Kao C H, Wang S J, Mak S C, Shian W J, Chi C S
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
AJNR Am J Neuroradiol. 1994 Aug;15(7):1369-73.
To assess the role of regional cerebral blood flow measured by technetium-99m hexamethyl propyleneamine oxime (HMPAO) brain single-photon emission CT (SPECT) in viral encephalitis of children.
Eighteen children diagnosed as having viral encephalitis (12 Epstein-Barr virus, 4 herpes simplex virus, and 2 Japanese B virus) underwent Tc-99m HMPAO brain SPECT and brain MR and/or CT.
During the acute episode, 4 (22%) of the 18 patients had localized abnormality on brain MR and/or CT. Tc-99m HMPAO brain SPECT in the acute phase showed that 17 (94%) of the 18 patients had increased regional cerebral blood flow and 1 (6%) of the 18 children had a normal brain SPECT. Follow-up brain SPECT was performed at least 15 days after the acute episode. In 17 patients with abnormal first brain SPECT, 12 (71%) had normal second brain SPECT and 5 (29%) had decreased regional cerebral blood flow. The group of patients with normal regional cerebral blood flow on the follow-up brain SPECT had a better outcome than the group of patients with decreased regional cerebral blood flow.
(a) The Tc-99m HMPAO brain SPECT was abnormal more often than CT or MR in children with acute viral encephalitis and provided better location. (b) In acute episodes of encephalitis, most patients showed locally increased regional cerebral blood flow. (c) After acute episodes, the regional cerebral blood flow returned to normal in most cases. (d) A normal Tc-99m HMPAO brain SPECT in the subacute phase usually indicates a good clinical outcome (no neurologic defect) 1 year after the acute illness in children with viral encephalitis.
评估用锝-99m六甲基丙烯胺肟（HMPAO）脑单光子发射计算机断层扫描（SPECT）测量的局部脑血流量在儿童病毒性脑炎中的作用。
18例被诊断为病毒性脑炎的儿童（12例为EB病毒感染，4例为单纯疱疹病毒感染，2例为日本乙型脑炎病毒感染）接受了锝-99m HMPAO脑SPECT检查以及脑部磁共振成像（MR）和/或计算机断层扫描（CT）检查。
在急性期，18例患者中有4例（22%）脑部MR和/或CT出现局部异常。急性期的锝-99m HMPAO脑SPECT显示，18例患者中有17例（94%）局部脑血流量增加，18例儿童中有1例（6%）脑SPECT正常。在急性期发作至少15天后进行了随访脑SPECT检查。在首次脑SPECT异常的17例患者中，12例（71%）第二次脑SPECT正常，5例（29%）局部脑血流量减少。随访脑SPECT显示局部脑血流量正常的患者组比局部脑血流量减少的患者组预后更好。
（a）在急性病毒性脑炎患儿中，锝-99m HMPAO脑SPECT比CT或MR更常出现异常，且定位更准确。（b）在脑炎急性期，大多数患者显示局部脑血流量增加。（c）急性期发作后，大多数情况下局部脑血流量恢复正常。（d）在亚急性期，锝-99m HMPAO脑SPECT正常通常表明病毒性脑炎患儿在急性发病1年后临床预后良好（无神经功能缺损）。
