CT血管造影联合单光子发射计算机断层扫描在短暂性脑缺血发作诊断中的价值

目的探讨CT血管造影(CTA)联合单光子发射计算机断层扫描(SPECT)在短暂性脑缺血发作(TIA)诊断中的价值。方法54例患者于TIA末次发作后3 d内同日行头颈部CTA和SPECT检查,对CTA和SPECT检查进行分析。结果54例TIA患者中32例(59.26%)CTA检查显示相应供血动脉狭窄,动脉粥样硬化6例(11.11%)。54例TIA患者的脑SPECT灌注显像中43例(79.63%)发现与发作期临床表现一致的低灌注区,其中包括13例CTA图像正常的患者。结论CTA联合SPECT对TIA的病因诊断、治疗方案的确定以及预后估计有重要价值。     

脑电图与单光子发射计算机断层扫描和CT对癫痫诊断的比较

癫痫是一种常见的中枢神经系统疾病，其发病率为0．5％～0．7％。目前普遍以EEG作为临床辅助检查的主要手段，对于发作期及浅表皮层损害所致的癫痫，其阳性率可达80％，而对于发作间期或深部病灶的阳性率不高，且临床上诊断为癫痫的部分患者，EEG无论在发作期或发作间期均无阳性发现。随着CT、SPECT的广泛使用，为癫痫的诊断提供了更多的辅助检查手段，特别是癫痫灶的定位，为开展外科手术治疗癫痫提供了强有力的依据。本文就EEG、CT、SPECT对癫痫的诊断进行比较，以了解更多引起癫痫的疾病及早期发现其可能引发的癫痫灶，以达到防治目的。     

X线断层扫描和单光子发射断层对急性脑血管病诊断价值的比较研究

69例急性脑血管病患者单光子发射计算机断层(SPECT)和CT对比观察,其中脑梗塞56例,起病48h内CT的检出率为40％,显著低于同期SPECT的检出率(87.5％)和起病48h后CT的检出率(88.9％)。9例脑出血两项检查全部阳性。起病48h后检查CT可明显提高脑梗塞的检出率。CT对脑梗塞和脑出血的定位和定性诊断优于SPECT。SPECT对短暂性脑缺血(TIA)的诊断优于CT。SPECT可发现CT未能显示的交叉性小脑联系障碍现象。     

单光子发射计算机断层扫描全身骨显像对多发性骨髓瘤的诊断价值

目的探讨单光子发射计算机断层扫描(SPECT)全身骨显像对多发性骨髓瘤(MM)的诊断价值。方法对50例临床确诊的MM患者行SPECT及X线平片检查,将二者检测结果进行对比分析。结果 50例患者共207个病灶中,SPECT阳性检出率为80.19%,X线平片阳性检出率为60.87%,两种检查方法的检测结果比较,差异有统计学意义(χ2=85.27,P<0.01)。核素显像对肋骨病灶的显示较X线更敏感(χ2=29.93,P<0.05),而颅骨病变则更适合行X线检查(χ2=27.84,P<0.01)。结论 SPECT全身骨显像对MM的诊断及疗效的监测具有较高的临床应用价值。     

单光子发射计算机断层扫描早期诊断阿尔茨海默病的研究

目的利用单光子发射计算机断层扫描(SPECT)探讨阿耳茨海默病(AD)的早期诊断,以及与AD患者神经心理学改变的关系。方法 50例可疑AD患者和50名健康对照组行CT,磁共振成像(MRI),SPECT以及临床神经心理量表检查,定量分析求出各脑叶计数与同侧小脑单位面积内平均放射性计数的比值,即脑血流指数和认知障碍之间进行相关性分析。结果 AD患者双侧脑血流指数呈不对称性降低,并与AD早期认知障碍不对称性吻合,以及神经心理不对称指数之间具有密切相关关系。结论 AD患者早期阶段已发生了血流速度的减低,SPECT是早期诊断AD的有效手段。     

