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目的探讨短暂性脑缺血发作(TIA)间歇期的局部脑血流状况。方法用99mTc-ECD对41例TIA患者进行脑SPECT血流灌注显像,分析轻、中及重度低灌注与TIA时的临床神经功能缺损评分及TIA次数的关系,并与同期脑CT结果进行对比分析。结果所有患者的脑SPECT灌注显像均有不同程度的低灌注区域,其中82.9%的患者发现有与症状相关的低灌注区,而脑CT仅显示了31.7%的临床责任病灶,SPECT的敏感性明显高于脑CT(x2=21.983,P<0.01),且这种差异对脑叶尤其颞叶病灶表现得更明显(x2=31.694,P<0.01);随着临床神经功能缺损程度的加重及TIA次数的增加,脑SPECT灌注显像低灌注区范围越大。结论SPECT发现的局部低灌注现象可能是以前或正在发生的临床或亚临床脑缺血事件的反映;用SPECT可观察TIA间歇期的脑血流状况,判断TIA的预后并调整治疗。
Objective To investigate the regional cerebral blood flow during transient ischemic attack (TIA). Methods Totally 41 patients with TIA underwent 99mTc-ECD brain perfusion SPECT perfusion imaging to analyze the relationship between clinical neurological deficit score and TIA in mild, moderate and severe hypoperfusion and TIA, and compared with brain CT results analysis. Results All patients underwent SPECT perfusion imaging with varying degrees of hypoperfusion. 82.9% of patients had hypoperfusion-related symptoms, while CT showed only 31.7% of clinical responsibility lesions and SPECT sensitivity (X2 = 21.983, P <0.01), and this difference was more obvious in the lobar lesions especially the temporal lobe lesions (x2 = 31.694, P <0.01). With the severity of clinical neurological deficits and TIA increased the number of brain SPECT perfusion imaging, the greater the area of low perfusion. Conclusions The local hypoperfusion induced by SPECT may be a reflection of previous or emerging clinical or subclinical ischemic events. SPECT can be used to observe the cerebral blood flow during intermittent TIA, to determine the prognosis of TIA and to adjust the treatment.