中华核医学与分子影像杂志
中華覈醫學與分子影像雜誌
중화핵의학여분자영상잡지
Chinese Journal of Nuclear Medicine and Molecular Imaging
2015年
2期
108-111
,共4页
靳丽丽%孙晓光%黄钢%修雁%石洪成
靳麗麗%孫曉光%黃鋼%脩雁%石洪成
근려려%손효광%황강%수안%석홍성
颈动脉狭窄%支架%体层摄影术,发射型计算机,单光子%ECD
頸動脈狹窄%支架%體層攝影術,髮射型計算機,單光子%ECD
경동맥협착%지가%체층섭영술,발사형계산궤,단광자%ECD
Carotid stenosis%Stents%Tomography,emission-computed,single-photon%ECD
目的 探讨SPECT脑血流灌注显像及定量分析在脑动脉狭窄支架植入术评估中的作用.方法 回顾性分析35例(男31例,女4例,平均年龄63.9岁)经DSA证实脑血管狭窄行动脉支架植入术的患者资料,患者均于手术前后行99Tcm-ECD SPECT脑血流灌注显像.所有图像先经过SPM 2.0进行配准和标准化,然后用Brain Search软件进行图像定量分析.软件根据Talarich图自动将大脑分为210个功能区,计算每个区的归一化平均值(NAC),并与28例对照组数据进行比较,＜1.96s的区域为是低灌注区.对术前低灌注区的NAC与术后相应脑区的NAC进行比较,并对灌注明显改善和无明显改善患者的平均病灶数与Essen卒中风险评分量表(ESRS)进行比较,分析颈内动脉(ICA)闭塞和ICA狭窄患者的平均病灶数与术后改善率的差异.统计学分析采用配对秩和检验、两样本t检验、两样本秩和检验和x2检验.结果 35例患者中有20例患者在支架植入后低灌注区明显改善.20例明显改善患者的平均病灶数明显高于15例无明显改善的患者(34.05±14.41和22.93±17.24;t=2.067,P＜0.05),明显改善患者的ESRS平均秩和明显低于无明显改善患者(14.8和22.3,Z=2.24,P＜0.05).28例ICA支架植入患者改善率为60.7％ (17/28),好于7例大脑中动脉(MCA)支架植入患者(3/7),但差异无统计学意义(P＞0.05).ICA闭塞患者的平均病灶数高于ICA狭窄患者(34.36±14.31和31.35±16.37),但差异无统计学意义(t=0.498,P＞0.05);ICA闭塞患者的术后改善率7/11高于ICA狭窄患者的10/17,但差异无统计学意义(P＞0.05).结论 SPECT脑血流灌注显像定量分析可较好地反映支架植入前的低灌注情况、预测支架植入后的灌注改善情况.
目的 探討SPECT腦血流灌註顯像及定量分析在腦動脈狹窄支架植入術評估中的作用.方法 迴顧性分析35例(男31例,女4例,平均年齡63.9歲)經DSA證實腦血管狹窄行動脈支架植入術的患者資料,患者均于手術前後行99Tcm-ECD SPECT腦血流灌註顯像.所有圖像先經過SPM 2.0進行配準和標準化,然後用Brain Search軟件進行圖像定量分析.軟件根據Talarich圖自動將大腦分為210箇功能區,計算每箇區的歸一化平均值(NAC),併與28例對照組數據進行比較,＜1.96s的區域為是低灌註區.對術前低灌註區的NAC與術後相應腦區的NAC進行比較,併對灌註明顯改善和無明顯改善患者的平均病竈數與Essen卒中風險評分量錶(ESRS)進行比較,分析頸內動脈(ICA)閉塞和ICA狹窄患者的平均病竈數與術後改善率的差異.統計學分析採用配對秩和檢驗、兩樣本t檢驗、兩樣本秩和檢驗和x2檢驗.結果 35例患者中有20例患者在支架植入後低灌註區明顯改善.20例明顯改善患者的平均病竈數明顯高于15例無明顯改善的患者(34.05±14.41和22.93±17.24;t=2.067,P＜0.05),明顯改善患者的ESRS平均秩和明顯低于無明顯改善患者(14.8和22.3,Z=2.24,P＜0.05).28例ICA支架植入患者改善率為60.7％ (17/28),好于7例大腦中動脈(MCA)支架植入患者(3/7),但差異無統計學意義(P＞0.05).ICA閉塞患者的平均病竈數高于ICA狹窄患者(34.36±14.31和31.35±16.37),但差異無統計學意義(t=0.498,P＞0.05);ICA閉塞患者的術後改善率7/11高于ICA狹窄患者的10/17,但差異無統計學意義(P＞0.05).結論 SPECT腦血流灌註顯像定量分析可較好地反映支架植入前的低灌註情況、預測支架植入後的灌註改善情況.
