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Sample records for hmpao spect cerebral

  1. HMPAO-SPECT in cerebral seizures

    International Nuclear Information System (INIS)

    Gruenwald, F.; Bockisch, A.; Reichmann, K.; Ammari, B.; Hotze, A.; Biersack, H.J.; Durwen, H.; Buelau, P.; Elger, C.E.; Rohde, A.; Penin, H.

    1988-01-01

    In nine patients with suspected psychogenic seizures and in three patients with proven epileptic seizures HMPAO-SPECT was performed prior to and during seizure. In the patients with lateron-proven psychogenic seizures no, or only slight, changes of regional cerebral blood flow were found. Patients with proven epilepsy revealed partly normal findings interictally but during seizure a markedly increased circumscript blood flow was found in all patients. Even though PET is superior to SPECT with respect to spatial resolution, in the diagnosis of seizures HMPAO-SPECT has the advantage of enabling injection of the tracer during the seizure and the performance of the SPECT study subsequently. (orig.) [de

  2. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

    Energy Technology Data Exchange (ETDEWEB)

    Shirazi, P.; Konopka, L.; Crayton, J.W. [Loyola Univ. Medical Center, Maywood, IL (United States)] [and others

    1994-05-01

    Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.

  3. 99mTc-HMPAO Regional Cerebral Blood Flow SPECT in Transient Ischemic Attacks

    International Nuclear Information System (INIS)

    Ahn, Myeong Im; Park, Young Ha; Lee, Sung Yong; Chung, Soo Kyo; Kim, Jong Woo; Bahk, Yong Whee

    1989-01-01

    Transient ischemic attacks (TJAs) is a syndrome resulting from brain ischemia lasting less than 24 hours. The mechanisms of TIAs may be similar to those of cerebral embolism and thrombosis, and thus TIAs may be followed by cerebral infarction. Despite the availability of CT scanning, the diagnosis and management of TIAs continue to be difficult. Recently SPECT has been advocated as a diagnostic imaging modality. We performed 99m Tc-HMPAO regional cerebral blood flow (rCRF) SPECT in 24 patients with the clinical diagnosis of TIAs to assess its ability to detect early changes of rCBF, and determine the diagnostic value. Ten men and fourteen women with an average of 51 years (range; 27-74 years) were included. All but 8 patients had normal brain CT prior to SPECT. The two patients had moderate degree of brain atrophy and the 6 patients nonspecific calcifications. Eighteen of the 24 patients had abnormal 99m Tc-HMPAO rCBF SPECT. Fifteen had unilateral involvement and the other three had bilateral involvements. Seventy-five percents of the defects were found in the left cerebral hemisphere. According to the distribution of the lesions (total number: 34 lesions), fourteen were in the parietal, eight in the temporal, and the remainders were elsewhere. 99m Tc-HMPAO rCHF SPECT is sensitive in detecting rCRF abnormalities in patients with TIAs, and represent the most accurate diagnostic tool available in the diagnosis of TIAs

  4. Presentation of regional cerebral blood flow in amphetamine abusers by 99Tcm-HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Kao, C.H.; Wang, S.J.; Yeh, S.H.

    1994-01-01

    The aim of this study was to describe the effectiveness of 99 Tc m -hexamethylpropyleneamine oxime ( 99 Tc m -HMPAO) brain single photon emission computed tomography (SPECT) in the assessment of the regional cerebral blood flow (rCBF) in amphetamine abusers. Twenty-one amphetamine abusers were included and 99 Tc m -HMPAO brain SPECT performed to evaluate rCBF. The drug-using periods ranged from 1 month to several years. The demonstrated neuropsychogenic symptoms and signs of the abusers were from normal presentation to various neurologic complications. The brain SPECT scans were interpreted visually as either normal or abnormal. The degree of abnormality was classified into mild or severe. The results revealed that (a) most SPECT studies in abusers show small defects (95%, 20/21 cases); 71% (15/21) of cases revealed multiple defects over both hemispheres (classified as severe); 24% (5/21) of the cases had focal defects (classified as mild); and only one case (5%, 1/21) demonstrated a normal SPECT finding; (b) the degree of abnormality on SPECT scans was not related to the dose and duration of drug use or the severity of the neuropsychiatric symptoms and signs. In conclusion, 99 Tc m -HMPAO brain SPECT is a sensitive but not specific test for neuropsychogenic abnormalities associated with amphetamine abuse. (Author)

  5. Analysis of Regional Cerebral Blood Flow Using 99mTc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    International Nuclear Information System (INIS)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In

    1988-01-01

    99m Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, 99m Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  6. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    International Nuclear Information System (INIS)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A.

    1998-01-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual's T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

  7. Statistical parametric mapping of Tc-99m HMPAO SPECT cerebral perfusion in the normal elderly

    Energy Technology Data Exchange (ETDEWEB)

    Turlakow, A.; Scott, A.M.; Berlangieri, S.U.; Sonkila, C.; Wardill, T.D.; Crowley, K.; Abbott, D.; Egan, G.F.; McKay, W.J.; Hughes, A. [Austin and Repatriation Medical Centre, Heidelberg, VIC (Australia). Departments of Nuclear Medicine and Centre for PET Neurology and Clinical Neuropsychology

    1998-06-01

    Full text: The clinical value of Tc-99m HMPAO SPECT cerebral blood flow studies in cognitive and neuropsychiatric disorders has been well described. Currently, interpretation of these studies relies on qualitative or semi- quantitative techniques. The aim of our study is to generate statistical measures of regional cerebral perfusion in the normal elderly using statistical parametric mapping (Friston et al, Wellcome Department of Cognitive Neurology, London, UK) in order to facilitate the objective analysis of cerebral blood flow studies in patient groups. A cohort of 20 healthy, elderly volunteers, aged 68 to 81 years, was prospectively selected on the basis of normal physical examination and neuropsychological testing. Subjects with risk factors, or a history of cognitive impairment were excluded from our study group. All volunteers underwent SPECT cerebral blood flow imaging, 30 minutes following the administration of 370 MBq Tc-99m HMPAO, on a Trionix Triad XLT triple-headed scanner (Trionix Research Laboratory Twinsburg, OH) using high resolution, fan-beam collimators resulting in a system resolution of 10 mm full width at half-maximum (FWHM). The SPECT cerebral blood flow studies were analysed using statistical parametric mapping (SPM) software specifically developed for the routine statistical analysis of functional neuroimaging data. The SPECT images were coregistered with each individual`s T1-weighted MR volume brain scan and spatially normalized to standardised Talairach space. Using SPM, these data were analyzed for differences in interhemispheric regional cerebral blood flow. Significant asymmetry of cerebral perfusion was detected in the pre-central gyrus at the 95th percentile. In conclusion, the interpretation of cerebral blood flow studies in the elderly should take into account the statistically significant asymmetry in interhemispheric pre-central cortical blood flow. In the future, clinical studies will be compared to statistical data sets in age

  8. Increased cerebral blood flow in MELAS shown by Tc-99m HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Peng, N.J.; Tsay, D.G.; Liu, R.S.; Li, J.Y.; Kong, K.W.; Kwok, C.G.; Strauss, H.W.

    2000-01-01

    We report cerebral SPECT studies on two siblings with the syndrome of mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Tc-99m HMPAO brain SPECT was performed 8, 19 and 30 days after a stroke-like episode in one case and 10 days after a stroke-like episode, 6 h after a partial seizure and as a follow-up study in the other. Increased blood flow was seen in both these patients with stroke-like episodes due to MELAS. The cause of the increased blood flow is uncertain, but it may be related to the decreased pH created by local increase in lactic acid. (orig.)

  9. Improvement of Cerebral Hypoperfusion with Levothyroxine Therapy in Hashimoto's Encephalopathy Demonstrated by 99mTc-HMPAO-SPECT

    Science.gov (United States)

    Schnedl, Wolfgang J.; Mirzaei, Siroos; Wallner-Liebmann, Sandra J.; Tafeit, Erwin; Mangge, Harald; Krause, Robert; Lipp, Rainer W.

    2013-01-01

    Background Hashimoto's encephalopathy (HE) is a rare immune-mediated encephalopathy associated with autoimmune Hashimoto's thyroiditis. Objectives and Methods We report on a patient with HE and significant clinical improvement correlating with an increase in cerebral blood flow demonstrated by hexamethylpropyleneamine oxime (HMPAO) single-photon emission computed tomography (SPECT). HMPAO-SPECT was performed with 740 MBq of technetium-99m-HMPAO. To demonstrate the improvement in regional cerebral blood flow, individual regions of interest were drawn around visually diminished HMPAO uptake, the lesion to reference region ratio was calculated and transverse section images and semi-quantitative measurements were performed. Results We show a 5-year follow-up with significant clinical improvement, a 10-fold reduction in autoantibodies to thyroid peroxidase and an approximately 20% improvement in cerebral blood flow with HMPAO-SPECT. Conclusion Adequate levothyroxine treatment achieving and maintaining euthyroidism should be considered as therapy to lower autoantibodies and improve clinical outcome in patients with Hashimoto's thyroiditis and encephalopathy. PMID:24783049

  10. Optimization method for the administered activity to patients in Tc-99-HMPAO cerebral blood flow SPECT in adults

    International Nuclear Information System (INIS)

    Perez Diaz, Marlen; Estevez Aparicio, Eric; Roque Diaz, Reinaldo; Hernandez Rodriguez, Carlos

    2002-01-01

    A method based on the construction of an image quality discriminant function is proposed. The parameters which characterise it are selected among the typical ones measured in a Tc 99m - HMPAO cerebral blood flow SPECT. The results are compared among groups of patient's studies who received different activity (430, 640 and 807 MBq), looking for the minimum that guaranty good image quality. A reduction in the administered 99m Tc-HMPAO activity to the patient down to 430 MBq was possible without affecting the tomographic image quality. The labelling yield was the main parameter that determined the image quality. (author)

  11. Decreased cerebral blood flow and prognosis of Alzheimer's disease. A multicenter HMPAO-SPECT study

    International Nuclear Information System (INIS)

    Nishimura, Tsunehiko; Hashikawa, Kazuo; Fukuyama, Hidenao

    2007-01-01

    The purpose of this study was to determine the usefulness of brain perfusion single photon emission computed tomography (SPECT) for evaluating the severity and progression of Alzheimer's disease (AD). Eighty-four AD patients were included. At entry, 99m Tc-HMPAO-SPECT, the Mini Mental State Examination (MMSE), Mental Function Impairment Scale (MENFIS), and the Raven Colored Progression Matrix (RCPM) were performed for all 84 patients. During the follow-up periods, two individual MMSE evaluations in 34 patients, two MENFIS evaluations in 30 patients, and two RCPM evaluations in 20 patients were performed. Based on the regions of decreased cerebral blood flow demonstrated on three-dimensional stereotactic surface projection (3D-SSP) images of SPECT, the cases were classified as type A (no decrease), type B (decreased blood flow in the parietal or temporal lobe), type C (decreased blood flow in the frontal lobe and parietal or temporal lobe), type Pc (decreased blood flow in posterior cingulate gyrus only), and ''other types''. The types of decreased blood flow, scores on neuropsychological evaluations, and symptom progression were analyzed. The MENFIS, MMSE, and RCPM scores were poorest in type C patients at entry. The degree of decrease of these scores during the follow-up periods was also greatest in type C. The greatest difference between patients with and without rapid progression in SPECT data of the mild AD patients (MMSE score≥24) was in the frontal lobe. Decreased blood flow in the frontal lobe of AD patients is correlated not only with reduced cognitive function at the time of the evaluation but with rapid progression in the subsequent clinical course. (author)

  12. Analysis of Regional Cerebral Blood Flow Using {sup 99m}Tc-HMPAO Brain SPECT in Senile Dementia of Alzheimer Type

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Hae; Lee, Myung Chul; Koh, Chang Soon; Roh, Jae Kyu; Woo, Chong In [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1988-03-15

    {sup 99m}Tc-HMPAO brain SPECT studies were performed in 11 patients with Alzheimer's disease, 7 patients with psychological depression and 12 normal controls. Changes of regional cerebral blood flow was semiquantitatively analyzed and the results were as follows. 1) In 11 patients with Alzheimer's disease, significant reduction of regional cerebral blood flow was found In both temporoparietal areas. 2) Relative perfusion between cerebral hemispheres was rather symmetrical in patient with Alzheimer's disease. 3) All patients with depression showed normal SPECT findings. As for conclusion, {sup 99m}Tc-HMPAO brain SPECT seemed to be a valuable method for clinical assessment and management of patients with Alzheimer's disease.

  13. SPECT with [99mTc]-d,l-hexamethyl-propylene amine oxime (HM-PAO) compared with regional cerebral blood flow measured by PET

    DEFF Research Database (Denmark)

    Yonekura, Y; Nishizawa, S; Mukai, Thomas Søgaard

    1988-01-01

    In order to validate the use of technetium-99m-d,l-hexamethylpropyleneamine oxime (HM-PAO) as a flow tracer, a total of 21 cases were studied with single photon emission computerized tomography (SPECT), and compared to regional cerebral blood flow (rCBF) measured by position emission tomography...... (PET) using the oxygen-15 CO2 inhalation technique. Although HM-PAO SPECT and rCBF PET images showed a similar distribution pattern the HM-PAO SPECT image showed less contrast between high and low activity flow regions than the rCBF image and a nonlinear relationship between HM-PAO activity and r......CBF was shown. Based on the assumption of flow-dependent backdiffusion of HM-PAO from the brain, we applied a "linearization algorithm" to correct the HM-PAO SPECT images. The corrected HM-PAO SPECT images revealed a good linear correlation with rCBF (r = 0.901, p less than 0.001). The results indicated HM-PAO...

  14. A study of acetazolamide-induced changes in cerebral blood flow using {sup 99m}Tc HMPAO SPECT in patients with cerebrovascular disease

    Energy Technology Data Exchange (ETDEWEB)

    Asenbaum, S. [Neurological Clinic, Univ. Vienna (Austria); Reinprecht, A. [Neurosurgical Clinic, Univ. Vienna (Austria); Bruecke, T. [Neurological Clinic, Univ. Vienna (Austria); Wenger, S. [Neurological Clinic, Univ. Vienna (Austria); Podreka, I. [Neurological Clinic, Univ. Vienna (Austria); Deecke, L. [Neurological Clinic, Univ. Vienna (Austria)

    1995-01-01

    For semiquantification of SPECT studies we tried to calculate cerebral {sup 99m}Tc-HMPAO uptake related to injected dose and estimated brain volume. The method was applied to SPECT investigations of 27 patients who had a least one ischaemic attack and a confirmed 80-100% stenosis of the corresponding internal carotid artery (ICA). Vascular reactivity was tested by parenteral administration of acetazolamide (AZ). Increase in HMPAO uptake after AZ was evident in both hemispheres, although the increase (AZ effect) was significantly lower in the affected hemisphere (+24% versus +28%). No interhemispheric uptake differences were seen in patients with largely normal SPECT studies, although local asymmetries in HMPAO deposition were visible. Patients with low density lesions on CT and with a well-demarcated lesion in the same location on SPECT revealed interhemispheric uptake differences, with lower uptake on the affected side. This was not due solely to alterations in the lesion, but also to reduced HMPAO uptake and AZ effect in the surrounding area. The AZ effect showed no correlation with angiographic findings, indicating no major haemodynamic influence of the ICA stenosis on cerebral hemisphere perfusion. Calculated cerebral HMPAO uptake changes after AZ administration were in good accordance with absolute cerebral blood flow measurements, and made interindividual comparisons possible. However, as changes in the area around an infarct or local reduction in vascular reserve may not be reproduced adequately by uptake calculations, visual inspection is still necessary. (orig.)

  15. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc- HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, Ra Hyeong; Suh, Tae Suk; Kwark, Chul Eun; Choe, Bo Young; Lee, Hyoung Koo; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo [College of Medicine, The Catholic Univ. of Seoul, Seoul (Korea, Republic of)

    2002-06-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of '9{sup 9m}Tc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and {sup 99m}Tc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map(SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  16. Quantitative evaluation of regional cerebral blood flow by visual stimulation in 99mTc-HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Juh, R. H.; Suh, T. S.; Chung, Y. A.

    2002-01-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of 99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99mTc- HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50±5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann

  17. Quantitative evaluation of regional cerebral blood flow by visual stimulation in 99mTc- HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Juh, Ra Hyeong; Suh, Tae Suk; Kwark, Chul Eun; Choe, Bo Young; Lee, Hyoung Koo; Chung, Yong An; Kim, Sung Hoon; Chung, Soo Kyo

    2002-01-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of '9 9m Tc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99m Tc-HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map(SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50±5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann

  18. Quantitative evaluation of regional cerebral blood flow by visual stimulation in {sup 99m}Tc-HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Juh, R. H.; Suh, T. S.; Chung, Y. A. [The Catholic Univ., of Korea, Seoul (Korea, Republic of)

    2002-07-01

    The purpose of this study is to investigate the effects of visual activation and quantitative analysis of regional cerebral blood flow. Visual activation was known to increase regional cerebral blood flow in the visual cortex in occipital lobe. We evaluated that change in the distribution of 99mTc-HMPAO (Hexamethyl propylene amine oxime) to reflect in regional cerebral blood flow. The six volunteers were injected with 925 MBq (mean ages: 26.75 years, n=6, 3men, 3women) underwent MRI and 99mTc- HMPAO SPECT during a rest state with closed eyes and visual stimulated with 8 Hz LED. We delineate the region of interest and calculated the mean count per voxel in each of the fifteen slices to quantitative analysis. The ROI to whole brain ratio and regional index was calculated pixel to pixel subtraction visual non-activation image from visual activation image and constructed brain map using a statistical parameter map (SPM99). The mean regional cerebral blood flow was increased due to visual stimulation. The increase rate of the mean regional cerebral blood flow which of the activation region in primary visual cortex of occipital lobe was 32.50{+-}5.67%. The significant activation sites using a statistical parameter of brain constructed a rendering image and image fusion with SPECT and MRI. Visual activation was revealed significant increase through quantitative analysis in visual cortex. Activation region was certified in Talairach coordinate and primary visual cortex (Ba17),visual association area (Ba18,19) of Brodmann.

  19. Findings of 99mTc-HMPAO Regional Cerebral Blood Flow SPECT in a Case of Herpes Simplex Encephalitis

    International Nuclear Information System (INIS)

    Ahn, Myeong Im; Lee, Sung Yong; Kim, Jong Woo; Bahk, Yong Whee

    1989-01-01

    Herpes simplex encephalitis (HSE) is one of the fulminant necrotizing, often fatal sporadic form of the encephalitis caused by herpes simplex type I virus. Characteristically, there is early and almost constant involvement of one or both temporal lobes, although there are common additional areas of involvement. Appropriate early treatment following correct diagnosis by clinical findings, CSF study, EEG and several radiological studies including angiography, radionuclide studies, CT or MRI can reduce its mortality and severity of the sequelae. We report a case of HSE diagnosed by adjuvant study of 99m Tc-HMPAO regional cerebral blood flow SPECT, which showed a marked increase in bitemporal cerebral blood flow in a 24-year-old man.

