进行回顾性分析,平面显像和SPECT／CT显像结果与病理结果对照21例,与2种以上影像技术（MRI、CT、X线）诊断结果对照106例,与随访2年结果对照110例,计算平面显像和SPECT／CT与这些对照方法的诊断符合率。采用SAS6．12软件进行统计学处理,对平面和SPECT／CT显像的诊断符合率行／检验。结果平面显像237例中142例诊断和对照方法诊断结果符合,其中72例良性病变,70例骨转移,肯定性诊断总符合率95．30％（142／149）。SPECT／CT显像237例中224例结果和对照方法诊断结果符合,其中104例为良性病变,120例为骨转移,SPECT／CT诊断总符合率94．51％（224／237）,其中肯定性诊断总符合率为99．48％（192／193）。平面显像和SPECT／CT对骨转移的肯定性诊断符合率差异有统计学意义（x2=5．37,P=0．024）。结论SPECT／CT显像不仅可以精确定位,而且还可补充单独CT检查获得的诊断信息,明显提高对骨病变诊断的价值。     

Assessment of cerebral hemodynamics before and after revascularization in patients with occlusive cerebrovascular disease by means of quantitative IMP-SPECT with double-injection protocol

The purpose of this study was to validate a double-injection (DI) method with N-isopropyl-[123I]p-iodoamphetamine (IMP) to measure regional cerebral blood flow (rCBF) twice in a single session of dynamic SPECT and to elucidate a possible role of this method to identify patients with occlusive disease of major cerebral arteries, who might benefit from cerebral revascularization procedures (CR). MATERIALS AND METHODS: Fourteen patients with occlusion or severe stenosis of the internal carotid or middle cerebral artery were studied before and after CR to assess hemodynamic changes after revascularization treatment. We quantitatively measured rCBF before and after acetazolamide (ACZ) challenge along with cerebrovascular reserve capacity (CVR) with two injections of IMP in a single session of dynamic SPECT scans (DI method). The reliability and reproducibility of the DI method were validated by means of a simulation study and in eight patients who were examined without ACZ challenge to measure baseline rCBF twice. RESULTS: The analysis of simulated noisy data with realistic noise levels showed that the errors of the estimates for the first and the second rCBF and for the increase in rCBF were 2.6%, 8.1% and 10.4%, respectively. In the 8 patients examined by the DI method to measure baseline rCBF twice, the mean and the SD of percentage differences between the two consecutive measurements in rCBF were -1.3% and 5.5%, respectively. Eight out of 14 patients with occlusive disease had at least one region with a CVR less than 10%. They showed a significant increase in resting rCBF after CR, not only in the ipsilateral hemisphere (from 26.1 +/- 6.4 to 33.4 +/- 4.7) but also in the contralateral one (from 28.3 +/- 7.0 to 34.7 +/- 4.7) with a recovery of the ipsilateral CVR from 9.3 +/- 17.2 to 41.2 +/- 20.1%. The remaining six patients with good-moderate CVR did not show an increase in rCBF after CR (from 28.0 +/- 2.7 to 28.3 +/- 3.4). The three of them with a moderate CVR (10-25%) before CR showed normalization of CVR after CR. CONCLUSION: Patients with decreased rCBF and reduced CVR benefited from CR in terms of an increase in rCBF and recovery of CVR. The quantitative double-injection IMP-SPECT has the ability to identify those patients who may benefit from CR.     

Development of quantification analysis software for measuring regional cerebral blood flow by the modified split-dose method with (123)I-IMP before and after acetazolamide loading

We developed a quantification analysis software program for measuring regional cerebral blood flow (rCBF) at rest and under acetazolamide (ACZ) stress by the modified split-dose (MSD) method with iodine-123 N-isopropyl-p-iodoamphetamine (IMP) and compared the rCBF values measured by the MSD method and by the split dose (123)I-IMP SPECT (SD) method requiring one continuous withdrawal of arterial blood. Since the MSD method allows the input of two arterial blood sampling parameter values, the background subtraction procedure for obtaining ACZ-induced images in the MSD method is not identical to the procedure in the SD method. With our software program for rCBF quantification, the resting rCBF values determined by the MSD method were closely correlated with the values measured by the SD method (r=0.94), and there was also a good correlation between the ACZ-induced rCBF values obtained by the MSD method and by the SD method (r=0.81). The increase in rCBF under ACZ stress was estimated to be approximately 26% by the SD method and 38% by the MSD method, suggesting that the MSD method tends to overestimate the increase in rCBF under ACZ stress in comparison with the SD method, but the variability of the rCBF values at rest and during ACZ stress analyzed by the MSD method was smaller than the variability with the SD method. Further clinical studies are required to validate our rCBF quantification analysis program for the MSD method.     

