脑梗死患者^(99m)Tc-ECD SPECT/CT感兴趣区成像局部脑血流的特征

Effect of local mild hypothermia on regional cerebral blood flow in patients with cerebral infarction assessed by ^(99m)Tc-ECD SPECT imaging

目的:探讨脑梗死(CI)患者SPECT/CT病灶率,局部脑血流(rCBF)变异与临床的关系。方法:分析67例CI患者的临床资料和脑部感兴趣区(ROI)rCBF变化特征。结果:67例患者观察ROI共804处,发现阳性251处,阳性率为31.2%。左侧阳性率高于右侧(38.1%vs.24.4%,χ2=17.522,P<0.01);正常组左侧r CBF平均值与右侧比较,额叶、颞叶、枕叶、丘脑、基底节差异无统计学意义(P>0.05),左侧顶叶r CBF平均值较右侧低(P<0.01);异常组r CBF平均值较同侧正常组低(P<0.01);异常组rCBF指数平均值较同侧正常组高(P<0.01);正常组额叶、顶叶低,丘脑、基底节高(P<0.01),异常组额叶、颞叶、顶叶、枕叶、丘脑、基底节rCBF平均值比较差异无统计学意义(P>0.05)。r CBF指数≥0.7是异常ROI的临床标志。结论:CI患者有30%的ROI有病灶,左侧阳性率高于右侧,额叶、颞叶、顶叶、枕叶、丘脑和基底节在生理上的rCBF值有所差异,用rCBF指数可以比较直观地反映ROI正常与否,rCBF指数≥0.7可成为临床定性异常ROI的标志。

Objective To investigate the frequency of lesions detection in patients with cerebral infarction （CI） with SPECT/CT. To investigate fluctuation of regional cerebral blood flow （rCBF） and its relationship with clinical symptoms. Methods Sixty-seven CI patients without cerebellar lesion were randomly selected. The ICBF in the regions of interest （ROI） was examined by SPECT/CT, which was collected from the frontal lobe, temporal lobe, parietal lobe, occipital lobe, thalamus, basal ganglia and cerebellum. The rCBF index was calculated. The association between fluctuation of rCBF index and clinical symptoms of patients was explored. Results There were 251 positive regions in all viewing regions, the total positive rate was 31.2%. The left side was 38.1%, while the fight side was 24.4% （X^2=17.522,P 〈 0.01）. In normal group, there were no statistical difference of average rCBF between two halves （P〉 0.05）. However, the average rCBF on the left parietal lobe was lower （P 〈 0.01）. The average rCBF in the abnormal group was lower than that in ipsilateral normal group （P 〈 0.01 ）. The average rCBF index in the abnormal group was higher （P 〈 0.01 ）. In normal group, the average rCBF on the frontal lobe and parietal lobe was low, but the average rCBF on the thalamus and basal ganglia was high （P 〈 0.01 ）. In abnormal group, there were no statistical difference in the average rCBF （P 〉0.05）. rCBF≥0.7 is a clinical sign of abnormal ROI. Conclusion 30% of ROI of CI patients have lesions and the positive rate of the left side was higher. The biological rCBF values of all lobes were different. Therefore, rCBF index could be used to reflect whether the ROI is normal, rCBF≥0.7 could be used as a sign to quantitatively assess abnormal ROI in clinical practice.