목적 탐토SPECT뇌혈류관주현상급정량분석재뇌동맥협착지가식입술평고중적작용.방법 회고성분석35례(남31례,녀4례,평균년령63.9세)경DSA증실뇌혈관협착행동맥지가식입술적환자자료,환자균우수술전후행99Tcm-ECD SPECT뇌혈류관주현상.소유도상선경과SPM 2.0진행배준화표준화,연후용Brain Search연건진행도상정량분석.연건근거Talarich도자동장대뇌분위210개공능구,계산매개구적귀일화평균치(NAC),병여28례대조조수거진행비교,＜1.96s적구역위시저관주구.대술전저관주구적NAC여술후상응뇌구적NAC진행비교,병대관주명현개선화무명현개선환자적평균병조수여Essen졸중풍험평분량표(ESRS)진행비교,분석경내동맥(ICA)폐새화ICA협착환자적평균병조수여술후개선솔적차이.통계학분석채용배대질화검험、량양본t검험、량양본질화검험화x2검험.결과 35례환자중유20례환자재지가식입후저관주구명현개선.20례명현개선환자적평균병조수명현고우15례무명현개선적환자(34.05±14.41화22.93±17.24;t=2.067,P＜0.05),명현개선환자적ESRS평균질화명현저우무명현개선환자(14.8화22.3,Z=2.24,P＜0.05).28례ICA지가식입환자개선솔위60.7％ (17/28),호우7례대뇌중동맥(MCA)지가식입환자(3/7),단차이무통계학의의(P＞0.05).ICA폐새환자적평균병조수고우ICA협착환자(34.36±14.31화31.35±16.37),단차이무통계학의의(t=0.498,P＞0.05);ICA폐새환자적술후개선솔7/11고우ICA협착환자적10/17,단차이무통계학의의(P＞0.05).결론 SPECT뇌혈류관주현상정량분석가교호지반영지가식입전적저관주정황、예측지가식입후적관주개선정황.
Objective To evaluate the role of SPECT cerebral perfusion imaging in assessing the stent implantation for cerebral artery stenosis.Methods A total of 35 patients (31 males,4 females,average age (63.9±10.8)years) with cerebral artery stenosis confirmed by DSA for cerebral artery stent implantation were retrospectively analyzed.99Tcm-ECD cerebral perfusion imaging was performed for all patients before and after stent implantation.The images were realigned and normalized by SPM 2.0 and then analyzed by Brain Search software for quantitative analysis.The brain was automatically separated to 210 functional areas according to Talarich map.The normalized averaged counts (NAC) of each area were calculated and compared with the data of 28 health controls (8 males,20 females,average age (35.8± 9.4) years).Less than 1.96s was defined as low perfusion lesions.The NAC values before and after stent implantation were compared for classifying improved from non-improved group.The mean number of lesions and Essen stroke risk score (ESRS) were analyzed between the two groups.The mean number of lesions and postoperative improvement rate of the internal carotid artery (ICA) occlusion and stenosis were compared.Paired rank sum test,two-sample t test,two-sample rank sum test and x2 test were used for statistical analysis.Results In 35 patients with low perfusion areas,20 were significantly improved after stent implantation.The mean number of lesions in the improved group (34.05± 14.41)was significantly higher than that in the non-improved group (22.93±17.24; t=2.067,P＜0.05).The mean ESRS of the improved patients (14.8)was significantly lower than that of the non-improved patients (22.3,Z=2.24,P＜0.05).The improvement rate of 28 cases with ICA stent implantation was (60.7％,17/28)higher than that of 7 cases with middle cerebral artery (MCA) stent implantation (3/7; P＞0.05).The mean number of the ICA occlusion lesions (34.36± 14.31)was higher than that of the ICA stenosis lesions(31.35± 16.37),but the difference was not statistically significant(t=0.498,P＞0.05).The improvement rate of the ICA occlusion was higher than that of the ICA stenosis (7/11 vs 10/17),but the difference was not statistically significant (P＞0.05).Conclusion SPECT cerebral perfusion imaging and its quantitative analysis can evaluate the low perfusion lesions before stent implantation and predict the perfusion improvement after stent implantation.
