中年患者128例生物型全髋置换和骨水泥全髋置换后的随访比较

背景：许多学者均认为骨水泥型全髋置换适合应用于年老且合并较严重的骨质疏松患者,生物型全髋置换适用于较为年轻的患者。目的：对比中年患者生物型全髋置换和骨水泥型全髋置换的临床效果。方法：对比分析58例骨水泥型全髋置换者与70例生物型全髋置换者置换后6个月、2年及5年的肢体功能恢复与影像学评估结果以及Harris评分,均为40～60岁中年患者。结果与结论：生物型假体置换后6个月、2年、5年的Harris评分明显优于骨水泥型假体（P〈0.05）,5年生存率也高于骨水泥型假体（P〈0.05）。骨水泥型假体置换后6个月,3例发生自发溶骨性疾病,3例2年后发生假体松动,3例5年后发生线性渗透溶;生物型假体置换2年后2例发生自发溶骨性疾病,置换后5年1例发生假体松动。说明生物型假体较骨水泥型假体更能促进中年患者置换后髋关节功能的恢复,减少并发症的发生,至少在5年的随访过程中获得了更令人满意的临床和影像学结果。     

Staphylococcus aureus prosthetic joint infection treated with prosthesis removal and delayed reimplantation arthroplasty.

OBJECTIVE: To estimate in patients with Staphylococcus aureus prosthetic joint infection after total hip arthroplasty (THA) or total knee arthroplasty (TKA) the microorganism-specific cumulative probability of treatment failure after prosthesis removal and delayed reimplantation arthroplasty. PATIENTS AND METHODS: All patients with S aureus THA or TKA infection, according to a strict case definition, who were treated with prosthesis removal and delayed reimplantation arthroplasty at Mayo Clinic Rochester between 1980 and 1991 were identified. The study group comprised patients who were free of infection at the time of reimplantation arthroplasty. This cohort was followed up until treatment failure, infection with another organism, prosthesis removal, death, or loss to follow-up occurred. The Kaplan-Meier survival method was used to estimate the cumulative probability of treatment failure. RESULTS: Among 120 S aureus prosthetic joint infections treated with prosthesis removal during the study period, 38 episodes (22 THA, 16 TKA) in 36 patients met the study inclusion criteria. After a median of 7.4 years (range, 0.9 year-16.4 years) of follow-up, treatment failure occurred in 1 (2.6%) of 38 episodes 1.4 years after reimplantation arthroplasty. The 5-year cumulative probability of treatment failure was 2.8% (95% confidence interval, 0%-8.2%). CONCLUSIONS: These data suggest that prosthesis removal and delayed reimplantation arthroplasty is an effective treatment to limit the recurrence of S aureus prosthetic joint infection, provided there is no evidence of infection at the time of reimplantation arthroplasty.     

18F-FDG SPECT/CT与99Tcm-MDP骨显像对肺癌骨转移诊断价值的对比研究

目的　比较18F FDGSPECT/CT显像与99Tcm MDP骨显像在肺癌骨转移诊断中的临床价值。方法　 19例经病理证实的肺癌患者同期进行18F FDGSPECT/CT显像和常规99Tcm MDP骨显像。结果　 19例患者 8例有骨转移 ,共发现 47个转移灶。18F FDGSPECT/CT发现 8例骨转移 ,99Tcm MDP骨显像发现 7例骨转移 (P >0 .0 5 ) ;18F FDGSPECT/CT发现 45个转移灶 ,99Tcm MDP骨显像发现 2 6个转移灶 (P <0 .0 1)。18F FDGSPECT/CT探测骨转移的灵敏度 95 .74% ,特异度 89.47% ,准确度93 .94% ;99Tcm MDP探测骨转移灵敏度 5 5 .3 2 % (P <0 .0 1) ,特异度为 94.74% (P >0 .0 5 ) ,准确度 66.67% (P <0 .0 1)。结论　在探测肺癌骨转移方面 ,18F FDGSPECT/CT显像较常规99Tcm MDP骨显像具有更高的灵敏度和准确度。对99Tcm MDP骨显像阴性、单一病灶及可疑脊椎转移患者 ,应进一步行18F FDGSPECT/CT显像 ,可起到信息互补、明确诊断的作用。     