强迫症与焦虑症、抑郁障碍脑单光子发射计算机断层扫描对照研究

目的　探讨强迫症患者局部脑血流量 (rCBF)特点及脑单光子发射计算机断层扫描 (SPECT)对强迫症诊断的价值。方法　对 13例强迫症患者、19例正常对照、7例焦虑症和 5例抑郁障碍进行脑SPECT检查 ,并比较检查结果。结果　强迫症患者左颞枕叶SPECT放射性记数比值明显低于正常对照组 (P <0 .0 5 ) ;轻、重度强迫症患者左右两侧尾状核SPECT放射性记数比值的差值具有显著性差异 (P <0 .0 5 ) ;强迫症患者大脑皮层前额叶、额颞叶、颞前叶、颞枕叶、枕前叶等部位 ,左侧脑血流灌注低于右侧 (P <0 .0 1或P <0 .0 5 ) ;强迫症组与焦虑症组相比 ,左侧颞枕叶和两侧枕前叶的SPECT放射性记数比值均较低 (P <0 .0 1或P <0 .0 5 ) ,而与抑郁障碍组相比 ,任一脑区均无显著性差异 (P >0 .0 5 )。结论　强迫症可能存在颞叶、尾状核功能障碍 ,大脑皮层脑血流灌注明显不对称 ;强迫症脑血流灌注与焦虑症差异明显 ,而与抑郁障碍无显著差异。     

正电子发射计算机断层扫描的特点和临床应用

正电子发射计算机扫描(PET)作为一种新的成像技术并不像CT、MRI那样显示组织的解剖形态，而是探查局部组织代谢的异常，所以非常适用于检测高代谢的组织器官，如脑、心脏及恶性肿瘤等。本文主要对PET的特点及临床应用作一介绍。     

强迫症与焦虑症、抑郁障碍脑单光子发射计算机断层扫描对照研究

目的探讨强迫症患者局部脑血流量(rCBF)特点及脑单光子发射计算机断层扫描(SPECT)对强迫症诊断的价值.方法对13例强迫症患者、19例正常对照、7例焦虑症和5例抑郁障碍进行脑SPECT检查,并比较检查结果.结果强迫症患者左颞枕叶SPECT放射性记数比值明显低于正常对照组(P<0.05);轻、重度强迫症患者左右两侧尾状核SPECT放射性记数比值的差值具有显著性差异(P<0.05);强迫症患者大脑皮层前额叶、额颞叶、颞前叶、颞枕叶、枕前叶等部位,左侧脑血流灌注低于右侧(P<0.01或P<0.05);强迫症组与焦虑症组相比,左侧颞枕叶和两侧枕前叶的SPECT放射性记数比值均较低(P<0.01或P<0.05),而与抑郁障碍组相比,任一脑区均无显著性差异(P>0.05).结论强迫症可能存在颞叶、尾状核功能障碍,大脑皮层脑血流灌注明显不对称;强迫症脑血流灌注与焦虑症差异明显,而与抑郁障碍无显著差异.     

护理工作在单光子发射计算机断层显像中的作用

<正>单光子发射型计算机断层扫描(SPECT)是临床核医学常用的显像仪器。它是将标记好的放射性核素引入受检者体内,通过SPECT在体外探测核素发射出的γ射线,经计算机     

