CT在诊断新生儿缺氧缺血性脑病中的价值

目的：通过对120例足月新生儿缺氧缺血性脑病（HIE）进行CT检查、诊断及随访复查，探讨CT在诊断新生儿缺氧缺血性脑病中的价值。方法：对120例HIE患儿进行CT检查，初次CT扫描时间为生后4－10d，生后14d所有病例均进行了新生儿行为神经评分，追踪复查时间分别为生后1，3，6，12，18，24及24个月以上。结果：①本组120例HIE中，轻度39例，新生儿行为神经评分≥35；中度67例，其中34例新生儿行为神经评分＜35,33例新生儿行为神经评分≥35；重度14例，梗死新生儿行为神经评分＜35。②随访复查：最后一次CT复查所见，正常46例，外部性脑积水28例，单纯脑沟加深26例，脑软化13例，脑萎缩7例，脑梗死7例，脑穿通畸形3例，脑钙化灶5例，死亡2例。结论：CT在诊断新生儿缺氧缺血性脑病中仍具有重要的价值。     

新生儿缺氧缺血性脑病:前10天的MRI和CT表现对比分析

目的：比较新生儿缺氧缺血性脑病前10d的MRI和CT征象，探讨更适合的检查方法。方法：回顾性分析和记录32例新生儿HIE的MRI和CT异常征象。结果：32例HIE患儿MRI均有不同程度的异常征象，主要表现为脑水肿28例，皮层下及深部脑白质斑点状和弯曲条状高信号（T1WI)15例，基底节及丘脑斑点状高信号（T1WI）9例，蛛网膜下腔出血或硬膜下血肿15例；CT仅27例有异常表现，以脑水肿为主要表现，仅见9例伴有蛛网膜下腔出血或硬膜下血肿。结论：新生儿HIE前10d MRI比CT能发现更多有价值的诊断征象，有助于早期准确诊断。     

新生儿缺氧缺血性脑病的CT诊断

目的：了解新生儿缺氧缺血性脑病（HIE）的CT表现特点及其预后。方法：对110例经临床诊断为HIE的患儿进行CT检查，分析其CT表现特点。结果：本组110例中有88例CT表现异常，占80％；轻度CT表现41例．占46．6％，中度CT表现45例，占51．1％．重度CT表现2例，占2．3％；蛛网膜下腔出血5例，占5．7％，脑室内出血2例，占2．3％；12例随访复查3例表现正常，6例表现外部性脑积水，2例表现为脑萎缩，1例表现为交通性脑积水。结论：HIE的CT诊断为：（1）脑水肿，表现为脑质低密区，CT值〈16Hu；（2）脑室系统受压变窄；（3）脑出血表现为蛛网膜下腔出血、脑实质出血和脑室内出血；（4）脑梗塞很少见。轻、中度HIE患儿临床预后较好，重度HIE患儿预后较差。     

99 Tcm-MIBI SPECT在原发性鼻咽癌诊断、放疗后残余或复发监测中的应用

目的：评价^99Tc^m-甲氧基异丁基异腈(MIBI)SPECT显像对原发性鼻咽癌的诊断和鼻咽癌放疗后局部残余或复发的鉴别价值。方法：20例经病理检查证实的原发性鼻咽癌患者于治疗前、放疗后3和6个月分别行^99Tc^m-MIBI SPECT显像，与同期CT和(或)MRI结果对照，分别计算肿瘤或正常鼻咽部与头皮的放射性计数比值，作为^99Tc^m-MIBI摄取指数(MUI)。以接受器工作特性(ROC)曲线确定MUI判别阈值。以鼻咽部内镜检查、病理活组织检查及18个月的临床随访资料作为鼻咽癌残余或复发的依据。结果以MUI≥2．15为阳性标准，^99Tc^m-MIBISPECT显像诊断原发性鼻咽癌的灵敏度、特异性和准确性均为95％。以MUI≥1．32为阳性标准，^99Tc^m-MIBI SPECT显像监测鼻咽癌残余或复发的灵敏度为3／4例，特异性93．8％，准确性90．0％。CT和(或)MRI监测鼻咽癌残余或复发的灵敏度为3／4例，特异性81．3％，准确性80．0％。^99Tc^m-MIBISPECT显像与CT和(或)MRI联合鉴别鼻咽癌残余或复发的灵敏度、特异性和准确性分别为2／2例、92．9％和93．8％。结论:^99Tc^m-MIBI SPECT显像对确定鼻咽癌原发灶范围有一定价值；与CT和(或)MRI联合，可提高对放疗后鼻咽癌残余或复发的早期诊断效能。     