99mTc-MDP骨显像联合CT在乳腺癌术后的临床价值

目的探讨99mTc-MDP骨显像联合CT在乳腺癌术后早期随访中,检测其复发及转移临床价值。方法对253例术后病理确诊的乳腺癌患者一年后分别进行99mTc-MDP骨显像、CT扫描,计算灵敏度、特异性、准确性以及分析骨转移的特点。结果253例乳腺癌全身骨显像中,发现复发或转移者122例,发生率为48．2％,99mTc-MDP发现骨转移灶分布以胸部肋骨组最多见（50．9％）,其次是脊柱椎体（41．8）,骨盆（25．4％）,四肢骨（14．5％）,颅骨和其他骨骼（9．1％）;99mTc—MDP骨显像对骨转移的灵敏度、特异性、准确性分别为93．2％、90．7％、91．3％,CT扫描对复发及转移的灵敏度、特异性、准确性分别为58．2％、87．8％、73．5％。CT联合99mTc-MDP骨显像诊断复发及转移的灵敏度、特异性、准确性分别为93．4％、91．6％、92．5％。结论乳腺癌骨转移发生率很高,骨转移的发生有一定的规律及特点,99mTc-MDP骨显像联合CT可显著提高乳腺癌术后复发及转移的灵敏度、特异性及准确性,对监测其复发及转移具有重要的临床价值。     

The clinical use of 99m-Tc-labeled WBC scintigraphy in critically ill surgical and trauma patients with occult sepsis

Objective To evaluate the clinical use of radionuclide-labeled white blood cell scintigraphy in the detection of focal sepsis.Design Prospective clinical study.Setting A medical/surgical 12-bed intensive care unit (ICU) in a university hospital.Patients 26 trauma and surgical patients affected by sepsis of unknown origin were studied.Measurements and results After the usual diagnostic approach, patients were submitted to a total body scan by using the patient's leukocytes labeled with technetium-99m (99m-Tc) HMPAO; three scintigraphy were performed within 20 h of tracer injection; the result of scan was completed with all clinical and instrumental data, including ultrasound (US) amd computed tomography (CT), and the diagnostic efficacy was demonstrated for each patient on discharge from the ICU. The scan was able to detect 20 sites of infection; it was possible to rule out 11 suspected sites; only in two cases was the result considered to be false positive or false negative; in two cases the result was considered to be uncertain. These results show the high sensitivity (95%), specificity (91%) and accuracy (94%) of the method.Conclusions In ICU patients with sepsis, nuclear medicine can provide additional data, as the injection of radionuclide-labeled white blood cells (WBCs) allows the imaging of sites of infection. Analysis of our results suggests that scintigraphy with 99m-Tc-labeled WBCs can be considered a useful tool in the detection of the source of infection.     

99Tcm-MDP与18F-FDG显像对转移瘤探测价值的比较

目的对恶性肿瘤患者同时行 99Tcm-MDP、 18F-FDG显像,以探索两种显像在检测转移瘤方面的能力与特点.方法对43例经病理证实的恶性肿瘤患者及1例结核患者在1个月内,分别进行 99Tcm-MDP、 18F-FDG显像.结果对骨转移瘤 99Tcm-MDP与 18F-FDG检出灵敏度、特异性、准确性分别为77%、77%,67%、91%,73%、82%. 18F-FDG对恶性肿瘤转移灶的总检出灵敏度(包括骨及骨外)为84%,较 99Tcm-MDP高出7%.结论 18F-FDG较 99Tcm-MDP对骨转移瘤更具特异性和准确性,因能发现早期骨外的软组织转移灶,故病灶隐匿者可先行 18F-FDG显像;由于二者对骨转移瘤检出灵敏度相同,且 99Tcm-MDP全身一次成像方便,故欲知有无骨转移瘤时,仍为一种准确经济的好方法.     

