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目的了解早期梅毒患者的脑血流灌注情况。方法病例组为28例病程在1年之内的早期梅毒患者,对照组为26例正常健康人,对两组对象行99Tcm-ECD脑血流灌注显像,并作图像视觉分析和定量分析。结果病例组26例有弥漫性、斑片样脑血流低灌注,21例患者在多个局部表现得更为明显,共45例次。其中累及左额叶3例次,右额叶2例次,左顶叶5例次,右顶叶4例次,左颞叶7例次,右颞叶6例次,左枕叶6例次,右枕叶5例次,左基底节2例次,小脑2例次,丘脑1例次,脑内核团2例次。对照组无1例异常。定量分析提示,病例组额叶、顶叶、颞叶的血流量明显低于对照组(P<0.01),枕叶、基底节、小脑、丘脑的血流量低于对照组(P<0.05)。结论SPECT图像分析和定量分析均提示,早期梅毒患者存在脑血流异常,普遍呈弥漫性、斑片样低灌注。
Objective To understand the cerebral blood flow in patients with early syphilis. Methods A total of 28 early syphilis patients whose disease duration was within 1 year and 26 normal controls were included in the study. The cerebral blood perfusion imaging of 99Tcm-ECD was performed in both groups. Visual visualization and quantitative analysis were performed. Results 26 cases of patients with diffuse, patchy cerebral perfusion, 21 patients showed more obvious in a number of local, a total of 45 cases. There were 3 cases of left frontal lobe, 2 cases of right frontal lobe, 5 cases of left parietal lobe, 4 cases of right parietal lobe, 7 cases of left temporal lobe, 6 cases of right temporal lobe, 6 cases of left occipital lobe , 5 cases of right occipital lobe, 2 cases of left basal ganglia, 2 cases of cerebellum, 1 case of thalamus and 2 cases of brain nucleus. No abnormality in the control group. Quantitative analysis showed that the blood flow in the frontal lobe, parietal lobe and temporal lobe was significantly lower than that in the control group (P <0.01). The blood flow in the occipital lobe, basal ganglia, cerebellum and thalamus was lower than that in the control group (P <0.05). Conclusions Both SPECT image analysis and quantitative analysis suggest that patients with early syphilis have abnormal cerebral blood flow and are generally diffuse and patchy hypoperfusion.