SPECT在脑部疾病中的应用

本文报告259例脑部疾病病人SPECT脑显像结果，并与CT，MRI，EEG及TCD等检查作比较。结果表明：SPECT对脑梗塞的早期确诊，TIA的辅助诊断和癫痫的定位诊断有较大价值。脑血流断层显像诊断意义大，但其他核素显像方法在某些疾病中仍有很大诊断价值。     

SPECT在诊断急性脑血管疾病方面的应用

急性脑血管疾病是常见病。颅脑CT 是其诊断的主要手段。本文主要介绍SPECT 脑显像的原理、方法及其在急性脑血管疾病方面的应用,并分析颅脑CT 与SPECT 脑显像对诊断急性脑血管疾病的特长和局限性,认为二者是相辅相成的关系,综合分析有利于进一步提高诊断率和指导临床。     

抑郁症患者SPECT研究

目的 探讨抑郁症脑血流灌注的特点及与临床症状的相关性。方法 开放式收集门诊及住院诊断为抑郁症患者37例,进行治疗前后的^99mTc-双半胱乙脂（ECD）单光子发射型计算机断层扫描（SPECT）技术,测量患者治疗前后脑血流灌注（rCBF）显像,半定量测定rCBF,并与12例正常对照者比较。结果 37例抑郁症患者双侧额叶、双侧颞叶、双侧顶叶,双侧枕叶、左基底核有脑低灌注现象。治疗后临床康复者各部位脑灌注明显改善,差异有显著性（P〈0.05）。结论 抑郁症患者存在额叶、颡叶、顶叶及枕叶多区域的脑血流低灌注,其中以左侧较为明显,治疗后明显改善。     

躯体形式障碍35例SPECT研究

目的　探讨躯体形式障碍脑灌注特点与潜在意义。方法　开放性收集门诊和住院诊断 为躯体形式障碍病人35例;进行99mTc 双半胱乙脂(ECD)单光子发射型计算机断层显像(SPECT)脑血 流灌注(rCBF)断层显像,半定量测定rCBF。结果　35例躯体形式障碍病人均出现有不同部位的脑 低灌注现象;具体为右额叶(13例,37%),左额叶(11例,31%),右颞叶(13例,37%),左颞叶(11例, 31%),右顶叶(11例,31%),左顶叶(4例,11%),右基底节(14例,40%),左基底节(17例,49%),右丘 脑(1例,3%),左丘脑(1例,3%),盐酸文拉法辛治疗2周后不同部位脑血流低灌注均明显改善,差异 有显著性(P<0.05)。结论　躯体形式障碍不同临床表现相应呈现额叶、基底节、颞叶、顶叶不同区域 脑血流低灌注,治疗后明显改善。     

SPECT在脑部疾病中的应用

单光子发射计算机断层显象(Single photon emission computed tomography:SPECT)是把同位素应用于CT的一种新的诊断技术,最早由Kahl等(1976)发现并应用于临床,80年代已广泛应用。 SPECT的基本原理是把能够放出纯粹γ光子的放射性核素或药物注入或吸入人体,     

SPECT及其在脑部疾病中的应用价值

脑影像是一种安全、简便、无创伤性、在临床上具有独特诊断价值的检查方法。脑平面影像在60年代曾一度对脑疾病诊断作出了贡献,后来给X线CT及磁共振影像(MRI)的发展,降低了脑平面影像作用。但是从80年代开始应用发射计算机断层(ECT)影像以后,由于它能反映出脑的功能如局部脑血流量     

99Tcm-DTPA脑池显像鉴别交通性蛛网膜囊肿1例

交通性蛛网膜囊肿（CIAC）与非交通性蛛网膜囊肿（NCIAC）根据蛛网膜囊肿（IAC）是否与蛛网膜下腔交通而区分，本科运用^99Tc^m-DTPA脑池显像（ECT）很好地鉴别了1例CIAC病人，现报道如下。     

SPECT和PET显像在脑血管疾病中的应用

SPECT和PET的脑血流量测定在缺血性中风、脑出血、蛛网膜下腔出血中的临床意义     

脑血管性痴呆局部脑血流的定量分析

目的探讨血管性痴呆的脑循环变化。方法采用单光子发射计算机断层显像（ＳＰＥＣＴ），９９ｍ－ＥＣＤ标记，定量测定血管性痴呆（ＶＤ）、多发性脑梗塞（ＭＩ）及正常老年人各１０例的局部脑血流量。结果ＶＤ组各脑叶及基底节区平均脑血流量均显著低于对照组（Ｐ＜０．０１）；ＶＤ组比ＭＩ组额颞叶皮质血流量明显减少（Ｐ＜０．０１，Ｐ＜０．０５）；ＶＤ额叶皮质脑血流量改变与神经心理测试ＭＭＳＥ呈正相关（ｒ＝０．６９２，Ｐ＜０．０５）。结论ＶＤ存在全脑广泛的脑血流灌注降低。额叶皮质血流灌注降低与痴呆的发生及痴呆的严重程度密切相关。ＳＰＥＣＴ局部脑血流定量测定对于ＶＤ的预测及早期发现有重要意义     

