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目的对22例癫癎患儿进行间歇期单光子发射型计算机断层扫描(SPECT)脑血流灌注显像,探讨癫癎患儿SPECT的影像特点,评价SPECT对癫癎患儿的诊断价值。方法静脉注射99Tcm-ECD30-40分钟后进行SPECT显像,以2个以上的断面出现异常放射性药物分布区为阳性病灶。结果17/22例癫癎患儿间歇期SPECT显像结果为阳性,阳性检出率为77.3%,其中15例表现为局部脑血流灌注减低。17例阳性检出者中2个以上病灶并存者13例,单个病灶者4例,共检出病灶42个。42个病灶中有20个病灶为某一叶的双侧对称性改变(占45.5%);22个病灶为单侧或双侧非对称性改变(占54.5%)。额叶、颞叶、枕叶、顶叶和基底神经核的病灶数分别占50.8%、26.3%、16.7%、5.3%和0.9%。结论本组患儿间歇期SPECT脑血流灌注显像大多表现为局部脑血流灌注减低,其病灶具有双侧对称性、多灶性或广泛性的特点,且额叶的病灶数明显多于其它各叶。
Objective To investigate the imaging characteristics of SPECT in children with epilepsy by intermittent single photon emission computed tomography (SPECT) cerebral perfusion imaging in 22 children with epilepsy. To evaluate the diagnostic value of SPECT in children with epilepsy. Methods 99Tcm-ECD was intravenously injected for 30-40 minutes and then SPECT imaging was performed. The distribution of abnormal radiopharmaceuticals in 2 or more sections was positive. Results 17/22 cases of epilepsy children intermittent SPECT imaging results were positive, the positive detection rate was 77.3%, of which 15 cases showed partial reduction of cerebral perfusion. Among the 17 positive cases, there were 13 cases with more than two lesions coexisting and 4 cases with single lesions, and 42 lesions were detected. Twenty lesions of 42 lesions were bilateral symmetry changes (45.5%) in one leaf; 22 lesions were unilateral or bilateral asymmetry changes (54.5%). Frontal, temporal lobe, occipital lobe, parietal lobe and basal ganglia lesions accounted for 50.8%, 26.3%, 16.7%, 5.3% and 0.9%, respectively. Conclusion The interictal SPECT cerebral perfusion imaging in this group mostly showed the reduction of local cerebral blood flow perfusion. The lesions were characterized by bilateral symmetry, multifocal or extensive features, and the number of lesions in the frontal lobe was significantly more than that Other leaves.