CT与全身核素骨显像联合诊断单发骨转移瘤

目的 评价全身骨显像、CT及二者联合诊断在单发骨转移病变定性诊断中的价值。方法 对102例全身骨显像表现为单发异常核素分布的恶性肿瘤患者行骨病变部位CT扫描。全身骨显像、CT及二者联合分别做出诊断,并与随访结果和病理对照。结果 102例患者,经随访和病理证实有53例为骨转移瘤。全身骨显像、CT与二者联合诊断骨转移瘤灵敏度分别为90.57％(48/53)、86.79％(46/53)、100%(53/53);特异度分别为61.22％(30/49)、97.96％(48/49)、91.84％(45/49);准确率分别为76.47％(78/102)、92.16％(94/102)、96.08％(98/102);阳性预测值分别为71.64%(48/67)、97.87%(46/47)、92.98%(53/57);阴性预测值分别为85.71%(30/35)、87.27%(48/55)、100%(45/45)。CT诊断特异度、准确率及阳性预测值优于全身骨显像(P＜0.05)。二者联合诊断特异度、准确率及阳性预测值明显优于单纯全身骨显像(P＜0.05),灵敏度和阴性预测值明显优于单纯CT(P＜0.05)。结论 CT有助于区分全身骨显像单发病变的良恶性。全身骨显像与CT联合诊断可明显提高肿瘤患者单发骨转移瘤的诊断准确率。     

人工髋关节置换术后并发症影像学表现

目的 探讨人工髋关节置换术后并发症的影像学表现。方法 回顾性分析28例(共31例次)人工髋关节置换术后出现并发症而接受髋关节翻修术患者,观察其影像学表现。结果 31例次中,术后诊断股骨头脱位4例次,X线平片表现为股骨头位于髋臼外;无菌性松动22例次,X线表现为假体周围2~30 mm的透亮带,其中,假体周围慢性肉芽肿性炎CT/MRI表现为骨质破坏并软组织肿块;感染4例次,X线表现为假体周围2~4 mm的轮廓与假体形态不一致的透亮带,MRI表现为感染区软组织肿胀,见环形强化病灶;异位骨化1例次,X线表现为髋臼假体周围软组织大量骨化影。结论 假体周围透亮带是人工髋关节置换术后关节松动最重要的X线表现,CT/MRI有助于区分无菌性松动中的假体慢性肉芽肿性炎、以鉴别感染性和无菌性松动。     

MIBI及MDP显像在骨单发病灶诊断中价值

目的探讨99mTc-MIBI显像在骨单发病灶鉴别诊断中价值并与99mTc-MDP骨显像进行比较。方法对105例骨单发病灶患者(恶性肿瘤70例,良性病变35例)均进行99mTc-MDP并SPECT/CT融合及99mTc-MIBI检查,用ROC曲线评价99mTc-MDP平面并融合显像及99mTc-MIBI显像对骨单发病灶的诊断效能。结果 99mTc-MDP及99mTc-MIBI显像灵敏度分别为94.29%和87.14%(P<0.05),特异度分别为80.00%和82.86%(P<0.05);99mTc-MDP骨显像中良、恶性病灶的T/N(放射性计数比)值差异无统计学意义(P>0.05);99mTc-MIBI早、晚期显像中T/N值恶性病灶分别为(2.45±0.79)和(2.96±0.89),均明显高于良性病灶(1.30±0.34)和(1.39±0.38)(P均<0.05);AUC依次为99mTc-MIBI晚期>99mTc-MIBI早期>99mTc-MIBI滞留指数>99mTc-MDP。结论 99mTc-MIBI显像较99mTc-MDP平面并融合显像灵敏度低、特异性高,对骨单发病灶有较好诊断效能。     

人工全髋关节置换治疗强直性脊柱炎髋关节强直畸形

背景：日前,人工全髋关节置换是治疗髋关节强直畸形髋关节晚期病变的最佳方案,但置换假体松动一直是置换后棘手的问题,主要与假体的界面应力和假体界面结合强度两方面有关。 目的：总结对强直性脊柱炎髋关节强直畸形患者行人工全髋关节置换的方法及疗效和并发症发生的机制。 方法：电子检索CNKI数据库、万方医学数据库等中文数据库和PubMed,SpringerLink等英文数据库1980／2011-12收录的人工全髋关节置换治疗髋关节强直畸形的临床病例研究和相关综述,关键词设定为：髋关节、强直畸形、人I：全髋关节置换、假体松动、并发症等,分析人_lr全髋关节置换治疗髋关节强直畸形的研究进展及髋关节植入后丰日关并发症的研究进展。结果与结论：根据患者自身状况进行簧换前后评什,选择合适型号、准备小同规格的假体对髋关：肖强直畸形疗效仃促进作用。强直性脊柱炎晚期髋关节骨性强直年轻患者骨增生活跃,新骨可较多地长入假体表面微孔中,因此非骨水泥型假体显示了独特的优势。随着生物型假体设计的进步,尤其具有各种涂层年¨金属微孔表嘶人工全髋关节具有多部化负重和紧密匹配的特点,也使其初期的固定较以往的假体更加可靠。近年来该方法取得了很大的进展,但胃换后似体的松动以及假体周围关节感染仍困扰着骨科医生和患肯。     