  20. Quantitative Analysis of Regional Cerebral Blood Flow using 99mTc-HMPAO SPECT in Parkinson's Disease

    International Nuclear Information System (INIS)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin; Lee, Myung Hae

    1992-01-01

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using 99m Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 ± 0.033 and 0.108 ± 0.062, respectively and PIA were -0.4 ± 0.7% and -0.7 ± 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  1. Quantitative Analysis of Regional Cerebral Blood Flow using {sup 99m}Tc-HMPAO SPECT in Parkinson's Disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Myung Chul; Bae, Sang Kyun; Chung, June Key; Koh, Chang Soon; Roh, Jae Kyu; Myung, Ho Jin [Seoul National University College of Medicine, Seoul (Korea, Republic of); Lee, Myung Hae [Asan Medical Center, Seoul (Korea, Republic of)

    1992-07-15

    Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using {sup 99m}Tc-HMPAO SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were 0.082 +- 0.033 and 0.108 +- 0.062, respectively and PIA were -0.4 +- 0.7% and -0.7 +- 1.0%, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

  2. Pre and post operative evaluation of the perfusion reserve by acetazolamide 99mTc-HMPAO SPECT in patients with chronic occlusive cerebral arteries. A comparative study with PET

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Sasaki, Masayuki; Akashi, Yuko; Yoshida, Tsuyoshi; Fukumura, Toshimitsu; Masuda, Kouji; Fujii, Kiyotaka; Fukui, Masashi

    1994-01-01

    We studied the pre and post-operative perfusion reserve using Diamox 99m Tc-HMPAO SPECT in 7 patients with chronic occlusive cerebral arteries and then compared the results with PET. STAMCA anastomosis was performed on 5 patients, while a carotid endarterectomy was done on 2 patients. The cerebral blood flow, the vascular response to CO 2 or Diamox, the oxygen extraction fraction and transit time (CBV/CBF) were measured by PET. In the pre-operative state, the visual evaluations for hypoperfusion area at rest agreed in 5 out of 7 patients in HMPAO SPECT and PET studies. In the remaining 2 patients, hypoperfusion areas were only detected in the PET study. The pre-operative evaluation of perfusion reserve agreed in 2 patients. In the remaining 5 patients, 3 patients showed definite positive (++) in PET and positive (+) in HMPAO SPECT, and one patient showed positive (+) in PET and negative (-) in HMPAO SPECT. The post-operative change of hypoperfusion areas well agreed in HMPAO SPECT and PET studies. However, the change of perfusion reserve was underestimated in HMPAO SPECT compared with PET. In the semiquantitative and quantitative analyses, the count rate ratios (affected/unaffected side) in HMPAO SPECT were apparently higher than those of CBF in PET. The postoperative change of the count rate ratios in HMPAO SPECT were smaller than those of CBF in PET. There was no significant correlation between the change in the ratio of the HMPAO SPECT after the administration of Diamox and the oxygen extraction fraction, and it was thus thought to be impossible to predict the areas with an increased oxygen extraction fraction. Thus, Diamox HMPAO SPECT may underestimate the areas of hypoperfusion or decrease in perfusion reserve when compared with PET. We should consider these limitations in the evaluation of pre and post operative cerebral hemodynamics. (author)

  3. Brain SPECT by intraarterial infusion of 99mTc-HMPAO for assessing the cerebral distribution of carotid artery infusions in patient with brain tumor

    International Nuclear Information System (INIS)

    Kosuda, Shigeru; Kusano, Shoichi; Aoki, Shigeki

    1993-01-01

    In order to assess the cerebral distribution of intracarotid chemotherapy, 17 postoperative patients with brain tumor underwent brain SPECT obtrained by intraarterial infusion of 18.5 MBq of 99m Tc-d,l,-hexamethylpropyleneamine oxime ( 99m Tc-HMPAO). Injection methods were continuous (5.0 ml/min) or pulsatile infusion with supra- or infraophthalmic catheterization. The findings obtained by brain SPECT were frequently different from those of angiography and/or DSA. In supraophthalmic catheterization with continuous infusion, only 2 of 10 studies (20%) had homogeneous distribution and 5 of them (50%) had maldistribution of 99m Tc-HMPAO which appears in association with laminar flow effect. The remaining 3 studies showed localized distribution (two: tumor localization, one: healthy brain localization). On the other hand, all of 5 studies with pulsatile infusion had homogeneous distribution of 99m Tc-HMPAO. In infraophthalmic catheterization, all but one of 5 studies had homogeneous distribution with continuous infusion. These results suggest that pulsatile infusion may be effective in eliminating maldistribution of 99m Tc-HMPAO in supraophthalmic catheterization. In conclusion, we are convinced that 99m Tc-HMPAO is a useful intraarterial agent for assessing cerebral distribution of intracarotid chemotherpay. (author)

  4. Types of traumatic brain injury and regional cerebral blood flow assessed by [sup 99m]Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi [Chiba Univ. (Japan). School of Medicine

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with [sup 99m]technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: (1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, (2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and (3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author).

  5. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Yamakami, Iwao; Yamaura, Akira; Isobe, Katsumi

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99m technetium-hexamethyl propyleneamine oxime (HMPAO). Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated: 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient. (author)

  6. An evaluation of the cerebral hemodynamics in moyamoya disease with acetazolamide (Diamox) 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Qin-Yi, Gao; Kuwabara, Yasuo; Ichiya, Yuichi

    1994-01-01

    We studied the cerebral hemodynamics using Diamox 99m Tc-HMPAO SPECT in 9 patients with moyamoya disease, consisting of 4 children and 5 adults. Diamox 99m Tc-HMPO SPECT studies were performed by the double injection method. Hypoperfusion areas were scored by a visual inspection as follows: ++, definite positive; +, probable positive; -, negative. Diamox test was interpreted as positive when the score increased over one degree. In the resting state, 6 out of 9 patients showed definite or probable positive hypoperfusion, while all of 9 patients showed a similar finding after Diamox injection. The Diamox test was positive in 6 out of 9 patients. It was positive in all 3 patients who showed a negative hypoperfusion in the resting state. The regional cerebrovascular response to Diamox was most severely impaired in the frontal region. However, it was relatively well preserved in the cerebellum and thalamus according to the semiquantiative analysis. Thus, the Diamox HOPAO SPECT was considered to be useful in evaluating the hemodynamics in patients with moyamoya disease. (author)

  7. HM-PAO SPECT in the diagnosis of cerebrovascular disease

    International Nuclear Information System (INIS)

    Cordes, M.; Rummeny, E.; Reissmann, M.; Fox, K.; Panitz, N.; Pfannenstiel, P.

    1987-01-01

    Single photon emission computed tomography (SPECT) after injection of 99m-Tc-HM-PAO was used to examine 34 patients whose clinical findings could not exclude a cerebrovascular disease. In all patients an X-ray computed tomography examination was inconclusive for the clinical-neurological findings. The regional cerebral bloodflow was pathologically disturbed in 10 of 34 patients in the HM-PAO SPECT examination. The detection of the regional cerebral bloodflow with HM-PAO SPECT is helpful in the diagnosis of cerebrovascular disease. (orig.) [de

  8. Normal Control Study of Cerebral Blood Flow by 99mTc HM-PAO SPECT

    International Nuclear Information System (INIS)

    Koong, Sung Soo; Moon, Dae Hyuk; Lee, Bum Woo; Lee, Kyung Han

    1989-01-01

    Regional cerebral perfusion was evaluated in 15 normal controls by single photon emission computed tomography using 99m Tc HM-PAO. For quantitative analysis, 13 pairs of homologous region of interest (ROI) were drawn on three transverse slices matching the vascular territories and cerebral cortices, and normal values of 3 semiquantitative indices including 'Right to left ratio' (R/L ratio), 'Regional index' (RI), and 'Region to cerebellum ratio (R/cbll ratio) were calculated. Mean values of R/L ratios of homologous regions were ranged from 0.985 to 1.023, and mean ± 2 s.d. of all regions did not exceed 11% of mean. Significant difference of Rls (mean count per voxel of a ROI/mean count per voxel of total ROls) between regions were found (p<0.001) with highest values in occipital cortex and cerebellum. After attenuation correction, Rls in deep gray, cranial portion of anterior cerebral artery and vascular territories in the 2nd slice increased significantly (p<0.05-0.001) hut vise versa in other ROIs. Region to cerebellum ratios also showed regional difference similar to Rls.

  9. A postural `stressed` cerebral HMPAO case study

    Energy Technology Data Exchange (ETDEWEB)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M. [Wangaratta District Hospital, VIC (Australia)

    1998-03-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia.

  10. A postural 'stressed' cerebral HMPAO case study

    International Nuclear Information System (INIS)

    Williams, R.C.; Jost, G.M.; Bolitho, L.; Grantham, M.

    1998-01-01

    Full text: This case study represents an example of the utility of postural hypoperfusion stressed HMPAO SPECT. An elderly woman of 78 with a long history of giddiness was referred to our laboratory for examination of possible cerebral ischaemia. She had recurrent dizzy episodes, sometimes posture related, over the past few years and had suffered several falls. Cerebral DSA revealed minimal disease. CT scans were reported as normal. Carotid duplex Doppler studies revealed bilateral plaque disease in the carotid bulbs extending to the origins of the ICAs which were not significant stenoses. Postural symptoms were induced by standing the patient up rapidly and HMPAO was administered at the same time. A SPECT scan of the brain was performed. Quantitative analysis showed a left to right decrease of 10.8% in the temporo-occipital area, 5.6% in the temporo-parietal area and 2.5% in the cerebellar and parietal areas. Images revealed moderately reduced tracer concentration in the left half of the cerebellum and the left occipital region extending as far forward as the temporo-parietal region A repeat HMPAO SPECT scan without stress was normal. This would appear to indicate reversible ischaemia in the left posterior region, and is consistent with the reported symptoms. This case illustrates the usefulness of HMPAO in the diagnosis of reversible cerebral ischaemia

  11. Scintigraphic assessment of cerebral blood flow changes in chrongic tobacco users using Tc-99m HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Saeed, S.; Raza, M.; Sohaib, M.

    2004-01-01

    HMPAO SPECT is a useful and readily available method for estimation of rCBE This study aimed at defining a correlation between chronic tobacco use and changes in cerebral blood flow, through visual and semi-quantitative scintigraphic assessment, rCBF in 48 chronic tobacco users and 11 quitters was evaluated, utilising a normal database created by HMPAO brain scans of 20 non-smokers. Subjects were classified into chronic tobacco users and non-tobacco users through the smoking index (SI). SI value of 100 was taken as the cut-off value. Tobacco users who had discontinued tobacco use for three months or more were classified as 'Quitters'. ROIs were declared hypo- or hyper-perfused if their percentage perfusion values relative to the average perfusion per pixel of the whole slice did not fall within + 2 SD of the mean regional perfusion in the corresponding ROI, in the normal control group.rCBF in chronic tobacco users was found to be far less than the non-tobacco users (P < 0.001). The quitters showed significantly better cerebral perfusion compared to the chronic tobacco users (P < 0.025) but their rCBF was still significantly decreased relative to the non-tobacco users (P < 0.005). In chronic tobacco users, the rCBF was decreased in parietal (P < 0.05) and occipital (P < 0.005) regions of the cortex, and increased in the temporal cortex (P < 0.001). The frontal cortex showed both hyperperfusion (P < 0.001) and hypoperfusion (P < 0.025), perhaps due to varying perfusion patterns in different areas / sub-regions of the frontal cortex. The cerebellar blood flow in chronic tobacco users was much decreased compared to the normal controls (P < 0.001).Generally, a satisfactory correlation between the results obtained visually and semi-quantitatively was found. Semi-quantitative approach, however, appeared better specially when regional radiotracer uptake (actual acquired average regional counts) were used as an adjunct to support the findings. (authors)

  12. Topodiagnosis in Creutzfeldt-Jakob disease by HMPAO-SPECT

    International Nuclear Information System (INIS)

    Heye, N.; Farahati, J.; Heinz, A.; Buettner, T.; Przuntek, H.; Reiners, C.

    1993-01-01

    A 80-year old female presented with an early stage of Creutzfeldt-Jakob disease with clinical, neurophysiological and neuropathological findings suggesting a focal involvement of the brain. HMPAO SPECT disclosed asymmetries of regional cerebral perfusion, thus suggesting that it may be a further diagnostic instrument in this disease. (orig.) [de

  13. Topodiagnosis in Creutzfeldt-Jakob disease by HMPAO-SPECT. Topodiagnostik der Creutzfeldt-Jakobschen Krankheit durch HMPAO-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Heye, N. (Neurologische Klinik, St. Josef Hospital, Bochum Univ. (Germany)); Farahati, J. (Klinik und Poliklinik fuer Nuklearmedizin, Essen Univ. (Gesamthochschule) (Germany)); Heinz, A. (Neurologische Klinik, St. Josef Hospital, Bochum Univ. (Germany)); Buettner, T. (Neurologische Klinik, St. Josef Hospital, Bochum Univ. (Germany)); Przuntek, H. (Neurologische Klinik, St. Josef Hospital, Bochum Univ. (Germany)); Reiners, C. (Klinik und Poliklinik fuer Nuklearmedizin, Essen Univ. (Gesamthochschule) (Germany))

    1993-02-01

    A 80-year old female presented with an early stage of Creutzfeldt-Jakob disease with clinical, neurophysiological and neuropathological findings suggesting a focal involvement of the brain. HMPAO SPECT disclosed asymmetries of regional cerebral perfusion, thus suggesting that it may be a further diagnostic instrument in this disease. (orig.)

  14. Comparison of Tc-99m HM-PAO and I-123 IMP cerebral SPECT images in Alzheimer's disease and multi-infarct dementia

    Energy Technology Data Exchange (ETDEWEB)

    Gemmell, H G; Sharp, P F; Besson, J A.O.; Ebmeier, K P; Smith, F W

    1988-10-01

    SPECT images of the brain can be obtained using either /sup 123/I labelled amines or /sup 99m/Tc-hexamethylpropyleneamineoxime (HM-PAO). Both materials produce images which are blood flow dominated and so appear similar in normal subjects, although the respective mechanisms of uptake are not yet finally established. It seems likely, however, that the different mechanisms of uptake are responsible for recent reports of some differences seen in images obtained with the two types of agent in patients with cerebral pathology, mainly cerebrovascular disease. In this study, 12 demented patients, 6 with dementia of the Alzheimer type (DAT) and 6 with multi infarct dementia (MID), were imaged with /sup 123/I-isopropylamphetamine (IMP) and /sup 99m/Tc-HM-PAO and the images compared. Significantly more lesions were seen with IMP than HM-PAO (P < 0.02); out of a possible 120 sites, 41 lesions were seen with IMP compared to 28 with HM-PAO, 23 being seen with both agents. However, it is concluded that either agent can be used for the differential diagnosis of dementia, a task for which the new cerebral blood flow agents seem well suited.

  15. Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by {sup 99m}Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru [Kushiro Neurosurgical Hospital, Hokkaido (Japan); Aburano, Tamio

    2000-02-01

    Cerebral blood flow (CBF) measured by {sup 99m}Tc-HMPAO SPECT before operation was studied in 60 patients with unilateral chronic subdural hematoma. The regional CBF was measured in 26 regions of the fronto-occipital 10 cortices, putamen, thalamus and cerebellar hemisphere on both sides. Sixty cases with unilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 17 cases with headache (headache group), 34 cases with hemiparesis (hemiparesis group) and 9 cases with consciousness disturbance or dementia (consciousness disturbance group), and into three groups on the basis of the degree of midline brain shift on MRI: 7 cases of mild shift group, 24 cases of moderate shift group and 29 cases of severe shift group. The average CBF in 60 patients in each region indicated that the regional CBF was reduced in frontal, occipital cortices and cerebellum on the non-hematoma side, and in putamen and thalamus on the hematoma side. In the headache group, the regional CBF reduction on the non-hematoma side was found in only frontal and occipital cortices compared with the corresponding regions on the hematoma side. In the hemiparesis group, the regional CBF was reduced in frontal and occipital cortices on the non-hematoma side and in putamen and thalamus on the hematoma side. The part of CBF reduction in both hemispheres was also noted in the hemiparesis group. In the consciousness disturbance group, the CBF reduction was markedly noted in whole brain. The CBF reductions in frontal and occipital cortices on the non-hematoma side and in putamen, thalamus and cerebellum on the hematoma side was not mutually related with the degree of midline brain shift. We concluded that the disturbance of CBF in chronic subdural hematoma was started from frontal and occipital cortices on the non-hematoma side observed in the headache group, and which was extended to putamen and thalamus on the hematoma side and a part of both hemispheres observed in

  16. Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru; Aburano, Tamio

    2000-01-01

    Cerebral blood flow (CBF) in 34 patients with bilateral chronic subdural hematoma was measured by 99m Tc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms :13 cases with headache (headache group), 10 cases with hemiparesis (hemiparesis group), 5 cases with tetraparesis (tetraparesis group) and 6 cases with consciousness disturbance or dementia (consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma was

  17. Clinical study of cerebral blood flow in bilateral chronic subdural hematoma measured by {sup 99m}Tc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru [Kushiro Neurosurgical Hospital, Hokkaido (Japan); Aburano, Tamio

    2000-08-01

    Cerebral blood flow (CBF) in 34 patients with bilateral chronic subdural hematoma was measured by {sup 99m}Tc-HMPAO SPECT before operation. The regional CBF was measured in 26 regions of the 10 cortical regions, putamen, thalamus and cerebellar hemisphere on both sides. According to the thickness of subdural hematoma, the thicker hematoma side was measured and examined as the thick hematoma side, and the other side as the thin hematoma side. Thirty four cases with bilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms :13 cases with headache (headache group), 10 cases with hemiparesis (hemiparesis group), 5 cases with tetraparesis (tetraparesis group) and 6 cases with consciousness disturbance or dementia (consciousness disturbance group), and into two groups according to the degree of midline brain shift on MRI: 14 cases of non-shifted group and 20 cases of shifted group. The average CBF of 34 patients in each region indicated a regional CBF reduction in the frontal, parietal and occipital cortices on the thin hematoma side, and in the putamen on the thick hematoma side. In the headache group, the regional CBF reduction on the thin hematoma side was found in the frontal, parietal and occipital cortices compared with the corresponding regions on the thick hematoma side, and in thalamus on the thick hematoma side. In the hemiparesis and tetraparesis groups, there was no statistically significant CBF reduction between the thick and thin hematoma sides. In the consciousness disturbance group, the CBF reduction in whole brain was remarkably significant. By the degree of the midline brain shift, the CBF reductions between the thick and thin hematoma sides were observed. Namely, in the shifted group, the CBF reductions were noted in the frontal, parietal and occipital cortices in the thin hematoma side, and in the putamen in the thick hematoma side. We concluded that the CBF reduction of bilateral chronic subdural hematoma

  18. Clinical study of cerebral blood flow in unilateral chronic subdural hematoma measured by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Okuyama, Tohru; Saito, Koji; Fukuyama, Kohichi; Yamamoto, Kouki; Morimoto, Mamoru; Aburano, Tamio

    2000-01-01

    Cerebral blood flow (CBF) measured by 99m Tc-HMPAO SPECT before operation was studied in 60 patients with unilateral chronic subdural hematoma. The regional CBF was measured in 26 regions of the fronto-occipital 10 cortices, putamen, thalamus and cerebellar hemisphere on both sides. Sixty cases with unilateral chronic subdural hematoma were classified into four groups on the basis of clinical symptoms: 17 cases with headache (headache group), 34 cases with hemiparesis (hemiparesis group) and 9 cases with consciousness disturbance or dementia (consciousness disturbance group), and into three groups on the basis of the degree of midline brain shift on MRI: 7 cases of mild shift group, 24 cases of moderate shift group and 29 cases of severe shift group. The average CBF in 60 patients in each region indicated that the regional CBF was reduced in frontal, occipital cortices and cerebellum on the non-hematoma side, and in putamen and thalamus on the hematoma side. In the headache group, the regional CBF reduction on the non-hematoma side was found in only frontal and occipital cortices compared with the corresponding regions on the hematoma side. In the hemiparesis group, the regional CBF was reduced in frontal and occipital cortices on the non-hematoma side and in putamen and thalamus on the hematoma side. The part of CBF reduction in both hemispheres was also noted in the hemiparesis group. In the consciousness disturbance group, the CBF reduction was markedly noted in whole brain. The CBF reductions in frontal and occipital cortices on the non-hematoma side and in putamen, thalamus and cerebellum on the hematoma side was not mutually related with the degree of midline brain shift. We concluded that the disturbance of CBF in chronic subdural hematoma was started from frontal and occipital cortices on the non-hematoma side observed in the headache group, and which was extended to putamen and thalamus on the hematoma side and a part of both hemispheres observed in the

  19. A new prognostic index - leucocyte infiltration - in human cerebral infarcts by 99Tcm-HMPAO-labelled white blood cell brain SPECT

    International Nuclear Information System (INIS)

    Kao, C.H.; Wang, P.Y.; Wang, Y.L.; Chang, L.; Wang, S.J.; Yeh, S.H.

