基底节区脑出血患者血肿周边血流变化的SPECT研究  

The SPECT study of rCBF around hematoma in the patients with basal ganglia hemorrhage

作　　者：丁宏岩[1] 董强[1] 史朗峰[1] 吕传真[1] 刘从进 刘兴党 

机构地区：[1]复旦大学附属华山医院神经内科,上海200040 [2]复旦大学附属华山医院核医学科,上海200040

出　　处：《中国神经精神疾病杂志》2007年第5期285-288,共4页Chinese Journal of Nervous and Mental Diseases

基　　金：卫生部临床课题重点基金资助项目(编号:20011523)

摘　　要：目的观察脑出血急性期、亚急性期血肿周边血流量的改变,判断血肿周边是否存在缺血半暗带。方法35例自发性基底节区脑出血患者在发病5d内、病后14d进行单光子发射断层扫描(SPECT),采用感兴趣区模型分析法,分别于血肿中心和其周边区、小脑中心区及上述区域的对侧镜像区用规则的9像素圆框做放射性摄取计数,计算病变侧与对侧放射性计数的摄取比(R)。R≤0.7认为存在缺血半暗带。结果首次检查时周边区的摄取比是(0.74±0.14),在发病12～20d检查时其摄取比是(0.64±0.16),P=0.003。小脑的摄取比首次检查是(1.09±0.11),14d时升高为(1.17±0.12),P=0.005。结论脑出血后血肿周边存在血流下降,在亚急性期更为明显,可达到缺血半暗带阈值。Objective To detect ischemic penumbra around hematoma by studying the change of regional cerebral blood flow（rCBF） at acute phase and subacute phase in patients with intracerebral hemorrhage. Methods 35 patients of spontaneous basal ganglia hemorrhage, ^99mTechnetium-ethyl-cysteinate-dimer single-photon emission CT （^99 Tc^m-ECD SPECT） were performed within 5 days after symptom onset and re-examined at 14 days to measure rCBF. The method of region of interesting was used to measure the uptake counts in the core of hematoma, frontal or parietal region around the le- sion, the center of cerebellum and their contralateral mirror regions, respectively, and calculation the ratio of uptake counts （R） with 9 pixel ring, it was decided there consists penumbra around hematoma if R ≤0. 7. Results The ratio of uptake counts around hematoma was 0. 74±0. 14 in the first exam, in the second time exam it was 0. 64±0. 16, P = 0. 003. The ratio of uptake counts in the core of cerebellum was 1.09±0. 11, 1.17±0. 12（P =0. 005） in twice study, respectively. Conclusions Compared to deceased rCBF of perihematoma in acute phase, it decreased more obviously in subacute phase after intracerebral hemorrhage, the ratio of uptake counts suggested there consists ischemic penumbra around hematoma.

关 键 词：脑出血 局部脑血流量 缺血半暗带 SPECT 

分 类 号：R743.3[医药卫生—神经病学与精神病学]