Messa C, Fazio F, Costa D C, Ell P J
INB-CNR, University of Milan, S. Raffaele Institute, Italy.
Semin Nucl Med. 1995 Apr;25(2):111-43. doi: 10.1016/s0001-2998(95)80022-0.
A recent survey of the knowledge and practice of both positron-emission tomography (PET) and single-photon emission computed tomography (SPECT) of the brain among referring physicians in Europe (neurologists and psychiatrists) showed a disquieting lack of knowledge of the potential of these methodologies in the investigation and management of patients of their own specialities. The need to bring the knowledge of the potential of these techniques to the practicing physicians is paramount. It is imperative that the methodologies and concepts that preside over the application of these techniques in neurology and psychiatry must become more uniform if an impact is to be felt at a clinical level. There is clear improvement in the instrumentation available with the new state-of-the-art tomographic devices and with the development of new technetium-based radiopharmaceuticals for the study of cerebral perfusion. The constant progress made with ligands that permit the study of neurotransmission, tumor metabolism, and turnover do expand our capability to improve the knowledge concerning neurophysiology, neuropathology, and neuropharmacology of a variety of disease states. PET and SPECT will be progressively included in protocols aimed at stratifying patients with dementia, monitoring therapeutic trials, and improving our ability to determine outcome. Clinical usefulness of PET and SPECT begin to emerge in cerebral vascular disease, in the identification of cerebral death, in epilepsy, in cerebral trauma, in the investigation of HIV-positive patients with cerebral involvement, and in the monitoring of tumor recurrence and postirradiation damage. This review article outlines a current perspective of SPECT and PET as practiced in Europe, its potential, and its limitations.
最近对欧洲转诊医生（神经科医生和精神科医生）关于脑部正电子发射断层扫描（PET）和单光子发射计算机断层扫描（SPECT）的知识及应用情况进行的一项调查显示，令人不安的是，他们对这些方法在其各自专业患者的检查和管理中的潜力缺乏了解。将这些技术潜力的知识传授给执业医生的需求至关重要。如果要在临床层面产生影响，那么在神经病学和精神病学中应用这些技术所依据的方法和概念必须更加统一。随着新的先进断层扫描设备的出现以及用于脑灌注研究的新型锝基放射性药物的开发，现有仪器有了明显改进。能够用于研究神经传递、肿瘤代谢和更新的配体不断取得进展，确实扩展了我们提高对各种疾病状态的神经生理学、神经病理学和神经药理学认识的能力。PET和SPECT将逐渐被纳入旨在对痴呆患者进行分层、监测治疗试验以及提高我们确定预后能力的方案中。PET和SPECT的临床实用性开始在脑血管疾病、脑死亡的识别、癫痫、脑外伤、对脑部受累的HIV阳性患者的检查以及肿瘤复发和放疗后损伤的监测中显现出来。这篇综述文章概述了欧洲目前对SPECT和PET的应用情况、其潜力及局限性。
