SPECT断层显像和半定量分析对早期脑动脉硬化症的诊断价值

Diagnostic value of SPECT anatomical imaging and semiquantitative analysis to early cerebral arteriosclerosis

目的 评价 99mTc-乙撑双半胱氨酸二乙酯 (ECD)SPECT脑血流灌注断层显像及半定量分析在早期脑动脉硬化症患者中的诊断价值。方法 5 6例临床确诊为该症患者及 12例正常对照者进行 99mTcECDSPECT检查及分析。计算机进行图像重建后 ,取各功能感兴趣区 (ROI) ,作左右ROI与两侧小脑平均放射性强度比值。结果 脑断层显像异常率 98 2 %(5 5 / 5 6 ) ,主要灌注低下区为颞叶 (75 % )、顶叶 (46 2 % )、枕叶 (44 6 % ) ,有两处以上灌注减低区占 6 9 7%。半定量分析示疾病组有弥漫性低灌注 (右额下、额上、左颞后、扣带回、右顶、左基底节、左丘脑 :P <0 0 5 ,左顶与右丘脑 :P <0 0 1) ,两侧不对称 ,以左侧灌注减低区占多数。结论 SPECT可作为脑动脉硬化症早期诊断的客观指标 ,对防治脑动脉病有重要价值。

Objective The diagnostic value of 99m Tc-ECD brain SPECT perfusion imaging and semiquantitative analysis was evaluated in patients with cerebral arteriosclerosis. Methods Fifty-six patients with cerebral arteriosclerosis and 12 normal controls were analyzed with 99m Tc-ECD SPECT and compared. Each functional region of interest (ROI)was decided after computer imaging reconstruction. The ratio of every right and left ROI radioactivity to the average one of double cerebellum was counted. Results The abnormal rate of brain imaging was 98.2%(55/56). The areas of hypoperfusion were temporal (75%), parietal (46.2%) and occipital (44.6%). Thirty-nine cases (69.7%) had more than two hypoperfusion areas. Semiquantitative analysis showed that diffuse hypoperfusion (RI Front, S Front, LP Temp,Cing, R Pari, L Gang, L Thala: P <0 05;L. Pari and R. Thala: P <0 01) was in patient group compared with control group and it was asymmetrical. Significant hypoperfusion areas were with every symptom and mainly in left hemisphere. Conclusion SPECT has objective values in diagnosing early cerebral arteriosclerosis. This is important in preventing and treating cerebral artery diseases.