早老性痴呆和血管性痴呆的核素影像学显像特点  

Tc-99m-ECD brain SPECT in differential diagnosis between Alzheimer's disease and Vascular dementia

作　　者：常杰[1] 张蓉[2] 顾兆祥[2] 唐熙[2] 魏文石[1] 蒋茂松[2] 

机构地区：[1]上海华东医院神经内科,200040 [2]上海华东医院核医学科,200040

出　　处：《上海医学影像》2005年第2期127-128,共2页Shanghai Medical Imaging

摘　　要：目的通过SPECT显像半定量法来进行Alzheimer’s病(AD)和血管性痴呆(VD)的早期诊断和鉴别诊断。方法AD组25例,VD组21例,正常对照组15例,通过Tc-99m-ECD脑显像SPECT显像,运用大脑皮质与小脑ROIs区比值来进行半定量分析。结果AD病人与正常对照组比较,双侧额叶、双侧后颞顶部,大脑皮质/小脑比值存在高度显著差异(P<0.05),其它二叶无明显差异。而VD病人的放射性比呈非对称性、局灶性放射性降低。结论SPECT半定量分析结果提示双侧额叶及后颞顶部的血流灌注降低是诊断AD的主要特征。结合SPECT和CT、MRI,有助于痴呆的诊断与鉴别诊断。Objective To evaluate the value of the brain SPECT for diagnosis in patients with Alzheimer's disease(AD) and vascular dementia(VD). Methods There were 25 patients of AD and 21 VD patients. Fifteen age matched normal controls were studied under identical condition. Tc-99m-ECD Brain SPECT and CT or MRI were carried out in all patients and controls. The images were analysed semiquantitatively. Results In Alzheimer disease,the greatest reduction of relative uptake value was found in the frontal and posterior temporoparietal cortical regions bilaterally(P<0.05). The semiquantitative method was not suitable for the diagnosis of VD. Conclusions The Tc-99m-ECD brain SPECT semiquantitative analysis can be a useful method for the differental diagnosis between AD and VD.

关 键 词：早老性痴呆 血管性痴呆 核素影像学显像特点 诊断 鉴别诊断 

分 类 号：R749.16[医药卫生—神经病学与精神病学]