新生儿缺氧缺血性脑病的CT诊断

目的：探讨新生儿窒息缺氧缺血性脑病(HIE)的诊断价值。材料与方法：应用CT对224例围产期窒息儿进行脑CT扫描，发现缺氧缺血性脑病184例，阳性率为82．1％，结果：对于HIE及其分期的判定，CT比临床更具有客观性；脑损伤程度与窒息程度有一定关系，窒息越严重，脑损伤越严重；HIE损伤越严重，并发颅内出血的机会越多；HIE损伤越严重，预后相对较差。结论：CT对HIE具有较高的诊断价值。     

新生儿缺氧缺血性脑病的CT诊断

目的：探讨新生儿缺氧缺血性脑病的CT表现及鉴别诊断。方法：对86例有明确围产期窒息史，且有临床症状的病例进行（T扫描，结合临床资料加以分析。结果：新生和缺氧缺血性脑病的CT表现为脑内多发斑片状低密度影，多为对称性分布；蛛网膜下腔出血是其最常见的并发症。结论：结合临床资料，CT可以对新生儿缺氧缺血性脑病提供准确的诊断。     

脑SPECT灌注显像在老年人脑血管疾病中的应用

目的：旨在研究脑SPECT血流灌注显像对老年脑血管疾病的诊断价值。材料和方法：对132例脑血管疾病患者进行脑SPECT血流灌注显像，并将SPECT结果与MRI、CT相比较。结果：脑梗塞患者96．1％有阳性发现，有些灌注减低灶较MRI，CT显示的范围大．可能由于包括了梗塞区及周围缺血半影区的缘故。对神经机能联系不能征象进行了观察．短暂性脑缺血发作患者在发作间期有61.9%阳性．病灶与发作期临床症状相符。脑供血不足、脑动脉硬化、脑出血的阳性率分别为64.3%、80%．95.5%。结论：脑SPECT灌注显像为老年人脑血管疾病的诊断提供了客观依据，有重要应用价值。     

新生儿缺氧缺血性脑病临床CT表现

目的 探讨新生儿缺氧缺血性脑病临床CT表现特征。方法 对78例临床诊断为HIE的患儿进行CT检查，分析其CT表现。结果 69例有异常CT表现，占89．5％。合并蛛网膜下腔出血20例，占29％，脑室系统出血5例，占7．2％，脑实质出血5例，占7．2％。结论 HIE的临床呼吸道感染出现越早，症状越重，其CT表现也越明显。     

缺氧缺血性脑病的CT诊断

目的：探讨新生儿缺氧缺血性脑病（HIE）的CT表现及诊断价值。方法：对出生1—3天，临床拟诊为缺氧缺血性脑病患儿进行颅脑CT平扫。结果：24例HIE中CT表现正常5例，轻度11例，中度5冽，重度3例，合并大脑出血1例，合并小脑出血1例，蛛网膜下腔出血4例，硬膜下血肿3例头皮血肿3例。结论：颅脑CT扫描对新生儿HIE病变的范围、程度、部位、性质具有确诊的价值。     

新生儿缺氧缺血性脑病rCBF断层显像的临床价值

新生儿缺氧缺血性脑病ｒＣＢＦ断层显像的临床价值谢昌辉龙桂芳祝文峰谢家骠温辉对２８例缺氧缺血性脑病（ＨＩＥ）患儿进行了局部脑血流（ｒＣＢＦ）断层显像，并对其临床价值进行了探讨，现报告如下。一、资料与方法研究对象：正常新生儿５例，年龄１５～２８天；ＨＩＥ...     

