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目的 使用潘生丁负荷试验脑灌注显像评估缺血性脑血管疾病 (CVD)患者的脑储备功能。方法 正常对照组 8例 ,CVD组 6 6例。用99Tcm 双半胱乙酯先做脑潘生丁负荷显像 :按体重静脉注射潘生丁 0 .14mg·kg-1·min-14min ,30min后行脑SPECT显像 ;2～ 5d后在同样条件下进行脑SPECT基态显像。图像行视觉及定量分析。 8例患者治疗后随访。结果 根据视觉及定量分析结果将脑血流对潘生丁的反应分为 4型 :A型 ,潘生丁试验后原有病灶扩大 ,不对称指数 (AI)及摄取指数(UR)均下降 ;B型 ,基态显像正常 ,用药后出现明显灌注低下区 ,AI值下降 ,UR由正常变为低于正常 ;C型 ,原有病灶用药后缩小或消失 ,AI、UR值均上升 ;D型 ,用药前后图像及AI、UR值均无差异。 14例小脑交叉性失联络现象在潘生丁试验后 8例恢复正常。结论 潘生丁负荷试验有助于CVD的诊断、预后估测及治疗方案制定。
Objective To evaluate brain reserve function in patients with ischemic cerebrovascular disease (CVD) using dipyridamole stress perfusion imaging. Methods 8 cases of normal control group, 6 6 cases of CVD group. Cerebral dipyridamole imaging was performed with 99Tcm double-catechin first: Pancreatin was injected intravenously at a weight of 0.14mg · kg-1 · min-14min for 30 min and then brain SPECT imaging was performed. After 2-5 days, brain was processed under the same conditions SPECT ground state imaging. Image line visual and quantitative analysis. Eight patients were followed up after treatment. Results According to the results of visual and quantitative analysis, the response of cerebral blood flow to dipyridamole was divided into 4 types: Type A, the original lesion enlarged after treatment with dipyridamole, the asymmetry index (AI) and the uptake index (UR) decreased; Type B, Imaging showed normal, after treatment obvious low perfusion area, AI decreased, UR from normal to less than normal; C type, the original lesion diminished or disappeared after treatment, AI, UR values were increased; D type, before and after treatment of the image And AI, UR values were no difference. 14 cases of cerebellar cross-connection loss phenomenon in the dipyridamole test after 8 cases returned to normal. Conclusion Dipyridamole load test is helpful for the diagnosis of CVD, estimation of prognosis and development of treatment plan.