15名健康人控尿状态脑激活区^(99)Tc^m-HMPAO局部脑血流显像

Brain activation study during urine withhold by ^(99)Tc^m-HMPAO SPECT brain imaging

目的应用^(99)Tc^m-六甲基丙二基胺肟(HMPAO)SPECT 显像和 NEUROSTAT 软件分析健康人的控尿脑激活区。方法 15名右利手健康男性志愿者(年龄24～45岁),在排空膀胱的静息状态和膀胱充满尿液的控尿状态接受2次显像。控尿状态图像由2次采集数据相减而获得。图像分析采用 NEUROSTAT 分析软件,进行多重对照校正(P<0.05)。结果与静息状态相比,控尿状态下,两侧额下回和右侧颞上、中回的放射性明显增高,其中右侧额下回尤为突出。结论健康男性控尿的大脑控制与两侧额下回和右侧颞上、中回密切相关,尤其右侧额下回在控尿的大脑控制中起重要作用。应用 SPECT 脑功能显像及 NEUROSTAT 分析软件可以确定控尿的大脑控制区,方法简便,易于推广。

Objective Lose of urinary continence control is related with the pathological process of many brain damages. The aim of this study was to identify cerebral activation areas during withholding urine in healthy subjects with cerebral perfusion agent [99^Tc^m-hexamethylpropylene amine oxime （HMPAO） ]. Methods Fifteen right-handed healthy male volunteers （age ranged 24 to 45 years old） was recruited. All had two brain perfusion SPECT scans （15 volunteers with 30 scans）. One was at resting state with empty bladder and the other was at urine withholding state with full bladder. The images were analyzed by neurological statistical image analysis software （NEUROSTAT） and was displayed on Z-score images at a significance threshold of P 〈0.05 with correction for muhiple comparisons. Results As compared with resting, the urine with-holding state showed a significant increase cerebral perfusion in bilateral inferior frontal gyri, the right superior and middle temporal gyri, with the most significant in the right infcrior frontal gyrus. Conclusions Although the control of urinary continence in healthy men was associated with bilateral inferior frontal gyri and the right superior and middle temporal gyri, the results showed that the right inferior frontal gyrus might also be important. Moreover, the combination of brain perfusion SPECT and NEUROSTAT was a rather easy method tot further understanding the mechanism of urinary, control in brain and could be popularized as a research tool for clinical use.