摘要
目的:测定无症状脑白质疏松患者脑血流量以观察患者脑循环、脑功能的变化。方法:采用单光子发射计算机断层显像,99mTc-乙撑双半胱氨酸二乙酯标记,定量测定无症状脑白质疏松患者20例及15例正常老年人的平均脑血流量和局部脑血流量。无症状脑白质疏松患者为2001-08/2003-01大连医科大学附属第一医院神经内科门诊及住院患者,正常老年人为大连医科大学附属第一医院的老年健康体检者,断层前30min口服过氯酸钾200～400mg,以减少脉络丛和唾液腺、甲状腺对显像剂的摄取,避免影响图像的质量。显像剂以肘静脉“弹丸式”注入,即刻进行动态采集。结束后于外耳孔及外眦放置点源,进行脑实质静态采集30s,以确定OM线,进行单光子发射计算机断层采集。对原始数据进行图像重建,得到大脑平均脑血流量后对单光子发射计算机断层定性图像进行Lassen校正,得到定量图像。于横断图像上选取OM线上50mm、60mm、70mm3个层面,在不同脑叶皮质及脑白质疏松区域左右对称设置感兴趣区各20个定量测定局部脑血流量。神经心理测试采用简易智力状态检查,满分30分,<24分判定为痴呆。结果:脑白质疏松组患者20例和对照组正常人15例均完成检查,全部进入结果分析。①无症状脑白质疏松组大脑平均脑血流量、额、颞、顶叶皮质及脑白质疏松区局部脑血流量与对照组比较均明显降低,差异有显著性[(369.1±41.6),(394.2±36.5)mL/(min·g),t=2.30,P<0.05];[(308.6±28.7),(340.8±36.2)mL/(min·g),t=2.56,P<0.05];[(384.9±50.1),(409.8±37.5)mL/(min·g),t=2.23,P<0.05];[(414.1±50.7)、(443.8±52.3)mL/(min·g),t=2.31,P<0.05];[(283.4±33.8),(312.5±34.3)L/(min·g),t=2.49,P<0.05],尤以额叶皮质降低显著。②轻、中、重度无症状脑白质疏松患者大脑平均脑血流量分别为(375.2±17.1),(368.5±32.9),(353.6±47.7)mL/(min·g),3组之间差异无明显统计学意义(F=2.46,P>0.05)。③
AIM： To detect the cerebral blood flow （CBF） of patients with silent Leukoaraiosis to observe the changes of their cerebral circulation and Cerebral function.
METHODS： The mean CBF and regional CBF were quantitatively detected with ^99mTc-ECD and consecutive single photon emission computerized tomography （SPECT） in 20 patients with silent Leukoaraiosis and. 15 normal elderly people. The patients with silent Leukoaraiosis were the outpatients or inpatients of the Department of Neurology, the First Affiliated Hospital of Dalian Medical University between August 2001 and January 2003, and the normal elderly people were the elderly healthy physical examinees in this hospital. At 30 minutes before, SPECT, all the subjects orally took potassium perchlorate （200-400 mg） to reduce the uptake of developer by choroids plexus, salivary gland and thyroid gland, in order to avoid affecting the quality of image. The developer was infused via elbow vein in a pellet manner, and dynamic collection was performed immediately. Spot sources were placed at external ear hole and lateral canthus to statically collected cerebral parenchyma for 30 s, so as to define the orbitomeatal （OM） line, and collected with SPECT. The image reconstruction was applied to the original data, and the SPECT image was treated with Lassen correction after the mean CBF was obtained, and then the quantitative image was collected, We selected three transaxial slices above the OM line at 50 mm, 60 mm and 70 mm, respectively, and 20 regions of interest （ROIs） were set symmetrically in different bagal ganglia and different cortex to quantitatively detect the regional CBF. Cognitive function was assessed with mini-mental state examination （MMSE）, and the total score was 30 points, 〈 24 was considerad as dementia.
RESULTS： All the 20 patients with silent Leukoaraiosis and 15 normal elderly people finished the examination and entered the analysis of results. （1） The mean CBF, and the regional CBF of frontal, temporal and parie
出处
《中国临床康复》
CSCD
北大核心
2006年第10期80-82,共3页
Chinese Journal of Clinical Rehabilitation
