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SPECT bei psychiatrischen Erkrankungen

  • Chapter
Single-Photon-Emissions-Computertomographie (SPECT) des Gehirns

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Zusammenfassung

Die Diskussion über Sinn und Nutzen einer emissionstomographischen Untersuchung des Gehirns wird nirgends kontroverser geführt als auf dem Gebiet der psychiatrischen Erkrankungen. Dies rührt daher, daß die Ergebnisse der bildgebenden Verfahren in der Psychiatrie anfangs als wenig hilfreich angesehen wurden, insbesondere die Ergebnisse der strukturabbildenden Untersuchungen. Hier sind allenfalls organische Psychosyndrome ihrer Diagnose nähergebracht worden. Eine neue Ära wurde mit der Einführung der funktionsabbildenden Verfahren eingeläutet, allen voran die Positronenemissionstomographie (PET), die Schnittbilder von Perfusion und Glukose-metabolismus in Abhängigkeit von Funktion und Stimulation darstellte. Damit war zum ersten Mal die Möglichkeit gegeben, Veränderungen der Hirnfunktion bei psychiatrischen Erkrankungen auf definierte anatomische Strukturen zu projizieren und mittels externer oder pharmakologischer Stimulation physiologische und pathologische Reaktionsmuster zu dokumentieren. Man erkannte, daß eine “physiologische Dysfunktion” eine “Verhaltensabnormalität” auslöst [1, 2]. Es zeigten sich Ansätze, ein neuronales System des Gehirns mit verschiedenen Ausdrucksformen und damit verschiedenen “Qualitäten” eines Krankheitsbildes, z.B. der Depression, in Verbindung zu bringen (Tabelle 4.1). Damit konnte der Weg des “functional imaging”, der einst bei Broca begann, über Penfield, Rasmussen und Lassen weitergeführt werden bis Sokoloff, Reivich und Ido in unsere Tage [3].

Jahrhundertelang stellten die traurigen Gesichter der Patienten die einzige Ansicht dar, die Psychiater von der klinischen Depression hatten.

Mark S. George

Unter Mitwirkung von D. Ebert und G. Platsch.

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  1. Abt. Nuklearmedizin, Bundeswehrzentralkrankenhaus Koblenz, Rübenacherstr. 170, 56072, Koblenz, Germany

    H. J. Wieler (Leitender Arzt) (Leitender Arzt)

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Feistel, H. (1995). SPECT bei psychiatrischen Erkrankungen. In: Wieler, H.J. (eds) Single-Photon-Emissions-Computertomographie (SPECT) des Gehirns. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79222-9_12

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  • DOI: https://doi.org/10.1007/978-3-642-79222-9_12

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79223-6

  • Online ISBN: 978-3-642-79222-9

  • eBook Packages: Springer Book Archive

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