Hawkeye SPECT仪融合图像用于脑脊液鼻漏诊断和定位

目的探讨HawkeyeSPECT仪融合图像对脑脊液鼻漏诊断和定位的临床价值。方法选择33例确诊脑脊液鼻漏的患者，术前腰椎穿刺注射^99Tc^m-DTPA后120和180min行脑池平面显像，然后分别在同一床位进行SPECT和CT扫描，扫描结束后，进行图像处理及图像融合，通过图像分析确定脑脊液鼻漏的漏口、漏道，并做对比分析。采用SAS6．12软件进行统计学处理，对平面和融合显像的2组数据比较行x^2检验。结果33例患者中，融合显像31例、平面显像30例颅底至鼻部有异常放射性浓聚影，其中融合显像有30例、平面显像有18例与手术证实漏口完全一致，其诊断灵敏度和定位准确性分别为93．9％（31／33），90．9％（30／33）和93．5％（29／31），78．3％（18／23）。2种方法的诊断灵敏度差异无统计学意义（x^2=0．65，P〉0．05），定位准确性差异有统计学意义（x^2=10．30，P〈0．05）。结论^99Tc^m-DTPA脑池SPECT显像与同机定位CT图像融合作为灵敏、简便和定位准确的检查手段，可用于诊断和定位脑脊液鼻漏的漏口、漏道。

The clinical value of Hawkeye SPECT fusion imaging in diagnosis and localization of cerebrospinal fluid rhinorrhea

Objective The purpose of this study was to evaluate the clinical value of the 99Tcm-DTPA cerebrospinal fluid (CSF) Hawkeye SPECT fusion imaging for diagnosing and localizing CSF rhinorrhea (CSFR). Methods Thirty-three patients with suspected CSFR were included in this study. All cases un-derwent planar and SPECT and CT imaging at 120 and 180 min, respectively, after 99Tcm-DTPA injection via lumbar puncture before surgery treatment. The location and path of CSF leakage were diagnosed on pla-nar and SPECT fusion imaging. SAS 6.12 software was used to analyze both sets of imaging data, and the χ2 test was used to compare the results from planar imaging with those of SPECT fusion imaging. Results In 33 patients with CSFR, 31 abnormally concentrated radionuclide activity and location of leakage were foun-ded on SPECT fusion imaging, whereas 30 of such abnormalities were detected by planar imaging. All CSFR cases were confirmed by surgery afterwards. The sensitivity and accuracy for diagnosing and localizing CSFR were 93.9% (31/33), 90.9% (30/33) in SPECT fusion imaging and 93.5% (29/31), 78.3% (18/23) in planar imaging. Conclusion 99Tcm-DTPA CSF Hawkeye SPECT fusion imaging is an efficient, simple and accurate method for diagnosing and localizing CSF leakage.