Lewis D H, Paul Elliott J, Newell D W, Eskridge J M, Richard Winn H
Department of Radiology Harborview Medical Center, University of Washington School of Medicine, Seattle, WA, USA.
J Stroke Cerebrovasc Dis. 1999 Mar-Apr;8(2):71-5. doi: 10.1016/s1052-3057(99)80057-3.
The effects of interventional endovascular treatment of cerebral vasospasm with balloon angioplasty or papaverine infusion were evaluated by single-photon emission computed tomography (SPECT) and transcranial Doppler (TCD) in 44 patients whose cerebral vasospasm was refractory to medical management. SPECT revealed blood flow improvements in 42% of patients with papaverine treated vessels and 70% of patients with balloon angioplasty (P=.037). TCD correlated with SPECT in 71% of patients in the papaverine group and 73% of patients in the balloon angioplasty group. TCD showed 93% of segments improved by angioplasty, whereas 43% of segments were improved with papaverine (P<.001). Disagreements were largely represented by patients with TCD velocity improvements in which SPECT blood flow imaging was, unchanged or worsened. Balloon angioplasty seems superior to papaverine infusion for treatment of vasospasm. SPECT and TCD are complementary tests in the evaluation of vasospasm and effect of interventional therapy.
采用单光子发射计算机断层扫描（SPECT）和经颅多普勒（TCD）对44例药物治疗无效的脑血管痉挛患者进行球囊血管成形术或罂粟碱灌注介入性血管内治疗的效果评估。SPECT显示，接受罂粟碱治疗血管的患者中42%血流改善，接受球囊血管成形术的患者中70%血流改善（P = 0.037）。罂粟碱组71%的患者以及球囊血管成形术组73%的患者中，TCD与SPECT结果相关。TCD显示，血管成形术使93%的节段血流改善，而罂粟碱使43%的节段血流改善（P < 0.001）。分歧主要表现为TCD流速改善但SPECT血流成像无变化或恶化的患者。球囊血管成形术在治疗血管痉挛方面似乎优于罂粟碱灌注。SPECT和TCD在评估血管痉挛及介入治疗效果方面是互补的检查方法。
