Postoperative assessment of cerebral blood flow in subarachnoid haemorrhage by means of99mTc-HMPAO tomography
Postoperative assessment of cerebral blood flow in subarachnoid haemorrhage by means of99mTc-HMPAO tomography
复制标题
99mTc-HMPAO断层扫描评估蛛网膜下腔出血术后脑血流
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
J. Baulieu
中科院分区：
文献类型：
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作者：
F. Tranquart;P. Ades;P. Groussin;J. F. Rieant;M. Jan;J. Baulieu
局部灌注不足是蛛网膜下腔出血（SAH）的一种非常常见的并发症，在大多数情况下与血管痉挛有关。26名因SAH入院的患者在术后3天和8天接受了锝-99m六甲基丙烯胺肟单光子发射断层扫描（SPECT）随访。其中15名患者在手术后15天进行了一次检查。使用不对称指数量化灌注不足的程度，该指数允许比较横轴切片上呈现最大灌注缺损的两个对称感兴趣区域（ROI）。比较CT、经颅多普勒、临床体征与99 mTc-HMPAO SPECT定量灌注结果，发现两个对称ROI之间计数差异小于10%无诊断价值。脑灌注的随访清楚地表明，手术后观察到最明显的低灌注，在手术后8天和15天逐渐恢复正常。手术后8天进行的99 mTc-HMPAO SPECT可以预测临床结果。由于这些原因，99 mTc-HMPAO SPECT是常规临床实践中唯一的脑灌注随访方法，应作为SAH患者术后的首次检查。
Regional hypoperfusion is a very frequent complication of subarachnoid haemorrhage (SAH), being related to vasospasm in the majority of cases. Twenty-six patients who were admitted for SAH underwent follow-up with technetium-99m hexamethylpropylene amine oxime single photon emission tomography (SPECT) 3 and 8 days after surgery. Fifteen patients of these had one more examination 15 days after surgery. The degree of hypoperfusion was quantified using an index of asymmetry which allow the comparison of two symmetrical regions of interest (ROIs) on the transaxial slice which presented the greatest perfusion defect. Comparison of CT data, transcranial Doppler data and clinical signs with the perfusion as quantified by99mTc-HMPAO SPECT indicates that a difference in counts of less than 10% between the two symmetrical ROIs is of no diagnostic value. Follow-up of the brain perfusion clearly shows that the most pronounced hypoperfusion was observed just after surgery, with progressive normalization at 8 and 15 days after surgery.99mTc-HMPAO SPECT performed 8 days after surgery allows prediction of the clinical outcome. For these reasons,99mTc-HMPAO SPECT, which is the only method for follow-up of cerebral perfusion in routine clinical practice, should be the first examination to be performed after surgery in patients with SAH.