    1991-01-01

    Twenty-six patients with acute cerebral infarction were imaged by 99 Tc m -hexamethylpropylene-amine oxime (HMPAO)-labelled white blood cell brain (Tc-WBC) single photon emission computed tomography (SPECT). The regions of interest were equally placed in the whole hemispheres of both sides with summation of all transaxial slices in the Tc-WBC SPECT. The asymmetric indices (AI) were calculated as 200 [|(right -left)|/(right + left)]. Grouping of patients with cerebral infarction was based on activities of daily living (ADL) at outcome. The results showed that the poor outcome patient group had a higher AI of Tc-WBC than that of the other patients (13.0 ± 3.0 S.E.M. versus 5.4 ± 1.0 S.E.M., and P < 0.05 by Wilcoxon rank sum test). In conclusion, the Tc-WBC SPECT may be considered as a new prognostic index to predict patient outcome in human cerebral ischaemic infarctions consistent with newly established ischaemic injury theories. (author)

  20. 99mTc-HMPAO Brain SPECT in Patients with Post-Traumatic Organic Mental Disorder

    International Nuclear Information System (INIS)

    Lee, Kang Wook; Lee, Dong Jin; Shong, Min Ho; Kang, Min Hee; Ghi, Ick Sung; Shin, Young Tai; Ro, Heung Kyu

    1994-01-01

    It is well known that 99m Tc-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 99m Tc-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 99m Tc-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 99m Tc-HMPAO SPECT. 2) Most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-HMPAO SPECT was decreased perfusion on both frontal lobe. And most frequent lesion on brain 99m Tc-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, 3 small cerebral infarction and 1 cerebellar encephalomalacia) which were not detected in brain 99m Tc-HMPAO SPECT. 4) The patients showing less than 20 points on MMSE disclosed abnormal results of EEG more frequently than those disclosing more than 20 points. In conclusion, we think that 99m Tc-HMPAO brain SPECT is sensitive method to detect functional lesions of the brains in patients with chronic post-traumatic organic mental disorder.

  1. 99mTc-HMPAO SPECT in brain death

    International Nuclear Information System (INIS)

    Tsuchida, Tatsuro; Sadato, Norihiro; Nishizawa, Sadahiko

    1993-01-01

    Brain single photon emission computed tomography (SPECT) with 99m Tc-d,l-hexamethyl-propyleneamine oxime (HMPAO) was performed twice in a 78-year-old man clinically diagnosed as brain death according to the standard criteria of the Japanese Ministry of Welfare. The first brain SPECT demonstrated the tracer accumulation in the brain, indicating preserved cerebral blood flow. The second brain SPECT performed 3 days later revealed cessation of the blood flow. In patients with preserved cerebral blood flow, the diagnosis of brain death cannot be made, even if they meet the existing criteria, because previous report noted the recovery in some of those patients. Brain perfusion SPECT plays an important role as a confirmatory test for the diagnosis of brain death. (author)

  2. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

    International Nuclear Information System (INIS)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G.; Zauner, H.

    2009-01-01

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  3. Change of cerebral blood flow distribution and vascular reserver according to age in Koreans measured by Tc-99m HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Song, Ho Cheon; Bom, Hee Seung; Sohn, Hye Kyung; Jeong, Hwan Jeong; Min, Jung Jun; Kim, Ji Yeol; Lee Jae Tae; Moon, Dae Hyuk; Lee, Hee Kyung

    1999-01-01

    The aim of this study was to evaluate the normal values of regional cerebral blood flow (rCBF) and cerebrovascular reserve (CVR) in normal children to aged volunteers using Tc-99m HMPAO. Thirty four right-handed normal volunteers (20 males, 14 females, mean age 40.3±24.9 years, range 4 to 82 years) were underwent rest/acetazolamide (ACZ) brain SPECT using Tc-99m HMPAO and the sequential injection and subtraction method. rCBF was estimated on the basis of a semiquantitative approach by means of right/left ratio, region/cerebellum and region to whole brain ratios in frontal, parietal, temporal, and occipital lobes, basal ganglia, thalami, and cerebellum. CVR was measured by means of % perfusion increase calculated as % mean count change compared to rest rCBF in each regions. Mean values of right to left ratios range from 1.004 to 1.018. rCBF was highest in cerebellum and lowest in basal ganglia and thalami. Frontal and temporal rCBF decreased while occipital and thalamic rCBF increased according to age. No sexual difference of rCBF was noted. Mean CVR was 29.9±12.9%. Mean CVR significantly increased to late teens, and declined thereafter. After 6th decade, CVR in both frontal lobes, left parietal lobe and right basal ganglia decreased significantly with advancing age. There was no sexual difference of CVR. Quantitative assessment of CVR was possible by ACZ Tc-99m MHPAO brain SPECT. It revealed that rCBF and CVR changed according to age in normal Korean volunteers. There was no sexual difference

  4. Cerebral blood flow assessed by brain SPECT with 99mTc-HMPAO utilising the acetazolamide test in systemic lupus erythematosus

    International Nuclear Information System (INIS)

    Lass, P.; Romanowicz, G.; Koseda-Dragan, M.

    1998-01-01

    Background: Cerebrovascular diseases are one of the most important complications of systemic lupus erythematosus (SLE). The diagnostic imaging of neuropsychiatric SLE complications presents many problems. This study was undertaken to investigate cerebral blood flow char s and its reactivity to hypercapnia by means of acetazolamide test in SLE patients. Methods: Brain SPECT studies using 99mTc-HMPAO were performed in 50 patients with SLE. Acetazolamide test was performed in 35 patients 3 days after the baseline study by means of repetitive scanning 20 min after i.v. injection of 1.0 g of acetazolamide. Results: Significant interhemispheric hypoperfusion areas were shown in 76.3% of all patients, 83.8% symptomatic and 63.1% asymptomatic. Patients with antiphospholipid syndrome showed multifocal perfusion deficits. The reaction of cerebral perfusion to acetazolamide was heterogenous and showed increase, decrease, no change or mixed reaction of baseline-study-found focal hypoperfusion. Acetazolamide test revealed hypoperfusion in two patients with normal baseline study. MRI scanning revealed cerebral lesions in 41% of patients. Conclusions: CBF asymmetries in symptomatic and asymptomatic patients with SLE are frequent. Regional CBF alterations seem to be different in patients with and without antiphospholipid syndrome. The part of the patients with SLE shows no or paradoxically inversed reaction to acetazolamide. (author)

  5. Types of traumatic brain injury and regional cerebral blood flow assessed by 99mTc-HMPAO SPECT.

    Science.gov (United States)

    Yamakami, I; Yamaura, A; Isobe, K

    1993-01-01

    To investigate the relationship between focal and diffuse traumatic brain injury (TBI) and regional cerebral blood flow (rCBF), rCBF changes in the first 24 hours post-trauma were studied in 12 severe head trauma patients using single photon emission computed tomography (SPECT) with 99mtechnetium-hexamethyl propyleneamine oxime. Patients were classified as focal or diffuse TBI based on x-ray computed tomographic (X-CT) findings and neurological signs. In six patients with focal damage, SPECT demonstrated 1) perfusion defect (focal severe ischemia) in the brain region larger than the brain contusion by X-CT, 2) hypoperfusion (focal CBF reduction) in the brain region without abnormality by X-CT, and 3) localized hyperperfusion (focal CBF increase) in the surgically decompressed brain after decompressive craniectomy. Focal damage may be associated with a heterogeneous CBF change by causing various focal CBF derangements. In six patients with diffuse damage, SPECT revealed hypoperfusion in only one patient. Diffuse damage may be associated with a homogeneous CBF change by rarely causing focal CBF derangements. The type of TBI, focal or diffuse, determines the type of CBF change, heterogeneous or homogeneous, in the acute severe head trauma patient.

  6. Preliminary results of SPECT studies with 99mTc-HMPAO in endogenous psychoses

    International Nuclear Information System (INIS)

    Wilhelm, K.R.; Georgi, P.; Schroeder, J.; Henningsen, H.; Sauer, H.

    1989-01-01

    18 psychopharmacologically treated patients (7 schizophrenics, 5 schizoaffectives, 6 depressives) were studied using 99m Tc-HMPAO-SPECT of the brain. The regional cerebral blood flow was measured in three transversal sections (infra-/supraventricular, ventricular) within 6 regions of interest (ROI) respectively (one frontal, one parietal and one occipital in each hemisphere). Corresponding ROIs of the same section in each hemisphere were compared. In the schizophrenics there was a significantly reduced perfusion in the left frontal region of the infraventricular and ventricular section (p 99m Tc-HMPAO-SPECT may be helpful in finding cerebral abnormalities in endogenous psychoses. (orig.) [de

  7. Study on effects of an atypical antipsychotic, risperidone on regional cerebral blood flow with 99mTc-HMPAO SPECT in drug-naive and unmedicated schizophrenic patients

    International Nuclear Information System (INIS)

    Koiwa, Daisuke

    2003-01-01

    To examine the underlying mechanisms of intracerebral or clinical actions of the atypical antipsychotic, risperidone (RIS), the effects of RIS on absolute regional cerebral blood flows (rCBFs) measured with 99mTc-HMPAO SPECT and correlations between the rCBFs and psychotic symptoms assessed with positive and negative syndrome scale (PANSS) were investigated in 10 drug-naive and unmedicated schizophrenic patients with acute hallucinatory and delusional state. Both the SPECT and PANSS were repeated before and after oral 2-week administration of RIS 3 mg/day in all of the 10 patients and after subsequent 2-week administration of RIS 4-6 mg/day in half of the patients. The rCBF values were significantly decreased in the left precentral gyrus alone after the low dose of RIS 3 mg/day in comparison with before the RIS dose. The rCBF values were significantly decreased in the right cingulate, postcentral, inferior parietal gyri and the left inferior temporal gyrus after the high dose of RIS 4-6 mg/day in comparison with before the low dose of RIS 3 mg/day. The psychiatric assessment with PANSS showed an improvement of positive and negative symptoms after the low RIS dose and still more after the high RIS dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the low RIS dose showed a positive correlation between the rCBF values in the right middle temporal gyrus and hallucinations (mainly auditory hallucination). These results suggest that chronic RIS administration dose-dependently produces a decrease of rCBF in the cerebral cortex in the manner that the low dose decreases rCBF in a few restricted cortical regions, while the high dose induces the rCBF reduction in more widespread cortical regions. The RIS-induced rCBF decrease in the cerebral cortex is considered to be attributable to a secondary inactivation in the cerebral cortex due to D 2 dopamine receptor blockade of RIS in the striatum through the cortico

  8. Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Kamoya, Masatoshi

    2001-01-01

    For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

  9. Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kamoya, Masatoshi [Kanazawa Medical Univ., Ishikawa (Japan)

    2001-03-01

    For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

  10. Regional Distribution of Cerebral Blood Flow in childhood Measured by '99mTc-HMPAO SPECT: Reference Values of Semiquantitative Indices and Effect of Age

    International Nuclear Information System (INIS)

    Kim, Sang Eun; Lee, Dong Soo; Chung, June Key

    1991-01-01

    Regional cerebral blood flow (rCBF) was evaluated in 12 children ranging in age from 2.7 to 10.0 yr using 99m Tc-HMPAO SPECT. For quantitative analysis, 13 pairs of homologous regions of interest (ROIs) were created on three attenuation-corrected 18,8 mm thick transverse slices matching the cerebral cortical regions, deep gray matter, cerebellar hemisphere, and vascular territories, and the semiquantitative indices including 'right to left ratio [(mean count/voxel of homologous right ROI) /(mean count/voxel of homologous left ROI)] and regional index '(RI) [(mean count/voxel of a ROI)/(mean count/voxel of all ROIs of each hemisphere)] were calculated. Mean values of right to left ratios of homologous regions ranged from 0.984 to 1.028 in children under 5 yr (group 1) and from 0.982 to 1.012 in children between 5 and 10 yr (group 2), and the mean value ±2 S.D. for each region did not exceed 11%. and 12% in group 1 and group 2, respective]y. There were no statistically significant differences between the RIs of the homologous right and left regions. Significant differences of RIs were found both between vascular regions (p<0,0005 for group 1, and p=0,0001 for group 2) and between regions of cerebral cortices (p<0,0005 for group 1, and p<0,005 for group 2) with a relatively high value in the occipital cortex and the lower values in the cerebellum and deep gray matter among the regions of cerebral cortices in both groups. There were no significant differences between the Rls of corresponding regions of group 1 and group 2, except a significantly higher value of right deep gray matter in group 2 than in group 1 (p=0.0301). The RIs of the superior frontal cortex and deep gray matter showed to be positively correlated with age (superior frontal cortex; right: rs=0.5254, p=0.0814, left: rs=0.5919, p=0.0496/deep gray matter; right: rs=0.8246, p=0.0062, left: rs=0.6266, p=0,0377). The results suggest that the rCBF pattern of children approaches that of adults in an occipito

  11. Utility of Brain SPECT 99mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia DA and dissociative motor disorders DMD (previously termed as hysteria)

    International Nuclear Information System (INIS)

    Ali, F.

    2007-01-01

    Full text: The aim of the study was to assess the utility of Brain SPECT 99 mTc-HMPAO scintigraphy for the evaluation of regional cerebral blood flow changes in patients suffering from dissociative amnesia (DA) and dissociative motor disorders (DMD) (previously termed as Hysteria). Materials and Methods: 20 patients were included in the study with a mean age of 26 years, 08 of them suffering from DA and 12 from DMDs. A consultant psychiatrist on the basis of ICD-10 criteria made the diagnosis. Patients were divided into two categories according to the duration of their illness. Category A; included 10 patients having less than six months duration of illness. Category B; included 10 patients having duration of illness more than six months. Ten normal controls having no signs and symptoms of any psychiatric disorder were also included in the study. Brain SPECT study was carried out using 99 mTc-HMPAO. Semiquantitative analysis was done by calculating cortical and cerebellar ratios in normals and comparing the same in the patients. Results: By comparing regional cerebral blood flow ratios of both the categories with normal group, patients suffering from DA showed hypoperfusion in bilateral temporal lobes, in both frontal association areas and both orbito frontal regions and patients suffering for more than 06 months showed a slightly more exaggerated pattern of hypoperfusion in the same cortical areas. On the other hand in DMD only the patients suffering for more than 06 months showed altered cerebral blood perfusion like hypoperfusion in both of the frontal motor areas, hypoperfusion in both temporal lobes and marked hyperperfusion in both orbito frontal areas. Conclusion: Patients of DA show abnormal cerebral perfusion pattern whether in acute or chronic stage while only chronic DMD states precipitate altered cerebral perfusion patterns and these can be visualized on a Brain SPECT study. (author)

  12. Effects of auditory recall experience on regional cerebral blood flow as assessed by 99m-Tc-HMPAO SPECT in 13 Post Traumatic Stress Disorder patients

    International Nuclear Information System (INIS)

    Pagani, M.M.E.; Salmaso, D.; Soares, J.; Aberg-Wistedt, A.; Sundin, O.; Jacobsson, H.; Larsson, S.A.; Haellstroem, T.

    2002-01-01

    Aim: Post Traumatic Stress Disorder (PTSD) is a severe condition affecting about 8% of population and increasing the risk of depression. PTSD patients, among other symptoms, suffer from intrusive distressing recollections of the traumatic event and avoidance of stimuli related to trauma. The aim of this study was to investigate the differences in regional cerebral blood flow (rCBF) between two groups of subjects exposed to the same type of traumatic stressor either developing PTSD or not. Materials and Methods: Thirteen subway drivers developing PTSD (PTSD) and 19 not developing PTSD (CTR) after being exposed to earlier person-under-the-train accident were included in the study. The rCBF distribution was compared between the two groups during a situation involving an auditory evoked re-experiencing of their traumatic event. 99m Tc-HMPAO SPECT, using a three-headed gamma camera, was performed and the radiopharmaceutical uptake in 7 bilateral regions of the brain was assessed using a standardised digitalised brain atlas. The chosen regions were those supposed to be involved in fear and emotional response and were located in the thalamus, limbic cortex and prefrontal, temporal and parietal lobes. Analysis of variance (ANOVA) was used to test the significance of the differences in flow in such functional regions. Results: In the global analysis, rCBF significantly differed between groups (0.04), hemispheres (p<0.02) and regions (p<0.0001). There was also a significant region x hemisphere interaction (p<0.0001). As compared to CTR, PTSD rCBF increased in the primary and associative auditory cortex (p<0.03) and in the temporal poles (p<0.02). Significant hemispheric differences were found in these latter regions (p<0.001 and p<0.0001, respectively), anterior cingulate cortex (p<0001) and multi-medial parietal association cortex (p<0.0001). Conclusions: Higher rCBF values in PTSD patients under recall of their traumatic experience were found as compared to CTR. The

  13. Regional cerebral blood flow changes as assessed by 99m-Tc-HMPAO SPECT in 70 Unipolar Depressed patients at rest

    International Nuclear Information System (INIS)

    Pagani, M.M.E.; Sanchez-Crespo, A.; Jonsson, C.; Jacobsson, H.; Waegner, A.; Larsson, S.A.; Gardner, A.; Haellstroem, T.; Salmaso, D.

    2002-01-01

    Aim: Alterations in excitatory or inhibitory signals between cortical and sub-cortical regions in patients with unipolar depression (MDD) may be assessed by investigating changes in regional cerebral blood flow (rCBF). Regions with abnormal metabolic activity might participate in neural networks and affect the rCBF distribution in functionally connected structures. The aim of this study was to identify the brain regions showing rCBF changes in MDD by means of SPECT and Principal Component Analysis (PCA). Materials and Methods: The rCBF distributions in 70 MDD and 66 control (CTR) subjects, at rest, were compared. 99m Tc-HMPAO SPECT, using a three-headed gamma camera, was performed and the uptake in 27 functional bilateral sub-volumes of the brain was assessed by a standardised digitalised brain atlas. Data were grouped into functional regions by means of PCA analysis performed on all 136 individuals. Analysis of variance (ANOVA) was used to test the significance of the differences in flow in such functional regions. Results: In the global analysis, rCBF significantly differed between groups (0.02). There were also significant hemispheres x groups interaction (p<0.003) and gender difference (p=0.003), with right hemisphere rCBF specifically increased in MDD and females showing a higher CBF. PCA identified 11 anatomo-functional regions that interacted with groups (p<0.001) and gender (p<0.001). As compared to CTR, MDD rCBF increased, bilaterally, in the right associative temporo-parietal cortex (p<0.007), in right frontal cortex and prefrontal cortex (p=0.002), in the temporal poles (p<0.03) and in thalamus and basal ganglia (p<0.001). Conclusions: Higher rCBF in MDD at rest was found in 4 clusters of regions sharing close anatomical and functional relationships. These regions represented large parts of the right hemisphere and the downstream central structures. These findings confirm rCBF changes in unipolar depressive disorders, suggest mutual rCBF relationships

  14. SPECT with technetium-99m-HMPAO in relation to late cognitive outcome after surgery for ruptured cerebral aneurysms

    International Nuclear Information System (INIS)

    Saeveland, H.; Uski, T.; Brandt, L.; Sjoeholm, H.; Sonesson, B.

