^(99)Tc^m-HL91 SPECT脑显像检测脑出血患者乏氧组织

A study of ^(99)Tc^m-HL91 SPECT imaging for the detection of hypoxic brain tissue in cerebral hemorrhage

目的探讨^(99)Tc^m-4,9-二氮-3,3,10,10-四甲基十二烷-2,11-二酮肟(HL91)脑显像检测脑出血患者脑组织乏氧的作用。方法 9名健康对照者和35例脑出血患者于起病96 h 内行^(99)Tc^m-HL91 SPECT 脑显像和同机 CT 扫描,并进行图像融合。其中7例患者于第10～90天内复查 SPECT显像(2例2次,5例1次)。若在同机 CT 显示的出血灶和(或)周围脑组织连续2个以上层面和2个以上不同轴向断层上见放射性浓聚区,且病灶/本底(L/B)放射性比值>1.2,为乏氧显像阳性。结果 (1)9名对照组受试者均未见脑皮质有异常放射性浓聚。(2)35例脑出血患者中,乏氧显像阳性15例(42.8%),乏氧灶位于出血灶和(或)周围组织,其中13例同机 CT 均见明显出血灶。2例治疗前血肿周围乏氧显像阴性,但治疗后乏氧显像阳性。2例患者共显像3次,随病情好转乏氧灶范围逐渐缩小,L/B 比值逐渐下降。结论 ^(99)Tc^m-HL91 SPECT 脑显像可清楚显示脑出血后的乏氧脑组织,并证实血肿周围存在乏氧组织。

Objective To investigate the detection of hypoxic brain tissue in cerebral hemorrhage using ^99Tc^m-4,9-diaza-3,3,10,10-tetramethyldedecan-2,11-dione dioxime（HL91）SPECF imaging. Methods Nine normal controls and 35 patients with cerebral hemorrhage underwent ^99Tc^m-HL91 SPECC and CT simultaneously within 96 h from the onset, 5 positive patients underwent repeated study 10 to 90 d later, while 2 negative patients after 21 d. Increased uptake of ^99Tc^m-HL91 in lesion site found in more than two slices and two tomographic views, and lesion/ background （L/B）ratio 〉 1.2 was considered as positive. Results （1）There was no obvious uptake in brain tissue in 9 normal controls. （2）In 35 patients with cerebral hemorrhage, 15 （42.8%）patients showed positive uptake in hemorrhagic region and its periphery. Among them 13 patients showed marked hemorrhagic region on CT. Two patients with negative result before therapy became positive after treatment. In 2 positive patients the uptake decreased and L/B ratios reduced with the improvement after therapy. Conclusion ^99Tc^m-HE91 SPECT imaging can detect hypoxic brain tissue in cerebral hemorrhage,and also in its periphery around the hemorrhagic area.