无症状脑梗死患者的乙酰唑胺脑负荷显像  

A study of "one day protocol" of ^(99)Tc^m-ECD brain SPECT imaging with acetazolamide stress and its application in silent cerebral infarction for assessment of cerebrovascular reserve capacity

作　　者：朱广文[1] 郑平伟[1] 郑丽莎[2] 张延军[1] 许晶[2] 

机构地区：[1]大连医科大学附属第一医院核医学科,116011 [2]大连医科大学附属第一医院神经内科,116011

出　　处：《中华核医学杂志》2001年第6期337-338,共2页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨乙酰唑胺介入一日法脑负荷显像在无症状脑梗死 (SCI)中的应用价值。方法　对照组 7例 ,无症状脑梗死 (SCI)患者 18例 ,进行一日法乙酰唑胺负荷和静息99Tcm 双半胱乙酯脑血流显像。所有受检者均有CT或MRI结果。对负荷和静息显像进行半定量分析 ,在大脑皮质设置 35 0个方型感兴趣区 (ROI) ,结合负荷和静息显像分 4种类型 :A型 :静息与负荷显像局部脑血流量(rCBF)都正常 ;B型 :静息时rCBF正常 ,负荷时出现血流灌注减低 ;C1 型 :静息时rCBF减低 ,负荷后无改变 ;C2 型 :静息时即出现rCBF减少 ,负荷后rCBF降低更明显 ;D型 :静息时rCBF减低 ,负荷后rCBF有改善。结果　对照组 98个ROI中 ,A型 96个 ,B型 2个 ;SCI组 2 5 2个ROI中 ,A型 198个 ,B型 9个 ,C1 型 5个 ,C2 型 6个 ,D型 34个。对照组负荷后脑血流平均增加 (32 .5 0± 3.5 6 ) % ,SCI组病变半球负荷后血流平均增加 (2 4.18± 4.85 ) % (t=12 .39,P <0 .0 1)。结论　乙酰唑胺负荷脑血流显像可评价SCI患者脑血管储备功能 ,一日法脑负荷显像简便、安全。Objective To evaluate the value of 99Tcm-ECD brain SPECT imaging with acetazolamide (ACZ, diamox) stress in silent cerebral infarction(SCI). Methods Brain 99Tcm-ECD SPECT studies before and after ACZ (1 g,i.v.) administration with in the same day were performed on 7 control subjects and 18 cases with SCI. CT and MRI were performed on all patients and control subjects as well.Imaging analysis: by semiquantitative method, 350 ROIs were set on brain cortical regions. The responses of rCBF to ACZ can be divided into the following five patterns: type A : rCBF were normal in both rest and stress test; type B : the rest rCBF was normal but new hypoperfused area appeared at stress test; type C 1 :the rest rCBF was decreased, and remained unchanged after ACZ; type C 2: the rest rCBF was decreased and decreased significantly after ACZ test; type D: the rest rCBF was decreased, but improved after ACZ test. Results There were total 98 ROIs in 7 control subjects, 96 were fit for type A and 2 for type B. There were total 252 ROIs in 18 cases with SCI, 198 were fit for type A,9 for type B,5 for type C 1,6 for type C 2,34 for type D.The average increase of rCBF after ACZ stress test was (32.50±3.56)% in control subjects; the average increase of rCBF in affected hemispheres was (24.18±4.85)% in cases with SCI ( t=12.39, P <0.01). Conclusions The vascular reserve in type B, type C 1 and type C 2 patients was poor; the vascular reserve in type D and type A patients was good. The protocol is useful for evaluating the cerebrovascular reserve capacity in SCI patients; it may be helpful for therapy programming and for predicting the therapeutic effects on this patients. 'One day protocol' ACZ test is a safe,convenient method and it is easy to perform.

关 键 词：脑梗塞 体层摄影术 发射型计算机 乙酰唑胺 SCI 脑负荷显像 

分 类 号：R817.4[医药卫生—影像医学与核医学]