潘生丁负荷试验脑血流灌注显像在缺血性脑血管病中的应用

Dipyridamole cerebral blood flow stress test in ischemic cerebrovascular diseases

目的 研究潘生丁负荷试验脑血流灌注显像在缺血性脑血管病中的应用。方法 2 4例缺血性脑血管病患者和 8例健康对照者均进行了静息和潘生丁负荷SPECT脑血流灌注显像 ,间隔时间 1周内。显像剂为99Tcm 双半胱乙酯 (ECD) ,仪器为ElscintApexSp 6SPECT仪 ,潘生丁剂量按体重 0 5 6mg/kg。结果采用半定量方法进行分析 ,比较静息及负荷显像探测脑缺血性病变的灵敏度及不对称指数。结果 潘生丁负荷试验脑血流灌注显像缺血性脑血管病判断病变的灵敏度可由静息时的 5 8 3%提高至 83 3%。对于椎基底动脉供血不足和短暂性脑缺血发作 ,负荷试验可将静息时的灵敏度从 46 7%提高至 73 3% ,对照组负荷前后不对称指数差异无显著性 ,患者组不对称指数差异有显著性。患者组负荷后脑血管呈不同的反应类型。结论 潘生丁负荷脑血流灌注显像有助于脑血管病变的检出 。

Objective To evaluate the clinical value of dipyridamole cerebral blood flow stress test in ischemic cerebrovascular diseases (CVD). Methods Twenty-four CVD patients and 8 controls received both rest and stress cerebral blood flow perfusion imaging within one week of each other using Elscint Apex SP-6 SPECT. The dose of dipyridamole was 0.56 mg/kg. The semiquantitative methods were used for result analysis and the sensitivity of rest and stress test were compared.The asymmetric indexes at both tests were analyzed using paired-t test. Results For CVD patients, the sensitivity was improved from 58.3% to 83.3% in dipyridamole stress test. For the evaluation of vertebrobasilar ischemia (VBI) and tranient ischemia attack (TIA), the sensitivity was improved from 46.7% to 73.3%. The asymmetric indexes before and after dipyridamole were of no significant difference for the controls,but it had significant difference between two tests for the 24 patients.In dipyridamole stress test, we found different reaction patterns also. Conclusions Dipyridamole stress test is helpful to finding more le-sions in CVD patients and may be it could reflect the cerebrovascular reaction.