血管神经性头痛患者脑血流灌注影像特点及临床研究

目的利用单光子发射计算机断层扫描（SPECT）脑灌注显像技术,观察针刺对血管神经性头痛患者局部脑血流灌注量的改变情况,探讨血管神经性头痛患者针刺前后局部脑功能状态和SPECT技术对针刺治疗血管神经性头痛疗效判定的临床应用价值。方法对38例符合临床血管神经性头痛诊断标准的患者针刺前后分别进行了SPECT 99mTc-ECD脑灌注显像检查,并对此类患者针刺前后局部脑血流灌注改变和易损部位进行统计学分析。结果 38例血管神经性头痛患者SPECT检查中发现大脑皮质不同的功能区均有不同程度的血流灌注异常,以额叶和颞叶功能受损最常见。血管神经性头痛患者针刺前后,血流灌注降低病灶放射性摄取改变差异显著,通过结果分析,可以得出针刺可使血管神经性头痛患者脑血流灌注降低病灶增加放射性摄取,即明显改善了局部脑血流灌注量。结论应用SPECT显像技术可直接观察血管神经性头痛患者针刺前后局部脑血流灌注量的改变情况,可客观定量分析针刺治疗效果,对以后评价、判断治疗疗效和针刺选穴等方面的工作打下良好的基础,是一种直观可行的客观研究手段。     

强迫症患者局部脑血流灌注与认知功能特点

目的:探讨强迫症患者局部脑血流灌注和认知功能特点及2者的相关性.方法:应用单光子发射计算机断层扫捕(SPECT)技术,对首发且未经治疗的39例强迫症患者(强迫症组)和39例正常人(正常对照组)于静息状态下行脑血流显像.以小脑皮质的放射性计数值为参考,计算各脑区放射性计数比值(RAR).采用威斯康星卡片分类测查进行认知功能评定.结果:强迫症组的左、右侧前额叶、前颞叶和右枕叶的RAR值分别为(94.4±6.1)、(99.8±6.4)、(91.6±6.1)、(92.8±6.6)和(102.3±7.7),高于正常对照组的(88.3±7.1)、(86.9±7.9)、(84.0±7.2)、(84.4±7.3)和(96.4±10.2),差异有统计学意义(t=6.78、11.93、7.15、9.40和4.89,P均＜0.05).威斯康星分类测查中,强迫症组正确数、完成分类数的得分为(33.24±5.39)和(4.42±1.62),低于正常对照组的(38.15±4.64)和(5.72±0.94)(t=-3.657和-2.495,P均＜0.05);在错误数和持续错误数上的得分为(13.21±6.89)和(6.79±4.89),高于正常对照组的(7.53±5.97)和(2.06±1.29)(t=5.881和4.873,P均＜0.05).右前额叶RAR与正确数呈负相关(r=-0.783.P=0.014),右前颢叶RAR与错误数旱正相关(r=0.384,P=0.047),右前额叶、左丘脑RAR与持续错误数呈正相关(r=0.511和0.610,P=0.041和0.049).结论:强迫症患者双侧前额叶、前颞叶脑血流灌注存在明显增高现象;右侧额叶、颞叶及左丘脑与认知损害相关.     

Single photon emission CT perfusion imaging of cerebral blood flow of early syphilis patients

Objective To injvestigate the cerebral blood flow of patients with early syphilis.Methods ^99Tc^m-ECD as brain perfusion imaging agent was used in single photon emission computed tomography (SPECT) for 32 patients with early syphilis and 15 controls. Visual analyses were made on every BSPECT image.Results The 32 patients with early syphilis had general, patchy hypoperfusion of cerebral blood flow.Fourteen of the 32 patients had 48 episodes of marked patchy hypoperfusion of rCBF. The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe (6 episodes), right frontal lobe (3), left parietal lobe (7), right parietal lobe ( 6 ), left temporal lobe ( 11 ), right temporal lobe(5), left occipital lobe (3), left basal ganglia (3), cerebellum (1), and nerve nuceus (1). No abnormality was found in the control group.Conclusions Cerebral blood flow abnormalities exist in patients with early syphilis. General patchyhy poperfusion on SPECT imaging is common.     

Regional cerebral blood flow in children with autism spectrum disorders: a quantitative 99mTc-ECD brain SPECT study with statistical parametric mapping evaluation

Background  Autism spectrum disorders (ASD), which include autism, asperger syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS), are devastating neurodevelopmental disorders of childhood resulting in deficits in social interaction, repetitive patterns of behaviors, and restricted interests and activities. Single photon emission computed tomography (SPECT) is a common technique used to measure regional cerebral blood flow (rCBF). Several studies have measured rCBF in children with ASD using SPECT, however, findings are discordant. In addition, the majority of subjects used in these studies were autistic. In this study, we aimed to investigate changes in rCBF in children with ASD using SPECT.