    1996-01-01

    Fifteen patients with a good neurological outcome after aneurysmal SAH and surgery were collected prospectively. Six months after surgery neurological examination and a SPECT study for evaluation of the three dimensional CBF distribution as well as an extensive neuropsychological test were performed. In all patients with pathological SPECT findings the location of the reduced regional CBF correlated with the location of the ruptured aneurysm and/or side of surgical approach. The volume of the brain tissue with reduced rCBF showed a great variety, from 9-112 cm 3 (mean: 33 cm 3 ). Similarly, the maximum flow reduction in the affected areas also varied considerably from 17-95 % (mean: 39 %). In general, the neuropsychological functioning of the patients post SAH was favourable. Seven individuals had a presumably normal neuropsychological appearance with respect to estimates of premorbid levels of functioning. Another four patients were slightly impaired and the remaining four were moderately affected. Only in five cases did the location of SPECT pathology and the site of neuropsychological impairment appear to coincide, whereas this was not the case in the remaining 10 patients. In general, the extent of SPECT pathology did not differ in the three neuropsychological outcome groups (normal, slight and moderate disability). (author)

  15. Role of SPECT (HM-PAO, Tc99mRc) and ultrasound (TCD) in the instrumental diagnostic approach to the comprehension of reversible ischemic symptoms

    International Nuclear Information System (INIS)

    Liboni, W.; Baggiore, P.; Chianale, G.; Marta, G.; Castellano, G.; Cornaglia, G.

    1989-01-01

    The relation between variations of cerebral and acute neurologic events, followed by partial or total recovery, has been investigated with SPECT HM-PAO and with ultrasound (TRANSCRANIAL DOPPLER). (H.W.). 3 refs.; 2 figs.; 2 tabs

  16. Delayed reflow of an ischemic infarct after spontaneous thrombolysis studied by CBF tomography using SPECT and Tc-99m HMPAO

    DEFF Research Database (Denmark)

    Companioni, J M; Lassen, N A; Tfelt-Hansen, P

    1991-01-01

    A patient with a large ischemic infarct in the left middle cerebral artery territory was studied six times in the acute/subacute phase by cerebral blood flow (CBF) tomography using Tc-99m-HMPAO. The SPECT instrument used was a brain dedicated highly sensitive four-camera system (TOMOMATIC 232...

  17. A new method for brain functional study using Tc-99m HMPAO SPECT

    International Nuclear Information System (INIS)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Iio, Masahiro

    1989-01-01

    The distribution of 99m Tc-HMPAO in brain is in proportion to regional cerebral blood flow (rCBF) and can be interpreted as functional mapping. To evaluate local changes in CBF during neuropsychological testing, we developed a new subtraction method using HMPAO and SPECT. With patients resting, 15 mCi of HMPAO was injected and the first acquisition was performed, lasting a total of 10 minutes. Soon after the end of the first scan, patients were requested to undergo Buschke's memory test or to repeat words or numbers (repetition test). During the task, an additional 15 mCi of HMPAO was injected using the same position as in the first scan, and a second acquisition was started. A functional image was made by subtracting the image in the first scan from that in the second. In two patients with transient global amnesia and two normal controls, Buschke's memory test was performed in combination with SPECT. A relative increase in activity was seen in the thalamus, subthalamic area, hippocampus, and some cortial areas, apparently reflecting local functional change induced by the memory task. In two patients with moderate Alzheimer's disease with severe memory loss, no increase was detected in these areas. In one patient with aphasia, the repetition test with SPECT was correlated with the WADA test and dichotic listening test, and good agreement was obtained. In conclusion, our new SPECT technique is useful in detecting alterations in rCBF during mental activity and can be applied to neurophysiological studies. (author)

  18. Tc-99m-HMPAO neuroactivation SPECT in patients with Alzheimer's disease

    International Nuclear Information System (INIS)

    Klissarova, A.; Tranulov, G.; Deleva, D.; Kaprelyan, A.; Tjaneva, M.

    2002-01-01

    Aim: Tc-99m-HMPAO-SPECT detects the hypoperfusion areas in the temporal and parietal lobes as well as in the frontal lobes in the advanced stages of Alzheimer's disease. These hypoperfusion areas correlate with decreased glucose metabolism and oxygen utilization. The aim of the study was to establish the neuroactivation effect on the regional cerebral blood flow and on the hypoperfusion areas detected by means of Tc-99m-HMPAO-SPECT in patients with Alzheimer's disease. Materials and methods: Subject to the study were 22 patients with Alzheimer's disease divided into two groups according to the results from the neuropsychological tests as follows: Ist group - 10 patients with slight cognitive disturbances; IInd group - 12 patients with prominent cognitive impairment. All patients underwent Brain-SPECT after I.V. injection of 740 MBq Tc-99m-HMPAO at rest and during neuroactivation by labyrinth task on the next day. Regional blood flow was detected by means of the hypoperfusion indices calculated as follows: hypoperfusion areas in the temporal lobe and /or the parietal lobe to the referent areas of the cerebellum. The regional blood flow decrease in hypoperfusion areas was calculated in per cent. Results: Hypoperfusion areas were detected at rest in 5 patients from the Ist group and in all patients from the IInd group. A decrease of the regional cerebral blood flow by 5-10% was established after neuroactivation in all the seventeen patients with hypoperfusion areas at rest. After neuroactivation three of the patients with normal regional cerebral perfusion at rest revealed hypoperfusion areas in the posterior part of the parietal lobe and the temporo-parietal areas. The remaining two patients showed normal regional cerebral blood flow at rest and during neuroactivation. Conclusion: Neuroactivation reduces the regional cerebral blood flow in hypoperfusion areas at rest in patients with Alzheimer's disease. Neuroactivation Tc-99m-HMPAO SPECT is useful for the detection

  19. A Case of Habitual Neck Compression Induced Electroencephalogram Abnormalities: Differentiating from Epileptic Seizures Using a Tc-99m HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Hongyoon; Seo, Minseok; Lee, Hoyoung; Kim, Youngsoo; Yun, Changho; Kim, Sangeun; Park, Sungho [Seoul National Univ. Bundang Hospital, Seongnam (Korea, Republic of)

    2014-06-15

    Self-induced hypoxia has been reported particularly in adolescents, and it can result in neurological injury. Here, we present a case of electroencephalogram (EEG) abnormalities induced by habitual neck compression differentiated from epileptic seizures by Tc-99m HMPAO SPECT. A 19-year-old male was admitted for evaluation of recurrent generalized tonic-clonic seizures. No interictal EEG abnormality was detected; however, abnormal slow delta waves were found immediately after habitual right neck compression. To differentiate EEG abnormalities due to a hemodynamic deficit induced by habitual neck compression from an epileptic seizure, Tc-99m HMPAO SPECT was performed immediately after right carotid artery compression. Abnormal delta waves were triggered, and cerebral hypoperfusion in the right internal carotid artery territory was detected on Tc-99m HMPAO SPECT. The slow delta wave detected on the EEG resulted from the cerebral hypoperfusion because of the habitual neck compression.

  20. A Case of Habitual Neck Compression Induced Electroencephalogram Abnormalities: Differentiating from Epileptic Seizures Using a Tc-99m HMPAO SPECT

    International Nuclear Information System (INIS)

    Choi, Hongyoon; Seo, Minseok; Lee, Hoyoung; Kim, Youngsoo; Yun, Changho; Kim, Sangeun; Park, Sungho

    2014-01-01

    Self-induced hypoxia has been reported particularly in adolescents, and it can result in neurological injury. Here, we present a case of electroencephalogram (EEG) abnormalities induced by habitual neck compression differentiated from epileptic seizures by Tc-99m HMPAO SPECT. A 19-year-old male was admitted for evaluation of recurrent generalized tonic-clonic seizures. No interictal EEG abnormality was detected; however, abnormal slow delta waves were found immediately after habitual right neck compression. To differentiate EEG abnormalities due to a hemodynamic deficit induced by habitual neck compression from an epileptic seizure, Tc-99m HMPAO SPECT was performed immediately after right carotid artery compression. Abnormal delta waves were triggered, and cerebral hypoperfusion in the right internal carotid artery territory was detected on Tc-99m HMPAO SPECT. The slow delta wave detected on the EEG resulted from the cerebral hypoperfusion because of the habitual neck compression

  1. Cerebral perfusion (HMPAO-SPECT) in patients with depression with cognitive impairment versus those with mild cognitive impairment and dementia of Alzheimer's type: a semiquantitative and automated evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Staffen, W.; Bergmann, J.; Schoenauer, U.; Kronbichler, M.; Golaszewski, S.; Ladurner, G. [Paracelsus Medical University, Christian-Doppler-Clinic, Department of Neurology, and Center of Cognitive Research Salzburg, Salzburg (Austria); Zauner, H. [Rehabilitation Center of the Pensionsversicherungsanstalt, Grossgmain (Austria)

    2009-05-15

    Comparative evaluation of regional brain perfusion measured by HMPAO-SPECT of patients with mild cognitive impairment (MCI), dementia of Alzheimer's type (DAT) and depression with cognitive impairment (DCI). A total of 736 patients were investigated because of suspected cognitive dysfunction. After exclusion of patients with other forms of dementia than DAT or relevant accompanying disorders, SPECT data from 149 MCI, 131 DAT and 127 DCI patients, and 123 controls without any cognitive impairment, were analysed. Relative cerebral blood flow of 34 anatomical regions was assessed with automated analysis software (BRASS). Calculation of global forebrain perfusion discriminated demented from nondemented patients. Compared to controls DCI patients showed hypoperfusion of the thalamus, lentiform nucleus and medial temporal cortex. MCI patients differed significantly from controls concerning perfusion in both hemispheric temporal and parietal areas, and in the (right hemispheric) posterior part of the cingulate gyrus. MCI and DCI patients differed in the parietal, temporal superior and right hemispheric cingulate gyrus posterior cortices. Global forebrain and regional perfusion was more extensively reduced in DAT patients and discriminated them from controls, and MCI and DCI patients. Frontal perfusion disturbance was only present in DAT patients. Automated analysis of HMPAO-SPECT data from MCI patients showed significant perfusion deficits in regions also involved in DAT patients, but ROC analysis demonstrated only moderate sensitivity and specificity for differentiating DAT patients from controls and DCI patients. Frontal hypoperfusion seems to correspond with conversion from MCI to DAT. Finally, the results in DCI patients again raise the question of depression as an early symptom of neurodegeneration. (orig.)

  2. Clinical Utility of '99mTc-HMPAO Brain SPECT Findings in Chronic Head Injury

    International Nuclear Information System (INIS)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo

    1992-01-01

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using 99m Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with 99m Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using 99m Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  3. A comparative study of perfusion CT and 99mTc-Hmpao spect measurement to assess cerebrovascular reserve capacity in patients with internal carotid artery occlusion

    Directory of Open Access Journals (Sweden)

    Eicker S

    2011-11-01

    Full Text Available Abstract Background and purpose Patients with internal carotid artery (ICA occlusion can demonstrate impaired cerebral vascular reserve (CVR. The detection of CVR using single photon emission CT (SPECT is nowadays widely accepted as a predictor in the diagnostic pathway in patients considered for cerebral revascularization. Recently perfusion CT (PCT gained widely acceptance in stroke imaging The present study was aimed at comparing the results of perfusion CT (PCT and 99mTc-HMPAO SPECT with acetazolamide challenge in patients with ICA occlusion. Methods 13 patients were included in the prospective evaluation. Both PCT and 99mTc-HMPAO SPECT were performed before and after the administration of acetazolamide. In detail, regional cerebral blood flow (rCBF, regional cerebral blood volume (rCBV, adapted time to peak (Tmax and mean transit times (MTT were compared with SPECT data. Results 99mTc-HMPAO SPECT demonstrated an impairment of CVR in six patients. A preserved CVR was present in seven patients. All patients with impaired CVR proven by SPECT had a delayed MTT (mean +2.98 s and a delayed Tmax (mean + 5.9 s, (both p Conclusion The prospective study demonstrated a highly significant correlation of perfusion parameters as' detected by 99mTc-HMPAO SPECT and the Tmax as detected by PCT in patients with ICA occlusion. Therefore this easy-to-perform technique seems to be an adequate method for the evaluation of cerebral perfusion in patients with ICA occlusion.

  4. Usefulness of change ratio map in 99mTc-HMPAO SPECT with acetazolamide enhancement

    International Nuclear Information System (INIS)

    Yamamoto, Naoyuki

    1996-01-01

    Although a sequential 99m Tc-HMPAO SPECT technique with Diamox test (seq-SPECT) is a simple and time-saving procedure to assess brain perfusion reserve, the influence of the first dose of the tracer on the second one is not negligible. Therefore, a subtraction of the rest-SPECT from the 2nd SPECT is widely-used. However, subtracted SPECT images not only need to be corrected for the injected dose and the radiochemical purity due to inherent instability of HMPAO but also are usually degraded in quality. This study was undertaken to resolve these problems utilizing a change ratio (CR) map. The CR map was obtained by dividing 2nd SPECT by rest-SPECT. Prior to subtraction, the 2nd SPECT was normalized with the ratio of the mean whole brain counts between both SPECTs. To validate CR map, 7 patients were studied with both seq-SPECT and 133 Xe inhalation CBF measurement (Xe-CBF). The right to left count ratio obtained from the ROIs placed on MCA territory of CR map correlated well with that from Xe-CBF (r=0.89, p<0.01). Fifty-three patients with stroke underwent the seq-SPECT which was compared with the cerebral angiography (CAG) and classified into 4 groups according to the CR map. In 25 patients, all of the rest-, the subtracted-SPECT and the CR map did not show any difference between the affected side and the contralateral normal side. Seven patients with normal rest-SPECT showed decreased subtracted-SPECT counts and CR on the affected side. Three of them showed more than 75% stenosis on CAG. Four patients with the decreased counts both at the rest-and the subtracted-SPECT revealed no difference on the CR map suggesting the matched decrease of both blood flow and metabolism in the affected side. In conclusion, the CR map was a simple and useful method to evaluate the brain perfusion reserve with the seq-SPECT. (author)

  5. A new method for brain functional study using Tc-99m HMPAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Momose, Toshimitsu; Kosaka, Noboru; Nishikawa, Junichi; Ohtake, Tohru; Watanabe, Toshiaki; Iio, Masahiro (Tokyo Univ. (Japan). Faculty of Medicine)

    1989-04-01

    The distribution of {sup 99m}Tc-HMPAO in brain is in proportion to regional cerebral blood flow (rCBF) and can be interpreted as functional mapping. To evaluate local changes in CBF during neuropsychological testing, we developed a new subtraction method using HMPAO and SPECT. With patients resting, 15 mCi of HMPAO was injected and the first acquisition was performed, lasting a total of 10 minutes. Soon after the end of the first scan, patients were requested to undergo Buschke's memory test or to repeat words or numbers (repetition test). During the task, an additional 15 mCi of HMPAO was injected using the same position as in the first scan, and a second acquisition was started. A functional image was made by subtracting the image in the first scan from that in the second. In two patients with transient global amnesia and two normal controls, Buschke's memory test was performed in combination with SPECT. A relative increase in activity was seen in the thalamus, subthalamic area, hippocampus, and some cortial areas, apparently reflecting local functional change induced by the memory task. In two patients with moderate Alzheimer's disease with severe memory loss, no increase was detected in these areas. In one patient with aphasia, the repetition test with SPECT was correlated with the WADA test and dichotic listening test, and good agreement was obtained. In conclusion, our new SPECT technique is useful in detecting alterations in rCBF during mental activity and can be applied to neurophysiological studies. (author).

  6. HMPAO-SPECT during epileptic seizures: Early and late images

    International Nuclear Information System (INIS)

    Overbeck, B.; Gruenwald, F.; Bockisch, A.; Biersack, H.J.; Reinke, U.; Gratz, K.F.

    1990-01-01

    For presurgical evaluation of epilepsy a 44-year old patient with complex-partial seizures underwent HMPAO-SPECT. The morphology of the seizures, the MRI-scan, psychometry and ictal as well as interictal EEGs showed a left temporal origin of the seizures. Early images were obtained 20 min and late images 24 h following injection. On both scans a marked hyperperfusion was observed in the left temporal area. A crossed cerebellar diaschisis was also seen on both SPECTs. It could be shown that during ictal examinations there is no bloodflow-dependent wash-out from brain tissue. (orig.) [de

  7. Brain perfusion SPECT imaging before and during the acetazolamide test using sup 99m Tc-HMPAO

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Higashi, Sotaro; Kinuya, Keiko; Tsuji, Shiro; Sumiya, Hisashi; Hisada, Kinichi; Yamashita, Junkoh (Kanazawa Univ. (Japan). School of Medicine)

    1990-05-01

    A new method using brain perfusion {sup 99m}Tc-HMPAO SPECT imaging was developed for evaluating cerebral perfusion reserve by the acetazolamide test with a short period. The first SPECT study was carried out for 13.5 min to obtain SPECT images at the resting state after 3 min postinjection of 555 MBq (15 mCi) of {sup 99m}Tc-HMPAO. At the same time as the start of the first SPECT study, 1 g of acetazolamide was intravenously injected. Immediately after the stop of the 1st SPECT study, 925 MBq (25 mCi) of {sup 99m}Tc-HMPAO from the same vial as in the first study was additionally injected. Three minutes later the second SPECT study was carried out for 10 min. After reconstruction the tomographic images in the first study were subtracted from the images in the second study to obtain those during the acetazolamide test after correction of the time differences in data acquisition between the two studies. This subtraction technique gives independent brain perfusion SPECT images before and during the acetazolamide test. Besides, the regional flow changes during the test were quantitatively analyzed. In conclusion this method seems to be practically useful for evaluating regional brain perfusion before and during drug treatments as a consecutive study with a short period of approximately 30 min. (author).

  8. Technetium-99mTc-HMPAO brain SPECT in antiphospholipid syndrome - preliminary data

    International Nuclear Information System (INIS)

    Romanowicz, G.; Lass, P.; Koseda-Dragan, M.; Nowicki, R.; Krajka-Lauer, J.

    2000-01-01

    Background: Antiphospholipid syndrome (APS) is defined as the presence of repeated episodes of arterial or venous thrombosis, recurrent spontaneous abortions and throbocytopenia in patients with elevated antiphospholipid antibodies. An important feature of APS are cerebrovascular disorders of thrombotic origin. The aim of the study was to assess cerebral blood flow changes utilising brain SPECT HMPAO scanning. METHODS: Brain SPECT 99mTc-HMPAO scanning was performed in 20 patients with APS: 12 with systemic lupus erythematosus, 4 with Sneddon's syndrome, 2 with Sjoegren's syndrome, 2 with primary APS. 30 healthy volunteers served as a control group. RESULTS: 19 studies were abnormal, 1 normal. Abnormalities consisted of multifocal perfusion deficits and diffuse decrease of regional blood flow. The average number of focal perfusion deficits was 4.8±1.7. In 7 patients diffuse hypoperfusion of frontal lobes was seen, in 1 patient additionally hypoperfusion of temporal and occipital lobes. There was a correlation between the number of focal perfusion deficits and cognitive impairment in this group of patients. Correlation between SPECT images and clinical data was moderate in cerebellar syndrome and paresis, weak in persistent headache and vertigo. CONCLUSIONS: Those results indicate the high utility of CBF brain SPECT scanning in antiphospholipid syndrome. (author)

  9. Comparison of Tc-99m HM-PAO SPECT brain scan and x-ray CT in the detection of brain metastases

    International Nuclear Information System (INIS)

    Abdel-Dayem, H.M.; Sadek, S.; Sahwell, A.; Kubasek, H.; El-Sayed, M.; Ziada, G.; Mobarak, L.; Al-Huda, F.; Omar, Y.T.

