王蓬莲 魏利华 朵振顺 李常新 张承刚 高润兰 030001 太原,山西医科大学第一医院神经内科(王蓬莲、魏利华、朵振顺、李常新、高润兰),核医学科(张承刚) 中华核医学杂志 1999 0 0 2


    关键词：脑梗死；体层摄影术；发射型计算机；单光子；体层摄影术；X线计算机 期刊 zhhyxzz 0 神经核医学 fur -->


    

摘要 目的 探讨SPECT和CT对老年急性脑梗死病人检查的异同和优缺点,以指导临床诊断和治疗。方法 对同一患者在发病后3d内进行CT和SPECT检查。结果 CT的病灶检出率为54%,SPECT为92%,两者存在相关关系(χ² =0.953,P >0.1),SPECT检出率高(χ² =30.422,P <0.05);SPECT可发现远隔损害。结论 SPECT可对老年急性脑梗死作出预警性诊断,发现的病灶更易解释临床症状;CT可发现小的深部梗死灶,可清晰地鉴别脑出血和脑梗死;两者不能互相替代。

    

Comparative study of SPECT and X-CTin examining elderly patients with acute cerebral infarction

WANG Penglian,WEI Lihua,DUO Zhenshun,etal.The First Affilliated Hospital,Shanximedical University,Taiyuan 030001

Abstract Objective Toinvestigate thedifferences of brain ⁹⁹ Tc^m -ECD SPECT and X-CT inexamining elderly patients with acute cerebral infarction thus to guide clinicaldiagnosisand treatment.methods 100 elderly patients with acute cerebralinfarction underwent ⁹⁹ Tc^m -ECD SPECT and X-CT between 1996 and1997.On each patient,the two procedures were performed sequentially within threedays.Results Thepositive rate of X-CT was 54%,while the positive rate of SPECT was 92%.The results of X-CTcorrelated with the results of SPECT (χ² =0.953,P >0.1),andthe positive rate of SPECT was higher (χ² =30.422,P <0.05).SPECTshowed not only primary ischemic lesions,but also remote consequential lesions.Conclusions ⁹⁹ Tc^m -ECDSPECT is better at predictivediagnosis of elderly acute cerebral infarction and gainvaluable time for in-time treating,and it ismore sensitive fordetecting and localizing thelesions andmakes the interpretation of clinical symptoms and signs easier.X-CT ismoresensitive todetect basal ganglionic lacunar infarction and todistinguish cerebralinfarction from cerebral hemorrhage.SPECT and X-CT can not be used in place of each other.

     ......

婵犵鈧啿鈧綊鎮樻径鎰畺闁靛ǹ鍎查煬顒€霉閿濆牊纭堕柡浣靛€濋獮宥団偓锝庡亝缁ㄦ氨绱掑☉姗嗘Ч缂佷緤濡囬幉鎾醇閻斿壊妲梺鍝勫暟婵數娑甸崼鏇炶摕闁靛／鍕暯闂佺懓鐡ㄩ悧鏃傜箔閸涱喗濮滈柦妯侯槸瀵潡鏌￠崒姘カ缂佽鲸绻堝畷锝夘敍濠靛棗骞嬮梺鍝勫閸ㄧ敻锝為敃鍌氱婵犲﹤鎳庨崑宥団偓娈垮枟濞叉﹢骞栭崨濠傜窞閺夊牃鏅滈崺鍌炴煃閵夛妇鐭庢繛鏉戞閹秵鎷呭ù瀣壕婵犲灚鎸剧粈澶愭偣閸ヮ剦妫戦柛瀣剁秮瀹曟瑧鎷犻懠顒佺秳濡ょ姷鍋炲ú妯恒€掗懜鐢碘枖閻庯綆鍋呴悡娆撴煟閵娿儱顏ら柍褜鍓氱划搴ㄥ极閹间焦鍤囬柟瀵稿Т椤ｅジ鏌嶉妷锔剧畺闁搞劊鍔戦崹鎯р堪閸愩劍鏋剧紓鍌氬暞閸ㄥ潡濡存径鎰伋婵犻潧饪撮崯蹇涙⒒閸屻倕鏋旈柍褜鍓ㄩ幏锟�


