Moretti J L, Defer G, Tamgac F, Weinmann P, Belin C, Cesaro P
Service de Médecine Nucléaire, CHU, Avicenne, Bobigny, France.
J Cereb Blood Flow Metab. 1994 Jan;14 Suppl 1:S84-90.
Single photon emission computed tomography (SPECT) using 99mTc-bicisate and N-isopropyl-p-[123I]iodoamphetamine ([123I]IMP) was compared in 25 patients suffering cerebral ischemia during the subacute phase (7-14 days) of stroke. Patients were classified as cortical strokes (15) and subcortical strokes (10) according to clinical and CT data. Images were analyzed by five independent blinded observers. Then, using a cross-matching method between normal and abnormal brain areas, we evaluated the sensitivity and specificity for 99mTc-bicisate and [123I]IMP and inter- and intraobserver reproducibility. A semiquantitative analysis was performed to compare abnormal hypoactive areas versus the corresponding contralateral areas for 99mTc-bicisate and [123I]IMP in the two patient groups. There was no significant difference for sensitivity and specificity between 99mTc-bicisate and [123I]IMP. Matching was approximately 90% in the two groups. The kappa-concordance index was satisfactory and slightly better for 99mTc-bicisate (0.485) than for [123I]IMP (0.435). Level of hypoactivity in the abnormal areas was significantly higher for 99mTc-bicisate (p < 0.03, n = 25) than for [123I]IMP, especially for cortical strokes. This comparative study demonstrates that 99mTc-bicisate is a very useful tracer for the detection of focal cerebral ischemia by SPECT during the subacute phase of stroke.
在25例处于中风亚急性期（7 - 14天）的脑缺血患者中，对比了使用99mTc - 双半胱乙酯和N - 异丙基 - p - [123I]碘安非他明（[123I]IMP）的单光子发射计算机断层扫描（SPECT）。根据临床和CT数据，患者被分为皮质中风（15例）和皮质下中风（10例）。图像由五名独立的盲法观察者进行分析。然后，通过正常与异常脑区之间的交叉匹配方法，我们评估了99mTc - 双半胱乙酯和[123I]IMP的敏感性和特异性以及观察者间和观察者内的可重复性。进行了半定量分析，以比较两组患者中99mTc - 双半胱乙酯和[123I]IMP的异常低活性区域与相应对侧区域。99mTc - 双半胱乙酯和[123I]IMP在敏感性和特异性方面无显著差异。两组的匹配率约为90%。kappa一致性指数令人满意，99mTc - 双半胱乙酯（0.485）略优于[123I]IMP（0.435）。99mTc - 双半胱乙酯在异常区域的低活性水平显著高于[123I]IMP（p < 0.03，n = 25），尤其是皮质中风患者。这项对比研究表明，99mTc - 双半胱乙酯是在中风亚急性期通过SPECT检测局灶性脑缺血的一种非常有用的示踪剂。
