^(99)Tc^m-HL91 SPECT脑显像显示急性脑梗死患者存活脑组织的初步研究

Preliminary study on survival cerebral tissue detected by SPECT with ~99Tc^m-HL91 after acute cerebral infarction.

目的 观察99Tcm-HL91 SPECT脑显像能否显示急性脑梗死的乏氧组织(处于缺血缺氧状态但尚存活的脑组织)。方法 起病96小时内的大脑半球梗死患者行99Tcm-HL91 SPECT脑显像和同机CT扫描,并进行图像融合。在连续2个以上层面和两个以上不同轴向断层上,在梗死侧大脑半球出现放射性浓集区,为乏氧显像阳性。结果43例患者中,乏氧显像阳性者24例,均属完全或部分前循环梗塞。乏氧显像区位于梗死灶周围。9例住起病后7～17天复查SPECT,仍呈阳性,但乏氧组织已减少。腔隙性梗死者,乏氧显像均阴性。结论99Tcm-HL91 SPECT显像能清晰地显示完全及部分前循环梗塞患者的脑乏氧组织,能提示急性脑梗死后脑组织的存活,有助于指导治疗。

Objective To show that SPECT with 99Tcm-HL91 can detect hypoxic but viable peri-infarct tissue in patients after acute cerebral infarction. Methods Patients with acute hemispheric infarction were studied using SPECT with 99Tcm-HL91 and CT simultaneously within 96 hours after stroke onset. Positive images were those regions with increased 99Tcm-HL91 activity ipsilateral to the infarct in more than two continuous slices and in two different oriental tomography. Results Forty-three patients were studied. Hypoxic tissue was detected in 24 patients with total or partial anterior circulation infarct, generally distributed in the peripheries of the infarct. The others did not exhibited increased 99Tcm-HL91 activity. 9 of the 24 patients were investigated again from 7 to 17 days after the onset of stroke and still exhibited 99Tcm-HL91 trapping in ischemic tissue, but the amout of hypoxic tissue decreased. Conclusions SPECT with 99Tcm-HL91 can show peri-infarct hypoxic tissue in patients with total and partial anterior circulation infarct and identify survival cerebral tissue after acute cerebral infarction.