Alexandrov A V, Ehrlich L E, Bladin C F, Norris J W
Stroke Research Unit, Sunnybrook Health Science Centre, University of Toronto, Canada.
J Neuroimaging. 1993 Oct;3(4):209-15. doi: 10.1111/jon199334209.
Single-photon emission computed tomography (SPECT) and transcranial Doppler (TCD) ultrasound are of good prognostic value in acute stroke, and combined they may be an accurate way to determine a target group of patients with maximum therapeutic response. Seventy consecutive patients were studied (42 with middle cerebral artery strokes, 18 with transient ischemic attacks {TIAs}; 10 were excluded due to failure of insonation). Two SPECT studies were performed at 2.1 +/- 1.2 and 13.8 +/- 3.1 days after onset. Serial TCD studies were done at 10 hours and at the time of the SPECT studies. Neurological deficit was scored on admission and 2 weeks later (using the Canadian Neurological Scale). Cerebral perfusion index (CPI) was derived by multiplying the values for TCD and SPECT patterns. Positive correlation was obtained in all 16 patients in whom cerebral angiography was performed within the first 3 days after onset. The occlusive TCD pattern and absence of perfusion on SPECT were common in the stroke group (19/42 patients) and were never seen in those with TIAs. A normal TCD pattern and normal perfusion on SPECT were more common in the patients with TIAs (9/18 vs 8/42, p = 0.02; 5/10 vs 1/40, p = 0.0003). The occlusive TCD and SPECT patterns were associated with the highest mean infarction volume (147 +/- 87 vs 19 +/- 21, p less than 0.0001) and all nonocclusive TCD and SPECT patterns were associated with the better short-term outcome (43.2 +/- 33.9 vs 92.4 +/- 20.2, p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
单光子发射计算机断层扫描（SPECT）和经颅多普勒（TCD）超声在急性卒中中具有良好的预后价值，两者联合使用可能是确定能获得最大治疗反应的目标患者群体的准确方法。对70例连续患者进行了研究（42例大脑中动脉卒中患者，18例短暂性脑缺血发作{TIAs}患者；10例因超声检查失败被排除）。在发病后2.1±1.2天和13.8±3.1天进行了两次SPECT研究。在10小时和SPECT研究时进行了系列TCD研究。入院时和2周后（使用加拿大神经功能量表）对神经功能缺损进行评分。脑灌注指数（CPI）通过将TCD和SPECT模式的值相乘得出。在发病后3天内进行脑血管造影的所有16例患者中均获得了正相关。闭塞性TCD模式和SPECT上无灌注在卒中组中很常见（19/42例患者），而在TIAs患者中从未见过。正常TCD模式和SPECT上正常灌注在TIAs患者中更常见（9/18比8/42，p = 0.02；5/10比1/40，p = 0.0003）。闭塞性TCD和SPECT模式与最大平均梗死体积相关（147±87比19±21，p<0.0001），所有非闭塞性TCD和SPECT模式与更好的短期预后相关（43.2±33.9比92.4±20.2，p<0.0001）。（摘要截短至250字）
