脑外伤患者99Tcm-ECD SPECT显像的影像特征和应用价值

目的　探讨99Tcm 双胱乙酯 (ECD)SPECT局部脑血流显像在各类脑外伤的影像特征和应用价值。方法　正常对照组 10例 ,脑外伤组 2 4例。病员准备、采集条件和图像处理基本同常规脑血流灌注断层显像。所有患者均进行同期CT扫描。结果　 2 4例脑外伤患者中 2 0例SPECT表现为异常 ,病灶累及脑的部位 71个 ,阳性率 83 % ,CT阳性率为 71%。SPECT发现病灶范围和数目均高于CT。各类脑外伤SPECT除表现为局限性放射性稀疏或缺损的共同特点外 ,不同类型脑外伤还具有各自相应的影像特征 ,如脑挫裂伤表现为假性结构紊乱 ;脑血肿清除术后表现为原血肿区缺损 ,酷似脑梗塞改变。结论　各类脑外伤患者SPECT脑灌注显像具有相应的影像特征 ,该显像具有重要临床价值。

Imaging Features and Clinical Value of Brain 99Tcm-ECD SPECT in Brain Injuries

Objective To study the imaging features and clinical value of 99 Tc m ECD SPECT regional cerebral blood flow (rCBF) imaging in various types of brain injuries. Methods Ten normal cases as controls and 24 patients with brain injuries were performed with 99 Tc m ECD rCBF tomographic imaging.All cases had been studied by X CT simultaneously. Results Twenty of the 24 patients had abnormal rCBF imaging.Seventy one lesions were demonstrated by SPECT imaging in them.Positive rate by SPECT was 83%.Positive rate by X CT was 71%.Range and number of the lesions demonstrated by SPECT were more than X CT.In various types of brain injuries,the total imaging features were various.For example,brain fissure injury showed false structure inordinate,while brain hematom post clear operation had showed defect in hematoma areas like brain infarction and peripheral of the lesion displayed various degree decreased perfusion.Two cases of brain injuries showed crossed cerebellar diaschisis by SPCET imaging. Conclusion The various types brain injury cases showed several imaging features on 99 Tc m ECD SPECT.SPECT brain image has great clinical significance and application value.