应用SPECT评估脑动静脉畸形治疗前后脑血流动力学变化及治疗策略

目的 评价单光子发射计算机断层扫描 (single photonemissioncomputedtomography ,SPECT)对脑动静脉畸形 (arteriovenousmalformation ,AVM)的影像学诊断价值。方法 :1.16例脑AVM病例同时行SPECT与DSA检查 ,两者对照研究。 2 .对脑AVM病例治疗前后作SPECT对比研究。结果 :16例脑AVM中 ,SPECT检查阳性诊断率 10 0 % ,与DSA比较 :(1)病灶显示范围明显比DSA显示大。 (2 )发现大部分脑AVM病灶旁局部脑血流灌注 (regionalcerebralbloodflow ,rCBF)低灌注区 (盗流区 )治疗后rCBF改善。(3)及时发现 2例术后正常灌注压突破。结论 :SPECT对脑AVM可作为评估治疗效果的客观标准。并对后续治疗有指导价值。本技术无创、低风险、价廉 。

Objective To evaluate the role of single-photon emission computed tomography (SPECT) in treatment and follow-up of cerebral arteriovenous malformation(cAVM).Metheds 1. 16 cases with cAVM were examined routinely with SPECT and DSA before and after treatment. 2. We then compared the SPECT parameters at different regions of intereting before and after treatment. Results 1. the single photon emission computed tomographic studies pointed out hypoperfusion in more extensive regions than the defects shown by DSA.2. rCBF in cerebral tissue adjacent to AVMs of hypoperfusion interpreted as cerebrovascular steal showed mostly improvement in the postoperative study.3 SPECT diagnosised early postoperative 2 cases of normal perfusion pressure breakthrough (NPPB)Conclusions SPECT can detect hemodynamic changes after treatment, and has a possibility to estimate the effect of treatment in patients with AVM. It is a noninvasive,low risk,cheap method , it may prove to be of value in treatment planning.