144例脑积水患者脑池显像价值分析  

Valuation of isotope cisternography in 144 patients with hydrocephalus

作　　者：唐宇辉 李赛春[1] 郭浩 王玉洁 杨惠芬 鲁涛 TANG Yu-hui;LI Sai-chun;GUO Hao;WANG Yu-jie;YANG Hui-fen;LU Tao(Department of Nuclear Medicine,Changsha Central Hospital,Changsha 410004,Hunan,China)

机构地区：[1]长沙市中心医院核医学科,湖南长沙410004

出　　处：《生物医学工程与临床》2020年第5期570-574,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨脑池显像在脑积水诊断分类、临床治疗方案决定及治疗效果上的应用价值。方法选择2014年1月至2017年12月长沙市中心医院CT或MRI诊断为脑积水患者144例,其中男性90例,女性54例;年龄2个月~69岁,中位年龄8岁。行双探头SPECT/CT显像(显像剂99mTc-DTPA);根据显像剂在脑室系统循环状态将脑积水分交通性和梗阻性脑积水2类。分别对脑池显像分型与疾病相关因素进行分析,并对脑积水治疗方法与治疗效果相关性进行分析。结果 144例脑积水脑池显像结果示交通性脑积水97例,占67.4%;梗阻性脑积水47例,占32.6%。交通性脑积水和梗阻性脑积水两组患者分别在性别、年龄、Evans指数、病因方面差异均无统计学意义(P> 0.05)。交通性脑积水患者中55例(56.70%)接受保守治疗,而梗阻性脑积水患者中39例(82.98%)接受手术治疗,两者差异有统计学意义(χ2=20.256,P <0.05)。交通性脑积水患者保守治疗(平均秩和为44.75)与手术治疗(平均秩和为54.56)治疗效果不同,差异有统计学意义(Z=-2.089,P <0.05)。梗阻性脑积水患者手术治疗(平均秩和为22.22)与保守治疗(平均秩和为32.69)治疗效果不同,差异有统计学意义(Z=-2.575,P <0.05)。结论脑池显像是对脑积水进行分类诊断的一种有效手段,为临床治疗方案的选择提供有力的参考依据,在保障治疗效果的同时获得最佳的治疗方案。Objective To analyze the application value of isotope cisternography(ICG) on diagnostic classification, clinical therapeutic regime and treatment effect in patients with hydrocephalus. Methods From January 2014 to December 2017, a total of 144 patients with hydrocephalus diagnosed by CT or MRI were enrolled, which included 90 males and 54 females, aged 2-month-old to 69-year-old with median age of 8 years old. All of them performed dual-probe single photon emission tomography(SPECT)/CT imaging(imaging agent 99mTc-DTPA). According to ventricular system circulation state of imaging agent, hydrocephalus were divided into communicative and obstructive hydrocephalus. The ICG classification and disease related factors were analyzed, respectively, and correlation between hydrocephalus treatment method and treatment effect were studied. Results The ICG showed that there were 97 patients(67.4 %) with communicative hydrocephalus and 47 cases(32.6 %) with obstructive hydrocephalus. There was no significant difference in gender, age, Evans index and etiology between 2 groups(P > 0.05).Fifty-five patients(56.70 %) with communicative hydrocephalus received conservative treatment, and 39 patients(82.98 %) with obstructive hydrocephalus received surgical treatment, and the difference was statistically significant between 2 groups(χ2=20.256, P < 0.05). The treatment effect was statistically significant different between conservative treatment(mean rank of44.75) and surgical treatment(mean rank of 54.56) in patients with communicative hydrocephalus(Z =-2.089, P < 0.05). The treatment effect was different between surgical treatment(mean rank of 22.22) and conservative treatment(mean rank of 32.69)in patients with obstructive hydrocephalus, and the difference was statistically significant(Z =-2.575, P < 0.05). Conclusion It is demonstrated that ICG is an effective method for classification and diagnosis of hydrocephalus, which provides reference basis for clinical treatment, and obtains best therapeutic regime while ensuring treatm

关 键 词：脑积水 脑池显像 SPECT CT 99MTC-DTPA 治疗效果 效果评价 

分 类 号：R742.7[医药卫生—神经病学与精神病学] R817.4[医药卫生—临床医学]