Grünwald F, Broich K, Kropp J, Hartmann A, Biersack H J
Institut für klinische und experimentelle Nuklearmedizin, Universität Bonn, BRD.
Nuklearmedizin. 1989 Dec;28(6):221-5.
In 16 patients with reversible symptoms of cerebrovascular disease a HMPAO- and/or IMP-SPECT was performed. 12 of these patients were suffering from TIA, 4 from PRIND. Using HMPAO-SPECT in 8 out of 9 patients with TIA and in 1 of 2 with PRIND a hypoperfusion could be demonstrated; IMP-SPECT showed a pathological pattern in 3 of 5 patients with TIA and in none of 2 patients with PRIND. A semiquantitative evaluation showed a tracer accumulation reduced by 13 +/- 12% (HMPAO) and 8 +/- 7% (IMP), respectively, in the clinically involved hemisphere, compared to the contralateral side. In circumscript SPECT lesions a reduction by 21 +/- 8% (HMPAO) or 17 +/- 7% (IMP) was observed. The interhemispheric ratio from the HMPAO-SPECT showed a significant correlation to that of the 133Xe-rCBF measurement (r = 0.86; p less than 0.001). SPECT was positive in a higher percentage than TCT, Doppler sonography, radioangiography and 133Xe-rCBF measurement. This does not imply a higher specificity or sensitivity, because a slight inhomogeneous SPECT pattern may occasionally be observed even in normal persons.
对16例有可逆性脑血管病症状的患者进行了HMPAO和/或IMP单光子发射计算机断层扫描(SPECT)。其中12例患有短暂性脑缺血发作(TIA),4例患有可逆性缺血性神经功能缺损(PRIND)。在9例TIA患者中的8例以及2例PRIND患者中的1例中,使用HMPAO-SPECT可显示灌注减低;IMP-SPECT在5例TIA患者中的3例显示出异常模式,而2例PRIND患者均未显示。半定量评估显示,与对侧相比,临床受累半球的示踪剂积聚分别减少了13±12%(HMPAO)和8±7%(IMP)。在局限性SPECT病变中,观察到减少了21±8%(HMPAO)或17±7%(IMP)。HMPAO-SPECT的半球间比值与133Xe局部脑血流(rCBF)测量的半球间比值显示出显著相关性(r = 0.86;p<0.001)。SPECT呈阳性的百分比高于经颅CT(TCT)、多普勒超声、放射性血管造影和133Xe-rCBF测量。这并不意味着具有更高的特异性或敏感性,因为即使在正常人中偶尔也可能观察到轻微的不均匀SPECT模式。