脑SPECT灌注显像用于尼莫地平疗效的评价

The clinical evaluation of nimodipine treatment by SPECT brain perfusion imaging

为探讨脑部疾病患者用尼莫地平前后脑ＳＰＥＣＴ灌注显像的临床价值，将５３例患者分为３组：偏头痛（普通型发作间期）２６例，缺血性脑血管病１９例〔其中短暂性脑缺血发作（ＴＩＡ）１１例，脑梗塞８例）〕，脑外伤８例。３组患者均在服尼莫地平前后进行脑ＳＰＥＣＴ灌注显像。使用正常／病灶镜像局部比值法进行定量分析。结果：ＳＰＥＣＴ显示各组在用药前皆见脑内有不同程度的局灶性放射性分布稀疏区或缺损区，用药后原放射性稀疏区或缺损区有不同程度放射性填充。偏头痛组显著填充病灶２７３％，填充病灶５７５％，总填充率８４８％；无变化病灶１５２％。ＴＩＡ显著填充病灶６４３％，填充病灶２８５％，总填充率９２８％；无变化病灶７２％。脑梗塞显著填充病灶２０％，填充病灶６０％，总填充率８０％，无变化病灶２０％。脑外伤组填充病灶１０００％。结果示服用尼莫地平后，绝大多数患者脑内病灶得到不同程度的改善。因此，脑ＳＰＥＣＴ灌注显像可用于观察和评价药物的治疗效果。

PURPOSE Clinical evaluation of patients with cerebropathy by SPECT brain perfusion imaging before and after nimodipine treatment were studied METHODS 53 patients were divided into 3 groups: 26 migraine (interictal), 19 cerebral ischemia (11 TIA and 8 cerebral infarction) and 8 brain trauma SPECT brain perfusion imaging was performed before and after nimodipine treatment, and quantitative analysis was processed with normal/focus mirror regions ratio on transverse images RESULTS Before nimodipine administration, the focal defects with various magnitude were showed by SPECT, and after treatment with nimodipine, the original focal defects were filled in varying degree The rate of significant filling, filling, total filling and non filling were 27 3%, 57 5%, 84 8% and 15 2% respectively in migraine, 64 3%, 28 5%, 92 8% and 7 2% respectively in TIA and 20%, 60%, 80% and 20% respectively in cerebral infarction, whereas in brain traumas, filling rate was 100%. CONCLUSIONS Most patients have various improvement of the focal defect after nimodipine treatment Therefore, SPECT brain perfusion imaging can be used to observe and evaluate the therapeutic effects of nimodipine