脑SPECT显像对高压氧治疗脑外伤后脑缺血疗效判断的价值  

The value of brain blood perfusion SPECT imaging in evaluation of the curative effect of hyperbaric oxygen in patients with ischemic brain injury

作　　者：金玉新[1] 李春梅[1] 刘琳[1] 黄彩英[1] 

机构地区：[1]甘肃省白银市第一人民医院核医学科,730900

出　　处：《中华核医学杂志》2009年第6期395-397,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的探讨SPECT脑血流灌注显像对高压氧（HBO）治疗脑外伤继发脑缺血患者疗效判断的价值。方法将65例脑外伤继发脑缺血患者按随机数字表法分为HBO治疗组和常规治疗组，在治疗前后分别进行脑血流灌注SPECT显像，应用计算机感兴趣区（ROI）技术，在横断面图像上采用局部镜像比值（Ra）法判断脑缺血病灶，Ra≤0．9视为异常。对治疗前后的脑血流灌注减低区Ra值进行比较。数据间的比较行t检验。结果HBO治疗组治疗前后局部脑血流（rCBF）减低区Ra值分别为0．58±0．11和0．82±0．12（t=7．327，P〈0．01），常规治疗组治疗前后rCBF减低区Ra值分别为0．61±0．13和0．73±0．12（t=2．153，P=0．038）；HBO治疗组和常规治疗组缺血灶rCBF增加值分别为0．24±0．08和0．12±0．06（t=2．571，P=0．015）。结论SPECT脑血流灌注显像可灵敏地反映HBO治疗脑外伤后脑缺血前后rCBF变化，可用于HBO治疗疗效的评价。Objective Brain blood flow SPECT perfusion can detect changes in brain blood flow. The objective of this study was to explore the clinical value of SPECT perfusion imaging in brain ischemie injury due to traumatic at before and after hyperbaric oxygen （ HBO ） treatment. Methods Sixty-five cases of secondary ischemic brain injury patients were randomly divided into two groups. One was with HBO treatment group and the other was with conventional treatment. All had brain perfusion SPECT at before and after treatment. Computer region of interest （ROI） technology was applied in the cross-sectional images using local mirror ratio （Ra） method to determine cerebral ischemie lesions. The t-test was used to analyze the quantitative data. It would be considered as abnormal if the brain perfusion SPECT reduce Ra≤0.9 after treatment. Results In HBO treatment group, regional cerebral blood flow （rCBF） before and after treatment to reduce the district Ra values were 0.58 ±0.11 and 0.82 ±0.12 （ t = 7. 327, P 〈 0.01 ）. In conventional treatment group, rCBF before and after treatment to reduce the district Ra values were 0.61 ±0.13 and 0.73 ±0.12 （t =2. 153, P =0. 038）. Increased rCBF at ischemic lesions in HBO treatment group was 0.24 ±0.08 and was 0.12 ±0.06 for conventional treatment group （t =2. 571, P =0. 015）. Conclusions Brain SPECT imaging could sensitively reflect the rCBF before and after treatment and was considered to be useful for therapeutic monitoring of HBO treatment efficacy.

关 键 词：脑损伤 脑缺血 高压氧 体层摄影术 发射型计算机 单光子 ECD 

分 类 号：R686[医药卫生—骨科学]