摘要
目的 探讨单光子发射计算机断层成像 (SPECT)在轻、中型颅脑损伤 (TBI)早期评估及预后判断方面的价值 ,为临床功能评估及预后估计提供有价值的依据。方法 2 4例轻中型颅脑损伤患者受伤 2周内行SPECT、CT检查及临床评定 ,3个月后所有患者行脑外伤后综合征的临床测试 ,并对首检SPECT阳性者复查SPECT。比较首检SPECT与CT检查结果 ,分析首检SPECT结果与损伤程度的关系 ,动态观察SPECT显像与预后的关系。结果 ① 2 4例轻中型颅脑损伤首检SPECT阳性率 71% ,高于CT阳性率 46% (P <0 .0 5 )。②首检SPECT发现阳性病灶 48处 ,高于CT的 2 1处 ,且分布范围广。③首检SPECT阳性预测率5 9 % ,阴性预测率 86%。 17例首检SPECT阳性患者复检显示 :8例 (4 7% )病灶明显吸收 ,其中 6例 (75 % )无脑外伤后综合征 ;另 9例 (5 3 % )病灶无明显吸收 ,其中 7例 (78% )遗留有脑外伤后综合征。复检SPECT阳性预测率 78% ,阴性预测率 75 %。结论 ①在轻中型颅脑损伤的早期评估中 ,SPECT显像较CT扫描更灵敏。②SPECT阳性率与脑损害程度相关。③首检SPECT阴性提示预后良好 ,复检SPECT阳性提示多出现脑外伤后综合征。
Objective To explore the validity of single photon emission computed tomography (SPECT) imaging in the early rehabilitation assessment and prognostic evaluation of patients with mild or moderate traumatic brain injury(TBI). Methods Twenty four patients with mild or moderate TBI underwent an initial SPECT, CT and clinical examination within 2 weeks after a closed head injury,and were reassessed 3 months later with clinical examination. Those who were with positive findings in their initial SPECT imagings were reexamined with SPECT. The findings on SPECT images and CT scans were compared, and the correlation between the findings of initial SPECT and severity of brain lesions was analyzed. Results It was found that: the positive rate of initial SPECT in detecting the TBI was significantly higher than that of CT scan(71% vs 46%, P <0.05); the number of lesions found by SPECT imaging exceeded that shown by CT scan (48 vs 21 lesions); among the 17 cases with initial positive SPECT findings, 8 were resoluted or completely disappeared with regard to the TBI lesions, while the remaining 9 showed no obvious change. This indicated that the positive rate of SPECT in detecting TBI lesions was closely correlated with the extent of intracranial lesions. Conclusion Early SPECT imaging is superior to CT in detecting intracranial lesions in patient with mild or moderate TBI. Positive or negative rate of SPECT imaging is closely correlated with the extent of TBI as well as the clinical manifestations of the patients.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2002年第2期78-80,共3页
Chinese Journal of Physical Medicine and Rehabilitation
