Kant R, Smith-Seemiller L, Isaac G, Duffy J
St Francis Medical Center, Head Injury Clinic, Pittsburgh, PA 15224, USA.
Brain Inj. 1997 Feb;11(2):115-24. doi: 10.1080/026990597123700.
The purposes of this study were: (1) to determine the prevalence of abnormal 99mTc-HMPAO SPECT scans in patients suffering from persistent post-concussive syndrome (PPCS) after mild closed head injury (CHI); (2) to compare SPECT with structural neuroimaging (MRI and CT) in patients with mild CHI; and (3) to investigate correlations between SPECT and clinical data obtained from the patient sample (neuropsychological testing, demographics, psychiatric diagnoses). Forty-three patients were included. SPECT was read as abnormal in 53% of patients and showed a total of 37 lesions while MRI was read as abnormal in 9% and CT scan in only 4.6% of patients after mild CHI. SPECT appears to be more sensitive in detecting cerebral abnormalities after mild CHI, especially in patients with PPCS symptoms, than either CT or MRI. No statistically significant relationship was found between SPECT scan abnormalities and age, past psychiatric history, history of substance abuse, or history of multiple CHI. Education level did not differ between patients with normal and abnormal SPECT. Current neuropsychiatric symptoms did not seem to have any impact on the results of SPECT scan.
（1）确定轻度闭合性颅脑损伤（CHI）后患有持续性脑震荡后综合征（PPCS）的患者中99mTc-HMPAO单光子发射计算机断层扫描（SPECT）异常的发生率；（2）比较轻度CHI患者的SPECT与结构性神经影像学检查（MRI和CT）；（3）研究SPECT与从患者样本中获得的临床数据（神经心理学测试、人口统计学、精神科诊断）之间的相关性。共纳入43例患者。轻度CHI后，53%的患者SPECT检查结果为异常，共显示37个病灶，而MRI检查结果为异常的患者占9%，CT扫描检查结果为异常的患者仅占4.6%。与CT或MRI相比，SPECT在检测轻度CHI后脑异常方面似乎更敏感，尤其是对有PPCS症状的患者。在SPECT扫描异常与年龄、既往精神病史、药物滥用史或多次CHI病史之间未发现统计学上的显著关系。SPECT检查结果正常和异常的患者之间教育水平无差异。目前的神经精神症状似乎对SPECT扫描结果没有任何影响。