    1986-01-01

    Tc-99m HM-PAO imaging was compared with x-ray CT in 14 patients with known or suspected brain metastases. Both studies were done within 3 days of each other. Static and single photon emission CT (SPECT) images were acquired after intravenous injection of 13 mCi of Tc-99m HM-PAO. All 14 patients underwent static and SPECT Tc-99m HM-PAO imaging and x-ray CT. Studies were positive in 7, 12, and 10 patients, respectively, by static, SPECT, and x-ray CT imaging, and negative in 7, 2, and 2. The number of lesions identified was 0 (static imaging), 32 (SPECT), and 26(x-ray CT). There were no ''suspicious'' studies by any modality. This study indicates that Tc-99m HM-PAO SPECT cerebral blood flow imaging is more sensitive than x-ray CT for detecting brain metastases, that biplane imaging is not sensitive and SPECT is essential, and that for Tc-99m HM-PAO SPECT brain imaging to regain its importance with respect to x-ray CT, acquisition time must be 10 minutes or less and determination of percentage brain uptake of the injected dose, and of regional distribution, is necessary

  10. Diagnosis of ischemic cerebrovascular diseases with 99mTc-HMPAO brain SPECT using upright stress test

    International Nuclear Information System (INIS)

    Chen Shaoliang; Xiu Yan; Sun Xiaoguang

    1998-01-01

    Purpose: To evaluate the value of upright brain SPECT stress test, the authors performed 99m Tc-HMPAO brain SPECT in association with measurement of blood pressure in both upright and supine positions. Methods: The authors studied 5 patients with unilateral stenosis occlusion of the internal carotid (Group A), 8 patients with orthostatic hypotension (group B) and 7 normal controls. 370 MBq 99m Tc-HMPAO was injected immediately after uprighting from a supine position. then the first SPECT scan were performed. After the first SPECT, another 555 MBq of 99m Tc-HMPAO were administered while the patients remained on original supine position. Results: Semiquantitive analysis showed that the asymmetric ratios between upright and supine positions in group A changed significantly. In group B, showed postural cerebral hypoperfusion in the bilateral frontal areas, the mean count ratio of the frontal to cerebellar area between the upright and supine positions also significantly changed. In the normal group, there were no significantly changes during the upright test. Conclusions: The upright stress test is useful for detecting not only silent cerebral hypoperfusion, but also orthostatic hypoperfusion

  11. MRI and HMPAO-SPECT in the diagnosis of epilepsy

    International Nuclear Information System (INIS)

    Bokisch, A.; Gruenwald, F.; Elger, C.E.; Kaiser, W.A.; Biersack, H.J.

    1992-01-01

    Eighty-three patients suffering from intractable epilepsy were investigated by magnetic resonance imaging (MRI) and by HMPAO-SPECT during presurgical evaluation. MRI was proven to be most sensitive concerning the detection of focal lesions. Acquisition of thin slices and high signal/noise ratios are prerequisites for optimal sensitivity, the use of Gd-DTPA, in addition, increases the reliability slightly. Histological findings were available in 21 patients and in all cases of focal lesions without prior surgery, malignancy was detected or excluded correctly. The sensitivity was reduced, however, in the 4 patients with recurrency of astrocytoma. 2 cases were missed. Quantitative evaluation of signal intensities in the amygdala/hippocampal region or of the signal dynamics after contrast media application were not helpful in patients without focal lesion. In these patients no reliable criterium to determine the side of the focus with MRI investigations could be established. HMPAO-SPECT investigations were found to be complementary to MRI. In 19 of 36 patients without focal lesions the lateralisation was feasible by scintigraphy. In addition a correlation between the volume asymmetry of the temporal horns detected by MRI and the scintigraphic finding was established. The statistical proven correlation between the unilateral dilatation of the temporal horn and relative hypoperfusion is too weak, however, to imply individual consequences. (orig.) [de

  12. Changes of rCBF 99mTc-HMPAO SPECT in a selected disorders

    International Nuclear Information System (INIS)

    Junik, R.

    2003-01-01

    With single photon emission computer tomography (SPECT) and HMPAO a noninvasive examination of regional cerebral blood flow can be performed (rCBF). The purpose of the SPECT examinations was to define the location and magnitude of blood flow disorder in selected diseases and the assessment of the results as complementary to morphological tests CT and MRI or functional tests, such as EEG. The examinations were carried out in 455 patients: 91 - patients with depression, 29 - congenital hypothyroidism, 66 - migraine, 34 - epilepsy, 6 - Landau-Kleffner syndrome, 20 - Alzheimer disease, 55 - with suspected Alzheimer disease, 105 - cerebral stroke, and 48 - transient cerebral ischemia. The control group comprised of 26 subjects. The SPECT method was used to perform examinations. The images were evaluated based on semiquantitative method. The asymmetry of activity and activity referred to the referential region were measured using symmetrical ROIs localized in hypoperfusion foci. The differences in perfusion in symmetric locations exceeding 10% were considered abnormal. During the depression stage, in patients with depression, a decrease of rCBF occurred. Regression of depression results in an increase of rCBF almost in the entire cerebrum. In patients with depression, SPECT examination is a useful method to monitor course of a disease and to objectively verify the results of treatment. 2. Disorders of rCBF, a decrease and/or asymmetry, occurred in patients with congenital hypothyroidism, migraine, and epilepsy. 3. There is a relation between patterns of cerebral perfusion in stroke, visible in SPECT image, and an extent and intensity of cerebral ischemia. (author)

  13. Discrepant 99mTc-ECD images of CBF in patients with subacute cerebral infarction. A comparison of CBF, CMRO2 and 99mTc-HMPAO imaging

    International Nuclear Information System (INIS)

    Shishido, Fumio; Uemura, Kazuo; Inugami, Atsushi; Ogawa, Toshihide; Fujita, Hideaki; Shimosegawa, Eku; Nagata, Ken.

    1995-01-01

    Three patients with subacute ischemic cerebral infarction examined by SPECT with 99m Tc-ECD and PET within the same day showed signs of luxury perfusion in the subacute phase, which is between 9 to 20 days after the onset. A 99m Tc-HMPAO SPECT study was also performed within 2 days of the ECD-SPECT study. ECD-SPECT images of three patients displayed a focal decreased uptake in the infarcted lesions, while in infarcted foci, there was almost equivalent or increased CBF compared to normal and unaffected areas, decreased CMRO 2 , and high HMPAO uptake. The ECD-SPECT results were similar to those of CMRO 2 rather than CBF, though the HMPAO-SPECT image was similar to that of CBF. In one patient, HMPAO images revealed hyperfixation of the tracer. In the chronic phase and in the acute phase before 5 days after the onset, there were no discrepancies among the ECD-SPECT, CBF, HMPAO-SPECT, and CMRO 2 images. These observations indicated that 99m Tc-ECD is a good indicator of damaged brain tissues in subacute ischemic infarction. They also suggested that 99m Tc-ECD is a potential agent with which to evaluate cerebral tissue viability in some pathological states of cerebrovascular disease. The characteristics may be suitable for confirming the effects of thrombolytic therapy in acute ischemia, because these conditions often show signs of luxury perfusion when the therapy is successful. (author)

  14. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  15. Technetium-99m-HMPAO SPECT in the evaluation of patients with a remote history of traumatic brain injury: a comparison with x-ray computed tomography.

    Science.gov (United States)

    Gray, B G; Ichise, M; Chung, D G; Kirsh, J C; Franks, W

    1992-01-01

    The functional imaging modality has potential for demonstrating parenchymal abnormalities not detectable by traditional morphological imaging. Fifty-three patients with a remote history of traumatic brain injury (TBI) were studied with SPECT using 99mTc-hexamethylpropyleneamineoxime (HMPAO) and x-ray computed tomography (CT). Overall, 42 patients (80%) showed regional cerebral blood flow (rCBF) deficits by HMPAO SPECT, whereas 29 patients (55%) showed morphological abnormalities by CT. Out of 20 patients with minor head injury, 12 patients (60%) showed rCBF deficits and 5 patients (25%) showed CT abnormalities. Of 33 patients with major head injury, 30 patients (90%) showed rCBF deficits and 24 patients (72%) showed CT abnormalities. Thus, HMPAO SPECT was more sensitive than CT in detecting abnormalities in patients with a history of TBI, particularly in the minor head injury group. In the major head injury group, three patients showed localized cortical atrophy by CT and normal rCBF by HMPAO SPECT. In the evaluation of TBI patients, HMPAO SPECT is a useful technique to demonstrate regional brain dysfunction in the presence of morphological integrity as assessed by CT.

  16. Clinical Utility of '9{sup 9m}Tc-HMPAO Brain SPECT Findings in Chronic Head Injury

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Jin ll; Chung, Tae Sub; Suh, Jung Ho; Kim, Dong Ik; Lee, Jong Doo; Park, Chang Yoon; Kim, Young Soo [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1992-03-15

    Minima deterioration of cerebral perfusion or microanatomical changes were undetectable on conventional Brain CT or MRI. So evaluation of focal functional changes of the brain parenchyme is essential in chronic head injury patients, who did not show focal anatomical changes on these radiological studies. However, the patients who had longstanding neurologic sequelae following head injury, there had been no available imaging modalities for evaluating these patients precisely. Therefore we tried to detect the focal functional changes on the brain parenchyme using {sup 99m}Tc-HMPAO Brain SPECT on the patients of chronic head injuries. Twenty three patients who had suffered from headache, memory dysfunction, personality change and insomnia lasting more than six months following head injury were included in our cases, which showed no anatomical abnormalities on Brain CT or MRI. At first they underwent psychological test whether the symptoms were organic or not. Also we were able to evaluate the cerebral perfusion changes with {sup 99m}Tc-HMPAO Brain SPECT in 22 patients among the 23, which five patients were focal and 17 patients were nonfocally diffuse perfusion changes. Thus we can predict the perfusion changes such as local vascular deterioration or functional defects using {sup 99m}Tc-HMPAO Brain SPECT in the patients who had suffered from post-traumatic sequelae, which changes were undetectable on Brain CT or MRI.

  17. 99mTc HM-PAO brain perfusion SPECT in brain death

    International Nuclear Information System (INIS)

    Bonetti, M.G.; Ciritella, P.; Valle, G.; Perrone, E.

    1995-01-01

    We have easily carried out and interpreted 99m Tc HM-PAO SPECT in a consecutive series of 40 comatose patients with brain damage, without discontinuing therapy. Brain death was diagnosed in 7 patients, by recognising absence of brain perfusion, as shown by no intracranial radionuclide uptake. In patients in whom perfusion was seen on brain scans, HM-PAO SPECT improved assessment of the extent of injury, which in general was larger than suggested by CT. (orig.)

  18. Functional and morphological findings in early and advanced stages of HIV infection: A comparison of 99mTc-HMPAO SPECT with CT and MRI studies

    International Nuclear Information System (INIS)

    Tatsch, K.; Bauer, W.M.; Markl, A.; Kirsch, C.M.; Schielke, E.; Einhaeupl, K.M.

    1990-01-01

    In fourty patients at early and advanced stages of HIV infection (Water-Reed stages I-VI) regional cerebral blood flow was determined by 99m Tc-HMPAO SPECT, comparing the results with CT and MRI findings. All patients with HIV encephalopathy (AIDS dementia complex) had pathologic SPECT results (multilocular, patchy uptake defects), but also in earlier and even earliest stages of HIV infection positive SPECT findings were observed. Compared to functional SPECT imaging, morphologically orientated method (CT, MRI) were insensitive in detecting HIV-induced foci: More than 50% of the patients with pathologic SPECT findings had negative CT or MRI scans. Most patients in advanced Walter Reed stages had neurological abnormalities accompanied by positive SPECT. Subtle alterations of HMPAO uptake were observed even in a few cases of early HIV infection without neurological CNS symptoms. The data presented suggest that HMPAO SPECT is highly sensitive in the detection of altered brain perfusion not only in advanced but also early stages of HIV infection. Changes in regional cerebral blood flow are presented before noticeable structural defects may be observed. (orig./MG) [de

  19. Cerebral blood flow imaging by I-123 IMP and Tc-99m HM-PAO

    Energy Technology Data Exchange (ETDEWEB)

    Uno, Koichi; Yoshikawa, Kyosan; Minoshima, Satoshi; Imaseki, Keiko; Arimizu, Noboru; Yamaura, Akira; Uematsu, Sadao

    1988-02-01

    SPECT studies with either N-isopropyl-p-(I-123)iodo- amphetamine (I-123 IMP) or Tc-99m hexamethyl propylene amine oxime (Tc-99m HM-PAO) were cuncurrently performed in 12 patients with brain disorders, comprising cerebral infarction (7), cerebral aneurysm (one), intracranial hemorrhage (3), and subdural hematoma (one). Whereas I-123 IMP was taken up gradually into the brain, the uptake of Tc-99m-HM-PAO in the brain reached the peak immediately after the iv injection, with 90% or more remaining constant by 15 min postinjection. On early SPECT images, a high uptake of I-123 IMP was observed in the lung, and the uptake of Tc-99m HM-PAO was observed as well in the soft tissue of cervical region. In all patients except for one, decreased rCBF was observed in the lesions on both I-123 and Tc-99m SPECT scans. Both of the radiopharmaceuticals were analogous in that decreased blood flow corresponded to cerebral lesions. (Namekawa, K).

  20. Cerebral perfusion study using 99mTc-HMPAO-ECT: Particular aspects regarding uptake and evaluation

    International Nuclear Information System (INIS)

    Spitz, J.; Clemenz, N.

    1988-01-01

    From the performance of about 250 99m Tc-HMPAO-SPECT studies for clarification of cerebro-vascular diseases, five essential problem groups have emerged: 1. Positioning of the patient's head and hence resulting rotation radius of the camera head. 2. Choice of the slice level for documentation and demonstration of the ECT study. 3. Standardization and colour codation of the single slice images. 4. Localization and identification of single slices in different slice levels. 5. Quantification of the distribution pattern. Whether nuclear medical cerebral perfusion study for diagnosis of cerebro-vascular diseases using 99m Tc-HMPAO may be an equivalent to DSA und TCT in future, should at least partially depend upon an adequate answer to the presented problems. (orig.) [de

  1. 99mTc-HMPAO SPECT in pediatric patients with neurological disorders

    International Nuclear Information System (INIS)

    Yamaoka, Mitsuko

    1994-01-01

    In 125 pediatric patients with suspected brain diseases, EEG, CT and MRI findings were compared with those obtained with single photon emission computed tomography (SPECT) of the brain using Tc-99m-d, 1-hexamethyl-propylene amine oxime ( 99m Tc-HMPAO), to determine the usefulness of SPECT as an adjunct to EEG, CT and MRI in this age group. The incidences of abnormal finding in the 125 patients were 53.6, 75.2, 60.6 and 51.4% using 99m Tc-HMPAO SPECT, EEG, CT and MRI respectively. In localization-related epilepsy and cerebrovascular diseases, the incidence of abnormality was higher with 99m Tc-HMPAO SPECT than with either CT or MRI. There was a tendency for mean age to be higher and mean IQ or DG lower in patients with more extensive abnormality in comparison to those who had normal or only focally abnormal SPECT findings. Nevertheless, some patients showed focal hypofusion in the frontal or occipital area without significant mental retardation. Epileptic foci detected by EEG corresponded to defects found using 99m Tc-HMPAO SPECT in 34.8% of the symptomatic localization-related epileptic patients. Pathological lesions detected by CT or MRI corresponded with SPECT findings in 48.1% of patients. Furthermore, the incidence of abnormal findings on SPECT was 30% in patients in whom CT or MRI was normal. Epileptic foci detected by EEG did not correspond well with the area of focal hyperfusion found on SPECT. Focal hyperfusion may sometimes occur even in the interictal period or postictal period in childhood seizure disorders. In conclusion, 99m Tc-HMPAO SPECT revealed abnormal findings at a moderate incidence in neuropediatric patients. Correlations with EEG, CT and MRI findings as well as assessment of clinical signs, including the investigation of epileptic foci, are essential for adequate interpretation of brain functions. (author)

  2. Serial 99mTc-HMPAO Brain SPECT for Assessing Perfusion Improvement after DEAS in Moyamoya Patients

    International Nuclear Information System (INIS)

    Lee, Kyung Han; Lee, Sang Hyung; Yeo, Jeong Seok; Kwark, Chul Eun; Chung, June Key; Lee, Myoung Chul; Cho, Byoung Kyu; Koh, Chang Soon

    1994-01-01

    Encephalo-duro-arterio-synangiosis (EDAS) is a relatively new surgical procedure for treatment of childhood moyamoya disease. We assessed regional cerebral perfusion in moyamoya patients before (1.3 mo) and after (6.8 mo) EDAS with 99m Tc-HMPAO brain SPECT. A total of 21 EDAS operations in 17 moyamoya patients was included. Preoperative CT or MRI showed cerebral infarction in 14 patients and carotid angiography showed Suzuki grade 1 to V stenosis in 6%, 9%, 62%, 12% and 12% of the hemispheres respectively. Preoperative SPECT showed regional hypoperfusion in all patients, bilateral frontal and temporal loves being the most frequently involved site. 4 X 4 pixel sized ROIs were applied on the frontotemmporal cortex in 3 slice averaged transverse tomographic images. An index of regional perfusion was measured as; PI (%)=average FT activity/average cerebellar activity X 100 Pre-EDAS ipsilateral PI ranged from 23.7 to 98.4% (mean:74.3 ± 17%) and increased significantly after operation (81.4 ± 17%, p 90, 0.5) (p<0.001). The amount of perfusion improvement (PI) showed significant correlation with CI (r-0.42, p=0.04). PI did not, however, correlate with the amount of neovascularization assessed angiographically in 8 patients. Serial HMPAO SPECT is an useful noninvasive study for assessing perfusion improvement after EDAS in childhood moyamoya patients.

  3. Is SPECT useful in imaging of abdominal inflammatory processes using 99mTc-HMPAO-WBCs?

    International Nuclear Information System (INIS)

    Smole, M.S.; Stantic, T.S.; Fettich, J.F.

