新型乏氧显像剂^(99)Tc^m-HL91在缺血性脑血管病中的试验研究

Experimental Study of ^(99)Tc^m-HL91 Hypoxia SPECT Brain Imaging in Ischemic Cerebrovascular Disease

目的 探讨新型乏氧显像剂99Tcm HL91在缺血性脑血管病中的临床应用价值。方法 对 18例临床确诊为缺血性脑血管病患者进行脑乏氧断层显像 ,其中临床诊断脑梗死 11例 ,短暂性脑缺血发作 (TIA) 5例 ,椎 基底动脉供血不足2例 ,取标记好的99Tcm HL915 5 5～ 1110MBq静脉推注 ,2 0～ 3 0min内行脑乏氧断层显像 ,17例患者同时进行了CT或MRI检查 ,11例患者次日行99Tcm ECD脑灌注断层显像 ,三种方法进行了对比研究。结果 18例患者中脑乏氧显像阳性者 5例 ,分别为脑梗死 4例 ,椎 基底动脉供血不足 1例。 11例同时行99Tcm ECD脑血流灌注显像者中 6例表现为局部脑血流灌注减低 ,CT或MRI检查异常者 9例。结论 99Tcm HL91脑乏氧显像诊断缺血性脑血管病的影响因素较多 ,但对脑血流灌注显像出现低灌注区时可以区分组织乏氧或坏死 ,对指导治疗有一定临床意义。

Objective To evaluate the clinical application of 99 Tc m HL91 hypoxia brain SPECT imaging in ischemic cerebrovascular disease. Methods Eighteen patients with ischemic cerebrovascular disease were studied by 99 Tc m HL91 hypoxia SPECT brain imaging. Among them,clinically diagnosed cerebral infarction in 11 cases,transient ischemic attack in 5 cases,vertebrobasilar artery insufficiency in 2 cases. All 18 patients SPECT brain scans were performed at 20-30min postinjection of 99 Tc m HL91 555-1110MBq. CT or MRI of 17 patients was performed at next day and in 11 patients brain SPECT with 99 Tc m ECD at the same day. All the results of three modalities imaging were compared with each other. Results 99 Tc m HL91 imaging showed visible uptake into the brain hypoxia area in 5 cases (cerebral infarction 4 cases and vertebrobasilar insufficiency 1 case). 99 Tc m ECD imaging showed brain blood flow perfusion decrease in 6 cases. CT or MRI showed abnormal in 9 cases. Conclusion 99 Tc m HL91 hypoxia brain SPECT imaging can distinguish hypoxia or necrotizing tissue from the decreased perfusion area showe by SPECT blood flow perfusion imaging.So it can also be used for directing the clinical treatment.