Baulieu F, Fournier P, Baulieu J L, Dalonneau M, Chiaroni P, Eder V, Pottier J M, Legros B
Department of Nuclear Medicine, Trousseau University Hospital, Tours, France.
J Neuroimaging. 2001 Apr;11(2):112-20. doi: 10.1111/j.1552-6569.2001.tb00020.x.
The aim of this study was to assess the prognostic value of early brain scintigraphy in head injury in relation to long-term neuropsychological behavior. Twenty-four patients underwent technetium-99m (Tc-99m) ethyl cysteinate dimer single photon emission computed tomography (SPECT) within 1 month of the trauma. Scintigraphic abnormalities were evaluated both visually and semiquantitatively using the brain-to-cerebellum ratio method. The clinical neuropsychological investigation was conducted to evaluate abnormalities related to motor deficit, frontal behavior, and memory and language disorders. All patients had abnormalities on SPECT scan. One year after trauma, 14 patients (58%) had neuropsychological sequelae. The brain-to-cerebellum ratios in the left basal ganglia and brain stem were significantly decreased in patients with memory disorders (P = .03 and P = .02, respectively). Moreover, SPECT visual analysis indicated that low uptake in the basal ganglia, thalamus, and brain stem was associated with subsequent motor deficit, frontal behavior, and language and memory disorders. The authors conclude that brain SPECT can be valuable in predicting the neuropsychological behavior of survivors of severe head injury.
本研究的目的是评估早期脑闪烁扫描术对头外伤患者长期神经心理行为的预后价值。24例患者在创伤后1个月内接受了锝-99m（Tc-99m）半胱氨酸乙酯二聚体单光子发射计算机断层扫描（SPECT）。采用脑与小脑比值法对视诊和半定量评估闪烁扫描异常情况。进行临床神经心理学调查以评估与运动缺陷、额叶行为以及记忆和语言障碍相关的异常情况。所有患者的SPECT扫描均有异常。创伤后1年，14例患者（58%）出现神经心理后遗症。记忆障碍患者左基底节和脑干的脑与小脑比值显著降低（分别为P = 0.03和P = 0.02）。此外，SPECT视觉分析表明，基底节、丘脑和脑干摄取降低与随后的运动缺陷、额叶行为以及语言和记忆障碍有关。作者得出结论，脑SPECT在预测重度颅脑损伤幸存者的神经心理行为方面可能具有重要价值。
