Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Sec. 3, Chung-Gung Rd., Taichung 407, Taiwan.
Ann Nucl Med. 2012 Dec;26(10):771-6. doi: 10.1007/s12149-012-0638-8. Epub 2012 Aug 8.
Early detection of regional cerebral anomalies in acute carbon monoxide (CO) poisoning by (99m)Tc-hexamethylprophylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) imaging has been reported previously. However, SPECT findings varied in these studies because of their small population sizes. In this study, we included 96 patients with acute CO intoxication and analyzed the regional perfusion changes in these patients by means of HMPAO brain SPECT.
Ninety-six patients, aged 4-80 years (mean age 32 years) with acute CO intoxication diagnosed by our emergency department were included in this study. Exclusion criteria included previous cerebrovascular diseases, brain injury, brain surgery and any known neurological and psychological disorders. All patients underwent a brain scan using a dual-head camera and fan-beam collimator 90-120 min after injection of (99m)Tc-HMPAO. Brain SPECT images were obtained for interpretation.
Our data suggested that 79 of the 96 patients (82.3 %) had abnormal HMPAO brain images. The predominant site of disease was basal ganglia (52/96 = 54.2 %), followed by temporal lobe (48/96 = 50.0 %), parietal lobe (44/96 = 45.8 %), frontal lobe (30/96 = 31.2 %), occipital lobe (21/96 = 21.9 %) and thalamus (8/96 = 8.3 %). No patients with acute CO intoxication had perfusion abnormalities in the cerebellum. In addition, there was no significant difference in serum COHb levels between patients with abnormal and normal HMPAO brain images.
(99m)Tc-HMPAO SPECT imaging is a useful tool to detect functional brain injury in acute CO intoxication.
先前已有报道称，（99m）Tc-六甲基丙烯酰胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT）成像可早期检测急性一氧化碳（CO）中毒的区域性脑异常。然而，由于这些研究的样本量较小，SPECT 结果存在差异。在本研究中，我们纳入了 96 例急性 CO 中毒患者，并通过 HMPAO 脑 SPECT 分析了这些患者的局部灌注变化。
本研究纳入了 96 例经我院急诊科诊断为急性 CO 中毒的患者，年龄 4-80 岁（平均年龄 32 岁）。排除标准包括既往脑血管病、脑损伤、脑外科手术以及任何已知的神经和心理障碍。所有患者均在 CO 暴露后 90-120 min 内接受（99m）Tc-HMPAO 脑扫描，并进行 SPECT 图像解释。
我们的数据表明，96 例患者中有 79 例（82.3%）的 HMPAO 脑图像异常。病变的主要部位是基底节（52/96=54.2%），其次是颞叶（48/96=50.0%）、顶叶（44/96=45.8%）、额叶（30/96=31.2%）、枕叶（21/96=21.9%）和丘脑（8/96=8.3%）。无急性 CO 中毒患者小脑有灌注异常。此外，异常和正常 HMPAO 脑图像患者的血清 COHb 水平无显著差异。
（99m）Tc-HMPAO SPECT 成像有助于发现急性 CO 中毒的功能性脑损伤。