Methods  A Technetium-99m-ethyl cysteinate dimmer (^99mTc-ECD) brain SPECT study was performed on an ASD group consisting of 23 children (3 girls and 20 boys; mean age (7.2±3.0) years) who were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria and an age-matched control group with 8 children (1 girl and 7 boys, mean age (5.5±2.4) years). Image data were evaluated with Statistical Parametric Mapping, 5th version (SPM5). A Student’s t test for unpaired data was used to compare rCBF and asymmetry in the autism and corresponding control group. The covariance analysis, taking age as covariance, was performed between the ASD and control group.

Results  There was a significant reduction in rCBF in the bilateral frontal lobe (frontal poles, arcula frontal gyrus) and the bilateral basal ganglia in the autism group, and a reduction in the bilateral frontal, temporal, parietal, legumina nucleus and cerebellum in the AS group compared to the control. In addition, asymmetry of hemispheric hypoperfusion in the ASD group was observed. Inner-group comparison analysis revealed that rCBF decreased significantly in the bilateral frontal lobe (42.7%), basal nucleus (24.9%) and temporal lobe (22.8%) in the autism group, and in the bilateral cerebellum (22.8%), basal nucleus (19.3%) and right thalamencephalon (16.6%) in the AS group (P <0.05).

Conclusions  The decrease in rCBF in ASD is a global event, which involves the bilateral frontal, temporal, limbic system and basal ganglias. Asymmetry of hemispheric hypoperfusion was more obvious in the AS group than the autism group, which indicates a different neurobiological mechanism from that of autism.

     

Therapeutic effects of Tongxinluo capsule on patients with acute small cerebral infarction and its influence on SPECT brain perfusion image

Objective: To investigate the influence of Tongxinluo capsule (TXL) on regional cerebral blood flow (rCBF) with 99mTc-ECD single photon emission computed tomography (SPECT) brain perfusion imaging, and to observe the therapeutic effects of TXL on acute small cerebral infarction (ASCI).Methods: Thirty-four patients with ASCI were enrolled and randomly divided into two groups: the control group (n = 17) was treated with the conventional treatment, i.e. 1. 0g of Citicoline added into 300 ml normal saline for intravenous dripping daily for 2 weeks and 0.8 g of Piracetam taken three times a day orally for 4 weeks, and the treatment group (n = 17) was treated additionally with 4 TXL capsules three times a day for 4 weeks besides the conventional treatment. The 99mTc-ECD SPECT brain perfusion imaging was performed before and after treatment to observe the change of rCBF, and the neurological deficit was evaluated by Edinburgh-Scandinavia stroke scale (SSS) scores and Barthel index (BI) at the same time.Results: After treatment, the rCBF in the treatment group was significantly improved (P<0.01), while that in the control group remained unchanged, with the comparison of the rCBF in the two groups after treatment showing significant difference (P<0.01). In addition, the SSS score was significantly lower and Bl significantly higher in the treatment group than those in the control group respectively after treatment.Conclusion: TXL could effectively improve rCBF and lessen the neurological deficit symptoms in patients with ASCI.     

SPECT脑血流灌注显像对癫(疒间)灶的诊断价值

目的探讨SPECT脑血流灌注显像（rCBF）对癫痫灶的检出及定位价值。方法72例临床确诊的癫痫患者行发作间期rCBF检查，并同CT、MRI影像检查结果进行比较，对其中7例拟行立体放射（伽玛刀）治疗的患者行发作期rCBF检查，立体放射治疗后随访疗效。结果①癫痫患者rCBF、CT、MRI检查阳性率分别为83．3％（60／72）、38．9％（21／54）和52．6％（20／38），rCBF阳性率明显高于CT和MRI（P〈0．01）。②7例患者发作间期rCBF影像中见14个低血流灌注区，发作期见9个相对高灌注或明显高灌注区，将两期吻合的8个异常灌注Ⅸ确定为癫痫灶。③7例患者行立体放射治疗后，根据Engels疗效分级，Ⅰ级1例，Ⅱ级4例，Ⅲ级1例，Ⅳ级1例，6例有效。结论rCBF检查是一种检测癫痫的敏感技术，发作期与发作间期rCBF检查结合可较准确地定位癫痫灶。     

