早期梅毒患者脑血流定量分析

目的了解早期梅毒患者的脑血流灌注情况。方法病例组为28例病程在1年之内的早期梅毒患者,对照组为26例正常健康人,对两组对象行99Tcm-ECD脑血流灌注显像,并作图像视觉分析和定量分析。结果病例组26例有弥漫性、斑片样脑血流低灌注,21例患者在多个局部表现得更为明显,共45例次。其中累及左额叶3例次,右额叶2例次,左顶叶5例次,右顶叶4例次,左颞叶7例次,右颞叶6例次,左枕叶6例次,右枕叶5例次,左基底节2例次,小脑2例次,丘脑1例次,脑内核团2例次。对照组无1例异常。定量分析提示,病例组额叶、顶叶、颞叶的血流量明显低于对照组(P<0.01),枕叶、基底节、小脑、丘脑的血流量低于对照组(P<0.05)。结论SPECT图像分析和定量分析均提示,早期梅毒患者存在脑血流异常,普遍呈弥漫性、斑片样低灌注。

Quantitative Analysis on Cerebral Blood Flow of Patients with Early Syphilis

Objective To investigate the cerebral blood flow of patients with early syphilis.Methods 99 Tcm-ECD as brain perfusion imaging agent was used in single photon emission computed tomography(SPECT) for 28 early syphilis patients whose disease course was shorter than 1 year and 26 controls. Visual analyses and quantitative analyses were made on every SPECT image.Results According to visual analyses,twenty-six of the 28 early syphilis patients had general, patchy hypoperfusion of cerebral blood flow.Twenty-one of the 26 patients had 45 episodes of marked patchy hypoperfusion of rCBF.The responsible areas of hypoperfusion in a patchy distribution involved the left frontal lobe ③,right frontal lobe ②,left parietal lobe ⑤,right parietal lobe ④,left temporal lobe ⑦,right temporal lobe ⑥,left occipital lobe ⑥,right occipital lobe ⑤,left basal ganglia ②,cerebellum ②,thalamus ① and nerve nuceus ②.Comparing with the controls,rCBF in frontal lobe,parietal lobe and temporal lobe decreased markedly(P<0.01) in early syphilis patients.rCBF in occipital lobe,basal ganglia,cerebellum, thalamus and nerve nuceus decreased (P<0.05) in early syphilis patients. No abnormality was found in the control group.Conclusion Cerebral blood flow abnormalities exist in patients with early syphilis. General patchy hypoperfusion on SPECT imaging is common.