SPECT显像在NPC放疗后所致脑损伤中的初步应用

目的 评价单光子发射型电子计算机断层（ＳＰＥＣＴ）脑血流灌注显像在鼻咽癌（ＮＰＣ）放射治疗后放射性脑损伤中的临床价值。方法 采用ＳＰＥＣＴ脑血流灌注显像检查，对１６例鼻咽癌放射治疗后有放射性脑损伤症状的患者和８例示经放疗的鼻咽癌患者作半定时分析对测量结果作统计学分析。１６例放射性脑损伤患者同期做电子计算机体层检查（ＣＴ）对比。结果 １６例有放射性脑损伤症状的鼻咽癌患者双侧颞叶局部脑血流灌注（ｒＣＢＦ）在横断面层面－放射性曲线相应部位上可见局部放射性下降峰或曲线变窄小，峰值降低，其曲线局部下降峰值与鼻咽癌放疗效量的生物效应剂量（ＢＥＤ）值呈正相关（ｒ＝０．８９７６，Ｐ〈０．０１）。８例未经放疗的鼻咽癌患者，在横断面图像上其双侧颞叶局部脑血流灌注的层面－放射性曲线大致呈正态分布曲线，未见异常的局部下降峰或曲线变窄小

Preliminary Application of Brain Perfusion SPECT Imaging in Radiation Brain Injury after Radiotherapy for Nasopharyngeal Carcinoma

Objective The clinical value of brain perfusion single photon emission computed tomography (SPECT) imaging was evaluated in patients with radiation brain injury after radiotherapy for nasopharyngeal carcinoma(NPC). Methods 16 NPC patients suffering from radiation brain injury (trial group) and 8 cases of NPC patients before radiotherapy without other brain diseases (contrast group) were analyzed quantitatively with SPECT imaging.The trial group patients were examined simultaneously by CT imaging. Results In trial group, regional cerebral blood flow (rCBF) perfusion rate decreased significantly in left temporal lobe.In the horizontal slice-count curve, it was showed to have the decreasing mount of regional cerebral blood flow perfusion; or the slice-count curve was small and no broad.The degree of decreasing rate was related proportionately to biological effective dose(BED) of given dose of the tumor(r=0 8976,p<0 01).There was a curve of normal regional cerebral blood flow perfusion of bilateral temporal lobe in contrast groups.The results showed that the horizontal slice-count curve of regional cerebral blood flow perfusion of bilateral temporal lobe in contrast group patients liked sinusoid.There was significantly difference of rCBF perfusion rate between above two groups.The positive rate of CT scan in the beginning of radiation brain injury was less than that of SPECT imaging.Conclusions brain perfusion SPECT imaging is useful for the early diagnosis and quantitative evaluation of radiation-reduced brain injury of NPC patients after radiotherapy.The damage degree of radiation brain injury of NPC patients after radiotherapy was related closely to BED of given dose of the tumor.