抑郁症患者局部脑血流灌注变化研究

目的 分析抑郁症患者单光子发射型计算机断层显像(SPECT)局部脑血流(SCBF)灌注变化的特点,并初步探讨rCBF显像在抑郁症患者中的诊断价值. 方法 对10例正常人及临床诊断为抑郁症的32例患者分别进行SPECT局部脑血流灌注显像,利用感兴趣区(ROI)法观察rCBF情况;11例患者同期行MRI普通扫描.结果 32例抑郁症患者中31例发现rCBF显像异常,共检出71个病灶,分别位于双侧额叶、颞叶、基底节、海马、扣带回及左侧岛叶,其中57个病灶位于颞叶、海马、扣带回及岛叶,即边缘系统,9个病灶位于额叶,5个病灶位于基底节;基底节区病灶局部脑血流灌注均增高,其他部位病灶均降低;双侧大脑半球rCBF病灶构成比差异无统计学意义(χ~2=409,P=0.790).11例患者同期做MRI扫描,3例发现异常(2例轻度脑萎缩,1例海马萎缩),而此11例患者rCBF显像均发现异常.1例正常人rCBF未发现异常显像.结论 大多数抑郁症患者存在脑边缘系统rCBF降低,部分患者存在基底节区rCBF增高.SPECT能敏感地发现抑郁症患者rCBF灌注的变化,对抑郁症的诊断具有一定的价值.

Detection of cerebral blood flow with single emission computed tomography in depressive patients

Objective To analyze the changes of regional cerebral blood flow (rCBF) with SPECT in depressive patients, and explore the diagnosis value of rCBF imaging for depression. Methods The rCBF imaging was detected by single emission computed tomography (SPECT) on 32 depressive patients and 10 normal subjects, and the characteristics of rCBF changes were assessed with a region-of-interest (ROI) technique. Normal MRI scans were conducted on 11 patients at the same stage. Results Abnormal rCBF was showed in 31 patients with 71 focuses that were located in the bilateral frontal lobe (9), the basal ganglia (5) and the limbic system (57), including the temporal lobe, the hippocampus, the cingulated gyms and the left insular cortex. All abnormalities presented a decreased rCBF except the basal ganglia. No differences in the incidences of abnormal rCBF were found on bilateral hemisphere (χ~2=2A09,P=0.790). Only 3 MRI-detected patients (2 with gently encephalanalosis, 1 with hippocampus atrophies) were found abnormality, while abnormal rCBF was observed in all these 11 patients. Conclusion Most depressive patients show a decreased rCBF at the cerebral limbic system, but part of them exist an increased rCBF at the basal ganglia. The changes of rCBF in depressive patients are sensitively observed by SPECT, suggesting its diagnosis values on depression.