局部脑血流显像对硬膜外血肿快速减压后脑损伤机理的实验研究  

Mechanism of brain damaging by rapid evacuation decompression of epidural hematoma explored with dynamic brain SPECT imaging

作　　者：李俊雄[1] 肖壮伟[1] 陈伟强[2] 欧阳亮[1] 

机构地区：[1]汕头大学医学院第一附属医院放射中心,515031 [2]汕头大学医学院第一附属医院神经外科,515031

出　　处：《中华核医学杂志》2004年第5期288-289,i004,共3页Chinese Journal of Nuclear Medicine

基　　金：广东省自然科学基金资助项目(010434);广东省科技计划项目(C31001)

摘　　要：目的探讨局部脑血流(rCBF)断层显像在硬膜外血肿快速减压后脑损伤的应用价值。方法利用rCBF显像分别对新西兰大白兔硬膜外血肿动物模型压迫前、压迫时及解压后的不同时段进行显像。对不同时相点数据进行三维重建,利用感兴趣区(ROI)技术,生成脑顶叶时间放射性曲线。同时分别测定局部脑游离[Ca2+]浓度与脑含水量的动态变化。结果硬膜外血肿急性减压后,rCBF显像示脑皮质首先表现为严重的低灌注,快速减压后则表现为急性的超过正常的过度灌注。[Ca2+]于压迫后明显升高;减压后短暂降低,继之缓慢增加,24h达到高峰。减压后[Ca2+]与脑组织含水量呈显著正相关关系(r=0469,P<001)。结论rCBF显像对判断硬膜外血肿急性减压后脑组织的再灌注损伤有价值。Objective To explore the value of dynamic brain SPECT imaging in clarifying the major mechanism of obstinate brain edema following evacuation of epidural hematoma. Methods The dynamic brain SPECT imaging was performed on New Zealand rabbit model of epidural hematoma. The changes of their intracellular [Ca^2+ ], and brain tissue water content were measured, and the correlation between them was analyzed. Results It is showed that the severe hypoperfusion occurred on compressing parietal lobe for 30 min and hyper-reperfusion occurred 10 min after decompression on dynamic brain SPECT imaging and on its time-radioactivity curve. [Ca^2+ ] increased remarkably after being pressed. There was a short-term decreasing following decompression and then increased gradually reaching the peak at 24 h. The correlation between [Ca^2+ ] and brain tissue water content was with magnificent value (r=0.469, P<0.01). Conclusions These findings indicate there exists severe reperfusion injury, which is the major mechanism of obstinate brain edema after evacuation of epidural hematoma.The dynamic brain SPECT imaging can show the image evidence of reperfusion clearly and non-invasively.

关 键 词：局部脑血流显像 硬膜外血肿 快速减压 脑损伤 实验研究 

分 类 号：R817[医药卫生—影像医学与核医学]