半限制性假体治疗重度畸形膝关节病的疗效分析

目的观察使用半限制性假体全膝关节置换术治疗膝关节骨关节病重度畸形的近期疗效。方法对23例(28膝)重度畸形的膝关节退行性骨关节病患者使用半限制性假体行全膝关节置换术。术前拍负重位下肢全长X线片,测量膝关节内翻、外翻角度。本组病例外翻膝外翻角均>15°,内翻膝内翻角均>20°,同时伴有程度不同的屈曲及旋转畸形。行全膝关节置换术,术中使用半限制性假体,使用金属垫块修复骨缺损。所有病例均进行跟踪随访与资料积累分析。结果术中关节畸形可有效修复,承载假体可靠;术后X线片显示假体位置及下肢力线恢复良好。术前HSS评分平均33.9分,术后随访6月~3年,平均随访2.3年,HSS评分平均87.6分。23例(28膝)中15例(18膝)为优,6例(8膝)为良,2例(2膝)尚可;其优良率92.9%。结论半限制性假体对严重畸形造成的骨缺损及软组织疲劳亏损导致的松弛能够进行满意的弥补。其设计及操作流程的科学性、可控性及合理性减少该类患者发生早期关节不稳定、下肢力线偏移、假体松动的几率。后期疗效有待于进一步观察随访。     

人工髋关节置换后股骨假体周围骨折

背景:人工髋关节置换是治疗严重髋关节疾病最有效的方法,股骨假体周围骨折是人工髋关节置换后严重的并发症之一。目的:对人工髋关节置换后股骨假体周围骨折研究的文献资料趋势进行多层次探讨分析。方法:以电子检索方式对CNKI数据库学术期刊2002-01/2011-12收录的有关人工髋关节置换后股骨假体周围骨折研究的文献进行分析,采用检索词为"髋关节置换;人工假体;周围骨折",运用数据库的分析功能和Excel软件图表的功能分析数据特征。结果与结论:人工髋关节置换后股骨假体周围骨折的主要原因是创伤,翻修治疗、患者老龄化、假体类型、假体固定方式和关节活动量的增加等,也与骨折发生有关。Vancouver分型方法主要用于人工髋关节置换后股骨假体周围骨折,Vancouver分型包含患者骨折的部位、骨折的类型、假体固定情况、假体松动情况以及股骨近端的骨量丢失等因素,对临床治疗股骨假体周围骨折具有良好的指导价值。人工髋关节置换后股骨假体周围骨折的治疗方法多采用形状记忆合金环抱器、微创内固定系统、锁定加压钢板、异体皮质骨板、碳纤维板、打压植骨及翻修等固定。     

Mimics软件在个体化全髋关节假体翻修中的应用

背景：人工髋关节翻修中髋臼骨质缺损常常是难以定位及定量的,因而利用计算机辅助设计与计算机辅助加工技术进行置换前准备可减少髋臼重建的难度及风险。目的：探讨Mimics软件在个体化全髋关节假体翻修中的应用及意义。方法：将全髋关节翻修患者髋关节CT扫描图像数据导入Mimics软件,重建髋关节三维模型。测量髋关节假体前倾角、外翻角、颈干角、股骨头直径、髋臼壁厚度/直径以及假体松动破碎情况,对髋臼骨质缺损范围进行定位以及定量,同时通过模拟翻修,设计植骨范围,拟植入全髋关节假体规格。结果与结论：通过Mimics三维窗口,精确定位该破碎假体,碎片最大纵径预测33.68mm,距离股骨头假体距离48.93mm,距离髋臼假体20.14mm。髋臼选取130.47mm2可视区域平均阈值339.98,骨质缺损区130.47mm2可视区域平均阈值-481.25,缺损面积21.41mm×21.38mm,根据三维模型评估骨质缺损并分类：AAOS分类ⅠB型,Gross分类ⅡA型,Engh分类Ⅰ型。结果证实,在髋关节翻修中借助Mimics软件可优化置换方案及方式,减少并发症,降低置换风险。     

