SPECT对脑梗死后交叉性小脑失联络的诊断价值  

Study of SPECT in patients with crossed cerebellar diaschisis after cerebral infarction

作　　者：候亚琴[1] 卢洁[1,2] 曹燕翔[2] 张海琴[1] 关乐[1] 帅冬梅[1] 梁志刚[1] 

机构地区：[1]首都医科大学宣武医院核医学科,北京100053 [2]首都医科大学宣武医院放射科,北京100053

出　　处：《医学影像学杂志》2018年第2期178-181,共4页Journal of Medical Imaging

基　　金：国家自然科学基金面上项目(编号:81671662)

摘　　要：目的探讨单侧幕上脑梗死后交叉性小脑失联络患者对侧小脑半球血流灌注及葡萄糖代谢的变化,及其与幕上梗死灶的关系。方法 30例单侧幕上脑梗死后交叉性小脑失联络(CCD)患者,行单光子发射计算机断层(SPECT)脑血流灌注和葡萄糖代谢显像,对SPECT显像进行定性和定量分析,分析幕上脑组织与对侧小脑半球不对称指数(AI)值、脑梗死体积与对侧小脑半球AI值的关系。结果 30例脑梗死后CCD患者,脑血流灌注和脑葡萄糖代谢显像均表现为单侧大脑半球多脑区放射性分布稀疏或缺损,以额叶累及频数最高。30例脑梗死后CCD患者幕上脑组织的血流灌注AI值与对侧小脑半球AI值呈显著正相关(P<0.01);葡萄糖代谢AI值与对侧小脑半球AI值无显著相关(P>0.05);患者梗死灶体积(25.87±16.43)cm3与对侧小脑半球血流灌注及葡萄糖代谢AI值均无显著相关(P>0.05)。结论SPECT检查能够显示患者的脑血流量和葡萄糖代谢改变,评价脑血流量和葡萄糖代谢异常与CCD的关系。Objective To explore the changes of cerebral perfusion and glucose metabolism in patients with crossed cerebellar diaschisis （CCD） after supratentorial unilateral cerebral infarction using single photon emission tomography （SPECT）. Methods Thirty CCD patients after cerebral infarction underwent SPECT 99mTc - ECD cerebral blood perfusion and glucose metabolism ima- ging. SPECT images were performed qualitative and quantitative analysis. The correlation of cerebral blood perfusion and glucose metabolism asymmetry index （AI） between supratentorial cerebral region and contralateral cerebellum were analyzed. The correla- tion between the infarction volume and cerebral blood perfusion and glucose metabolism AI of contralateral cerebellum was also an- alyzed. Results SPECT demonstrated cerebral blood perfusion and glucose metabolism decreased of multiple cerebral regions in patients with CCD. The most involved cerebral region was the frontal lobe. The AI of cerebral blood perfusion between supratento- rial cerebral region and contralateral cerebellum had positive correlation （ P 〈 0.01 ）. However, there had no correlation of glu- cose metabolism AI between supratentorial cerebral region and contralateral cerebellum （ P 〉 0.05）. There also had no correla- tion of infarction volume （25.87 ± 16.43 ） cm^3 and cerebral blood perfusion and glucose metabolism AI of contralateral cerebellum （ P 〉 0.05）. Conclusion SPECT could demonstrate the changes of cerebral blood flow and glucose metabolism, and evaluate the relationship between cerebral blood flow and abnormal glucose metabolism and CCD.

关 键 词：脑梗死 交叉性小脑失联络 单光子发射计算机断层 

分 类 号：R743[医药卫生—神经病学与精神病学] R445[医药卫生—临床医学]