Demirören Kaan, Tastekin Güngör, Oran Bülent
Department of Pediatrics, Meram Medical Faculty, Selçuk University, Konya, Turkey.
Pediatr Int. 2004 Aug;46(4):450-5. doi: 10.1111/j.1442-200x.2004.01909.x.
The objective of this study was to determine whether technetium-99m hexamethyl-propyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) imaging is capable of detecting perfusional abnormalities in Sydenham's chorea (SC) patients and contributing to diagnosis of SC.
In this study, 17 SC patients were evaluated. HMPAO SPECT was performed on all patients at the acute phase and six of them at the recovery phase. Magnetic resonance imaging (MRI) of the brain was performed to 13 patients. SPECT images of basal ganglia and thalamus were evaluated both visually and by measuring the radioactivity uptakes. Ten subjects constituted the control group.
HMPAO SPECT was visually evaluated as indicating hyperperfusion in the basal ganglia and thalamus in 16 patients, and evaluated as normal in one patient at the acute phase. The radioactivity uptakes of basal ganglia and thalamus of the patients at the acute phase were found statistically higher than those of the patients at the recovery phase, and also higher than those of the control group (P < 0.05). A significant difference between the radioactivity uptake of the patients at the recovery phase and those of the control group was not found (P > 0.05). Only one patient did not show any abnormality in both acute and recovery phases. MRI study did not show any abnormality in the basal ganglia and thalamus.
It is suggested that brain SPECT can contribute to the diagnosis of SC as an objective tool. Resolving of the hyperperfusion at the recovery phase provides further support for the diagnosis of SC.
本研究的目的是确定锝-99m六甲基丙烯胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT）成像是否能够检测出 Sydenham 舞蹈病（SC）患者的灌注异常，并有助于 SC 的诊断。
在本研究中，对 17 例 SC 患者进行了评估。所有患者在急性期均进行了 HMPAO SPECT 检查，其中 6 例在恢复期进行了检查。对 13 例患者进行了脑部磁共振成像（MRI）检查。对基底节和丘脑的 SPECT 图像进行了视觉评估和放射性摄取测量。10 名受试者组成对照组。
在急性期，16 例患者的 HMPAO SPECT 视觉评估显示基底节和丘脑血流灌注增加，1 例患者评估正常。急性期患者基底节和丘脑的放射性摄取在统计学上高于恢复期患者，也高于对照组（P < 0.05）。恢复期患者与对照组的放射性摄取之间未发现显著差异（P > 0.05）。只有 1 例患者在急性期和恢复期均未显示任何异常。MRI 研究未显示基底节和丘脑有任何异常。
提示脑 SPECT 可作为一种客观工具有助于 SC 的诊断。恢复期血流灌注增加的消退为 SC 的诊断提供了进一步支持。