闂傚倸瀚崝鎺旇姳椤掑嫬瀚夌€广儱鎳庨～銈夋煕閿濆啫濡奸悽顖氭喘瀹曟繂鈽夊畷鍥╊槷缂傚倸鍟崹褰掓偟椤栫偞鐒鹃柕濞垮劚閻庤菐閸ワ絽澧插ù鐓庢嚇瀹曪綁顢旈崘顏囩箲闂佺粯鐗曞畷顒傜紦閻愵剙顕辨慨姗嗗墯閸犲懘鏌熺€涙ḿ澧繝鈧担鍦枖闁逞屽墰閳ь剝顫夊銊ㄢ叾闂佸憡甯掑Λ娑樷枔閹存績鏋栭柕濞垮劚閺傗偓婵炴潙鍚嬮懝楣冨箟閸愯瑙勬媴缁涘缍岄梺闈涙４閹凤拷
濠殿喗绻愰幏锟�婵烇絽娲犻崜婵囧閿燂拷闂傚倸娲犻崑鎾绘偡閺囶亝瀚� 2 缂備礁顦介崹浼村垂鎼淬劍鏅柛顐ｇ箓鐢娊鎮归幇顖ｆ綈闁轰胶鍋ゅ畷妯虹暆閳ь剙鈻嶉妷銊ｄ汗闁哄洨鍋為崐锟�濠殿噯绲界换鎰板Φ婢舵劕鐭楁い鏍ㄧ懁缁ㄦ澘螞閺夋寧顥滅憸甯嫹10婵炴垶鎼╂禍鐐垛叾闂佸憡甯幏锟�闂佹寧绋戦ˇ顓㈠焵椤掑﹥瀚�
    濠电儑绲藉ú鐘诲礈濠靛洤顕遍柛娑卞枤椤╃兘鏌涘☉鍗炲閺夆晜妫冮弻娑樷枎韫囨挴鍋撴禒瀣劦妞ゆ巻鍋撻柛鐘崇〒濡叉劕鈹戦崶鈹炬灃閻庡箍鍎卞Λ娑㈠焵椤掑鐏︽鐐差儔楠炲洭顢旈崨顓炵哎濠电偠鎻徊鎯洪幋鐘典笉闁挎繂鎷嬮崵鍫澪旈敂绛嬪劌闁哥偞鎸抽弻鏇㈠幢閺囩姴濡介柣銏╁灠缂嶅﹪骞婇敓鐘茬疀妞ゆ挾鍋熸禒鎰版⒑閸︻厐鐟懊洪妶鍥潟闁冲搫鎳庤繚闂佺ǹ鏈粙鎺楁倵椤斿墽纾奸柡鍐ㄥ€稿暩婵犫拃鍕垫疁鐎殿喖鐖煎畷姗€濡歌閸撴垶绻涚€涙ḿ鐭婂Δ鐘叉憸閺侇噣顢曢敂钘夘€涘┑锛勫仜婢х晫绮欐繝鍥ㄧ厸濠㈣泛锕ら弳鏇熸叏閻熼偊妯€闁轰礁绉撮悾婵嬪礃椤垳鎴烽梻浣筋嚃閸犳捇宕濊箛娑辨晣缂備焦岣块埢鏃堟煟閹寸儑渚涢柛鏂垮暣閺岋繝宕掑顓犵厬缂備焦顨呴ˇ閬嶅焵椤掑喚娼愮紒顔肩箻閿濈偤鏁冮崒姘卞摋闁荤娀缂氬▍锝囩矓閸喓鈧帒顫濋鐘闂侀潧娲ゅú銊╁焵椤掑偆鏀版繛澶嬬洴瀹曘垽濡堕崶銊ヮ伕閻熸粎澧楃敮妤咃綖婢舵劖鍋ｉ柛銉娑撹尙绱掓潏銊х畼闁归濞€閹粓鎸婃径澶岀梾濠电偛顕慨楣冨春閺嶎厼鍨傞柕濞炬櫆閸嬨劌霉閿濆懎鏆熸俊顖氱墦濮婃椽顢曢敐鍡欐闂佺粯鎼换婵嬬嵁鐎ｎ喖绠ｆ繝濠傚閹枫劑姊洪幐搴ｂ槈闁哄牜鍓熷畷鐟扳堪閸曨収娴勫銈嗗笂閻掞箓寮抽鍫熺厱闁瑰搫绉村畵鍡涙煃瑜滈崜姘潩閵娾晜鍋傞柨鐔哄Т鐟欙箓骞栭幖顓炵仯缂佲偓婢跺⊕褰掑礂閸忚偐娈ら梺缁樼箖閻╊垰鐣烽敓鐘茬闁肩⒈鍓氶鎴︽⒑鐠団€虫灁闁告柨楠搁埢鎾诲箣閻愭潙顎撳┑鐘诧工閸燁垶骞嗛崒姣綊鎮╅幓鎺濆妷濠电姭鍋撻柟娈垮枤绾鹃箖鏌熺€电ǹ啸鐟滅増鐓￠弻娑㈠箳閺傚簱鏋呭┑鐐叉噹闁帮絾淇婇幘顔芥櫢闁跨噦鎷�

闁诲海鏁婚崑濠囧窗閺囩喓鈹嶅┑鐘叉搐濡﹢鏌涢妷銏℃珖鐟滃府鎷�  闂備胶枪缁绘鈻嶉弴銏犳瀬闁绘劗鍎ら崕宀勬煟閹伴潧澧い搴嫹  闂佽崵濮村ú銈団偓姘煎灦椤㈡瑩骞嬮敃鈧粈鍕煟濡绲荤紓宥忔嫹  闂備胶鎳撻崥瀣垝鎼淬劌纾奸柕濞炬櫅閸楁娊鏌℃径瀣劸婵☆垽鎷