Evaluation of time dependency of the acetazolamide effect on cerebral hemodynamics as measured by 99mTc-ECD single-photon emission computed tomography

PURPOSE: Kuwabara et al. have examined the cerebral artery dilation with acetazolamide (ACZ) challenge test using PET. And, they reported that ACZ reaction came out time dependently. We have developed a unique SPECT's method using Technetium-99m ethyl cysteinate dimer (99mTc-ECD) to verify the results obtained by Kuwabara et al. METHOD: 1000 MBq of 99mTc-ECD was exactly divided into three syringes. Each of which was intravenous infused (i.v.) at rest, 7.5, and 20 minutes after ACZ administration. Data collection was started using dynamic SPECT immediately after 99mTc-ECD i.v. at rest. Using necessary data only, SPECT images representing each of the three 99mTc-ECD i.v. was reconstructed. SPECT counts were obtained by the ROI method from each images to calculate relative CBF from rest to 7.5 and 20 minutes after ACZ administration. RESULT: The 18 hemispheres of nine patients in the negative control group in whom ACZ was not loaded. CBF was stable during the three evaluation. The measurement error our method was estimated as small. The 18 hemispheres of nine patients in the positive control group who has normal vasodilatory reserve, CBF was increased by 26.2 +/- 8.1% at 7.5 minutes and 29.3 +/- 13.1% at 20 minutes after ACZ administration. Seven patients with and chronic stage unilateral internal carotid artery severe stenosis and/or occlusion were evaluated as the test group. Case of unaffected side, CBF was increased by 17.6 +/- 6.9% at 7.5 minutes and 24.8 +/- 11.3% 20 minutes after ACZ administration. And, increase rate of CBF in the affected side was 2.8 +/- 1.6% at 7.5 minutes and 17.3 +/- 5.0% at 20 minutes after ACZ administration. In the affected side, timing of the maximum CBF increase caused by ACZ was remarkably delayed. CONCLUSION: Our method based on 99mTc-ECD SPECT also revealed delayed cerebral artery dilation in the affected side. It was suggested that ACZ reaction came out time dependently, as reported by Kuwabara et al.     

脑SPECT显像对高压氧治疗脑外伤后脑缺血疗效判断的价值

目的探讨SPECT脑血流灌注显像对高压氧（HBO）治疗脑外伤继发脑缺血患者疗效判断的价值。方法将65例脑外伤继发脑缺血患者按随机数字表法分为HBO治疗组和常规治疗组,在治疗前后分别进行脑血流灌注SPECT显像,应用计算机感兴趣区（ROI）技术,在横断面图像上采用局部镜像比值（Ra）法判断脑缺血病灶,Ra≤0．9视为异常。对治疗前后的脑血流灌注减低区Ra值进行比较。数据间的比较行t检验。结果HBO治疗组治疗前后局部脑血流（rCBF）减低区Ra值分别为0．58±0．11和0．82±0．12（t=7．327,P〈0．01）,常规治疗组治疗前后rCBF减低区Ra值分别为0．61±0．13和0．73±0．12（t=2．153,P=0．038）;HBO治疗组和常规治疗组缺血灶rCBF增加值分别为0．24±0．08和0．12±0．06（t=2．571,P=0．015）。结论SPECT脑血流灌注显像可灵敏地反映HBO治疗脑外伤后脑缺血前后rCBF变化,可用于HBO治疗疗效的评价。     

小儿癫痫的SPECT、EEG和MRI的对比研究

目的 评价ＳＰＥＣＴ脑血流灌注显像在小儿癫痫灶定位诊断的价值。方法 对７４例发作间期、１０例发作期,共８４例癫痫患儿行ＳＰＥＣＴ脑血流灌注显像及ＥＥＧ检查,其中６７例作了ＭＲＩ检查,并对各种检查结果进行比较。结果 ＳＰＥＣＴ、ＥＥＧ和ＭＲＩ的异常率分别为８２．１４％、７１．４３％和４７．７６％;ＥＥＧ异常的６０例患儿中与ＳＰＥＣＴ异常部位完全或基本符合率为７０．５９％;ＭＲＩ异常的３２例患儿中１７     

脑SPECT显像和CT扫描观察高压氧治疗脑外伤后综合征疗效

目的 对比研究脑外伤后综合征患者在高压氧（ＨＢＯ）治疗前后的脑ＳＰＥＣＴ和脑ＣＴ扫描结果,并对两者的临床及其优越性进行评价。方法 ２８８例脑外伤后综合征患者接受２－４个疗程的ＨＢＯ治疗,并在治疗前后用＾９９Ｔｃ＾ｍ－双半胱乙酯（ＥＣＤ）ＳＰＥＣＴ和ＣＴ进行疗效监测和对比分析。     

Clinical evaluation of 99mTc ethyl cysteinate dimer SPECT in patients with spinocerebellar degeneration; comparison with cerebral blood flow determined by PET]

Technetium-99m ethyl cysteinate dimer (99mTc-ECD) is regarded as a promising radiopharmaceutical for imaging regional cerebral blood flow (rCBF). We evaluated 99mTc-ECD SPECT comparing with rCBF images obtained by PET in 12 patients with spinocerebellar degeneration (SCD). SPECT images of 99mTc-ECD demonstrated characteristic findings of decreased rCBF in bilateral cerebellar hemisphere and almost identical with PET rCBF images in all patients based on the visual inspection. Semiquantitative analysis by drawing 14 intracranial regions of interest on SPECT and PET images revealed linear correlation between 99mTc-ECD count and rCBF measured by PET even in relatively high rCBF regions. In summary, 99mTc-ECD is a promising tracer for evaluating rCBF in patients with SCD and distribution of it correlates well with rCBF measured by PET.     

