Hendler T, Gross R, Goshen E, Faibel M, Hirshmann S, Zwass T S, Grunhaus L, Zohar J
Psychiatry Unit, Chaim Sheba Medical Center, Tel Hashomer.
Harefuah. 1997 Nov 2;133(9):337-42, 416.
The common structural and functional brain imaging techniques are described from a practical, clinical point of view. The clinical indications for brain imaging in psychiatry are reviewed in relation to the specific limitations and advantages of each technique. The clinical applications of computerized tomography (CT), magnetic resonance imaging (MRI) and single photon emission computerized tomography (SPECT) are discussed in relation to the differential diagnosis between organic and functional psychiatric disorders. In a 55-year-old man with late onset of behavioral changes but without neurological signs the application of structural brain imaging (CT and MRI) in case management was demonstrated. The imaging findings involved the differential diagnosis between depression and focal brain lesions. In a 38-year-old man with personality changes and depression following a traumatic brain injury, time interval repeated functional brain imaging (SPECT) was used. Brain imaging reflected improvement in clinical status following treatment and was able to differentiate between reversible and permanent traumatic brain injuries. The superior yield of time interval repeated functional imaging in diagnosis and management of postconcussion syndrome is discussed.
本文从实际临床角度描述了常见的脑部结构和功能成像技术。结合每种技术的具体局限性和优势,对精神病学中脑成像的临床适应症进行了综述。讨论了计算机断层扫描(CT)、磁共振成像(MRI)和单光子发射计算机断层扫描(SPECT)在器质性和功能性精神障碍鉴别诊断方面的临床应用。文中展示了在一名55岁、出现行为改变但无神经体征的男性患者中,结构脑成像(CT和MRI)在病例管理中的应用。成像结果涉及抑郁症与局灶性脑病变的鉴别诊断。在一名38岁、因创伤性脑损伤后出现人格改变和抑郁的男性患者中,使用了时间间隔重复功能脑成像(SPECT)。脑成像反映了治疗后临床状况的改善,并且能够区分可逆性和永久性创伤性脑损伤。文中还讨论了时间间隔重复功能成像在脑震荡后综合征诊断和管理中的更高效能。