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目的 观察99Tcm-HL91 SPECT脑显像能否显示急性脑梗死的乏氧组织(处于缺血缺氧状态但尚存活的脑组织)。方法 起病96小时内的大脑半球梗死患者行99Tcm-HL91 SPECT脑显像和同机CT扫描,并进行图像融合。在连续2个以上层面和两个以上不同轴向断层上,在梗死侧大脑半球出现放射性浓集区,为乏氧显像阳性。结果43例患者中,乏氧显像阳性者24例,均属完全或部分前循环梗塞。乏氧显像区位于梗死灶周围。9例住起病后7～17天复查SPECT,仍呈阳性,但乏氧组织已减少。腔隙性梗死者,乏氧显像均阴性。结论99Tcm-HL91 SPECT显像能清晰地显示完全及部分前循环梗塞患者的脑乏氧组织,能提示急性脑梗死后脑组织的存活,有助于指导治疗。
Objective To observe whether 99Tcm-HL91 SPECT brain imaging can show the hypoxic tissue of acute cerebral infarction (in ischemic hypoxia but surviving brain tissue). Methods 99Tcm-HL91 SPECT brain imaging and CT scans were performed in patients with cerebral hemispheres within 96 hours after onset of disease. Image fusion was performed. In more than two consecutive levels and more than two different axial faults, a radioactive concentration region appears in the infarct hemisphere, which is positive for hypoxic imaging. Results Among the 43 patients, 24 cases were positive for hypoxia, all of them were complete or partial anterior circulation infarction. Hypoxic imaging is located around the infarct. SPECT was observed in 9 cases 7-17 days after onset of illness, but still positive, but hypoxic tissue was reduced. Lacunar infarction, hypoxia were negative imaging. Conclusion 99Tcm-HL91 SPECT imaging can clearly show the brain hypoxic tissue in patients with complete and partial anterior circulation infarction, can prompt the survival of brain tissue after acute cerebral infarction, and help to guide the treatment.