中国脑血管病杂志Issue(10)：516-521,6.DOI:11.3969/j.issn.1672-5921.2014.10.003
SPECT与CT影像融合在烟雾病血管重建术中的应用价值
Application value of SPECT-CT fusion imaging in moyamoya disease revascularization:a clinical study
摘要
Abstract
Objective To investigate the application value of identification of the scalp surface locations of cerebral ischemia lesions before direct revascularization for moyamoya disease and to design surgical approaches according to this by using the fusion of single photon emission computed tomography ( SPECT) cerebral perfusion imaging with CT imaging. Methods The clinical data of 13 adult patients with ischemic-type moyamoya disease underwent superficial temporal artery-middle cerebral artery bypass surgery were analyzed retrospectively. SPECT cerebral perfusion imaging was fused with CT imaging of the same machine before procedure. The lesions of ischemia were located on the cortical surface. The surgical approaches were designed at the center of the ischemic lesions. The patients were followed up for 6 to 12 months after procedure. The improvement of clinical symptoms and cerebral perfusion of the patients were observed after operation. Results One patient had perioperative cerebral hyperperfusion syndrome,and the others did not have any perioperative complications. At one-month follow-up, the improvement of symptoms in 4 patients were excellent,in 5 were good,in 4 were fair,and none was poor. At 6 to 12 month follow-up,the improvement of symptoms in 9 patients were excellent,in 4 were good,and none was poor. The postoperative visual SPECT cerebral perfusion imaging analysis suggested that the cerebral perfusion was improved significantly as compared with before procedure in all patients. Quantitative analysis:There was significant difference in target ischemic lesions between preoperative Fb and postoperative Fb ([2. 13±1. 06]% vs. [4. 13±2. 09]%;P<0. 05). There was significant difference between preoperative Fb and Fe ([2. 46±1. 97]% vs. [2. 13±1. 06]%;P<0. 05). The postoperative BFCR was [67. 57±3. 78]%( >50%) , which indicated that the efficacy of the procedure was remarkable. The superficial temporal arteries fed to brain of the patients were observed after procedure by using the head CT angiography. The postoperative head MRI reexamination showed no new infarcts occurred at 6 months. Conclusion Combine SPECT cerebral perfusion imaging with CT imaging to design surgical approach for superficial temporal artery-middle cerebral artery bypass surgery may improve the efficacy and reduce the risks of operation.关键词
脑底异常血管网病/体层摄影术,发射型计算机,单光子/体层摄影术,X线计算机/颞浅动脉-大脑中动脉旁路移植术Key words
Moyamoya disease/Tomography,emission computed,single photon/Tomography,X-ray computed/Superficial temporal artery-middle cerebral artery bypass surgery引用本文复制引用
齐辉,赵雷,吴广源,郑思阳,黄达,尹卫,杨红杰,贾少微..SPECT与CT影像融合在烟雾病血管重建术中的应用价值[J].中国脑血管病杂志,2014,(10):516-521,6.基金项目
深圳市科创委2014年基础研究项目(JCYJ201404151623387997) （JCYJ201404151623387997）