脑SPECT灌注显像用于尼莫地平疗效的评价

为探讨脑部疾病患者用尼莫地平前后脑ＳＰＥＣＴ灌注显像的临床价值，将５３例患者分为３组：偏头痛（普通型发作间期）２６例，缺血性脑血管病１９例〔其中短暂性脑缺血发作（ＴＩＡ）１１例，脑梗塞８例）〕，脑外伤８例。３组患者均在服尼莫地平前后进行脑ＳＰＥＣＴ灌注显像。使用正常／病灶镜像局部比值法进行定量分析。结果：ＳＰＥＣＴ显示各组在用药前皆见脑内有不同程度的局灶性放射性分布稀疏区或缺损区，用药后原放射性稀疏区或缺损区有不同程度放射性填充。偏头痛组显著填充病灶２７３％，填充病灶５７５％，总填充率８４８％；无变化病灶１５２％。ＴＩＡ显著填充病灶６４３％，填充病灶２８５％，总填充率９２８％；无变化病灶７２％。脑梗塞显著填充病灶２０％，填充病灶６０％，总填充率８０％，无变化病灶２０％。脑外伤组填充病灶１０００％。结果示服用尼莫地平后，绝大多数患者脑内病灶得到不同程度的改善。因此，脑ＳＰＥＣＴ灌注显像可用于观察和评价药物的治疗效果。     

Relationship between vasodilatation and cerebral blood flow increase in impaired hemodynamics: a PET study with the acetazolamide test in cerebrovascular disease.

The changes in cerebral blood flow (CBF) and arterial-to-capillary blood volume (V(0)) induced by acetazolamide (ACZ) are expected to be parallel each other in the normal circulation; however, it has not been proven that the same changes in those parameters are observed in patients with cerebrovascular disease. To investigate the relationship between changes in CBF, vasodilatory capacity, and other hemodynamic parameters, the ACZ test was performed after an (15)O-gas PET study. METHODS: Twenty-two patients with unilateral major cerebral arterial occlusive disease underwent PET scans using the H(2)(15)O bolus method with the ACZ test after the (15)O-gas steady-state method. CBF and V(0) for each subject were calculated using the 3-weighted integral method as well as the nonlinear least-squares fitting method. After evaluation of accuracy in V(0) values, a new parameter, the CBF/V(0) ratio, which is expected to disclose arterial perfusion pressure, was also compared between the conditions. RESULTS: The regional CBF (rCBF) and V(0) increased significantly after ACZ administration in the hemisphere contralateral to the ischemic side. However, in a subgroup of patients who showed a significant reduction in the rCBF increase in the ipsilateral hemisphere (group A), the ACZ injection caused no change or a slight decrease in rCBF even though the V(0) showed a significant increase. Thus, the increases in rCBF and V(0) did not necessarily parallel each other in the ipsilateral hemispheres of patients who have impaired cerebral circulation. A parameter defined by the rCBF/V(0) ratio decreased significantly in the ipsilateral hemisphere of group A after ACZ administration, although the ratio showed no change in the contralateral hemisphere or in the other subgroup (group B). CONCLUSION: The change in the rCBF/V(0) ratio after ACZ challenge may represent an alteration in arterial perfusion pressure that is expected to indicate a critical hemodynamic status in patients with cerebrovascular disease, especially in patients who have a reduced rCBF response.     

The effect of acetazolamide on regional cerebral blood flow in normal human subjects as measured by single-photon emission computed tomography

Regional cerebral blood flow (rCBF) was evaluated in 15 normal, healthy volunteer control subjects before and after the administration of 1 g acetazolamide (ACZ) using a rotating four-detector single-photon emission computed tomograph (SPECT). ACZ, a carbonic anhydrase inhibitor, is a cerebral vasodilator. RCBF values in mL/minute/100 g were derived within eight cortical regions of interest (ROI), and from the whole slice as an expression of whole brain blood flow (WBF). ROI/WBF ratios were established for each ROI in each of the 15 subjects for both pre-ACZ and post-ACZ studies. ACZ produced a 30% +/- 17% increase in WBF. Studies were done in random order, with nine subjects undergoing the post-ACZ study first, and six the pre-ACZ, or baseline, study first. Statistical analysis showed no significant difference in any ROI that might be caused by sequence of test procedures. Ratios were then examined to determine whether rCBF elevation was proportionate in all ROI in all subjects. No significant difference was found in any ROI except for the left parietal, for which marginally significant change was identified. Subjects also were examined for possible age and sex differences in ACZ response, and no differences were found.