半侧空间忽略SPECT rCBF显像研究  

Preliminary clinical study of regional cerebral blood flow SPECT imaging in patients with hemispatial neglect

作　　者：尹雅芙[1] 任艳[2] 李亚明[1] 韩春起[1] 李德顺[1] 马爱萍[1] 梁辰荣[1] 孙振秋[1] 刘浩[1] 高沁怡[1] 

机构地区：[1]中国医科大学附属第一医院核医学科,沈阳110001 [2]中国医科大学附属第一医院神经内科,沈阳110001

出　　处：《中华核医学杂志》2002年第1期9-11,共3页Chinese Journal of Nuclear Medicine

摘　　要：目的　探讨半侧空间忽略的发生及程度与脑血流改变的部位、范围及程度间的关系。方法　对临床确诊为单侧脑卒中、忽略组合试验证实有忽略表现的右利手患者行SPECT局部脑血流(rCBF)显像 ,判定rCBF改变的部位、范围及程度。结果　SPECT显像示忽略患者的脑损伤部位最多见于额叶 ,其次是顶叶、枕叶、颞叶、基底节和丘脑。 2个或 2个以上部位的联合损伤更易出现忽略 ,最明显的部位是颞顶枕交界处。病灶区的rCBF及rCBF降低的百分比与忽略程度的相关系数为 - 0 34 (t=- 1.5 ,P >0 .0 5 )和 0 .34 (t=1.47,P >0 .0 5 ) ,病灶的范围、病灶数及病灶缺血体积与忽略程度之间的相关系数分别为 0 .71(t=4.13,P <0 .0 1)、0 .70 (t=4.0 7,P <0 .0 1)和 0 .6 4(t=3.40 ,P <0 .0 1)。结论　忽略患者病灶区的rCBF及rCBF降低的百分比与忽略程度的相关性较小 ,而病灶的范围、病灶数及缺血体积与忽略程度呈正相关。半侧空间忽略可发生于多个大脑部位的损伤 ,多部位联合损伤忽略程度更明显。Objective To explore the relationships between the occurrence and severity of the neglect and the region, range or extent of the decrease of regional cerebral blood flow (rCBF), we performed rCBF SPECT imaging on 19 patients with hemispatial neglect. Methods Nineteen dextromanual subjects who were diagnosed with unilateral stroke clinically and neglect by a neglect test battery underwent rCBF SPECT imaging. Results On SPECT imaging, the patients with neglect had damages in the frontal cortex mostly, parietal secondly, and then in order of occipital, temporal cortex, basal ganglia and thalamus. The patients who had two or more regions damaged showed neglect more frequently. The most significant region was temporal-parietal-occipital junction. The correlation coefficients between rCBF and the decreased percentage of rCBF and the severity of neglect were -0.34 ( t=-1.5,P >0.05)and 0.34( t=1.47,P >0.05). The correlation coefficients between the range, number of foci, the flow deficit size and the severity of neglect were 0.71( t=4.13,P <0.01), 0.70( t=4.07,P<0.0 1)and 0.64( t=3.40,P <0.01), respectively. Conclusions The severity of neglect correlates with rCBF and the decreased percentage of rCBF insignificantly, while it correlates positively with the range, number of foci and the flow deficit size significantly. We suggest that hemispatial neglect usually results from the damage of multiple sites, and the complex damage of multiple sites results in more severe neglect.

关 键 词：半侧空间忽略 SPECT 脑梗塞 RCBF 诊断 

分 类 号：R817[医药卫生—影像医学与核医学]