人工髋关节置换后假体周围骨折的治疗

背景：股骨假体周围骨折是人工髋关节置换后常见的并发症之一,并且发病率在不断增加,改进股骨假体周围骨折的治疗方法及技术成为研究的课题之一。目的：明确各种内固定对于人工髋关节置换后假体周围骨折的治疗效果,为治疗技术的改进以及患者生活质量的改善提供理论参考信息。方法：分别对人工髋关节置换治疗中以及治疗后并发假体周围骨折的影响因素及内固定治疗方法进行实验数据分析,重点分析形状记忆合金环抱器和锁定钢板内固定治疗人工髋关节置换后假体周围骨折的临床效果,同时比较不同内固定方法对假体周围骨折的治疗效果。结果与结论：患者的性别、年龄、假体的类型以及假体的稳定性均为人工髋关节置换后周围假体骨折发生的危险因素,非骨水泥型假体发生骨折的风险高于骨水泥型假体发生骨折的风险。对于人工髋关节置换后周围假体骨折治疗方法的选择,形状记忆合金环抱器内固定不损害假体周围骨皮质,并且具有固定稳固、操作简单、创伤较小、并发症少等优点,而锁定加压钢板结合钢缆内固定具有创伤小、对骨折断端血供干扰小、固定稳固等优点,2种内固定治疗均可以获得较好的临床治疗效果,但是相比较而言,锁定加压钢板内固定比形状记忆合金环抱器内固定治疗获得更好的临床效果。     

^99mTc-MDP骨显像联合CT对乳腺癌术后早期随访的临床价值

目的^99mTc-MDP骨显像联合CT对乳腺癌术后早期随访，监测其复发及转移的临床应用价值。方法81例乳腺癌手术化疗后3年内的病人，女性，年龄29—65岁，分别行^99mTc-MDP骨显像、CT显像、计算灵敏度、特异性、准确性。结果81例乳腺癌手术化疗后病人中，经病理检查或临床及其他影像学诊断转移的31例，^99mTc-MDP骨显像诊断骨转移的15例，CT显像诊断复发及转移的病例18例，^99mTc-MDP骨显像对骨转移的灵敏度、特异性、准确性分别为93．8％、90．8％、91．4％，CT显像对复发及转移的灵敏度、特异性、准确性分别为58．1％、88．0％、93．8％、90．8％、91．4％，其对骨转移的灵敏度、特异性、准确性分别为51．2％、91．0％、88．4％。CT联合^99mTc-MDP骨显像诊断复发及转移的灵敏度、特异性、准确性分别为94．3％、90．6％、93．3％。结论CT对乳腺癌术后病人软组织的复发及转移有较高的灵敏度，但对于骨转移病灶不及^99mTc-MDP骨显像敏感。因此，两者联合应用可明显提高乳腺癌术后复发及转移的灵敏度、特异性和准确性，对监测其复发及转移具有重要的临床应用价值。     

类风湿性关节炎继发髋臼内陷的髋关节置换

背景：类风湿性关节炎导致的髋臼内陷,髋臼运动中心重建和髋关节功能重建是人工全髋置换的两大技术难点。目的：探讨类风湿性关节炎继发髋臼内陷时行的髋关节置换的效果。方法：纳入治类风湿性关节炎累及髋关节造成髋臼内陷的患者16例（22髋）行全髋关节置换,其中男5例8髋,女11例14髋。所有患者置换过程中均行不同程度植骨,置换后随访28—94个月,平均50个月,行髋关节×射线进行影像学评估,关节活动度、Harris评分进行临床疗效评估。结果与结论：至末次随访,所有患者获得影像学上假体良好稳定,假体周围无明显透亮线,移植骨稳定,Harris评分由置换前42．4±8．6,上升为87．5±5．6,关节活动度中屈曲由置换前（45．2±5．5）°,提高为（95．6±5．8）°,外展由（15．2±8．5）°,提高至（32．6±6．6）°。说明类风湿性关节炎继发髋臼内陷,进行全髋关节置换时,根据骨缺损情况结合自体骨移植,能有效恢复髋关节中心,重建髋关节功能。     

