SPECT脑血流灌注显像在老年人脑梗塞中的应用

目的：评价ＳＰＥＣＴ脑血流灌注显像在老年病中的临床应用价值。材料和方法：４６例脑梗塞患者行９９ｍＴｃ－ＥＣＤ脑血流灌注显像，并与ＣＴ、ＭＲＩ、对照。其中４例行Ｄｉａｍｏｘ脑血流负荷检查。结果：４６例脑梗塞患者４５例脑血流灌注异常，占９７．８％．３３例同时做过ＣＴ，其灵敏度９６．７％．２５例做过ＭＲＩ，灵敏度９６％。ＳＰＥＣＴ脑血流显像灵敏度与ＣＴ及与ＭＲＩ间无显著性差异（Ｐ＞０．０５）。７例ＳＰＥＣＴ图像上出现＂交叉性小脑神经失联络征＂。４例行Ｄｉａｍｏｘ脑血流负荷检查，１例原梗塞灶血流明显改善；两例显示病灶范围更广泛；另１例除小脑血流分布改善外．余处未见明显改变。４例中３例有＂交叉性小脑神经失联络征＂，使用Ｄｉａｍｏｘ后小脑血流改善。结论：本组病例ＳＰＥＣＴ灵敏度与ＣＴ及ＭＲＩ无显著差异；ＳＰＥＣＴ脑血流灌注显像可探测梗塞后存活的脑组织，为临床治疗提供客观依据；结合Ｄｉａｍｏｘ脑血流负荷检查有望进一步提高诊断的阳性率

The Clinical Application of SPECT Cerebral Blood Flow Perfusion Imaging in Aged Cerebral Infarct Patients

To evaluate the clinical application of SPECT in geriatric patients, Materials and Methods: 99mTc-ECD cerebral blood flow perfusion imagings were compared with those of CT and MRI scans, in 46 cerebral infarct cases including Diamox cerebral blood flow stress test in 4.Results: 45 out of the 46 patients had abnormal cerebral blood flow (CBF) in SPECT,the sensitivity reached 97.8%.CT and MRI were performed in 35 and 26 with the resulted sensitivities of 96.7% and 96% respectively. The sensitivities of SPECT,CT and MRI were not significantly different (P>0.05). Seven of the 45 SPECT had "crossed cerebellar diaschsis". Four with Diamox cerebral blood flow stress test, showed improved cerebral blood flow of the infarct area in one,decreased cerebral blood flow of the areas in two and with the same CBF and only improved cerebellar stress test in the other. Three of the 4 patients had " crossed cerebellar diaschisis" and the blood flow had improved in all the 3 after the Diamox test. Conclusion:The sensitivities among SPECT,CT and MRI were not significantly different in our cases.SPE CT C BF perfusion imaging can detect survial brain tissues after infarction and provide useful information for clinical therapy.The sensitivity may be further raised by combinding use of Diamox CBF stress test.