远红外热像图对缺血性脑血管病的诊断价值及疗效评价的意义

Using Infrared Thermography to Diagnose Ischemic Cerebrovascular Disease and Evaluate Its Treatment Effect

目的探讨远红外热像图对缺血性脑血管疾病的诊断及疗效评价的意义。方法应用远红外热像图对16例临床诊断为缺血性脑血管病患者进行头部温度测定。结果(1)缺血性脑血管病的远红外热像图:16例缺血性脑血管病患者左右两侧温区中额区、内眦区、眶上区及面颊区的温度差别明显,表现为缺血侧的温度明显低于对侧,与临床采用脑血管造影(DSA)或磁共振(MRA)的诊断基本一致。(2)静脉给药治疗前后远红外热像图的变化:在首日输液治疗后即刻,4例患者缺血侧的温度明显升高,表现为左右两侧额区、内眦区、眶上区及面颊区的温差显著减小。在次日输液治疗后,两侧的温差小于前日输液治疗前。在1个疗程(14 d)输液治疗结束时,左右两侧额区、内眦区、眶上区、枕区、耳后区或面颊区的温差均明显小于首日输液治疗前。提示该输液治疗方法有助于改善缺血性脑血管病的脑供血状态。(3)介入治疗患者左右两侧额区、内眦区、眶上区及面颊区的温差较治疗前明显减小。在治疗后1d左右时,3例患者出现左右两侧部分测温区枕区、颞区的温差加大,随后两侧的温差减小的现象。分析可能与介入治疗引起一过性血管痉挛有关。结论远红外热像图可较好地反映脑供血状态及代谢水平的变化,有望为临床提供缺血性脑血管疾病诊断及疗效评价的良好的评估指标。

Objective To define the infrared thermography as an index for the clinical dynamic diagnosis and the effect evaluation after treatment to the ischemic cerebrovascular disease. Methods Thermography was used to study 16 cases of ischemic cerebrovascular disease. Results （ 1 ） The thermography of ischemic cerebrovascular disease ： it showed that the temperature differences in the following parts such as inner canthus,frontal area,supraorbital region and cheek regions of these 16 cases were obviously dissymmetric,and it showed that the temperature in the ischemic side was obviously lower than the opposite side, and this was approximately in accord with the results of the diagnosis of DSA or MRA. （ 2 ） The changes in the thermography of ischemic cerebrovascular disease before and after transfusion through vein： instantly after the transfusion treatment on the 1st day, 4 cases showed that the temperature in the ischemic side arouse apparently. Before the transfusion treatment of the next day, the temperature difference was lower compared with it measured before transfusion of the last day. After a course（ 14 days） of transfusion treatment, the temperature difference between the corresponding parts as inner eanthus, frontal area,supraorbital region,cheek regions, occipital region and postauricular region reduced apparently compared with that measured before transfusion of the last day. It showed that transfusion treatment had an good effect on improving the status of blood-supply in the ischemlc cerebrovascular patients. （3） The changes in the thermography of ischemic cerebrovascular disease before and after interventional therapy： the temperature difference in inner canthus ,frontal area, supraorbital region and cheek regions reduced apparently after interventional therapy. In the first day after interventional therapy, a few of patients appeared that the temperature difference between left and right sides became larger and then decreased. That might be corresponded with the temporary vasospasm. Conclusions The infrared thermography could be used as a functional imaging measurement technology to reflex the changes of the blood-supply status and the metabolic levels in the brain more effectively and give a clinical index of diagnosing and evaluating the effects of treatment on the ischemic cerebrovascular disease.