用脑SPECT显像观察失语患者脑血流的变化

The study of correlation between neurological function rehabilitation and dynamic change of rCBF in patients with aphasia

目的观察失语症患者局部脑血流量(rCBF)变化与大脑功能活动的关系。方法对30例经头部CT检查确诊为左侧基底节区梗死的患者进行SPECT显像,按有无失语分为A、B2组,半定量分析采用感兴趣区(ROI)技术。结果①A组患者SPECT显像示rCBF左侧基底节区呈低灌注区,范围比头部CT所见大,语言中枢外侧裂周围额下回、颞上回尚存在低灌注区;B组患者只有左侧基底节区为低灌注区,额、颞区无明显改变。②A组中有6例出现对侧交叉性小脑失联络现象(CCD)。③失语组患者恢复状况比较,语言功能改善较好者语言中枢脑血流量增加,反之无明显改善,两组比较差异有显著性。结论脑SPECT显像可间接反映大脑的功能活动,对研究失语的中枢定位及鉴别诊断有意义,并可能帮助判断预后及指导治疗。

Objective To evaluate the result of SPECT and CT in the patients with acute cerebral infarction and further more, to study the correlation between aphasia and dynamic change of regional cerebral blood flow (rCBF) in patients. Methods Thirty cases with cerebral infarction of left basal ganglia were divided into two groups according to the presence or absence of aphasia; the vision and semi-ration analysis were used in photograph reading and region of interest (ROI) technology, respectively. Results ①Group A: there was a low rCBF in left basal ganglia, the dimension was larger than that in CT. There was also a low rCBF in frontal lobe and temporal lobe. Group B: there was only a low rCBF in left basal ganglia. ②There were 6 cases with crossed cerebellar diaschisis (CCD) in the patients with aphasia. ③The comparison about aphasia: the rCBF was higher in language center in the patients with improved language function than that in the patients without language function improvement and the difference between them was significant. Conclusions The neurological function can be indirectly reflected through the study of the rCBF. At the same time, it may conduce to the locating of the damage in the central nervous system and to the differentiative diagnosis. It may also conduce to the programming of the therapeutic course and prognostication.