摘要
目的 分析ATP负荷脑血流灌注显像对缺血性脑血管病的诊断价值.方法 对2016年11月至2017年2月在中日友好医院就诊的32例脑缺血、脑梗死伴缺血的患者[男26例、女6例,平均年龄（63.0±8.7）岁]行99Tcm-双半肌乙酯（ECD）负荷及静息脑血流灌注显像.在双侧额叶、顶叶、颗叶、枕叶、基底节区对称部位勾画感兴趣区并计算局部脑血流量（rCBF）,对比分析负荷前后图像及rCBF.观察患者负荷前后脑血流灌注的反应情况.采用配对t检验分析数据.结果 静息与负荷脑血流灌注显像诊断32例患者脑血流灌注减低的阳性率分别为53.1％（17/32）和65.6％（21/32）,两者联合诊断的阳性率为100％（32/32）.单侧血管狭窄患者16例,血管狭窄侧静息显像rCBF为（65.8±13.2）ml·100 g^-1·min^-1,负荷显像rCBF为（62.7±13.3）ml·100 g^-1·min^-1,后者较前者减低（t=3.07,P〈0.05）;健侧静息与负荷显像rCBF间差异无统计学意义[（67.4±13.3）与（65.9±13.0）ml·100 g^-1·min^-1;t=1.90,P〉0.05].双侧多支血管病变患者16例,其静息显像rCBF为（62.5±13.9）ml·100 g^-1·min^-1,负荷显像rCBF为（57.5±11.6）ml·100 g^-1·min^-1,后者较前者减低（t=3.50,P〈0.05）.观察32例患者ATP负荷的反应,21例患者出现脑血流储备下降.结论 联合静息与负荷脑血流灌注显像能明显提高对缺血病灶诊断的阳性率,评价脑血流储备情况.
ObjectiveTo investigate the value of ATP stress cerebral blood flow perfusion imaging （CBFPI） in diagnosis of ischemic cerebrovascular disease.MethodsThirty-two patients with cerebral ischemia and ischemic cerebral infarction （26 males, 6 females, average age： （63.0±8.7） years） in China-Japan Friendship Hospital from November 2016 to February 2017 were enrolled. All subjects underwent 99Tcm-ethylcysteinate dimer （ECD） rest and ATP stress CBFPI. Region of interest （ROI） was drawn in the symmetrical parts of the bilateral frontal lobe, parietal lobe, temporal lobe, occipital lobe and basal ganglia region, and the regional cerebral blood flow （rCBF） was automatically calculated. The images and rCBF of post- and pre-ATP stress CBFPI were analyzed and compared. Paired t test was used for statistical analysis.ResultsThe positive rates of rest CBFPI, ATP stress CBFPI, and combination of both imaging were 53.1%（17/32）, 65.6%（21/32）, and 100%（32/32）, respectively. In 16 cases with unilateral vascular stenosis, the average rCBF of diseased hemisphere was lower in stress imaging （62.7±13.3） ml·100 g^-1·min^-1 than that in rest imaging （（65.8±13.2） ml·100 g^-1·min^-1;t=3.07, P〈0.05）. While the average rCBF of the contralateral hemisphere in rest and stress imaging showed no significant difference （（67.4±13.3） vs （65.9±13.0） ml·100 g^-1·min^-1;t=1.90, P〉0.05）. In the other 16 patients with bilateral multivessel disease, the average rCBF of whole brain in rest imaging was higher than that in stress imaging： （62.5±13.9） vs （57.5±11.6） ml·100 g^-1·min^-1;t=3.50, P〈0.05. There were 21 out of the 32 patients presented with a decreased cerebrovascular reserve.ConclusionATP stress combined with rest CBFPI may improve positive rate remarkably and help to evaluate the cerebrovascular reserve.
作者
尹立杰
颜珏
刘杰
续蕊
金超岭
王荣福
Yin Lifie;Yan Jne;Liu Jie;Xu Rui;Jin Chaoling;Wang Rongfu(Department of Nuclear Medicine,Peking University First Hospital,Beijing 100034,China;Department of Nuclear Medicine,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中华核医学与分子影像杂志》
CAS
北大核心
2018年第8期521-526,共6页
Chinese Journal of Nuclear Medicine and Molecular Imaging
基金
国家重大科学仪器设备开发专项（2011YQ03011409）
十二五国家科技支撑计划（2014BAA03803）
中日友好医院2015年院级科研基金（2015-1-QN-26）
关键词
脑缺血
体层摄影术
发射型计算机
单光子
腺苷三磷酸
锝
半胱氨酸
Brain ischemia
Tomography
emission-computed
single-photon
Adenosine triphosphate
Technetium
Cysteine