Radionuclide imaging in the evaluation of osteomyelitis and septic arthritis

Despite controversy over its exact role, radionuclide imaging plays an important role in the evaluation of patients suspected of having osteomyelitis. The differentiation between osteomyelitis and cellulitis is best accomplished by using a three-phase technique using Tc-99m methylene diphosphonate (MDP). Frequently, it is necessary to obtain multiple projections and magnification views to adequately assess suspected areas. It is recommended that a Ga-67 or In-111 leukocyte scan be performed in those cases where osteomyelitis is strongly suspected clinically and the routine bone scan is equivocal or normal. Repeated bone scan after 48 to 72 h may demonstrate increased radioactivity in the case of early osteomyelitis with the initial photon-deficient lesion. In-111 leukocyte imaging is useful for the evaluation of suspected osteomyelitis complicating recent fracture or operation, but must be used in conjunction with clinical and radiographic correlation. The recognition of certain imaging patterns appears helpful to separate osteomyelitis from septic arthritis or cellulitis.     

Predictive value of the three-phase technetium bone scan in diagnosis of reflex sympathetic dystrophy syndrome

Reflex sympathetic dystrophy syndrome (RSDS) is a painful and disabling problem, the diagnosis of which can be difficult to confirm by objective measures. The three-phase technetium bone scan (TPBS), with a combined sensitivity and specificity of greater than 90%, has been recommended for use in the diagnosis of RSDS. The purpose of this study was to determine the predictive value and usefulness of the TPBS in the diagnosis of RSDS and to discover how the predictive value might be influenced by demographic and medical factors (eg, duration of symptoms). A retrospective chart review was conducted of 119 patients who underwent a TPBS as part of a workup for unexplained limb pain. Twenty-five patients met the Kozin criteria for definite or probable RSDS. All patients were injected with technetium-99m methylene diphosphonate and scanned using established criteria. The three-hour delayed image demonstrated a sensitivity of 44%, a specificity of 92%, a positive predictive value of 61%, and a negative predictive value of 86%. The blood-flow and pool-imaging phases added no further sensitivity or specificity to that achieved by the uptake scan in patients with upper-extremity involvement. Blood-flow and pool-imaging did improve the predictive value of the TPBS in patients with involvement of the lower extremities. We conclude that a more cost-effective approach to diagnosis of upper-extremity RSDS is to use the uptake scan alone.     

Bone infection in patients suspected of complicating osteomyelitis: the diagnostic value of dual isotope bone-granulocyte scintigraphy

AIM: The purpose of this study was to evaluate the diagnostic value of dual isotope bone-granulocyte scintigraphy in patients with known bone pathology clinically suspected of osteomyelitis, i.e. complicating osteomyelitis, using per-operative bacterial culture from bone as reference. METHODS: Simultaneous dual isotope bone-granulocyte scintigraphic images were obtained in 42 consecutive patients in whom conventional X-ray, erythrocyte sedimentation rate, and C-reactive protein were also available. 99mTc MDP bone and 111In labelled granulocyte imaging was obtained simultaneously. The images were interpreted as positive for osteomyelitis if regions of interests of pathologic 111In granulocyte accumulation included 99mTc MDP activity on the bone images (except in the spine). RESULTS: The sensitivity, specificity, and accuracy were 84, 71 and 79%, respectively, for simultaneous, dual isotope bone-granulocyte scintigraphy, higher than the other diagnostic parameters. CONCLUSION: Simultaneous bone-granulocyte scintigraphy is a valuable diagnostic tool in diagnosing osteomyelitis complicating other bone pathology with or without soft-tissue infection.     

脑葡萄糖代谢显像诊断缺血性脑血管病

目的通过比较脑血流灌注显像和脑葡萄糖代谢显像,观察脑葡萄糖代谢显像在缺血性脑血管病诊断中的价值.方法对43例缺血性脑血管病患者和5例正常人的脑18氟-脱氧葡萄糖(18F-FDG)符合线路显像与99锝m-双半胱氨酸乙酯(99Tcm-ECD)脑血流灌注显像进行对比分析.结果脑葡萄糖代谢显像的灵敏度、特异度分别为71.81%、95.71%,脑血流灌注显像的灵敏度、特异度分别为57.45%(P＜0.01)、92.86%(P＞0.05).结论在诊断缺血性脑血管病中脑葡萄糖代谢显像较脑血流灌注显像更灵敏,故可用于早期诊断缺血性脑血管病.