经颅多普勒超声评价脑血流状况的价值——与核素脑血流灌注断层显像的比较

TCD Assessment of Cerebral Hemoperfusion:Compared with Brain SPECT Imagings

本文２５例，行ＴＣＤ及脑ＳＰＥＣＴ显像对比研究。两者均可用于间接评价轻度脑供血减少。ＴＣＤ直接显示脑动脉的主干，对头晕、头痛患者脑血管舒缩状况及脑供血改变评价较好。脑ＳＰＥＣＴ显像评价核素在脑组织中的分布，与小动脉关系密切，对组织水平供血状况了解较好。ＴＣＤ受侧枝循环影响小，ＳＰＥＣＴ受影响大。ＴＣＤ对动静脉畸形有特异性，ＳＰＥＣＴ却没有。ＴＣＤ受骨窗限制，ＳＰＥＣＴ不受限制。对轻度脑供血不足，ＴＣＤ假阳性率可能较高，ＳＰＥＣＴ假阴性率可能较高，两者在评价脑血流灌注方面呈互补关系。

Comparative studies of TCD and brain SPECT imagings on cerebral hemoperfusion were made in 25 cases.Both indirectly show the light cerebrovascular hemoperfusion insufficiency.But TCD detected the flow of main cerebral artery,good at assessing vasomotor reactivity and cerebral hemoperfusion on patients suffered from vertigo and headache.Brain SPECT imagings detected the radioactivity in cerebral tissue.The imagings correlated closely with small artery and good at assessing the tissue hemoperfusion.The assessment were less affected by lateral circulation on TCD,but more on SPECT.Cerebral arteriovenous malformation detected by TCD were special while SPECT not.TCD limited by bone windows while SPECT didn’t.Detecting the light cerebrovascular hemoperfusion insufficiency,the false positive rate might be high with TCD,and the false negative rate might be high with SPECT.It was concluded that TCD and brain SPECT imaging were mutual complementarity on assessing cerebral hemoperfusion.