未经治疗的强迫障碍患者静息态磁共振脑功能局部一致性研究

目的:采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging, RS-fMRI)技术,探讨未经治疗的强迫障碍(obsessive-compulsive disorder,OCD)患者脑局部一致性(regional homogeneity, ReHo)的变化以及与强迫症状严重程度的相关性?方法:对46例OCD患者和31例性别?年龄?受教育程度相匹配的健康对照进行静息态功能磁共振扫描,使用SPM8?DPARSF?REST等软件对影像学数据进行处理分析,比较两组间全脑ReHo的改变;采用耶鲁-布朗强迫量表(the Yale-Brown Obsessive Compulsive Scale,Y-BOCS)?17项汉密尔顿抑郁量表 (17-Item Hamilton Rating Scale for Depression,HAMD-17)?汉密尔顿焦虑量表(Hamilton Anxiety Rating Scale,HAMA)等评估临床症状,并分析OCD患者脑ReHo值与临床现象之间的关系?结果:和对照组相比,OCD患者左侧前额叶的ReHo值显著升高,左侧颞枕部和双侧梭状回的ReHo值显著降低,以上脑区的ReHo改变均未发现与Y-BOCs量表的相关性?结论:未经治疗的OCD患者在静息态下存在局部脑区的神经元活动一致性异常,这些异常改变可能与OCD的病理机制有关?     

应用SPECT研究通心络胶囊对脑梗死患者局部脑血流的影响

目的 研究通心络胶囊对脑梗死患者局部脑血流变化与临床神经功能缺损改善关系。方法 22例脑梗死患者随机分为两组,分别口服通心络胶囊和丹参片,连服15d。在治疗前后应用SPECTROI技术测定其病变及健侧镜像ROI区域内的平均放射性计数,以了解局部脑血流量变化;并且每个患者在治疗前后做神经功能缺损评分判定其情况。结果 服用通心络胶囊组患者原脑血流减低区和对侧大脑半球镜像区域脑血流,差异有统计学意义（P〈0．05）;神经功能缺损评分差异有统计学意义（P〈0．05）;服用通心络胶囊组与丹参片组比较,差异有统计学意义（P〈0．05）。丹参片组治疗前后脑血流和神经功能缺损评分改善不明显,差异无统计学意义（P〉0．05）。结论 通心络胶囊对脑梗死患者的脑血流功能改善有肯定作用,而且临床神经功能缺损评分亦显著改善,说明其有促进神经功能恢复作用。     

急性脑梗塞病人神经机能失联络现象的临床研究

目的：探讨急性缺血性脑血管病后神经机能失联络现象及其临床意义。方法：采用９９ｍＴｃ－ＥＣＤ－ＳＰＥＣＴ技术，动态观测３６例急性单侧基底节梗塞患者脑血流的变化，同时评估患者的神经系统体征及脑梗塞的体积。结果：在发病３．４ｄ内，１１例（约３１％）患者出现了不同程度的神经机能失联络，表现为梗塞灶对侧小脑（８例）、同侧顶区（２例）和同侧枕区（１例）的血流量减少。此１１例患者脑梗塞体积明显大于２５例无神经机能失联络现象者（Ｐ＜０．０５）。两组病人入院时神经功能缺损积分相近，但前者３周后的积分明显大于后者。结论：急性脑梗塞后神经机能失联络的出现可能是神经系统功能预后不良的一个指标。