Rajendran J G, Lewis D H, Newell D W, Winn H R
Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, Seattle 98195, USA.
Clin Nucl Med. 2001 Feb;26(2):125-30. doi: 10.1097/00003072-200102000-00007.
The primary objective of this study was to correlate Tc-99m HMPAO and ethyl cysteine dimer perfusion brain SPECT imaging with angiography and transcranial Doppler (TCD) to identify vasospasm after subarachnoid hemorrhage.
A retrospective analysis of consecutive patients who had cerebral blood flow SPECT imaging for subarachnoid hemorrhage and aneurysm clipping was made. Flow velocity measurements were correlated using TCD and cerebrovascular angiography.
Of the 129 patients were included in this study, 84 were female and 45 were male, with a mean age of 51.9 years and a median age of 51 years (range, 9 to 84 years). Eighty-nine patients had brain SPECT evidence of hypoperfusion. Concordance was found between SPECT and TCD with vasospasm in 57 of 89 (64%) patients and nonconcordance was evident in 32 patients (36%). Eleven patients who had concordance between SPECT and TCD had nonconcordant results of angiography for vasospasm.
These findings suggest that all three methods are complementary to each other in the evaluation of patients with vasospasm after subarachnoid hemorrhage. Concordance of 64% between SPECT and TCD is acceptable and explicable by the differences in technique and measurement of cerebral blood flow compared with vascular narrowing, respectively.
本研究的主要目的是将锝-99m六甲基丙二胺肟（Tc-99m HMPAO）和半胱氨酸二聚体灌注脑单光子发射计算机断层扫描（SPECT）成像与血管造影及经颅多普勒（TCD）相关联，以识别蛛网膜下腔出血后的血管痉挛。
对因蛛网膜下腔出血和动脉瘤夹闭术而进行脑血流SPECT成像的连续患者进行回顾性分析。使用TCD和脑血管造影对血流速度测量结果进行关联。
本研究纳入的129例患者中，84例为女性，45例为男性，平均年龄51.9岁，年龄中位数为51岁（范围9至84岁）。89例患者脑SPECT有灌注不足的证据。89例患者中有57例（64%）SPECT与TCD在血管痉挛方面结果一致，32例（36%）结果不一致。11例SPECT与TCD结果一致的患者血管造影显示血管痉挛结果不一致。
这些发现表明，在评估蛛网膜下腔出血后血管痉挛的患者时，这三种方法相互补充。SPECT与TCD之间64%的一致性是可以接受的，分别与血管狭窄相比，脑血流技术和测量方法的差异可以解释这一点。