持续植物状态99Tcm-ECD脑SPECT显像

目的：观察持续植物状态（PVS）患者脑血流灌注情况及其对高压氧配合药物治疗疗效和预后判断的意义，方法：用99Tc^m－双半胱乙酯（ECD）局部脑血流（rCBF）显像方法对26例不同病因所致的PVS患者进行了检测，9例进行了动态观察。结果：26例PVC患者脑血流灌注均显著, 部位可与脑CT或MRI检查相符或不符，随病情恢复，脑血流灌注亦恢复正常。结论：99Tcm-ECD脑SPECT显像观察rCBF可反映PVS患者脑血流灌注情况，并可作为高压氧配合药物治疗PVS疗效及预后判断的指标。     

脑SPECT显像和CT扫描观察高压氧治疗脑外伤后综合征疗效

目的 对比研究脑外伤后综合征患者在高压氧（ＨＢＯ）治疗前后的脑ＳＰＥＣＴ和脑ＣＴ扫描结果,并对两者的临床及其优越性进行评价。方法 ２８８例脑外伤后综合征患者接受２－４个疗程的ＨＢＯ治疗,并在治疗前后用＾９９Ｔｃ＾ｍ－双半胱乙酯（ＥＣＤ）ＳＰＥＣＴ和ＣＴ进行疗效监测和对比分析。     

Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study

PURPOSE: To explore the role of single-photon emission CT (SPECT) in initial diagnostic evaluation of patients with mild traumatic brain injury (MTBI) and to identify subgroups in which it may serve as a useful diagnostic tool. MATERIALS AND METHODS: Patients with MTBI seen during a 14-month period were prospectively included in this study. All patients had a CT of head within 12 hours of injury and SPECT by using technetium Tc99m ethyl cysteinate dimer (Tc99m-ECD) within 72 hours of injury. Both SPECT and CT findings were compared with clinical features such as posttraumatic amnesia (PTA), postconcussion syndrome (PCS), and loss of consciousness (LOC). RESULTS: Ninety-two patients with MTBI underwent SPECT in the study period. There were 28 children and 64 adults, with male-to-female ratio of 4.5 to 1. CT findings were abnormal in 31 (34%) and SPECT in 58 (63%). The most common abnormality was hypoperfusion in the frontal lobe(s) in adults and the temporal lobe in children. A significantly higher number of perfusion abnormalities were seen in patients with PTA (P = .03), LOC (P = .02), and PCS (P = .01) than in patients without these symptoms. Compared to CT, SPECT had a much higher sensitivity for detecting an organic basis in these subgroup, of patients (P < .05). CONCLUSION: Tc99m-ECD SPECT can be used as a complementary technique to CT in initial evaluation of patients with MTBI. It is particularly useful in patients having PCS, LOC, or PTA with normal CT scan.     

脑肿瘤SPECT阳性显像与CT影像的对照研究

目的 :探讨99mTc MIBISPECT与CT在脑肿瘤的影像特征及其应用价值。材料和方法 :对 5 0例脑肿瘤、10例脑内非肿瘤病变患者行99mTc MIBISPECT及CT扫描 ,对其影像特点进行分析比较。结果 :99mTc MIBISPECT术前诊断脑肿瘤的灵敏度、特异性和准确性分别为 96.9%、90 .0 %和 95 .2 % ,而CT分别为 90 .6%、80 .0 %和 88.1% ,两者均无显著性差异(P >0 .0 5 ) ;99mTc MIBISPECT诊断胶质瘤术后残留与复发的灵敏度、特异性和准确性均为 10 0 % ,而CT分别为 3 0 %、75 %和 5 0 % ,前者比后者高 (P <0 .0 1)。结论 :99mTc MIBISPECT在诊断胶质瘤术后残留与复发方面可作为CT的一种有效补充手段 ;二者结合 ,对确定脑肿瘤的诊断具有重要的应用价值。     

Video/EEG,SPECT和MRI对部分性癫痫定位诊断作用及临床意义探讨

目的：探讨录像脑电图检测（Ｖｉｄｅｏ／ＥＥＣ）,ＳＰＥＣＴ和ＭＲＩ３种方法对部分性癫痫的无创性定位和病因诊断的作用及临床意义。材料与方法：对５２例部分性癫痫患者分别进行Ｖｉｄｅｏ／ＥＥＧ,＾９９ｍＴｃ－ＨＭＰＡＯ－ＳＰＥＣＴ脑血流显像,＾１２３Ｉ－Ｉｏｍａｚｅｎｉｌ ＳＰＥＣＴ脑受体显像和全脑ＭＲＩ检查。根据Ｖｉｄｅｏ／ＥＥＧ记录的癫痫发作类型,ＳＰＥＣＴ显示的ｒＣＢＦ和ＢＺＤ的分布以及ＭＲＩ显示     