痴呆的SPECT—rCBF研究近况

本文介绍不同原因痴呆的单光子发射计算机痴断层显象(SPECT)局部脑血流(rCBF)测定近况,认为其对早期诊断Alzheimer型痴呆(DAT)有重要价值,有助于鉴别DAT和多梗塞痴呆(MID)。目前尚不能肯定脑放射性活性减低与痴呆严重程度有相关性,需进一步的研究。     

The Clinical Role of SPECT in Patients with Brain Tumors

The introduction of computed tomography (CT) in the early 1970s effectively replaced radionuclide brain imaging as the main modality to evaluate the structure and morphology of brain tumors. There are, nevertheless, a number of management problems in patients with suspected brain tumors that can be addressed only by functional imaging. There is the need to determine whether a focal mass detected on CT or magnetic resonance imaging (MRI) is benign or malignant. Since the prognosis of the patient is related to the tumor grade, and because stereotactic biopsy recovers only a small fragment of the tumor, there is the need for an imaging technique that reflects the behavior and the malignancy of the tumor. After treatment, it is important to continue to determine the cause of clinical deterioration in patients with glioma who have received high doses of radiation. Progressive radiation necrosis may require surgical debulking. Detection and localization of solid tumor recurrence, on the other hand, may aid in designing treatment. Positron emission tomography (PET) using 1xF-fluorodeoxyglucose (18FDG) has been the standard functional imaging modality in these patients. With the introduction of single-photon emitting brain perfusion tracers in the last decade, brain single-photon emission computed tomography (SPECT) has reemerged as a useful measure of brain function. Other tracers such as thallium-201 (²⁰¹TI) chloride have emerged as tumor markers and have also found a role in brain SPECT. This review evaluates the clinical value and potential of²⁰¹TI and perfusion brain SPECT in patients with brain tumors     

High-Resolution Brain SPECT Imaging in ADHD

Children and adolescents with ADHD were evaluated with high-resolution brain SPECT imaging to determine if there were similarities between reported PET and QEEG findings. Fifty-four children and adolescents with ADHD by DSM-III-R and Conners Rating Scale criteria were evaluated. A non-ADHD control group was also studied with SPECT. Two brain SPECT studies were done on each group, a resting study and an intellectual stress study done while participants were doing a concentration task. Sixty-five percent of the ADHD group revealed decreased perfusion in the prefrontal cortex with intellectual stress, compared to only 5% of the control group. These are findings consistent with PET and QEEG findings. Of the ADHD group who did not show decreased perfusion, two-thirds had markedly decreased activity in the prefrontal cortices at rest.     

Brain SPECT imaging in multiple system atrophy

Summary. Clinical diagnosis of multiple system atrophy (MSA) relays on signs and symptoms that are often difficult to identify particularly at early stage. Indeed neuropathological studies have demonstrated that MSA is the first cause of misdiagnosis in a cohort of patients presenting with parkinsonian features. Dopamine transporter imaging (DAT) shows striatal decrements in both MSA and Parkinson’s disease (PD) making it not sensitive for differential diagnosis. Studies of dopamine D2 receptors with IBZM may help revealing striatal degeneration but a large overlap exist particularly if PD patients with advanced disease are included. We have measured brain flow with technetium-99m ethyl cysteinate dimer (ECD-SPECT) in 36 MSA patients and compared it with 43 PD and 39 age-matched controls. Using Statistical Parametric Mapping (SPM99) we found areas of significant reduced perfusion in the striatum, brain stem and cerebellum in MSA compared to the other groups. We believe that ECD-SPECT imaging may offer significant advantages compared to other imaging techniques in the assessment of neuronal degeneration in MSA and may help the clinician in the diagnostic characterization of patients presenting with atypical parkinsonism.     

Brain perfusion SPECT in impulsivity-related personality disorders

BACKGROUND: Impulsive behaviours in patients with cluster B personality disorders are associated with low glucose metabolism and regional cerebral blood flow in the frontal cortex and subcortical structures. The aim of this study is to confirm the presence of a particular pattern of brain perfusion in a sample of borderline (BPD) and anti-social personality disorder (ASPD) patients using brain perfusion single photon emission computed tomography (SPECT). METHODS: A brain perfusion SPECT study was performed in 37 patients with BPD or ASPD (and no Axis I diagnosis) and 34 healthy control participants. Data were acquired on a triple head Toshiba gamma camera. Scatter and attenuation correction was done. Reconstructed SPECT images were analyzed by Statistical Parametrical Mapping (SPM99). RESULTS: There were no significant differences in age and gender distributions between the patients and the healthy controls. With regard to the functional imaging results, patients were characterized by a reduced regional cerebral blood flow (rCBF) in right temporal and prefrontal brain areas, including the right lateral temporal cortex (BA 21), the right frontopolar cortex (BA 10) and the right ventrolateral prefontal cortex (BA 47). CONCLUSIONS: Patients with BPD and ASPD who showed impulsive behaviour have diminished rCBF in areas of the right prefrontal and temporal cortex.     

