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- 저자 : Ick Sung Ghi (검색결과 2 건)
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만성 외상성 뇌 손상 환자의 정신의학적 후유 장애 평가에서 Tc-99m HMPAO 뇌혈류 SPECT의 역할
소영,이강욱,이선우,지익성,송창준 대한핵의학회 2002 핵의학 분자영상 Vol.36 No.4
Purpose: We studied whether brain perfusion SPECT is useful in the psychiatric disbility evaluation of patients with chronic traumatic brain injury (TBI). Materials and Methods: Sixty-nine patients (M:F=58:11, age 39±14 years) who underwent Tc-99m HMPAO brain SPECT, brain MRI and neuropsychological (NP) tests during hospitalization in psychiatric wards for the psychiatric disability evaluation were included; the severity of injury was mild in 31, moderate in 17 and severe in 21. SPECT, MRI, NP tests were performed 6∼61 months (mean 23 months) post-injury. Diagnostic accuracy of SPECT and MRI to show hypoperfusion or abnormal signal intensity in patients with cognitive impairment represented by NP test results were compared. Results: Forty-two patients were considered to have cognitive impairment on NP tests and 27 not. Brain SPECT showed 71% sensitivity and 85% specificity, while brain MRI showed 62% sensitivity and 93% specificity (p>0.05, McNemar test). SPECT found more cortical lesions and MRI was superior in detecting white matter lesions. Sensitivity and specificity of 31 mild TBI patients were 45%, 90% for SPECT and 27%, 100% for MRI (p>0.05, McNemar test). Among 41 patients with normal brain MRI, SPECT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Conclusion: Brain SPECT has supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI. (Korean J Nucl Med 2002;36;232-43)
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두부외상후 만성 기질성 정신장애 환자에서 Tc-99m HMPAO Brain SPECT 분석
이강욱,이종진,송민호,강민희,지익성,신영태,노흥규 ( Kang Wook Lee,Jong Jin Lee,Min Ho Shong,Min Hee Kang,Ick Sung Ghi,Young Tai Shin,Heung Kyu Ro ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3
It is well known that Tc-99m HMPAO brain SPECT can reflect the functional lesions better than X-ray computerized tomography(CT) and magnetic resonance imaging(MRI) in the cerebral disorders. In order to evaluate the clinical utilities of Tc-99m HMPAO brain SPECT in patients with post-traumatic chronic organic mental disorder(OMD). We included 28 patients diagnosed as OMD in department of psychiatry after traumatic head injury. And we compared the results of Tc-99m HMPAO SPECT with those of MRI, EEG and MINI mental status examination(MMSE). The results were as follows 1) All patients diagnosed as OMD showed diffuse or focal decreased cerebral perfusion on Tc-99m HMPAO SPECT. 2) Most frequent lession on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain Tc-99m HMPAO SPECT showing normal brain MRI result was also decreased both frontal perfusion. 3) Eight of 28 patients showed focal brain MRI lesions(4 small frontal hygroma, 3small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain Tc-99m HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20points. In conclusion, we think that Tc-99m HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disoder.
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