SPECT与CT或MRI对缺血性脑病诊断价值的比较

The diagnostic value of SPECT for ischemic cerebrosis in comparison with CT or MRI.

为比较ＳＰＥＣＴ与ＣＴ或ＭＲＩ对缺血性脑病的诊断价值，对６７例缺血性脑病患者以及１只栓塞实验猴进行了９９ｍＴｃ－ＥＣＤＳＰＥＣＴ和ＣＴ或ＭＲＩ检查，按解剖分区对ＳＰＥＣＴ阳性程度进行相对定量并与ＣＴ或ＭＲＩ结果进行了比较。结果显示ＳＰＥＣＴ的阳性率为１００％且阳性范围显示较大；ＣＴ为７２５％，ＭＲＩ为８６７％；特别是急性脑梗塞后ＳＰＥＣＴ即可显示阳性，而ＣＴ和ＭＲＩ于２４小时内敏感性差。但是，ＳＰＥＣＴ不能显示白质缺血和不能区分出血病灶。提示对于缺血性和功能减低性脑病，特别是脑梗塞早期，ＳＰＥＣＴ比ＣＴ或ＭＲＩ更敏感，但对白质梗塞以及出血灶则明显不如ＣＴ或ＭＲＩ。

Objective To compare the diagmostic value of SPECT for ischemic cerebrosis with CT or MRI. Methods 99m Tc—ECD SPECT, CT or MRI were studied in 67 patients with ischemic cerebrosis and one monkey that was undergone with experimental cerebral infarction. The positive (ischemic) regions on SPECT were relatively quantitated and compared with CT or MRI. Results The positive rate separately was 100% on SPECT, 72 6% on CT, and 86 7% on MRI, and the positive areas on SPECT were larger. SPECT could show the positive areas immediately after infarction took place but CT or MRI was not sensitive in 24 hours. But, SPECT was not able to show the ischemic lesions in white matter and to differentiate the hemorrhage lesions which could be shown and differentiated by CT or MRI. Conclusion SPECT is more sensitive than CT and MRI in ischemic and hypofunctional cerebrosis, especialy in the early period of cerebral infarction. But, it is less valuable than CT or MRI for the ischemic lesions in white matter and the hemorrhage lesions.