Hyun I Y, Lee J S, Rha J H, Lee I K, Ha C K, Lee D S
Department of Nuclear Medicine, Inha University College of Medicine, Incheon, Korea, Korea.
Eur J Nucl Med. 2001 Feb;28(2):191-7. doi: 10.1007/s002590000437.
The purpose of this study was to investigate the differences between technetium-99m ethyl cysteinate dimer ((99m)Tc-ECD) and technetium-99m hexamethylpropylene amine oxime ((99m)Tc-HMPAO) uptake in the same brains by means of statistical parametric mapping (SPM) analysis. We examined 20 patients (9 male, 11 female, mean age 62±12 years) using (99m)Tc-ECD and (99m)Tc-HMPAO single-photon emission tomography (SPET) and magnetic resonance imaging (MRI) of the brain less than 7 days after onset of stroke. MRI showed no cortical infarctions. Infarctions in the pons (6 patients) and medulla (1), ischaemic periventricular white matter lesions (13) and lacunar infarction (7) were found on MRI. Split-dose and sequential SPET techniques were used for (99m)Tc-ECD and (99m)Tc-HMPAO brain SPET, without repositioning of the patient. All of the SPET images were spatially transformed to standard space, smoothed and globally normalized. The differences between the (99m)Tc-ECD and (99m)Tc-HMPAO SPET images were statistically analysed using statistical parametric mapping (SPM) 96 software. The difference between two groups was considered significant at a threshold of uncorrected P values less than 0.01. Visual analysis showed no hypoperfused areas on either (99m)Tc-ECD or (99m)Tc-HMPAO SPET images. SPM analysis revealed significantly different uptake of (99m)Tc-ECD and (99m)Tc-HMPAO in the same brains. On the (99m)Tc-ECD SPET images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the left superior temporal lobe and in the superior region of the cerebellum. On the (99m)Tc-HMPAO SPET images, relatively higher uptake was observed in the medial temporal lobes, thalami, periventricular white matter and brain stem. These differences in uptake of the two tracers in the same brains on SPM analysis suggest that interpretation of cerebral perfusion is possible using SPET with (99m)Tc-ECD and (99m)Tc-HMPAO.
本研究的目的是通过统计参数映射（SPM）分析，研究锝-99m 半胱氨酸乙酯二聚体（（99m）Tc-ECD）和锝-99m 六甲基丙烯胺肟（（99m）Tc-HMPAO）在同一脑部摄取情况的差异。我们对 20 例患者（9 例男性，11 例女性，平均年龄 62±12 岁）在中风发病后不到 7 天，使用（99m）Tc-ECD 和（99m）Tc-HMPAO 进行单光子发射断层扫描（SPET）及脑部磁共振成像（MRI）检查。MRI 显示无皮质梗死。MRI 发现脑桥梗死（6 例）、延髓梗死（1 例）、缺血性脑室周围白质病变（13 例）和腔隙性梗死（7 例）。（99m）Tc-ECD 和（99m）Tc-HMPAO 脑部 SPET 采用分剂量和序贯 SPET 技术，患者无需重新定位。所有 SPET 图像均进行空间变换至标准空间、平滑处理及全局归一化。使用统计参数映射（SPM）96 软件对（99m）Tc-ECD 和（99m）Tc-HMPAO SPET 图像之间的差异进行统计学分析。两组之间的差异在未校正 P 值小于 0.01 的阈值时被认为具有显著性。视觉分析显示，（99m）Tc-ECD 或（99m）Tc-HMPAO SPET 图像上均无灌注减低区。SPM 分析显示，（99m）Tc-ECD 和（99m）Tc-HMPAO 在同一脑部的摄取存在显著差异。在（99m）Tc-ECD SPET 图像上，额叶、顶叶和枕叶、左侧颞上叶及小脑上部摄取相对较高。在（99m）Tc-HMPAO SPET 图像上，颞内侧叶、丘脑、脑室周围白质和脑干摄取相对较高。SPM 分析中两种示踪剂在同一脑部摄取的这些差异表明，使用（99m）Tc-ECD 和（99m）Tc-HMPAO 的 SPET 进行脑灌注的解读是可行的。
