颅内破裂性动脉瘤介入治疗前后^(99)Tc^m-ECD显像研究  

^(99)Tcm-ECD cerebral perfusion SPECT imaging in patients with ruptured intracranial aneurysm before and after interventional therapy

作　　者：彭静[1] 秦杰[2] 孔令山[2] 谢明萱[2] 

机构地区：[1]兰州军区乌鲁木齐总医院核医学科,830000 [2]第二军医大学附属长海医院核医学科

出　　处：《中华核医学杂志》2005年第3期154-155,i003,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的用99Tcm双半胱乙酯(ECD)SPECT显像观察颅内破裂性动脉瘤介入治疗前后脑血流量变化。方法14例经脑血管造影(DSA)证实的颅内动脉瘤患者,在自发性蛛网膜下腔出血(SAH)后接受电解可脱卸弹簧圈(GDC)栓塞术。分别在介入治疗术前和术后,对患者进行99TcmECDSPECT脑血流灌注显像和半定量分析(脑缺血指数),并在同期进行经颅多普勒超声(TCD)检查。结果14例患者术前SPECT显像均可见不同程度的放射性减低区,即局部脑血流量(rCBF)减低区,其范围除包括DSA所示动脉瘤所在部位外,还包括病灶以外的远隔部位。术后14例患者中有12例SPECT图像上原rCBF减低区消失或较术前明显增高。半定量分析示,术前患者典型缺血部位的脑缺血指数为0.26±0.17,术后同一部位的脑缺血指数为0.13±0.18,差异有显著性(P<0.05)。12例术后原rCBF减低区消失或较术前明显增高患者,其脑缺血指数下降幅度为(68±17)%。结论SPECT脑血流灌注显像能发现颅内动脉瘤破裂后SAH所致脑血管痉挛和评价介入治疗疗效。Objective To investigate the value of 99Tcm-ethylene cysteinate dimer (ECD) cerebral perfusion SPECT imaging in patients with ruptured intracranial aneurysm before and after interventional therapy. Methods 14 patients with aneurysmal subarachnoid hemorrhage confirmed by digital subtraction angiography (DSA) underwent 99Tcm-ECD cerebral perfusion SPECT imaging before and after interventional embolization with detachable coils with a semi-quantitative analysis of these images. Also transcranial doppler (TCD) was performed at the same time for comparison. Results 14 patients showed decreased regional cerebral blood flow (rCBF) on preoperative SPECT images with focal areas on SPECT images larger than that of angiography, and decreased rCBF in remote areas also could be found. After interventional therapy, all of the 12 patients became negative or improved in SPECT images. The semi-quantitative analysis showed: index of preoperative cerebral ischemia (ICI) decreased from (0.26±0.17) to (0.13±0.18) after operation. The statistic difference was significant (P<0.05). The amplitude of decreasing was (68±17)%. Conclusion 99Tcm-ECD cerebral perfusion SPECT imaging can denote cerebral vasospasm after aneurysmal subarachnoid hemorrhage, and also can provide a method to evaluate the therapeutic effect of interventional therapy.

关 键 词：^99TC^M-ECD 治疗前后 破裂性 ^99Tc^m-双半胱乙酯 显像研究 蛛网膜下腔出血(SAH) 经颅多普勒超声(TCD) SPECT显像 脑血流灌注显像 电解可脱卸弹簧圈 SPECT图像 颅内动脉瘤破裂 半定量分析 局部脑血流量 介入治疗疗效 RCBF 

分 类 号：R739.4[医药卫生—肿瘤]