^(99m)Tc-ECD SPECT显像定量测定平均脑血流的临床应用研究  

Clinical and experimental investigation of measurements of mean regional cerebral blood flow using technetium-99m ethyl cysteinate dimer

作　　者：张凯军[1] 张永学[1] 高再荣[1] 安锐[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院核医学科,武汉430022

出　　处：《放射学实践》2004年第9期685-687,共3页Radiologic Practice

摘　　要：目的 :应用显像剂99mTc 半双胱乙酯寻求建立一种非侵入性、便于临床应用的定量方法 ,以定量评价大脑及各部位的平均脑血流量。方法 :应用99mTc ECD放射性核素心脑血管造影术和图形法技术测量脑血流灌注指数 ,据经验方程获得大脑半球的平均血流量 ,并进行重复性研究 ;然后根据断层显像和经验公式获得局部平均脑血流量。共分析了正常对照组 2 5例 ,脑血管病组 3 3例 ;且将正常对照组的脑血流量与文献报道的结果进行了比较。结果 :本方法获得的脑血流灌注指数 (BPI)重复性好 ,正常对照组和脑血管病组BPI的平均值分别为 10 .6± 1.4和 6.2± 1.2 ,差异存在显著性意义(P <0 .0 0 1) ;而脑血流量平均值分别为 ( 4 7.41± 3 .2 9)ml/( 10 0g·min)和 ( 3 5 .3 1± 3 .0 6)ml/( 10 0g·min) ,差异亦存在显著性意义 (P <0 .0 1)。正常对照组大脑半球的平均脑血流量与文献报道的结果差异无显著性意义 (P >0 .0 5 )。结论 :研究结果表明 ,该定量计算平均脑血流量的方法 (不需要抽取动脉血液样本 ) ,简便易行 ,且具有潜在的临床应用前景和实用价值。Objective:A non-invasive,simple method for the quantitative evaluation and measurement of mean cerebral blood flow (mCBF,ml/100g/min) is presented using radionuclide angiography with technetium-99m-ethyl cysteinate dimer ( 99m Tc-ECD).Methods:The brain perfusion index (BPI) for the brain hemisphere or for the whole brain was obtained from graphical analysis of radionuclide angiography,and the reproducibility of the method was investigated.We describe a further development of this method to measure mean regional mCBF (mrCBF) in conjunction with SPECT and empirical equation.This method of measuring mCBF from SPECT has been validated in 25 normal control subjects and 33 patients with cerebrovascular disease.Results:BPI value measured by graphical analysis showed a high degree of reproducibility.The mean whole brain BPI of 6.2±1.2 in cerebrovascular disease was significantly lower than that of 10.6±1.4 in normal control subjects.Simultaneously the mean CBF of (35.31±3.06)ml/100g/min in cerebrovascular disease was significantly lower than that of (47.41±3.29)ml/(100g·min) in normal control subjects.There was no significant difference between rCBF of normal subjects using this method and the results reported in literature.Conclusion:The quantitative method of graphical analysis permits the routine measurement of rCBF from 99m Tc-ECD SPECT tomograms of perfusion.The method is non- invasive (without any blood sampling) and has a prospective application and practical clinical value.

关 键 词：^99MTC-ECD SPECT显像 定量测定 脑血流 

分 类 号：R817.4[医药卫生—影像医学与核医学]