Ozyurt Gurayten, Kaya Fatma Nur, Kahveci Ferda, Alper Eray
Uludag University, Bursa, Turkey.
Clin Toxicol (Phila). 2008 Mar;46(3):218-21. doi: 10.1080/15563650701378704.
Abnormal regional cerebral blood flow in patients with acute carbon monoxide (CO) and organophosphate (OP) poisoning was examined using (99m)Tc-hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) in fourteen patients. We evaluated the predictive significance of acute phase brain SPECT findings for long-term neuropsychological sequelae. Changes were found in the frontal, temporal, parietal lobes within the first week after both types of poisoning. The distribution of the hypoperfused cerebral areas as demonstrated by (99m)Tc-HMPAO imaging was similar in the two groups during the acute phase. Neuropsychological sequelae developed in five patients poisoned with OP and six with CO. Patients who had SPECT findings heterogeneously or in the temporal or frontal lobes displayed disorientation. Those with fronto-parietal and frontal lobe changes displayed mental confusion. Parkinsonism also was observed in patients with parieto-occipital, parietal and frontal lobe lesions. The distribution of these lesions appears to predict the long term sequelae of these poisonings, though additional studies with larger numbers of patients are needed to confirm the role of SPECT imaging in both OP and CO poisonings.
我们使用锝-99m标记的六甲基丙烯胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT）对14例急性一氧化碳（CO）中毒和有机磷（OP）中毒患者的局部脑血流异常进行了检查。我们评估了急性期脑SPECT检查结果对长期神经心理学后遗症的预测意义。在两种中毒后的第一周内，额叶、颞叶、顶叶均发现有变化。在急性期，两组经锝-99m HMPAO成像显示的脑灌注不足区域分布相似。5例OP中毒患者和6例CO中毒患者出现了神经心理学后遗症。SPECT检查结果显示为异质性或颞叶或额叶改变的患者出现定向障碍。额顶叶和额叶有改变的患者出现精神错乱。顶枕叶、顶叶和额叶有病变的患者还出现了帕金森综合征。这些病变的分布似乎可以预测这些中毒的长期后遗症，不过还需要更多患者的进一步研究来证实SPECT成像在OP和CO中毒中的作用。
