摘要
目的:根据单光子发射计算机体层摄影术(SPECT)所测局部脑血流量值的变化,比较视觉判定法和定量分析法对癫痫病灶的评估作用。方法:选择1998-10/2000-06在陕西省人民医院就诊的门诊及住院患者。纳入标准:临床确诊的原发性癫痫患者。排除标准:患其他心脑血管疾病者。符合以上纳入标准者共54例作为癫痫组,男33例,女21例,年龄7～64岁。另外选择健康志愿者20例作为对照组,男13例,女7例,年龄22～55岁。两组均知情同意。对54例癫痫患者进行发作间期SPECT脑显像测定,用自编软件定量测定其局部脑血流量。视觉判定法由两位有经验的医师同时对断层图像进行阅片,其中一位不知情,至少在连续两个层面或不同轴向切面的相应部位出现异常灌注,比对侧相应部位低或高两个色阶者,为血流灌注减低或增加;定量分析法将由程序所测得的患者各部位局部脑血流量测量值与正常志愿者所测得的正常值进行比较,若测量值比正常值高20%或低20%,则该部位为血流灌注增加或减低。得出结果后比较两种方法的检出阳性率。结果:按意向处理分析,进入结果分析患者和健康志愿者分别为54和20例。原发性癫痫患者致痫灶局部脑血流量值较正常对照组明显减低,平均下降29.3%。定量分析法阳性率高于视觉判定法犤79.6%,63.0%,(χ2=3.665,P<0.05)犦。
AIM: To compare the effects of visualization analysis and quantitative analysis in evaluating the epilepsy according to the changes of cerebral blood flow detected by using single photon emission computerized tomography(SPECT). METHODS: Patients from People's Hospital of Shaanxi Province from October 1998 to June 2000 were selected.The inclusive criterion was patients with primary epilepsy.The exclusive criterion was patients with other cerebrovascular and cardiovascular diseases. A total of 54 patients(male: 33 cases, female: 21 cases; 7- 64 years of age) met the inclusive criteria and were selected as epilepsy group.Another 20 healthy volunteers(male: 13 cases, female: 7 cases; 22- 55 years of age) were selected as control group.The brain imaging during the intermittent period in 54 patients was detected by using SPECT.Regional cerebral blood flow was quantified with self made software. Visualization analysis was performed by two experienced physicians,one of whom did not know the truth.Those abnormal perfusion indicated that,in the corresponding areas of no less than two consecutive sections or different axial sections, two color levels lower or higher than corresponding areas in opposite sections were considered as decreased or increased perfusion.The quantitative analysis was to compare the cerebral blood flow in patients detected by using self made software with the normal value in control group. If the detected value was 20% higher or lower than the normal value, the section was considered as increased or decreased perfusion. The positive rats were compared in the two methods.RESULTS:According to intention to treat, 54 patients and 20 healthy volunteers were involved in the result analysis.The regional cerebral blood flow of epileptic patients was obviously decreased as compared with that in control group, the mean decreased value was 29.3% . The positive rate of quantitative analysis was higher than that of visualization analysis (79.6% , 63.0% , χ 2=3.665,PCONCLUSION: The quantitative analysis of SPECT
出处
《中国临床康复》
CSCD
北大核心
2005年第17期120-121,共2页
Chinese Journal of Clinical Rehabilitation
基金
陕西省卫生厅科研基金资助(97008)~~