    2002-01-01

    Aim: The aim of the study is to determine whether SPECT gives additional information in the assessment of inflammation of the abdominal region with labelled white blood cells as compared with usual planar imaging. Patients And Methods: SPECT and planar imaging was performed in 26 patients with suspected inflammatory process in the abdomen, within three hours after injection of autologous white blood cells labelled with 99m Tc HMPAO. Planar images where acquired as static spot images using high resolution low energy collimator on 256 x 256 matrix. SPECT was performed using the same collimator on 128 x 128 matrix in 128 projections. Filtered back projection was used for reconstruction and volume rendering was performed. Results: The lesions in the abdomen were classified as jejunum, colon ascendents, colon transversum, colon descendents, sigmoid, and lesions outside GIT. All lesions, which were seen on planar images, except one, were also seen on SPECT. Five equivocal lesions seen on planar images were reconfirmed as pathological on SPECT. Additionally SPECT revealed three lesions not seen on planar images. Fourteen lesions were seen by both imaging techniques. All together SPECT improved diagnostic accuracy of 99m Tc - HMPAO - WBC scintigraphy in 7/28 patients. Conclusion: more inflammatory lesions in the abdomen are revealed by SPECT and volume rendering, than by planar imaging equivocal lesions seen on planar images can be characterised as positive or negative by SPECT. SPECT artefacts can cause possible false positive results; therefore usual planar imaging cannot be omitted if SPECT is performed

  4. Mismatched uptake of Tc-99m-ECD and Tc-99m-HMPAO in subacute cerebral infarction: Tc-99m-ECD for viability and Tc-99m-HMPAO for flow restoration

    Energy Technology Data Exchange (ETDEWEB)

    Lee, D. S.; Hyun, I. Y.; Kim, S. K. [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)] [and others

    1997-07-01

    Tc-99m-HMPAO reflects tissue perfusion but Tc-99m-ECD uptake is affected by tissue viability in addition to tissue perfusion which the varied state of cellular retention of Tc-99m-ECD reflects. Luxuriously perfused area on Tc-99m-HMPAO SPECT implies that this cortex was already reperfused either spontaneously or after thrombolysis and that accompanied paralysis of vascular reactivity in those zones warms progressive deterioration. We tried to find out if we can use sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT to reveal cortical perfusion and severity and range of risky areas of cerbral cortex despite reperfusion in sub-acute infarction. In 13 patients (M ; F =7 : 6, mean age 57 (range: 26-84)) with cortical (n=12) and basal ganglia infarction (1), we performed sequential Tc-99m-ECD/Tc-99m-HMPAO SPECT at the same position. At first, 555 MBq of Tc-99m-ECD was injected and imaged and then 1110 MBq of Tc-99m-HMPAO was injected again and imaged with the patients in situ, and the first image (Tc-99m-ECD) and the subtracted image (2nd- 1st : Tc-99m-HMPAO) were compared slice by slice. Study was done from 3 days to 31 days (16{+-}9) after ictus. Tc-99m-ECD uptake was always less than or equal to Tc-99m-HMPAO uptake at the lesion in all cases. Luxury perfusion was prominent in four patients. Mismatched uptake was found in 10 patients. Severity of mismatch showed diverse spectrum and was ranged from total middle cerebral artery territory (1 case) to peripheral thin zones around infarction (2 cases). The other 7 showed intermediate amount of tissues with mismatch , i.e., Tc-99m-ECD defects where Tc-99m-HMPAO uptake is in part increased, normal or decreased. Upon discharge, patients having more uptake with Tc-99m-ECD predicted improvement. Patients having mismatched uptake went dichotomous way. In conclusion, Tc-99m-ECD/Tc-99m-HMPAO sequential SPECT is feasible and reveal both tissue perfusion (Tc-99m-HMPAO ) and discrepant Tc-99m-ECD uptake probably reflecting viability in acute

  5. HMPAO-SPECT in dementia of the Alzheimer type and major depression with memory impairment

    International Nuclear Information System (INIS)

    Gruenwald, F.; Horn, R.; Rieker, O.; Klemm, E.; Menzel, C.; Moeller, H.J.; Biersack, H.J.

    1993-01-01

    The aim of the present study was to see whether HMPAO-SPECT may contribute to the differentiation between dementia of the Alzheimer type (DAT) and major depression (MD). The results in 77 patients with memory impairment were evaluated. 48 patients suffered from DAT and 29 from MD. Initially, the defects in SPECT imaging were attributed to a cerebral region and the degree of decrease was evaluated (-1/-2/-3). Thereafter, the results were classified by 7 categories. In some of these categories an accumulation of cases of either DAT or MD was found. 35% of the patients suffering from DAT had bilateral defects with distinct (>-1) parietal/parietotemporal hypoperfusions, but no patient with MD showed this perfusion pattern. 62% of the patients with MD had unilateral defects but only 31% of the patients with DAT. The present study demonstrates that only 35% of all patients suffering from DAT show a perfusion pattern, thought earlier as ''pathognomonic'' for this disease. This perfusion pattern - if it exists - may be used as a safe criterion to exclude MD. Beyond that no clearcut (''specific'') perfusion pattern may be recognized but unilateral defects point to MD. (orig.) [de

  6. Regional cerebral blood flow studies with single photon emission computed tomography (SPECT); Clinical experiences, possibilities. Regionalis agyi veratfolyas vizsgalata egyfotonos emissios computer tomographiaval (SPECT); Klinikai tapasztalatok, lehetoesegek

    Energy Technology Data Exchange (ETDEWEB)

    Pavics, Laszlo; Csernay, Laszlo; Doczi, Tamas; Lang, Jenoe; Blaho, Gabor; Janka, Zoltan; Bodosi, Mihaly [Szegedi Orvostudomanyi Egyetem, Szeged (Hungary)

    1990-01-07

    Clinical experiences based on regional cerebral blood flow investigations with {sup 99m}Tc hexamethylpropyleneamin-oxime (HMPAO) SPECT in 164 patients are reported. The pharmacokinetics of the {sup 99m}Tc HMPAO are summarized, and the important indications of the investigations are interpreted in case reports (stroke, surgical solution of intracavernous aneurysm, Alzheimer and multiinfarct types of dementia). The literature data suggest that the diagnostic possibilities with this method are advantageous, even in other diseases. (author) 36 refs.; 7 figs.

  7. Combined study of 99mTc-HMPAO SPECT and computerized electroencephalographic topography (CET) in patients with medically refractory complex partial epilepsy

    International Nuclear Information System (INIS)

    Rodrigues, M.; Botelho, M.M.; Fonseca, A.T.; Peter, J.P.; Pimentel, T.; Vieira, M.R.

    1996-01-01

    For successful surgery for drug-resistant partial epilepsy the site of the seizure focus needs to be known exactly. The purpose of this study was to compare the evaluation of the regional cerebral blood flow (rCBF) (localization and degree of disturbances) by 99m Tc-hexamethylpropylene-amineoxime (HMPAO) single photon emission computed tomography (SPECT) with computerized electroencephalographic topography (CET) and transmission computed X-ray tomography (CT) in partial epilepsy. The study included 20 patients with medically refractory complex partial seizures. Of the 20 patients included, 15 were studied interictally, four ictally and one in both states, interictally and ictally. 99m Tc-HMPAO SPECT detected rCBF changes in 95% of the patients. Interictal studies demonstrated focal areas of hypoperfusion in 93% of the patients. Ictal studies demonstrated an area of hyperperfusion in all patients. Blood flow disturbances in deeper structures of the brain, such as basal ganglia, could be detected. The areas with abnormal 99m Tc-HMPAO uptake were concordant, in localization, with CET in 85% of the patients. Abnormal data with CT scans were found in only 45% of the patients. Focal lesions were found in 20% of the patients by CT scans. 99m Tc-HMPAO SPECT combined with CET may be a useful screening procedure prior to referral for invasive diagnostic procedures in future management of patients with medically refractory complex partial seizures. (author)

  8. Reduced brain perfusion in basal forebrain associated with cognitive decline in Alzheimer's diseases: a Tc-99m HMPAO SPECT study

    International Nuclear Information System (INIS)

    Lee, M.C.; Kang, H.; Kang, E.; Lee, J.S.; Lee, D.S.; Lee, D.W.; Cho, M.J.

    2002-01-01

    Aim: Reduction of regional cerebral blood flow (rCBF) in various cerebral regions and decline of cognitive function have been reported in Alzheimer's disease (AD) patients. The aim of this study was to identify the brain areas showing correlation between longitudinal changes of rCBFs and decline of general mental function, measured by Mini-Mental State Examination (MMSE) in probable Alzheimer's disease patients. Materials and Methods: Nine probable AD patients according to NINCDS-ADRDA criteria and DSM-IV were studied with Tc-99m HMPAO SPECT at an initial point and at the follow-up after a period of average 1.8 year. MMSE score was obtained in both occasions (average MMSE 16.4 at initial study; average MMSE = 8.1 at follow-up). Single SPECT was performed in 30 age-matched normal controls. Each SPECT image was normalized to the cerebellar activity. Using statistical parametric mapping (SPM99), correlation was analyzed between individual changes in rCBF of two SPECT scans and the MMSE scores at the time of each study in AD patients. In addition, the SPECT images of the initial study and the follow-up study were compared with SPECT images of the age-matched normal group respectively. Results: Significant correlation between longitudinal changes of rCBFs and MMSE scores was found in left basal forebrain region including substantia innominata (x, y, z = -24, 16, -23; P < .05, corrected). Within a short follow-up period of 1.8 years, cerebral hypoperfusion extended to various cortical regions from bilateral temporo-parietal to bilateral frontal regions and cingulate cortex, compared to normal controls. Conclusion: The decline of cognitive function in individual AD patients was correlated with rCBF reduction in left basal forebrain. This finding supports the cholinergic hypothesis of AD since hypoperfusion in basal forebrain region might indicate deterioration of cholinergic neurons in nucleus basalis of Meynert or substantia innominata

  9. Evaluation of SPECT with N-isopropyl [I-123]-p-iodoamphetamine (IMP) or technetium-99m [99mTc]-d,1-hexamethyl-propyleneamine oxime (d,1-HM-PAO) in cerebral concussion patients

    International Nuclear Information System (INIS)

    Torigoe, Ryuichiro; Hayashi, Takashi; Anegawa, Shigetaka; Harada, Katsuhiko; Matsuo, Hiromasa; Yoshikawa, Ichiro.

    1991-01-01

    123 I-IMP and Tc-PAO SPECT were performed in 20 cases of cerebral concussion ranging in age from 4 to 20 years old, including six cases of the juvenile head trauma syndrome (JHTS). The SPECT findings were divided into two main types: six cases in the normal group with no blood flow abnormalities, and 14 cases in abnormal group showing reduced blood flow, mainly in cerebellum and occipital lobe except in one case. In 10 cases of reduced blood flow which could be analyzed, calculation of the blood flow ratio in the temporal and occipital lobes and the cerebellum with the frontal lobe taken as 100 showed values of 93.5% for the temporal lobe, 82.7% for the occipital lobe and 76.8% for the cerebellum. A statistically significant reduction in blood flow occurred in the occipital lobe and cerebellum. In blood examination, abnormally high values of white blood cell counts were observed transiently in 94% of cerebral concussion cases. Abnormalities in brain stem and hypothalamus appeared to cause these abnormal WBC values. From these findings, it was suggested that the blood flow regions of the basilar and posterior cerebral arteries, i.e., the brain stem and hypothalamus are closely connected with the lesions responsible for cerebral concussion. It also appeared that the JHTS occurs in cerebral concussion cases where recovery of the abnormal blood flow in these regions in poor. (author)

  10. Study of cerebrovascular diseases and SPECT with 99mTc HMPAO

    International Nuclear Information System (INIS)

    Collazo de la Maza, A.; Borron Molinos, M.; Barroso, E.

    1997-01-01

    Thirty eight patients with Cerebrovascular disease, that had suffered a Thrombotic brain infraction, demonstrated by Computed electroencephalogram or Brain Mapping (BM) and Computerized Tomography (CT) were investigated with '99' '9' 'm' Tc HM-PAO brain SPECT. Their ages ranged from 37 to 73 years old, 18 males and 20 female. Some of them were followed up with these diagnostic methods. The acquisition and processing of the SPECT studies were donw with a SOPHY DS7 Gamma Camera. The results showed that the global diagnostic sensibility of the SPECT was 79%. The sensibility of SPECT in the Acute stage was 75 %, CT 57% and BM 92%. In Steady stage we found a high positivity of SPECT with 83 %, Ct 66% and BM 66%. In the Recuperation Stage SPECT was 77%, CT 66% and 45%. Some phenomenon like the Luxury Perfusion and Diaschisis were studied and it is possible to found some prognostic relation

  11. 99mTc-HMPAO-SPECT in the diagnosis of senile dementia of Alzheimer's type - a study under clinical routine conditions

    International Nuclear Information System (INIS)

    Stoppe, G.; Staedt, J.; Schuetze, R.; Kunert, H.J.; Ruether, E.; Koegler, A.; Sandrock, D.; Emrich, D.

    1995-01-01

    This study was designed to evaluate whether investigations of cerebral blood flow can be a helpful diagnostic tool in the differential diagnosis between (senile) dementia of Alzheimer's type [(S)DAT] and geriatric depression with cognitive impairment. Under clinical routine conditions we performed Single Photon Emission Computed Tomography (SPECT) using 99m Tc-Hexamethylpropyleneamine Oxime (HMPAO) in 23 patients with (S)DAT (14 f, 9 m; mean age 68.9 y), 17 patients with geriatric depression (9 f, 8 m; mean age 66.4 y) and 12 age-matched controls (9 f, 3 m; mean age 69.2 y). Semiquantitative analysis (corticocerebellar ratios) of eight different regions of interest (ROI) revealed a significantly ( p 99m Tc-HMPAO SPECT is a valuable additional tool in the differential diagnosis of depression and dementia in the elderly. (author)

  12. Herpes simplex encephalitis: increased retention of Tc-99m HMPAO on acetazolamide enhanced brain perfusion SPECT

    International Nuclear Information System (INIS)

    Choi, Yun Young; Kim, Kwon Hyung; Kim, Seung Hyun; Cho, Suk Shin

    1998-01-01

    We present an interesting case of herpes simplex encephalitis, which showed increased upta unilateral temporal cortex on brain perfusion SPECT using Tc-99m HMPAO, but in bilateral tem cortex after acetazolamide administration. A 42-year-old man was admitted via emergency room, due to rapidly progressing hea disorientation and mental changes. On neurologic examination, neck stiffness and Kernig sign noted. CSF examination showed pleocytosis with lymphcyte predominance. MRI showed swelling bilateral temporal lobe with left predominance, suggestive of herpes simplex encephalitis. Baseline/ Acetazolamide brain perfusion SPECT were acquired consecutively at the same position IV administration of 740MBq and additional 1480 MBq of Tc-99m HMPAO respectively. The temporal and inferior frontal cortex showed markedly increased perfusion on the baseline acetazolamide-enhanced SPECT images. The right temporal cortex showed normal uptake on the b SPECT images, and markedly increased uptake after acetazolamide administration, which seemed to the abundant vascularity at the acute inflammation site without marked brain damage. The fo brain perfusion SPECT after 6 months showed perfusion defect in left temporal cortex but norm perfusion in right temporal cortex. Therefore, we can conclude that baseline SPECT is helpful for the prediction of the prognosis acetazolamide SPECT for the evaluation of the extent of herpes simples encephalitis

  13. 99mTc-HMPAO SPECT of the brain in mild to moderate traumatic brain injury patients: compared with CT--a prospective study.

    Science.gov (United States)

    Nedd, K; Sfakianakis, G; Ganz, W; Uricchio, B; Vernberg, D; Villanueva, P; Jabir, A M; Bartlett, J; Keena, J

    1993-01-01

    Single photon emission computed tomography (SPECT) with Technetium-99m hexamethyl propylenamine oxime (Tc-99m-HMPAO) was used in 20 patients with mild to moderate traumatic brain injury (TBI) to evaluate the effects of brain trauma on regional cerebral blood flow (rCBF). SPECT scan was compared with CT scan in 16 patients. SPECT showed intraparenchymal differences in rCBF more often than lesions diagnosed with CT scans (87.5% vs. 37.5%). In five of six patients with lesions in both modalities, the area of involvement was relatively larger on SPECT scans than on CT scans. Contrecoup changes were seen in five patients on SPECT alone, two patients with CT alone and one patient had contrecoup lesions on CT and SPECT. Of the eight patients (50%) with skull fractures, seven (43.7%) had rCBF findings on SPECT scan and five (31.3%) demonstrated decrease in rCBF in brain underlying the fracture. All these patients with fractures had normal brain on CT scans. Conversely, extra-axial lesions and fractures evident on CT did not visualize on SPECT, but SPECT demonstrated associated changes in rCBF. Although there is still lack of clinical and pathological correlation, SPECT appears to be a promising method for a more sensitive evaluation of axial lesions in patients with mild to moderate TBI.

  14. 123I-iomazenil brain receptor SPECT in focal epilepsy. In comparison with 99mTc-HMPAO brain SPECT, MRI and Video/EEG monitoring

    International Nuclear Information System (INIS)

    Xu Hao; Wang Tongge; Huang Li; Michael Cordes

    1998-01-01

    Purpose: To evaluate the clinical value of 123 I-Iomazenil brain receptor SPECT in diagnosis of focal epilepsy in comparison with 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Methods 123 I-Iomazenil brain receptor SPECT was performed on 40 patients with focal epilepsy. The results were compared with those obtained by 99m Tc-HMPAO brain SPECT, MRI and Video/EEG monitoring. Results: In 40 patients, the sensitivity of Video/EEG monitoring for localization of epileptogenic area was 95% (38/40). The sensitivity of 123 I-iomazenil brain receptor SPECT, 99m Tc-HMPAO brain SPECT and MRI for localization of epileptogenic area compared with Video/EEG monitoring ('gold standard') was 65.8%(25/38), 55.3%(21/38) and 47.4%(18/38), respectively. The localization of epileptogenic area with 123 I-Iomazenil brain receptor SPECT was in concordance with Video/EEG monitoring in 20 patients, 99m Tc-HMPAO brain SPECT in 15 patients and MRI in 16 patients, respectively. The sensitivity of 123 I-Iomazenil brain receptor SPECT combined with MRI for localization of epileptogenic area was 84.2%(32/38). Conclusions: 123 I-Iomazenil brain receptor SPECT is a useful method in detecting and localizing epileptogenic area. The combination of 123 I-Iomazenil brain receptor SPECT and MRI has a high sensitivity for detecting epileptogenic area

  15. Differences of Tc-99m HMPAO SPECT imaging in the early stage of subcortical vascular dementia compared with Alzheimer's disease

    International Nuclear Information System (INIS)

    Park, Kyung Won; Kang, Do Young; Park, Min Jeong; Cheon, Sang Myung; Cha, Jae Kwan; Kim, Sang Ho; Kim, Jae Woo

    2007-01-01

    The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected ρ < 0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected ρ < 0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness

  16. Regional cerebral blood flow in SPECT pattern in Parkinson's disease

    International Nuclear Information System (INIS)

    Lenart-Jankowska, D.; Junik, R.; Sowinski, J.; Gembicki, M.; Wender, M.

    1997-01-01

    The purpose of our work was to compare the regional cerebral blood flow (rCBF) in SPECT examination in Parkinson's disease with (17 cases) and without (7 cases) dementia and in various clinical stages of the disease. The patients underwent SPECT examination 5-40 min after intravenous application of HMPAO (Ceretec, Amersham) with 740 Mbq (20 mCi) pertechnate 99m Tc. SPECT was performed with a Siemens Diacam single-head rotating gamma camera coupled to a high resolution collimator and Icon computer system provided by the manufacturer. The results were defined in relative values of ROI in relation to cerebellum. Patients with Parkinson's disease showed hypoperfusion in cerebral lobes and in deep cerebral structures including the basal ganglia. Regional perfusion deficit in SPECT was seen with and without associated dementia and already in early stage of the disease. Parkinson's disease is provoked by the lesions of dopaminergic neurons of the central nervous system leading to domination of extrapyramidal symptoms. There are many indications that also the neurotransmitters associated with cognitive functions as acetylcholine demonstrate some abnormalities. However, only in some cases of Parkinson's disease dementia is the dominating symptom. Our results of regional cerebral blood flow testify that in Parkinson's disease the dysfunction of the central nervous system is more diffuse than has previously been suggested. (author)

  17. Age-related changes in brain perfusion of normal subjects detected by 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Krausz, Y.; Karger, H.; Chisin, R.; Bonne, O.; Gorfine, M.; Lerer, B.

