中国药物警戒 ›› 2025, Vol. 22 ›› Issue (3): 313-315.
DOI: 10.19803/j.1672-8629.20240858

• 安全与合理用药 • 上一篇    下一篇

99m锝-双半胱乙酯在缺血性脑血管病检查中的应用研究

杨淑贞, 朱传明, 李燕, 刘婷婷, 王洪兴, 郑晓风   

  1. 北京航天总医院影像科,北京 100076
  • 收稿日期:2024-11-06 出版日期:2025-03-15 发布日期:2025-03-17
  • 作者简介:杨淑贞,女,硕士,医学影像诊断。
  • 基金资助:
    北京医学奖励基金会（YXJL-2021-0118-0194）

Applicability of 99mTc-Ethyl Cysteinate Dimer in the Examination of Ischemic Cerebrovascular Diseases

YANG Shuzhen, ZHU Chuanming, LI Yan, LIU Tingting, WANG Hongxing, ZHENG Xiaofeng   

  1. Department of Radiology of Beijing Aerospace General Hospital, Beijing 100076, China
  • Received:2024-11-06 Online:2025-03-15 Published:2025-03-17

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摘要： 目的 探讨99m锝-双半胱乙酯（99mTc-ECD）脑血流灌注单光子发射计算机断层成像仪（SPECT/CT）融合显像在缺血性脑血管病中的应用价值。方法 收集112例临床诊断为缺血性脑血管病患者,头颈部计算机断层血管造影（CTA）均发现不同程度的血管狭窄,均在发病5 d内行99mTc-ECD SPECT/CT脑血流灌注显像,对比分析SPECT/CT脑血流灌注融合图像、单纯SPECT脑血流灌注图像及同机CT图像对病变的检出数量及范围和阳性率,并对各种显像方式的阳性率进行χ2检验,以P<0.05为差异具有统计学意义。结果 112例缺血性脑血管病患者使用99mTc-ECD显像时均无明显不适症状,112例患者SPECT/CT脑血流灌注同机融合显像的阳性率为100%,检出缺血或梗塞灶381个;SPECT脑血流灌注显像的阳性率为98.21%,检出缺血或梗塞灶316个;同机CT图像的阳性率为67.86%,检出缺血或梗塞灶192个。3种显像方法两两进行统计学分析,SPECT/CT融合图像与单纯SPECT图像对缺血性脑血管病诊断阳性率比较差异无统计学意义,SPECT/CT融合图像、单纯SPECT图像分别与CT图像对缺血性脑血管病诊断的阳性率比较分析差异均具有统计学意义（P<0.05）。结论 99mTc-ECD脑血流灌注显像安全、便捷;SPECT/CT脑血流灌注同机融合显像对缺血性脑血管病患者病变的检出范围、数量及阳性率方面优于SPECT脑血流灌注显像及CT显像。

关键词: 99m锝-双半胱乙酯, 脑血流灌注, 缺血性脑血管病, 单光子发射计算机断层成像仪

Abstract: Objective To explore the applicability of 99mTc-ECD cerebral perfusion SPECT/CT fusion imaging in ischemic cerebrovascular diseases. Methods The clinical data of 112 patients clinically diagnosed with ischemic cerebrovascular diseases was collected. Computed tomography angiography (CTA) of the head and neck revealed varying degrees of vascular stenosis. All the patients underwent 99mTc-ECD cerebral perfusion SPECT/CT imaging within 5 days of onset. The detection rate, range, and positive rate of lesions were compared and analyzed between SPECT/CT fusion images, pure SPECT perfusion images, and CT images. The positive rates of different imaging methods were analyzed using the McNemar test, with P <0.05 indicating statistical significance. Results None of the 112 patients experienced significant discomfort during 99mTc-ECD imaging. The positive rate of SPECT/CT fusion imaging was 100%, with 381 ischemic or infarct lesions detected, compared with 98.21%, and 316 for SPECT perfusion imaging and 67.86% and 192 for CT imaging. Statistical analysis showed no significant difference in the diagnostic positive rate between SPECT/CT fusion images and pure SPECT images. However, both SPECT/CT fusion images and pure SPECT images had significantly higher diagnostic positive rates than CT images (P <0.05). Conclusion 99mTc-ECD cerebral perfusion imaging is safe and convenient. SPECT/CT fusion imaging is superior to SPECT cerebral perfusion imaging and CT imaging in terms of the detection range, number, and positive rate of lesions in patients with ischemic cerebrovascular disease.

Key words: 99mTc-ECD, Cerebral Blood Flow Perfusion, Ischemic Cerebrovascular Disease, SPECT/CT

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