脑SPECT血流灌注显像对老年人Alzheimer病和多发性梗塞痴呆的诊断研究

Diagnosis of Alzheimer's Disease and Multiple Infarct Dementia in the Elderly Using SPECT and (99m)￣Tc-HMPAO

目的：本文旨在研究脑ＳＰＥＣＴ血流灌注显像对老年人阿尔海默氏病和多发性梗塞痴呆的诊断价值。材料和方法：对６例阿尔海默氏病及６例多发性梗塞痴呆患者进行脑ＳＰＥＣＴ血流灌注显像，使用放射性药物为９９ｍ锝－六甲基丙叉二胺肟（９９ｍＴｃ－ＨＭＰＡｏ），ＳＰＥＣＴ结果与ＭＲＩ、ＣＴ相比较。结果：阿尔海默氏病表现为大脑皮质血流灌注的广泛减低，以颞，顶叶较为明显，个别病例一侧大脑皮质灌注减低较对侧明显者伴有同侧基底节或对侧小脑的低灌注，可能与＂神经机能联系不能＂有关。多发性梗塞痴呆患者，呈不规则、局灶性大脑皮质灌注减低，多伴有基底节或小脑的低灌注，与阿尔海默氏病的脑ＳＰＥＣＴ图像有明显区别。结论：脑ＳＰＥＣＴ血流灌注显像对阿尔海默氏病与多发性梗塞痴呆的诊断与鉴别诊断有重要价值。

Purpose:To deliberate diagnosis of Alzheimer's disease and multiple infarct dementia in the elderly using SPECT and 99mTc-HMPAO. Materials and Methods:Regional cerebral blood flow was measused with SPECT using 99mTc hexamethylpropyleneamine oxime(99mTc-HMPAO)in 6 patients with Alzheimer's disease(AD) and 6 patients with multi-infarct dementia (MID).A comparative study with MRI,CT was performed.Results:The regional cerebral blood flow was significantly decreased in all patients with AD especially in the tempoprietal region. In individual cases of AD,the prominent unilateral cortical hypoperfusion accompanied with unilateral basal garglia and contralateral regional cerebellum hypoperfusion may be due to diaschisis. MID manifested the multiple, irregular cortical hypoperfusion,mostly involved with basal ganglia or cerebellum can differentiated well with AD. Conclusion:Regional cerebral blood flow by using SPECT and 99mTc-HMPAO is very useful for diagnosis of AD and MID.