乙酰唑胺负荷实验^(99m)Tc-HMPAO脑血流灌注显像评价烟雾病的脑血流储备

Evaluation of cerebral hemodynamics in moyamoya disease using acetazolamide(Diamox) ^(99m)Tc-HMPAO SPECT

目的 :使用99mTc HMPAOSPECT及乙酰唑胺 (Diamox)负荷显像评价烟雾病 (Moyamoyadisease)患者的脑血流储备。方法 :血管造影诊断为烟雾病人 9例 (儿童 4例 ,成人 5例 ) ,6例为短暂性缺血发作 (TIA)型 ,3例为出血型。用99mTc HMPAO显像 ,先取安静时图像 ,之后注入Diamox进行第二次显像 ,两次图像相减为负荷像 ,再行图像校正。结果 :静息时 6例血流低下 ,3例血流正常 ,Diamox负荷显像 9例中 6例阳性 ,静息像未见异常的 3例也全部呈阳性。结论 :Diamox负荷实验99mTc

Objective: To evaluate cerebral hemodynamics of moyamoy adisease with acetazolamide(Diamox)and 99m Tc-HMPAO SPECT. Metho ds:We studied the cerebral hemodynamics using Diamox, 99m Tc-HMP AO SPECT in 9 patients with Moyamoya disease diagnosed with angiography, inc luding 4 children and 5 adults. Six of 9 patients were transient ischemia attack (TIA)type, and 3 were hemorrhage type. Diamox 99m Tc-HMPAO SPECT studies w ere performed by the double injection method in one day. Image at resting statewas taken first, then the second image was taken after injection of Diamox. Theload image was taken by subtraction between the two images, then rectified again . Results:Six of 9 patients had hypoperfusion,3 patient had n ormal perfusion at rest. The Diamox test was positive in 6 of 9 patients. Threepatients with negative results at rest had hypoperfusion after Diamox injection.The regional cerebrovascular reponse to Diamox was most severely impaired in th e frontal region. However, it was relatively well preserved in the cerebellum an d thalamus according to the semiquantitative analysis. Conclusion:The Diamox 99m Tc-HMPAO SPECT was useful in evaluation of hemodynamic s in patients with Moyamoya disease.