    1998-01-01

    Previous functional imaging data generally show impairment in global cerebral blood flow (CBF) with age. Conflicting data, however, concerning age-related changes in regional CBF (rCBF) have been reported. We examined the relative rCBF in a sample of healthy subjects of various ages, to define and localize any age-related CBF reduction. Twenty-seven healthy subjects (17 male, 10 female; mean age 49 ± 15, range 26-71, median 47 years) were studied by 99m Tc-HMPAO brain SPECT. The younger age group consisted of subjects below, the older group above 47 years of age, respectively. Analysis was performed by applying three preformed templates, each containing delineated regions of interest (ROIs), to three transaxial brain slices at approximately 4, 6, and 7 cm above the orbitomeatal line (OML). The average number of counts for each ROI was normalized to mean uptake of the cerebellum and of the whole brain slice. Globally, 99m Tc-HMPAO uptake ratio normalized to cerebellum was significantly decreased in older subjects, affecting both hemispheres. A slight left-to-right asymmetry was observed in HMPAO uptake of the whole study group. It did not, however, change with age. Regionally, both cortical and subcortical structures of older subjects were involved: uptake ratio to cerebellum was significantly lower (after correction for multiple testing) in the left basal ganglia and in the left superior temporal, right frontal and bilateral occipital cortices at 4 cm above the OML. At 6 cm above the OML, reduced uptake ratios were identified in the left frontal and bilateral parietal areas. At 7 cm, reduced uptake was detected in the right frontal and left occipital cortices. Most of these differences were reduced when uptake was normalized to whole slice, whereas an increase in uptake ratios was observed in the cingulate cortex of the elderly. An inverse correlation between age and HMPAO uptake ratios normalized to cerebellum was observed in a number of brain regions. These

  18. Effect of linearization correction on statistical parametric mapping (SPM). A 99mTc-HMPAO brain perfusion SPECT study in mild Alzheimer's disease

    International Nuclear Information System (INIS)

    Ansar, A.B.; Osaki, Yasuhiro; Kazui, Hiroaki

    2006-01-01

    Statistical parametric mapping (SPM) was employed to investigate the regional decline in cerebral blood flow (rCBF) as measured by 99m Tc-hexamethyl propylene amine oxime (HMPAO) single photon emission computed tomography (SPECT) in mild Alzheimer's disease (AD). However, the role of the post reconstruction image processing on the interpretation of SPM, which detects rCBF pattern, has not been precisely studied. We performed 99m Tc-HMPAO SPECT in mild AD patients and analyzed the effect of linearization correction for washout of the tracer on the detectability of abnormal perfusion. Eleven mild AD (National Institute of Neurological and Communicative Disorders and National Institute of Radiological Sciences (NINCDS-ADRDA), male/female, 5/6; mean±SD age, 70.6±6.2 years; mean±SD mini-mental state examination score, 23.9±3.41; clinical dementia rating score, 1) and eleven normal control subjects (male/female, 4/7; mean±SD age, 66.8±8.4 years) were enrolled in this study. 99m Tc-HMPAO SPECT was performed with a four-head rotating gamma camera. We employed linearization uncorrected (LU) and linearization corrected (LC) images for the patients and controls. The pattern of hypoperfusion in mild AD on LU and LC images was detected by SPM99 applying the same image standardization and analytical parameters. A statistical inter image-group analysis (LU vs. LC) was also performed. Clear differences were observed between the interpretation of SPM with LU and LC images. Significant hypoperfusion in mild AD was found on the LU images in the left posterior cingulate gyrus, right precuneus, left hippocampus, left uncus, and left superior temporal gyrus (cluster level, corrected p 99m Tc-HMPAO SPECT with or without linearization correction, which should be carefully evaluated when interpreting the pattern of rCBF changes in mild Alzheimer's disease. (author)

  19. 99mTc-HMPAO SPECT in patients with Alzheimer's disease and multiinfraction dementia

    International Nuclear Information System (INIS)

    Klisarova, A.; Tranulov, G.; Deleva, N.; Kaprelian, A.; Terzieva, M.; Ivanov, B.

    2002-01-01

    Alzheimer's disease (AD) and multiinfarktion dementia (MD) are the commonest causes giving rise to progressive cognitive function deficit in adult individuals. It is the purpose of the study to evaluate 99m Tc-HMPAO SPECT in making the diagnosis and differential diagnosis of Alzheimer's disease and multiinfarction dementia in patients presenting progressive cognitive disorders. Twenty patients with symptoms of dementia divided up in two groups (10 suspected for AD, and 10 with evidence of MD) are subjected to 99m Tc-HMPAO SPECT. To assay the scintigraphic images semi-quantitative perfusion indices are introduced. Bilateral hypoperfusion zones in the temporoparietal and temporal regions are detected in nine AD patients. In 4 of them in advanced stage of the disease hypoperfusion zones are found in the frontal lobe. In 8/10 MD patients vascular dependent hypoperfusion areas are located along the course of vessels. The perfusion indices implemented in practice contribute to the semi-quantitative evaluation of hypoperfusion areas and precise assessment of the scintigraphic findings. 99m Tc-HMPAO SPECT is an atraumatic, noninvasive technique, taken to be the method of choice in making the diagnosis and differential diagnosis of Alzheimer's disease and multiinfarction dementia in routine clinical practice. (authors)

  20. Value of Tc-99m HMPAO SPECT imaging in patients with TIA or acute stroke and normal CT

    International Nuclear Information System (INIS)

    Koster, K.; Brass, L.M.; Hoffer, P.B.; Gottschalk, A.; Smith, E.O.; Rehm, P.K.

    1988-01-01

    To determine the value of Tc-99m HMPAO single photon emission CT (SPECT) imaging, 51 patients with transient, acute, or chronic cerebrovascular disease were studied. Seventeen patients presented with recent transient ischemic attack (TIA) or acute stroke and underwent SPECT imaging and CT within 72 hours of presentation. SPECT image interpretation was independent of clinical history and CT findings. Four patients with acute stroke and eight patients with TIA had normal CT findings. All patients with acute stroke (three nonlacunar, one lacunar infarct) and three of eight patients with TIA also showed perfusion abnormalities on Tc-99m HMPAO scans. Thus, Tc-99m HMPAO SPECT may be useful in the early diagnosis and subtype determination of acute stroke and in the evaluation of TIA

  1. Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents

    International Nuclear Information System (INIS)

    Roo, M. de; Mortelmans, L.; Devos, P.; Verbruggen, A.; Wilms, G.; Carton, H.; Wils, V.; Bergh, R. van den

    1989-01-01

    In order to evaluate the diagnostic contribution of brain SPECT imaging with 99m Tc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploaration of cerebral infarction, with detection in, respectively, 89,5% and 87,5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia. (orig.)

  2. Clinical experience with Tc-99m HM-PAO high resolution SPECT of the brain in patients with cerebrovascular accidents

    Energy Technology Data Exchange (ETDEWEB)

    Roo, M. de; Mortelmans, L.; Devos, P.; Verbruggen, A.; Wilms, G.; Carton, H.; Wils, V.; Bergh, R. van den

    1989-01-01

    In order to evaluate the diagnostic contribution of brain SPECT imaging with /sup 99m/Tc-HMPAO in cerebrovascular disease, we examined 92 stroke cases (144 lesions), 2 hematoma cases and 30 cases with transient neurologic symptoms. Abnormal tracer distribution is visible as zones of either hypoactivity or hyperactivity (border zone hyperemia or luxury perfusion). Remote vascularization changes could also be found (crossed cerebellar diaschisis or ipsilateral cortical perfusion reduction in thalamic or capsula interna lesions). Both X-ray CT and blood flow SPECT have comparable sensitivity in the exploaration of cerebral infarction, with detection in, respectively, 89,5% and 87,5% of the lesions. False negative scintitomographic images are frequently recorded in small lacunar infarcts within the basal ganglia and white matter (capsula interna). Some early infarcts and asymmetry of brain perfusion in patients with transient neurologic symptoms are frequently not detected by CT. An additional advantage of blood flow SPECT is its ability to visualize remote blood flow changes and the changing pattern of vascularization of ischemic lesions and their surrounding areas including hyperemia.

  3. Usefulness of {sup 99m}Tc-HMPAO SPECT in Patients with Subarachnoid Hemorrhage due to Ruptured Intracranial Aneurysm

    Energy Technology Data Exchange (ETDEWEB)

    Choi, C. W.; Lee, K. H.; Kim, J. H.; Kwark, C. E.; Lee, D. S.; Chung, J. K.; Lee, M. C.; Han, D. H.; Koh, C. S. [Seoul National University Hospital, Seoul (Korea, Republic of)

    1993-07-15

    We evaluated the usefulness of {sup 99m}Tc-HMPAO SPECT in 21 Patients with subarachnoid hemorrhage due to ruptured intracranial aneurysm and in 3 patients with unruptured intracranial aneurysm. SPECT study could detect the bilaterally hypoperfused cases in 10 patients(48%), but CT/MRI showed the bilateral abnormalities in only 3 patients(14%). The number of abnormal lesions were 56 in SPECT and 25 in CT/MRI. The lesions found in SPECT were well correlated with the neurological signs of the patients such as aphasia or hemiplegia. SPECT study during Matas test was helpful in evaluating the risk for carotid artery occlusion therapy. We thought that {sup 99m}Tc-HMPAO brain SPECT is helpful in evaluating the functional changes in patients with subarachnoid hemorrhage.

  4. Quantitation of cerebral blood flow using HMPAO tomography

    International Nuclear Information System (INIS)

    Bruyant, P.; Mallet, J.J.; Sau, J.; Teyssier, R.; Bonmartin, A.

    1997-01-01

    A method has been developed to quantitate regional cerebral blood flow (rCBF) using 99m Tc-HMPAO. It relies on the application of the bolus distribution principle. The rCBF is determined using compartmental analysis, by measuring the amount of tracer retained in the parenchyma and the input function. The values for blood: brain partition coefficient and for the conversion rate from the lipophilic to the hydrophilic form of the tracer are taken from the literature. Mean values for rCBF in eight patients are 41.1 ± 6.4 et 25.6 ± 5.8 mL.min -1 for the grey matter and for the white matter respectively (mean±standard deviation). This method allows to quantitate rCBF with one SPET scan and one venous blood sample. (authors)

  5. Evaluation of Gilles de la Tourette syndrome with [99mTc] HMPAO Brain SPECT

    International Nuclear Information System (INIS)

    Carreira, LCTF; Santos, A. O; Juarez, B. A; Leite, H. A; Lima, M. C. L; Ramos, C. D; Camargo, E. E

    2002-01-01

    Gilles de la Tourette syndrome (GLTS) is a disorder characterized by tics and several behavioral disturbances. Although GLTS is a relatively common disorder, little is known about its pathophysiology. Previous studies with SPECT and PET were performed in a small number of patients and have shown some discordant data. The aim of this study is to evaluate brain perfusion abnormalities in patients with GLTS and to correlate them with the clinical manifestations of the syndrome. Twenty-eight patients were submitted to brain [99mTc]-HMPAO SPECT. 82 percent of the patients had abnormal studies. The most frequent finding was perfusion abnormalities in the thalami in 16 patients (57 percent) and 85 percent of patients with hyperperfusion of one or both thalami had complex motor tics. This investigation has demonstrated that brain perfusion SPECT is able to identify cortical perfusion abnormalities, associated with clinical symptoms in patients with GLTS. These abnormalities involve the pre-frontal-striatal-thalamic-cortical pathways (Au)

  6. Functional brain SPECT with 99mTc-HMPAO in the diagnosis of Alzheimer disease

    International Nuclear Information System (INIS)

    Urbanek, J.; Kupka, K.; Samal, M.; Jirak, R.; Obenberger, J.

    1998-01-01

    The explanatory power of perfusion diagrams obtained by the title technique was examined. In addition to the standard reconstruction procedure, a special reorientation procedure aimed at a differentiation of the hippocampus structure was applied. The study gave evidence of a high specificity and sensitivity of brain SPECT in the differential diagnosis of dementias. Multifactorial analysis of all available diagnostic techniques has borne out the dominant position of brain SPECT with 99m Tc-HMPAO, particularly when using special projection onto the hippocampus, and has led to the formulation of an examination algorithm where a combination of SPECT and MRI (and CT) enables DAT to be distinguished from dementias of other etiologies with a probability higher than 90%

  7. Memory functions and rCBF-99mTc-HMPAO-SPECT: Developing diagnostics in Alzheimer's Disease

    International Nuclear Information System (INIS)

    Sundstroem, T.; Riklund Ahlstroem, K.; Elgh, E.; Naesman, B.; Nyberg, L.

    2002-01-01

    Alzheimer's disease (AD) is a primary degenerative disease of the brain. The prevalence increases with age with devastating consequences for the individual and for the society. The aim of this study was to evaluate if patients with early AD show an altered regional cerebral blood flow (rCBF) compared to control persons. The aim was furthermore to investigate the correlation between rCBF in sub-lobar volumes of the brain and performance on memory tests. Memory tests were chosen to evaluate episodic and semantic memory. Fourteen patients (75.2±8.8 yrs) with early AD, and 15 control persons (71.4±3.2 yrs) were included. rCBF measurements with single photon emission computerized tomography (SPECT) using 99m Tc-hexamethyl propylenamine oxime (HMPAO) were performed. The rCBF- 99m Tc-HMPAO-SPECT images were spatially transformed to fit a brain atlas and normalized for differences in rCBF (Computerized Brain Atlas software). Cortical and sub-cortical volumes of interests (VOI) were analyzed and compared. Compared to the controls, AD-patients showed a significantly lower rCBF ratio in temporoparietal regions including left hippocampus. The diagnostic sensitivity and specificity for AD were high in temporoparietal regions. AD-patients had significantly reduced performance on semantic and, in particular, episodic memory tests compared to age matched normative data, and their performance on several episodic tests correlated with rCBF ratios in parietal and temporal regions including left hippocampus. The correlation between rCBF ratio and level of episodic memory performance suggests that abnormalities in rCBF pattern underlie impaired episodic memory functioning in AD

  8. Technetium-99m-HMPAO SPECT in patients with hemiconvulsions followed by Todd`s paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Kimura, M.; Sejima, Hitoshi; Ozasa, Hiroshi; Yamaguchi, Seiji [Department of Pediatrics, Shimane Medical University, 89-1 Enya-cho, Izumo, Shimane 693 (Japan)

    1998-02-01

    We performed technetium-99m-hexamethylpropylene- amineoxime (Tc-HMPAO) single photon emission computed tomography in two patients with prolonged hemiconvulsions followed by transient hemiparesis (Todd`s paralysis). In both cases, a prolonged post-ictal cerebral hyperperfusion state of approximately 24 h was observed, even after the neurological deficits had resolved. The cerebral hyperperfusion in both cases was of much longer duration than that in previously reported cases of single and uncomplicated focal seizures. The prolonged cerebral hyperperfusion might have been due to impairment of the cerebrovascular autoregulation in seizures followed by Todd`s paralysis. (orig.) With 2 figs., 9 refs.

  9. 99mTc-HMPAO SPECT thalamic blood flow study in migraine

    International Nuclear Information System (INIS)

    Zhang Zhijian; Steiner, T.J.

    1995-01-01

    The changes of blood flow in the thalamic of migraineurs by 99m Tc-HMPAO SPECT imaging are investigated. 60 cases with migraine were performed by Novo 810 high-resolution SPECT 30 minutes after injection of 99m Tc-HMPAO. The quantitative analysis of SPECT data was based on the irregular ROI% uptake normalized to total slice method. There were significantly increased mean % uptake values in migraine with aura (259.1 +-17.1), and more significantly in those who experienced hemisensory symptoms and hemiparesis during aura (263.8 +- 17.2), compared to that of migraine without aura (249.1 +- 14.9), but there were not statistically significant difference between migraine with only visual disturbance during aura (255.1 +- 16.4) and without aura. The possible explanations for the increased mean % uptake values in migraineurs who experienced hemisensory symptoms and hemiparesis during aura are: (1) the reactive postischemic hyperemia. (2) excepting thalamus, the regional blood flow was decreased. (3) the secondary phenomenon to the various neurogenic and chemical stimuli

  10. HMPAO-SPECT in dementia of the Alzheimer type and major depression with memory impairment. HMPAO-SPECT bei Demenz vom Alzheimer-Typ und Major Depression mit mnestischen Stoerungen

    Energy Technology Data Exchange (ETDEWEB)

    Gruenwald, F [Bonn Univ., Klinik fuer Nuklearmedizin (Germany); Horn, R [Bonn Univ., Psychiatrische Klinik (Germany); Rieker, O [Bonn Univ., Klinik fuer Nuklearmedizin (Germany); Klemm, E [Bonn Univ., Klinik fuer Nuklearmedizin (Germany); Menzel, C [Bonn Univ., Klinik fuer Nuklearmedizin (Germany); Moeller, H J [Bonn Univ., Psychiatrische Klinik (Germany); Biersack, H J [Bonn Univ., Klinik fuer Nuklearmedizin (Germany)

    1993-06-01

    The aim of the present study was to see whether HMPAO-SPECT may contribute to the differentiation between dementia of the Alzheimer type (DAT) and major depression (MD). The results in 77 patients with memory impairment were evaluated. 48 patients suffered from DAT and 29 from MD. Initially, the defects in SPECT imaging were attributed to a cerebral region and the degree of decrease was evaluated (-1/-2/-3). Thereafter, the results were classified by 7 categories. In some of these categories an accumulation of cases of either DAT or MD was found. 35% of the patients suffering from DAT had bilateral defects with distinct (>-1) parietal/parietotemporal hypoperfusions, but no patient with MD showed this perfusion pattern. 62% of the patients with MD had unilateral defects but only 31% of the patients with DAT. The present study demonstrates that only 35% of all patients suffering from DAT show a perfusion pattern, thought earlier as ''pathognomonic'' for this disease. This perfusion pattern - if it exists - may be used as a safe criterion to exclude MD. Beyond that no clearcut (''specific'') perfusion pattern may be recognized but unilateral defects point to MD. (orig.)

  11. Dose response from pharmacological interventions for CBF changes in a baboon model using 99Tcm-HMPAO and SPECT

    International Nuclear Information System (INIS)

    Dormehl, I.C.; Hugo, N.; Oliver, D.W.

    1993-01-01

    This study assesses the sensitivity of the baboon model under anaesthesia to determine by single photon emission computed tomography (SPECT) and 99 Tc m -hexamethylpropyleneamine oxime (HMPAO) dose responses from drugs (acetazolamide) with known regional cerebral blood flow (rCBF) effects on humans. Three dosages of acetazolamide were chosen: 250, 500 and 750 mg. The effects of these were studied by conventional SPECT 5 min after intravenous (i.v.) administration and compared to previous studies of rCBF with the baboons under anaesthesia only. An additional study concerned the effect of 500 mg acetazolamide at 15 min after administration. Haemodynamic parameters and blood gases were also monitored. No statistically significant regional effects were noted. The largest increase in CBF (39%) was observed from 500 mg acetazolamide after 5 min. This was statistically significantly different from control values only at a 10% level of confidence; then following a 27% increase above control values after 750 mg (5 min). At 15 min 500 mg yielded values lower by 10% than the high dose. No effects were observed from 250 mg acetazolamide; only pO 2 showed changes which largely confirm the CBF findings. The model did not give significant results at a 5% level of confidence but large fluctuations were observed, also in the haemodynamic and blood gas values. At a 10% level a significant dose response was confirmed for acetazolamide. (author)

  12. Evaluation of hemodynamic effects of extracranial carotid stenoses by adenosine-induced vasodilatation in combination with 99mTc-HMPAO SPECT

    International Nuclear Information System (INIS)

    Ussov, V.Yu.; Plotnikov, M.P.; Yaroshevsky, S.P.; Shipulin, V.M.; Sokolov, AA.