脑SPECT显像在癫痫中的应用

目的：本文主要研究脑ＳＰＥＣＴ在癫痫应用中的作用和地位。材料和方法：对８１例癫痫患者进行了１０２次发作间期脑ＳＰＥＣＴ血流灌注显像，并与ＥＥＧ、脑ＣＴ、ＭＲＩ比较。结果：８１例ＳＰＥＣＴ检查中６６例显示异常，检出率８１．４％（６６／８１），ＥＥＧ、ＭＲＩ、ＣＴ阳性率分别为８２．９８％（３９／４７）、３８．２４％（１３／３４）、４５．９５％（１７／３７）。结论：ＳＰＥＣＴ显像在癫痫诊断和定位方面与ＥＥＧ、ＭＲＩ、ＣＴ相比具有优势，且有助于癫痫病灶局部血流变化与临床症状、疗效及其他影响因素之间关系的研究。     

橄榄桥脑小脑萎缩SPECT脑显像和MRI对比研究

目的 评价SPECT脑血流灌注显像在橄榄桥脑小脑萎缩（OPCA）诊断中的价值。方法 对20例OPCA患者行SPECT脑血流灌注显像和头颅MRI检查,并对各项检查结果进行比较。结果 OPCA患者的SPECT显像异常表现为脑局部血流低灌注,以脑干、脑小及基底节为主,也可累及大脑各叶;与MRI比较,SPECT显示病变范围更广泛;SPECT和MRI的异常率分别为95％和75％。结论 SPECT脑血流灌注显像为诊断OPCA提供了新方法,灵敏度优于MRI;SPECT与MRI相结合,有助于提高OPCA诊断的准确性。     

Frontotemporal decreases in rCBF correlate with degree of dysnomia in primary progressive aphasia.

Primary progressive aphasia (PPA) is an uncommon degenerative dementia characterized by gradual impairment of language function with initial sparing of the memory domain. Using semiquantitative 99mTc-hexamethyl propyleneamine oxime (HMPAO) brain SPECT as a measure of regional cerebral blood flow (rCBF), we investigated the relationship between reduced 99mTc-HMPAO uptake and the severity of dysnomia in PPA. METHODS: Seven right-handed patients with PPA had their dysnomia assessed by the Boston Naming Test (BNT), a subtest of the Boston Diagnostic Aphasia Examination. Neuroimaging studies, including 99mTc-HMPAO brain SPECT, CT, and MRI, were performed. Correlational analysis between reduced rCBF and BNT was performed. RESULTS: Brain SPECT showed a reduction in 99mTc-HMPAO uptake involving the frontal and temporal lobes in all 7 patients. CT and MRI showed mild to moderate cerebral atrophy in 4 patients. Low scores on the BNT correlated with low frontotemporal 99mTc-HMPAO (Spearman r = 0.97, P = 0.004) in the 5 patients with left-hemisphere involvement. CONCLUSION: Decreased rCBF to the frontotemporal region characterized the cerebral abnormalities associated with PPA. The finding of focal rCBF abnormalities in the right hemisphere of 2 right-handed women corroborates that PPA symptoms may arise from a "non-left-dominant"-hemisphere degenerative process. Our results support the usefulness of rCBF SPECT imaging as a diagnostic aid in PPA.     

Technetium-99m-ECD SPECT in antiphospholipid antibody syndrome: a drastic improvement in brain perfusion by antiplatelet therapy

We present a case of antiphospholipid antibody syndrome (APS) with repeated transient ischemic attacks (TIAs). Magnetic resonance imaging showed multiple cerebral infarcts and ischemic changes in the cerebral white matter. Cerebral angiographies showed no abnormalities. Technetium-99m-ethyl cysteinate dimer (Tc-99m-ECD) brain SPECT showed multiple decreased perfusion areas, which were more extensive than the lesions demonstrated on MRI. After treatment with an antiplatelet agent, the patient subsequently recovered from the TIAs. Although no interval changes were observed by MRI after therapy, follow-up Tc-99m-ECD SPECT revealed a marked improvement in brain perfusion. This is the first imaging report of remarkable post-therapy improvement in brain perfusion in APS cases.