静息和腺苷负荷脑血流灌注同日法与两日法显像可信度的比较

目的：与两日法静息腺苷负荷脑血流灌注显像比较,探讨同日法显像的可行性。方法：64例行静息与腺苷负荷脑SPECT血流灌注显像的非器质性精神疾病患者,同日法组和两日法组各32例,在重建的横断面图像上选择3个参考层面,分别勾画其双侧镜像部位小脑、额叶、颞叶、顶叶、枕叶相同大小的感兴趣区（ROI）,测定各ROI放射性计数。选取正常部位的大脑ROI,以双侧小脑ROI平均放射性计数为参照,分别计算双侧大脑额叶、颞叶、顶叶、枕叶ROI放射性计数与其比值,对每组患者腺苷负荷后显像的比值与静息显像的比值进行配对t检验,差异有无统计学意义。结果：同日法组：共获得194组大脑ROI,负荷显像的比值与静息显像的比值配对t检验示额叶（静息组0.922±0.101,腺苷负荷组0.905±0.093;P〉0.05）、顶叶（静息组0.876±0.082,腺苷负荷组0.884±0.097;P〉0.05）、枕叶（静息组1.029±0.136,腺苷负荷组1.020±0.125;P〉0.05）,差异无统计学意义。颞叶（静息组0.940±0.096,腺苷负荷组0.905±0.081;P〈0.05）,差异有统计学意义。两日法组：共获得视为正常的174组大脑ROI,负荷显像的比值与静息显像的比值配对t检验示额叶（静息组0.901±0.100,腺苷负荷组0.956±0.149;P〈0.05）、颞叶（静息组0.923±0.070,腺苷负荷组0.981±0.090;P〈0.05）、顶叶（静息组0.840±0.126,腺苷负荷组0.887±0.091;P〈0.05）,差异有统计学意义。枕叶（静息组1.102±0.146,腺苷负荷组1.010±0.124;P〉0.05）,差异无统计学意义。结论：同日法静息与腺苷负荷脑血流灌注显像可信度欠佳,建议采用两日法。

The Comparative Study of Rest and Adenosine Stress Brain Blood Flow Perfusion Imaging between Using One Day and Two Days Protocol

Objective：Adenosine was used for pharmacologic stress in brain blood flow perfusion imaging. Rest and adenosine stress ^99m Tc-ECD brain SPECT were often undergone using two days protocol. This study was to research the feasibility of stress brain blood flow perfusion imaging using one day protocol. Methods： Sixty {our patients with non-organic mental disorders underwent rest and adenosine stress ^99mTc ECD brain SPECT blood flow perfusion imaging. Thirty-two cases were using one day protocol and Thirty two cases were using two days protocol. Three reference slices in the reconstructive transverse image were selected to draw regions of interest （ROI） in bilateral symmetrical cerebellums, frontal lobes, temporal lobes, parietal lobes and occipital lobes in the normal cerebrum lobes, all of the ROI were the same size. The radioactive counts of each ROI were calculated. The average radioactive counts of bilateral cerebellum ROI were calculated as a reference. The ratio between the radioactive counts of each cerebrum ROI and the average radioactive counts of bilateral cerebellum ROI was calculated. The ratio of adenosine stress and rest cerebral blood flow perfusion imaging was compared using the paired t-test. Results： Among the 194 normal cerebrum ROI in one day group, the ratio between the adenosine stress and rest in the frontal lobe （0. 922± 0. 101 vs. 0. 905 ± 0. 093. P〈0. 05）, parietal Lobe （0. 876 ± 0. 082 vs. 0. 884 ± 0. 097, P〉0.05 ） and occipital lobe （1. 029 ± 0. 136 vs. 1. 020 ± 0. 125, P〉0. 05） , rcspcctively. All showed no statistical significance. While in the temporal lobe （0. 940 ± 0. 096 vs. 0.905 ± 0.081, P〈0.05） showed statistical significance. Among the 174 normal cerebrum ROI in two days group, the ratio between the adenosine stress ,and rest in the frontal lobe （0. 901 ± 0. 100 vs. 0. 956 ±0. 149, P〈0.05）, temporal lobe （0. 923 ± 0. 070 vs. 0. 981 ± 0. 090. P〈0.05） and parietal lobe （0.840 ± 0. 126 vs. 0. 887 ± 0. 091, P〈0. 05）