放射性核素脑脊液显像的临床应用

Clinical Application of Radionuclide Cerebrospinal Fluid Scintigraphy

目的 :评价放射性核素脑脊液显像临床应用价值。材料和方法 :对190例核素脑脊液显像的随访病史 ,部分结合CT和(或)MRI进行回顾性图像分析。结果 :交通性脑积水 ,脑池显像均可见脑室返流明显 ;正常脑压脑积水 ,示踪剂缓慢上升到大脑凸面 ,上矢状窦放射性分布少 ,即使伴脑室返流 ,但其程度较轻。脑脊液漏诊断的灵敏度在持续性、间歇性、可疑或无明显脑脊液鼻漏三组中分别为100 %(19/19) ,90 %(27/30)及71 %(17/24)。其他 ,脊髓空洞症12例中无阳性发现4例 ,脑脊液吸收缓慢5例 ,脊髓段有放射性缺损区3例。颅内压增高21例中脑脊液吸收缓慢9例 ,吸收正常12例。脑室分流术后11例 ,放射性核素分流显像可以显示分流管是否畅通。本组与脑脊液相通的蛛网膜囊肿5例均能显示。结论 :脑池显像有助于正常脑压脑积水的诊断 ,及估测手术预后 ;结合棉拭放射性计数测定 ,是诊断脑脊液漏有效而灵敏的方法。还可用于脑室分流术后随访。

To evaluate clinical application of radio nuclide cerebrospinal fluid sc intigraphy Materials and Methods:Retrospectively analyzed 190 cases investigated radionuclide cerebrospinal fluid scintigraphy combining with their clinical his tory and part with cranial MRI or CT findings for evaluating the value.Result:Co mmunicating hydrocephalus 42 cases,normal intracranial pressure hydrocephalus 24 cases,cerebrospinal fluid(CSF) leakage 75 cases,intracranial hypertension 21 ca ses,after CSF shunting surgery 11 cases,syringomyelia 12 cases,subarachnoid c ysts 5 cases.All the communicating hydrocephalus tracer activity had refluxed in to the ventricles obviously.Normal intracranial pressure hydrocephalus there was little or much lesser accumulation of radioactivity over the cerebral convexiti es to the sagittal area.There were ventricular reflux in some cases but it was n ot as marked as or persistent in communicating hydrocephalus.CSF leakage studied by radionuclide cisternography with the concomitant use of nasal pledgets.The s ensitivity of continue,intermittent and suspicious were 100%(19/19),90%(27/30 ) and 71%(17/24),respectively.Conclusion:Radionuclide cisternography is useful in diagnosing normal intracranial pressure and predicting the outcome of CSF shu nting surgery.This investigation is a simple and reliable in identifying the pre sence of CSF leakage.