单光子发射计算机断层扫描在颅脑创伤后临床探究.docVIP

单光子发射计算机断层扫描在颅脑创伤后临床探究 　　【摘要】 目的 探索单光子发射计算机断层扫描（SPECT）在脑外伤评估及预后方面的价值的依据。方法 28例中、重度颅脑损伤患者分别于伤后3天 、10天及3～4周接受SPECT、CT检查及临床评定。3个月后所有患者行脑外伤综合征的临床测试，对首检SPECT显像阳性者复查SPECT，分析首检SPECT显像阳性者与损伤程度的关系，动态观察SPECT显像与预后的关系。结果 SPECT显像阳性与脑损伤程度有关，首检SPECT显像阳性提示预后良好，复查SPECT显像阳性提示多出现脑外伤综合征。对幕上损伤患者表现的小脑症状、体征可以做出合理的解释。结论 在中至重度颅脑损伤后SPECT显像与CT扫描比较更敏感，脑SPECT具有无创性、功能性及灵敏性高等特点，是脑外伤后功能评估、预后判断及临床研究的可靠方法。 　　【关键词】 脑梗死；局部血流；体层摄影术；发射型计算机；单光子 　　Single photon emission computed tomography imaging for craniocerebral trauma 　　【Abstract】 Objective To explore the validity of single photon emission computed tomography（SPECT） imaging in the rehabilitation assessment and prognostic evaluation of patients with traumatic brain injury（TBI）.Methods Twenty eight pations with morderate or severe TBI underwent an initial SPECT,CT and clinical examination within 3 days,10 days and 3 to 4 weeks after a closed head injury ，and were reassessed 3 months later with clinical examination.Those who were with postive findings in their initial SPECT imagings were reexamined with SPECT.The finding on SPECT images and CT scan were compared,and the correlation between the findings or initial SPECT and activity brain lesions was analyzed.Results It was found that the positive rate of initial SPECT in detecting the TBI was significantly higher than that of CT scan.With morderate or severe TBI postive or negative rate of SPECT imaging was closely correlated with the extent of TBI as well as the clinical manifestations of the patients.We can explicated reasonably with the symptom and syndrome of the cerebellum from traumatic brain injury.Conclusion SPECT imaging is superior to CT in detecting intracranial lesions in patients.SPECT is noinvasive,functional and high superiority and it is positive method of functional assess,recover and clinical research after traumatic brain injury. 　　【Key words】 brain infarction；regional blood flow；tomography；emission-computed；single photon 　　SPECT作为一门新型技术开始在临床应用，具有较高的实用价值和指导作用，笔者应用SPECT观察中、重度颅脑损伤后脑血流的变