乙酰唑胺脑血流负荷试验在缺血性脑血管病中的-中国科技论文在线.PDF

中华核医学杂志 CHINESE JOURNAL OF NUCLEAR MEDICINE 1998年 第1期 No.1 february 1998 介入性脑灌注显像 乙酰唑胺脑血流负荷试验 在缺血性脑血管病中的应用 修雁 陈绍亮 孙晓光 牛敬忠 朱文炳 崔尧元 陈可靖 谢瑞满 【摘要】 目的 探讨乙酰唑胺SPECT脑血流负荷试验在脑血管病中的应用价值。 方法 对18例缺血性脑血管疾病患者进行了静息显像及负荷试验,脑灌注显像剂为99mTc-乙撑双半胱 氨 酸二乙酯。 结果 根据多感兴趣区半定量分析结果,可将脑血流对乙酰唑胺的反应性分成以 下 四种类型:A型,235处皮质区域用药前后局部脑血流(rCBF)都正常;B型,静息rCBF正常,用药后 32处 区域出现新的血流灌注减低区;C型,静息rCBF减低,负荷后17处rCBF减低更明显,15处无明显改 变; D型,用药前rCBF减低,用药后rCBF改善25处。18例患者中6例出现交叉性小脑神经失联络现 象,3 例于用药后rCBF恢复正常。 结论 乙酰唑胺脑血流负荷试验可观察脑血流反应储备力,发现 隐 匿性脑缺血,有利于脑血管疾病的诊断及治疗。 【关键词】 脑血管意外 乙酰唑胺 放射性核素显像 Diamox cerebral blood flow stress test in ischemic cerebrovascular diseases Xiu Yan, Chen Shaoliang, Sun Xiaoguang, et al. Zhongshan Hospital, Shanghai, 200032 【Abstract 】  Purpose To evaluate the value of Diamox SPECT regional cerebral blood flow (rCBF) stress test in cerebrovascular diseases (CVD). Methods Rest and stress rCBF imaging test were performed in 18 CVD patients. The 99m Tc-ECD brain perfusion imaging agent was used. Results By semiquantitation method, the responses of rCBF to Diamox can be divided into following four patterns: A: The rCBF of 235 cortical regions was normal in both rest and stress test. B: Rest rCBF was normal but new hypoperfused area appeared in 32 regions at stress test. C: rCBF decreased significantly after injecting Diamox in 17 regions and unchanged in 15 regions. D: rCBF decreased in 25 regions, and improved after stress test. Six of 18 patients showed cerebellar crossed diaschisis (CCD), cerebellar blood flow returned to normal after Diamox in 3 cases. Conclusions Diamox rCBF stress test can reflect the reserve capability of rCBF reaction, detect the si