Regional cerebral blood flow in patients with sickle cell disease: study with single photon emission computed tomography
Regional cerebral blood flow in patients with sickle cell disease: study with single photon emission computed tomography
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DOI：
10.1007/s12149-007-0050-y
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发表时间：
2007-10-01
影响因子：
2.6
通讯作者：
Mohammed, Ahmed M.
中科院分区：
文献类型：
--
作者：
Al-Kandari, Fareeda A.;Owunwanne, Azu;Mohammed, Ahmed M.
目的：利用正电子发射断层扫描(PET)、核磁共振成像(MRI)和计算机断层扫描(CT)已报道了镰状细胞病(SCD)患者的神经系统并发症，但单光子发射计算机断层扫描(SPECT)未见报道。本研究的目的是探讨99m-六甲基丙基丙胺(Tc99m-HMPAO)治疗SCD后SPECT脑血流灌注的变化，并与人口学、体格检查、MRI和血液学检查结果进行比较。方法：21例SCD患者，男12例，女9例，年龄8~45岁。这些患者没有急性危象，神经功能评估正常，没有已知的中风或短暂性脑缺血发作病史，也没有既往异常的CT或MRI脑扫描，而且是右撇子。成人静脉注射740MBq(20mCi)(99m)，或儿童患者静脉注射适量正电子发射计算机断层扫描(SPECT)。两名核医学医生对扫描结果进行了视觉解读，并达成了共识。3个月后做的核磁共振检查由放射科医生解释。结果：21例患者中，7例(11~22岁)以额叶为主，或合并额叶和/或顶叶。MRI异常者2例。结论：SPECT可用于SCD患者脑血流灌注缺陷的检测，这种早期检测可能对后续的临床治疗有帮助，因为脑血流灌注缺陷可导致无症状脑梗塞和/或显性卒中，并影响认知能力。
Objective: Neurological complications have been reported in patients with sickle-cell disease (SCD) using positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT), but not with single photon emission computed tomography (SPECT). The objective of this study was to investigate brain perfusion in the patients with SCD using SPECT after technetium-99m hexamethylpropylene amine oxime (Tc-99m-HMPAO), was administered and compare the findings with those of demography, physical examination, MRI and hematological profile.Methods: The study involved 21 patients (12 males, 9 females, age at study 8-45 years) who were known to be having SCD for a duration of at least 5 years. The patients were not in acute crisis and had normal neurological assessments with no known history of stroke or transient ischemic episode or previous abnormal CT or MRI brain scan, and were right-handed. The brain SPECT was performed after intravenous injection of 740MBq (20mCi) (99m)supercript stopTc-HMPAO in adults or an appropriate dose in pediatric patients. The scans were visually interpreted by two nuclear medicine physicians and a decision was reached by consensus. An MRI done 3 months later was interpreted by a radiologist. The demographic data and hematological profile were obtained from the medical records of the patients.Results: Of the 21 patients, 7 (age 11-22 years) had brain perfusion deficit mostly in the frontal lobe either alone or in combination with temporal and/or parietal lobe. The MRI was abnormal in 2 patients. The brain perfusion deficit was not associated with the demographic data of the patients or hematological profiles.Conclusions: The findings show that SPECT was useful in detecting brain perfusion deficit in SCD patients, and such an early detection may be clinically useful in the subsequent follow-up of such patients, since it is known that cerebral perfusion deficit can lead to silent infarct and/or overt stroke, and affect cognitive skills.