Brain SPECT and migraine in childhood.

The recent development of SPECT has introduced a new procedure to evaluate neurological diseases. By mean of Tc99mHM-PAO we studied a group of 19 pediatric subjects (7 males and 12 females) with different form of migraine, within five days after the last headache attack. Postictally SPECT shows regionally decreased CBF in 3/4 of HM, in 5/6 of BAM, in 5/5 of CM and in 2/4 of M.     

SPECT在常见脑血管疾病中的应用研究

SPECT脑血流显像能灵敏反映局部脑血流量的变化,在脑血管疾病中有重要应用价值:能早期诊断脑梗死,指导临床治疗,并评价疗效和估计预后;有利于短暂性脑缺血发作的早期诊断和及时治疗,预防脑卒中;脑出血后存在局部脑血流量降低,且持续时间长,出血后亚急性期和恢复期行SPECT检查有助于指导临床治疗。     

Brain SPECT in subtypes of mild cognitive impairment

The Development of Screening Guidelines and Clinical Criteria of Predementia Alzheimer's Disease (DESCRIPA) multicenter study enrolled patients with MCI or subjective cognitive complaints (SUBJ), a part of whom underwent optional brain perfusion SPECT. These patients were classified as SUBJ (n = 23), nonamnestic MCI (naMCI; n = 17) and amnestic MCI (aMCI; n = 40) based on neuropsychology. Twenty healthy subjects formed the control (CTR) group. Volumetric regions of interest (VROI) analysis was performed in six associative cortical areas in each hemisphere. ANOVA for repeated measures, corrected for age and center, showed significant differences between groups (p = 0.01) and VROI (p < 0.0001) with a significant group-region interaction (p = 0.029). In the post hoc comparison, SUBJ did not differ from CTR. aMCI disclosed reduced uptake in the left hippocampus and bilateral temporal cortex (compared with CTR) or in the left hippocampus and bilateral parietal cortex (compared with SUBJ). In the naMCI group, reduced VROI values were found in the bilateral temporal cortex and right frontal cortex. In the comparison between aMCI and naMCI, the former had lower values in the left parietal cortex and precuneus. Discriminant analysis between SUBJ/CTR versus all MCI patients allowed correct allocations in 73 % of cases. Mean VROI values were highly correlated (p < 0.0001) with the learning measure of a verbal memory test, especially in the bilateral precunei and parietal cortex and in the left hippocampus. In a subset of 70 patients, mean VROI values showed a significant correlation (p < 0.05) with the white matter hyperintensities score on MRI. In conclusion, MCI subtypes have different perfusion patterns. The aMCI group exhibited a pattern that is typical of early Alzheimer's disease, while the naMCI group showed a more anterior pattern of hypoperfusion. Instead, a homogeneous group effect was lacking in SUBJ.     

SPECT及SOD检测在颅脑损伤患者中的应用

目的探讨超氧化物歧化酶（SOD）及单光子发射计算机体层摄影（SPECT）在评价颅脑损伤后病情和预后中的作用。方法选择符合要求的颅脑损伤患者60例，按照GCS评分标准分成轻型损伤组45例，中型损伤组8例和重型损伤组7例。20例健康员工为对照组。对人选的所有对象进行SPECT、CT扫描和SOD检测，其中颅脑损伤患者在伤后24h内和2周后进行SPECT和CT检查，伤后12h、24h、36h、48h、72h、1周、2周、1月和2-月抽取外周静脉血测定SOD含量。并对所有患者在伤后6月按GOS评价预后。结果入院初和伤后2周，对颅脑损伤患者SPECT检出阳性率要明显高于CT检出阳性率（P〈0．01），尤其对轻型损伤的患者更是如此．SPECT检出的颅脑损伤病灶数也比CT多。外周血SOD含量在伤后24h显著下降（P〈0．05），其中中型和重型损伤组SOD值下降最明显，直到1月后其值才恢复正常；伤后24h外周血SOD值与入院时GCS评分及伤后6月GOS评分呈正相关（P〈0.05）。结论颅脑损伤后早期进行SPECT和SOD的检测可以评价病情等级并可以对预后情况最出初步估计。