Alzheimer病与血管性痴呆的SPECT

目的：研究脑ＳＰＥＣＴ在诊断及鉴别Ａｌｚｈｅｉｍｅｒ病（ＡＤ）和血管性痴呆（ＶＤ）方面的作用。材料和方法：分别选择符合《精神障碍诊断和统计手册》第４版（ＤＳＭ—ＩＶ）中ＡＤ或ＶＤ诊断标准的患者各１７例和１２例，进行ＳＰＥＣＴ检查，兼作ＣＴ（或ＭＲＩ），并作神经心理测定及其它相关量表评分。将ＡＤ、ＶＤ和ＳＰＥＣＴ结果，以及ＳＰＥＣＴ和ＣＴ（或ＭＲＩ）的结果进行比较。结果：ＡＤ的ＳＰＥＣＴ以颞、顶叶低灌注为典型表现，ＶＤ以局灶性低灌注为主。在右颞下回和右枕叶，ＡＤ组ＳＰＥＣＴ放射性计数比值显著低于ＶＤ组（Ｐ＜０．０５，Ｐ＜０．０１），而在左顶叶显著高于ＶＤ组（Ｐ＜０．０５）。两组左半球的放射性计数比值普遍低于右半球，但ＶＤ的左右不对称性明显重于ＡＤ，以左顶叶最为突出（Ｐ＜０．０１）。ＭＲＩ结果与ＳＰＥＣＴ有较多的一致性。各量表评分除Ｈａｃｈｉｎｓｋｉ缺血指数外，均无显著差异。结论：ＳＰＥＣＴ在诊断和鉴别ＡＤ与ＶＤ方面有一定实用价值

Application of SPECT in Diagnosis ofAlzheimer's Disease and Vascular Dementia

Purpose:To study the brain SPECT in the diagnosis of Alzheimer's disease(AD) and vascular dementia.Materials and Methods:17 AD and 12 VD underwent a series of examinations,including SPECT(both group),CT(or MRI),neuropsychological test and other related rating scales.Indexes from SPECT were compared between the two groups.Comparison were also carried out between the results of SPECT and CT(or MRI).Result:AD was characterized with lower perfusion at temporal and parietal lobes in SPECT while VD was characterized with localized low perfusion.The radioactive count was significant lower in AD group than in VD at right inferior temporal lobe and right occipital lobe(P<0.05,P<0.01)and significant higher in VD at left parietal lobe (P<0.05).The radioactive count ratio was lower at left hemisphere than right hemisphere of both groups while the hemispheric asymmetry was more significant in VD than in AD,especially at left parietal lobe(P<0.01).Results from MRI shared more consistencies with that from SPECT.No significant difference was found in the scores of rating scales between the 2 groups,except for Hachinski ischemic indexes.Conclusion:SPECT is a promising measure in the diagnosis and differentiate diagnosis of AD and VD.