儿童病毒性脑炎^(99)Tc^m-ECD SPECT脑血流显像的研究

The study on ^(99) Tc^m-ECD SPECT regional cerebral blood flow imaging in pediatric viral encephalitis

目的 探讨99Tcm 双半胱乙酯 (ECD)SPECT脑血流显像在儿童病毒性脑炎中的显像特点和应用价值。方法 对 2 2例临床诊断为病毒性脑炎患儿进行99Tcm ECDSPECT脑血流显像 ,4例于治疗后 13～ 40d进行复查。结果 病毒性脑炎急性期 2 2例患儿中 2 1例脑SPECT显示异常。 17例为多发病灶 ,其中可有双侧对称性或不对称性改变 ;4例为单发病灶。病变处可表现为血流高灌注、低灌注或两者并存。治疗后高灌注区可转变为正常灌注或低灌注 ,低灌注区可转变为正常灌注或持续存在 ;转变为正常灌注者预后可能好于转变为低灌注者。结论 ①儿童脑血流显像异常的判断需依据正常同龄儿童的脑显像特点。②99Tcm ECDSPECT脑血流显像可作为病毒性脑炎辅助诊断。

Objective To assess the characteristics and the value of 99 Tc m ECD SPECT regional cerebral blood flow (rCBF) imaging in pediatric viral encephalitis Methods 22 children (14 boys, 8 girls, 3 months to 12 years old) diagnosed as having viral encephalitis underwent 99 Tc m ECD SPECT rCBF imaging Results Within the acute period of the disease, 21 of the 22 patients had abnormal SPECT rCBF imaging 17 of the 21 cases had multiple foci (which were either unilateral or bilateral, symmetrical or asymmetrical), 4 had single focus The abnormalities were either increased perfusion or decreased perfusion or both The second SPECT examination was performed on 4 patients with first abnormal SPECT rCBF imaging After treatment, some increased perfusions turned to normal or to decreased perfusions, while decreased perfusions remained or turned to normal perfusions Patients with normal perfusions seemed to have better outcome than those with decreased perfusions Conclusions ①In order to evaluate the abnormalities on children SPECT rCBF imaging, referring to the images taken from age matched normal children was necessary ② 99 Tc m ECD SPECT rCBF imaging could be used to help to diagnose viral encephalitis and to predict the outcome in these children patients