【摘要】 目的　评价脑血流SPECT断层显像对糖尿病脑血管病 (DCD)的早期诊断价值。方法　用99mTc -ECD对 30例临床确诊 2型糖尿病患者进行了脑血流SPECT断层显像 ,按脑正常解剖和脑SPECT图像应用解剖关系将有每侧大脑灰质分为11个区域 ,用目测法对每个区域的核素分布进行判定。结果　糖尿病组检出 2 2人共 6 0处有脑血流灌注异常减低 ,低灌注以颞叶发生率最高 (33.33) % ,提示脑缺血以大脑中动脉受累为主。糖尿病 <5年的异常影像主要表现为脑皮层限局性楔形样稀疏 /缺损 ;随病程延长 ,尤其是 >10年者 ,主要表现为一叶皮层大范围核素分布稀疏 ,甚至还可伴有楔形病性 ,说明糖尿病病程也是影响DCD的主要因素。该法对诊断糖尿病缺血性脑血管病的灵敏度 ,特异性、准确性分别为 73.33% ,90 0 0 %和80 0 0 %。结论　脑血流SPECT断层显像能直观显示脑皮层缺血部位 ,范围及程度 ,有助于临床早期发现DCD ,以达到积极治疗目的。更多还原

【Abstract】 Objective To enhance t he sensitivity an d accuracy in early detection of diabetic cerebrovascular disease(DCD)with singl e photon emission computed tomography.Method The cerebral blood tomograp hy imag ing with SPECT was performed in 30 patients with diabetic and 20 controls. Res ul ts ①Sixty areas of 22 patients with diabetic had significant hypoperf usio n of cerebral blood.②The temporal lobes had the highest detection rate.It showe d that the middle cerebral artery was involved particularly.③The cerebral corte x perfusion abnormality showed small regional wedge with radioactive nuclide dec rease/defect in multiareas or severe reduction in big areas.④The cerebral blood was affected by course of diabetic disease.⑤The sensitivity,specificity and ac curacy rate of cerebral blood flow tomography with SPECT in DCD were 73.33%、90. 0 0% and 80.00%respectively.Conclusion The results demonstrate that cerebral blood flow tomography with SPECT not only directly reflects the area ranges and degre e of cerebrovascular ischemia but also the severity of clinical manifestation of DCD and helps to decide the therapeutic measure.更多还原