    1999-01-01

    Methods: Adenosine was evaluated in combination with 99mTc-HMPAO SPECT as an intravenous agent for the pharmacological stress-test of the regional cerebral blood flow (rCBF) in 12 patients with internal carotid artery (ICA) stenosis without neurologic deficit (8 subjects) or with minimal deficit (4 subjects). Also, the adenosine-induced effects on rCBF were correlated with the anatomic severity of ICA stenosis. Six normal age-matched volunteers served as control. Results: The rest 99mTc-HMPAO SPECT data did not reveal any significant interhemispheric asymmetry of perfusion either in ICA stenosis patients or in control subjects. No interhemispheric asymmetry was observed in control subjects during adenosine infusion either. In ICA stenosis the adenosine test did induce interhemispheric asymmetry of perfusion, which ranged between 0.73 and 0.96 when quantified as an interhemispheric ratio of 99mTc-HMPAO uptake. In 5 of the 12 patients with ICA stenosis, adenosine also elicited a short - term muscular weakness and/or skin paresthesia consistent with cerebral location of the related cortical zones in the stenosis - dependent hemisphere. No correlation was noted between the interhemispheric anatomic planimetric asymmetry of stenosis (as ratio of patent ICA vessel lumen areas) and perfusion asymmetry at rest. The planimetric asymmetry of stenosis correlated significantly with the adenosine-induced asymmetry of rCBF in ICA - dependent areas (r = 0.78, p < 0.02). The correlation could be observed beginning from the magnitude of 70-75% relatively to the cross-sectional area of the contralateral intact vessel, equivalent to 45-50% decrease in the arterial diameter as compared to the intact artery. Conclusion: Therefore, the conclusion can be drawn that adenosine as a potent cerebral vasodilatator may be employed as a challenging agent for functional tests of rCBF and that the adenosine test facilitates detection of the hemodynamic effects of ''minor'' stenoses. (author)

  13. Correlation of Tc-99m HMPAO SPECT with surface EEG, MR, and CT for noninvasive localization of seizure foci

    International Nuclear Information System (INIS)

    Engelstad, B.L.; Laxer, K.D.; Dickson, H.S.; Cooper, K.E.; Huberty, J.P.; White, D.L.

    1987-01-01

    Some patients with refractory seizure disorders are candidates for surgical management. Correct preoperative lateralization is essential. Of 19 patients with seizure disorders who underwent Tc-99m HMPAO SPECT, 14 were considered to have ultimately had definitive localization by other means: consistently abnormal surface electroencephalogram (EEG), subdural or deep electrode EEG, EEG response to resection, abnormal histopatholgy, or grossly abnormal MR image. Lateralization with SPECT was (1) focal or regional hypoperfusion (11 patients) or (2) discrete focal hyperperfusion (one patient). Correct lateralization was obtained in ten of 14 with SPECT, nine of 14 with surface EEG, seven of 12 with MR, and one of eight with CT. Preoperative evaluation of patients with medically refractory seizures can be aided by Tc-99m HMPAO SPECT

  14. Comparison of {sup 99m}Tc-HMPAO SPECT and MRI after Acute and Subacute Closed-Head Injury

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Won Jong; Lee, Sang Hoon; Sohn, Hyung Sun; Lee, Han Jin; Park, Jeong Mi; Chung, Soo Kyo; Kim, Choon Yul; Bahk, Yong Whee; Shin, Kyung Sub [Catholic University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    The purpose of this study was to compare {sup 99m}Tc-HMPAO SPECT with MRI after acute and subacute closed head injury. There were thirty two focal lesions in all cases of these, Fifteen lesions(47%) were seen on both MRI and SPECT. Fourteen lesions(44%) were seen only on MRI. Three lesions(9%) were seen only on SPECT. Of the 14 lesions seen only on MRl, one was epidural hematoma, two were subdural hematoma, three were subdural hygroma, one was intracerebral hematoma, four were contusion, and three were diffuse axonal injuries. SPECT detected 52% of the focal lesions found on MRI. For the detection of lesions, MRl was superior to SPECT in fourteen cases, while SPECT was superior to MRI in three cases. In conclusion, there was a tendency that detection rate of the traumatic lesions was higher on MRI, but the SPECT could delineate more wide extent of lesion.

  15. {sup 99m}Tc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Hyung In [Kyunghee University Hospital, Seoul (Korea, Republic of); Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon [Seoul National University Hospital, Seoul (Korea, Republic of)

    1994-03-15

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  16. 99mTc-HMPAO Brain SPECT in Seizure Disorder: Comparison Brain SPECT, MRI / CT and EEG

    International Nuclear Information System (INIS)

    Yang, Hyung In; Im, Ju Hyuk; Choi, Chang Woon; Lee, Dong Soo; Chung, June Key; No, Jae Kyu; Lee, Myung Chul; Koh, Chang Soon

    1994-01-01

    We studied 115 patients with seizure who had been performed brain SPECT brain MRI of CT and EEG. To evaluate the pattern of brain SPECT in seizure patients 28 of them had secondary epilepsies, 87 had primary epilepsies. In primary epilepsies, 42 were generalized seizure and 45 were partial seizure. The causes of secondary epilepsies were congenital malformation, cerebromalacia, cerebral infarction ultiple sclerosis, AV-malformation. granuloma and etc, in order. In 28 secondary epilepsies, 25 of them, brain SPECT lesions was concordant with MRI or CT lesions. 3 were disconcordant. The brain SPECT findings of generalized seizure were normal in 22 patients, diffuse irregular decreased perfusion in 8, decreased in frontal cortex in 4. temporal in 5 and frontotemporal in 3. In 45 partial seizure, 19 brain SPECT were concordant with EEG (42.4%).

  17. Comparison of 99Tcsup(m) complexes (NEP-DADT, ME-NEP-DADT and HMPAO) with 123IAMP for brain SPECT imaging in dogs

    International Nuclear Information System (INIS)

    Bok, B.D.; Scheffel, U.; Goldfarb, H.W.; Burns, H.D.; Lever, S.Z.; Wong, D.F.; Bice, A.; Wagner, H.N. Jr.

    1987-01-01

    In this study we have compared brain uptake and blood clearance of 99 Tcsup(m)-N-ethylpiperi-dinediamino dithiol ( 99 Tcsup(m)-NEP DADT), its 4-methylated derivative ( 99 Tcsup(m)-Me-NEP-DADT) and 99 Tcsup(m)-hexamethyl-propylene-amine-oxime ( 99 Tcsup(m)-HMPAO) with that of N-isopropyl( 123 I)iodoamphetamine ( 123 IAMP) in two dogs. Single photon emission tomography (SPECT) was employed to measure brain accumulation and retention of the four radiopharmaceuticals. Cerebral uptake of the 99 Tcsup(m) complexes was lower than that of 123 IAMP. There was considerable extracerebral activity in the dog's head, especially in the olfactory and snout regions. Because of slow blood clearance, 99 Tcsup(m)-HMPAO showed high uptake in these regions. Brain uptake of 99 Tcsup(m)-HMPAO reached a plateau 5 to 10 min after intravenous injection and remained constant for the entire study period (1 h). 99 Tcsup(m)-NEP-DADT, on the other hand, showed significant clearance from the brain after reaching maximal uptake at 10 to 15 min after injection. However, brain imaging with these agents was possible during the first 20 min. (author)

  18. Surface and volume three-dimensional displays of Tc-99m HMPAO brain SPECT images in stroke patients with three-head gamma camera

    International Nuclear Information System (INIS)

    Shih, W.J.; Slevin, J.T.; Schleenbaker, R.E.; Mills, B.J.; Magoun, S.L.; Ryo, U.Y.

    1991-01-01

    This paper evaluates volume and surface 3D displays in Tc-99m HMPAO brain SPECT imaging in stroke patients. Using a triple-head gamma camera interfaced with a 64-bit supercomputer, 20 patients with stroke were studied. Each patient was imaged 30-60 minutes after an intravenous injection of 20 mCi of Tc-99m HMPAO. SPECT images as well as planar images were routinely obtained; volume and surface 3D display then proceeded, with the process requiring 5-10 minutes. Volume and surface 3D displays show the brain from all angles; thus the location and extension of lesion(s) in the brain are much easier to appreciate. While a cerebral lesion(s) was more clearly delineated by surface 3D imaging, crossed cerebellar diaschisis in seven patients was clearly exhibited with volume 3D but not with surface 3D imaging. Volume and surface 3D displays enhance continuity of structures and understanding of spatial relationships

  19. Differences of Tc-99m HMPAO SPECT imaging in the early stage of subcortical vascular dementia compared with Alzheimer's disease

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Won; Kang, Do Young; Park, Min Jeong; Cheon, Sang Myung; Cha, Jae Kwan; Kim, Sang Ho; Kim, Jae Woo [College of Medicine, Dong-A University, Busan (Korea, Republic of)

    2007-12-15

    The aim of this study is to assess the specific patterns of regional cerebral blood flow (rCBF) in patients with the early stage of subcortical vascular dementia (SVaD) and Alzheimer's disease (AD) using Tc-99m HMPAO SPECT, and to compare the differences between the two conditions. Sixteen SVaD, 46 AD and 12 control subjects participated in this study. We included the patients with SVaD and AD according to NINCDS-ADRDA and NINDS-AIREN criteria. They were all matched for age, education and clinical dementia rating scores. Three groups were evaluated by Tc-99m HMPAO SPECT using statistical parametric mapping (SPM) for measuring rCBF. The SPECT data of patients with SVaD and AD were compared with those of normal control subjects and then compared with each other. SPM analysis of the SPECT image showed significant perfusion deficits on the right temporal region and thalamus, left insula and superior temporal gyrus, both cingulate gyri and frontal subgyri in patients with SVaD and on the left supramarginal gyrus, superior temporal gyrus, postcentral gyrus and inferior parietal lobule, right fugiform gyrus and both cingulate gyri in AD compared with control subjects (uncorrected {rho} < 0.01). SVaD patients revealed significant hypoperfusion in the right parahippocampal gyrus with cingulated gyrus, left insula and both frontal subgyral regions compared with AD (uncorrected {rho} < 0.01). Our study shows characteristic and different pattern of perfusion deficits in patients with SVaD and AD, and these results may be helpful to discriminate the two conditions in the early stage of illness.

  20. Evaluating acute effects of Electro Convulsive Therapy (ECT) on brain perfusion with Tc-99m HMPAO brain SPECT

    International Nuclear Information System (INIS)

    Ozguven, M.; Ozturk, E.; Gunalp, B.; Ozgen, F.; Bayhan, H.

    1992-01-01

    Regional cerebral blood flow (rCBF) was measured by Tc-99m HMPAO brain perfusion SPECT in 10 schizophrenes (8 male, 2 female) undergoing electro convulsive therapy (ECT) and the results were compared to those of baseline studies performed 3 days prior to the ECT application to evaluate its acute effect on brain perfusion. ECT caused a redistribution in the tracers uptake. There was a global increase in the rCBF and the uptake became more pronounced in the basal ganglia (left: 44.4+-1.9%, right: 43.1+-19%) and to a degree in the parietal (left: 26.5+-4.1%, right: 25+-3.4%) and temporal (left: 22.9+-4.3%, right: 22.3+-3.6%) cortices. When evaluating the effects of ECT on rCBF, factors like the used perfusion agent, the injection and rCBF measurement times, clinical status of the patient, duration of the illness, used therapeutic agents and variations in the ECT application should be taken into consideration because the obtained data may reflect either the ictal or post-ictal changes on rCBF and is specific to the group of patients undergoing the study

  1. Cerebral perfusion changes in schizophrenia patients evaluated with Tc-99 HMPAO

    International Nuclear Information System (INIS)

    Sehweil, A.; El-Hilu, S.; Jahan, S.; Higazi, E.; Salhat, M.; Al-Mohannadi, S.; Abdel-Dayem, H.M.

    1989-01-01

    Tc-99m HMPAO has been used to image cerebral perfusion changes in 20 chronic schizophrenia patients (19 men and 1 woman), with an average age of 29 years (range, 22-48 years). All were receiving neuroleptic drugs. Twelve had received electroconvulsive therapy. All patients had abnormal studies (except one, which was normal) and poor response to treatment. Ventricular dilation and cerebral atrophy were seen in 11 patients. Seventy-seven focal lesions were detected. Forty-two lesions showed increased HMPAO retention: 26 in the basal ganglia in 14 patients (12, bilateral, two unilateral), 10 along the sylvian fissure in the parietotemporal region, three in the frontal region, and one in each of the temporal, parietal, and occipital regions. Thirty-five focal lesions showed decreased perfusion: 10 parietal, eight frontal, seven temporal, six cerebellar, and four occipital. This study demonstrates the potential value of Tc-99m HMPAO in the study of schizophrenia and other psychiatric disorders

  2. Neuro-functional alteration in disorders of the encourage they cause with conducts self-mutilations study of cerebral regional perfusion starting from the technique of Neuro-SPECT Tc99-HMPAO

    International Nuclear Information System (INIS)

    Mena, Ismael; Correa, Rodrigo; Nader, Armando

    2007-01-01

    We report NeuroSPECT findings in mood disorders, including bipolar disorder, major depression and self-mutilation. We compare results in 29 patients with bipolar disorder complicated by self-mutilation, a group of 20 patients with bipolar disorder uncomplicated and 22 patients with mayor depression uncomplicated by self-mutilation. Among the NeuroSPECT findings we report the association of mood disorders and self-mutilation with hyper perfusion of the anterior-dorsal-ventral segment of both thalami concomitant with hypoperfusion in perilimbic cortex, namely areas 32, 24 (anterior cingulate gyrus) and 23 of Brodmann. Multiple reports in the literature relate both, in animals and man, self-mutilation with phenomena of hypoalghesia, anesthesia, or dysestesias and are the basis for our hypothesis linking dysfunction of limbic-thalamic circuits, associated with nocioceptive fibers, somato-psychic consciousness and self-mutilation phenomena

  3. Hemodynamic and metabolic state of hyperfixation with 99mTc-HMPAO brain SPECT in subacute stroke

    International Nuclear Information System (INIS)

    Cho, Ihnho; Hayashida, Kohei; Imakita, Satoshi; Kume, Norihiko; Fukuchi, Kazuki

    2000-01-01

    By means of positron emission tomography (PET), we investigated the hemodynamic and metabolic state of the hyperfixation identified as the increased accumulation with 99m Tc-d, l-hexamethylpropyleneamine oxime (HMPAO) by single photon emission computed tomography (SPECT) in patients with subacute stroke. We studied four patients with subacute stroke having hyperfixed areas evaluated with CBF, CMRO 2 , OEF and CBV by PET. The hyperfixation rate with 99m Tc-HMPAO was obtained by comparing the surplus rate with standardized CBF. The OEF and CMRO 2 values in the hyperfixed areas of 4 patients were significantly lower than those in normal 5 controls (p 99m Tc-HMPAO in the infarct area revealing a mismatch between CMRO 2 and CBF meant relative luxury perfusion. The hyperfixation rate determined by 99m Tc-HMPAO brain SPECT correlated with CBV in the PET study. We can conclude that one of the main factors which caused hyperfixation was vasodilatation as well as the blood brain barrier disruption and the neovascularization. (author)

  4. Cerebral fat embolism studied with MRI and SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Erdem, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Namer, I.J. (Inst. of Biophysics, Faculty of Medicine, Louis Pasteur Univ., Strasbourg (France)); Saribas, O. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Aras, T. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Tan, E. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey)); Bekdik, C. (Dept. of Nuclear Medicine, Hacettepe Univ. School of Medicine Ankara (Turkey)); Zileli, T. (Dept. of Neurology, Hacettepe Univ. School of Medicine, Ankara (Turkey))

    1993-03-01

    In a patient with fat embolism to the brain CT showed no abnormality. MRI performed after recovery from coma, when the patient had aphasia and quadriparesis, demonstrated multiple high signal abnormalities in the white matter on both T1- and T2-weighted images. HMPAO-SPECT showed left-sided hypoperfusion which resolved in parallel with clinical improvement 1 month later. (orig.)

  5. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    International Nuclear Information System (INIS)

    Ichiseki, Hajime; Terashi, Akiro; Hamamoto, Makoto; Miyazaki, Tokuzo.

    1995-01-01

    We have performed single photon emission computed tomography (SPECT) with 99m Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author)

  6. Regional cerebral blood flow in status epileptics measured by single photon emission computed tomography (SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Ichiseki, Hajime; Terashi, Akiro [Nippon Medical School, Tokyo (Japan); Hamamoto, Makoto; Miyazaki, Tokuzo

    1995-12-01

    We have performed single photon emission computed tomography (SPECT) with {sup 99m}Tc-hexamethylpropylene amineoxime (HM-PAO) to evaluate regional cerebral blood flow (rCBF) in status epileptics (SE) caused by a cerebral vascular accident. In addition, we have discussed the neurophysiology of SE based on the SPECT findings. A total of sixteen patients (5 males and 11 females, average age; 78.2 years old) with SE who were suffering from prolonged consciousness disturbance were investigated. When SPECT was performed in the ictal state, there was a remarkable increase in radio isotope (RI) uptake at the focus which correlated well with EEG findings. However, in other cortical regions, basal ganglia and thalamus, there was a relatively demonstrated decrease in RI uptake compared with that of the focus. Additionally in the interictal state, we found a decrease in RI uptake in the epileptic foci and normal recovery of the RI uptake level in other cerebral regions. We speculate that these characteristic patterns of cerebral blood flow distribution shown by SPECT scans in the ictal state reflect the state of consciousness disturbance due to SE. In general, in the elderly, it is difficult to make a differential diagnosis between prolonged consciousness disturbance due to nonconvulsive SE and other diseases such as cardiovascular diseases, dehydration, metabolic disorder, etc. Nevertheless, nonconvulsive SE causes diffuse cell loss and irreversible brain damage. Therefore the elderly who have suffered from prolonged consciousness disturbance due to SE need an exact diagnosis and immediate medical treatment. When we diagnose a nonconvulsive SE, the characteristic findings of SPECT scans in the ictal state are very clear and useful. In conclusion, SPECT is a very simple and non-invasive method that demonstrates abnormalities of brain function exactly. Therefore, we should perform not only EEC but also SPECT scans when making a diagnosis of SE. (author).

  7. Technetium-99m HMPAO brain SPECT in children with attention deficit hyperactivity disorder

    International Nuclear Information System (INIS)

    Kaya, G.C.; Pekcanlar, A.; Bekis, R.; Ada, E.; Miral, S.; Emiroglu, N.; Durak, H.

    2002-01-01

    Attention deficit hyperactivity disorder (ADHD) is a developmental, neurobehavioral syndrome with an onset in childhood. The aim of this study was to investigate the existence of regional perfusion changes in ADHD by means of Tc-99m HMPAO brain SPECT. Thirteen children with a diagnosis of ADHD and 7 healthy, age-matched controls were included in this study. Hypoperfusion was observed on the right temporal cortex in 9, and on the left temporal cortex in 3 children. The distribution of the lesions showed right lateral temporal cortex involvement in 3, right medial temporal cortex in 9 and left medial temporal cortex in 8 children. Asymmetric perfusion was seen on the caudate nucleus in 4, on the thalamus in 3 and on the frontal cortex in 6 children. There was a significant difference between children with ADHD and controls in right medial temporal cortex: cerebellum and right lateral temporal cortex: cerebellum ratios. Hypoperfusion in the right medial temporal cortex was significantly and inversely correlated with Du Paul teachers' questionnaire rating scale (r=-0.71, p=0.006). It has been postulated that difficulty in self regulating response to stimuli in ADHD is mediated by underfunctioning of the orbital frontal cortex and subsequent connection to the limbic system. Decreased temporal cortex perfusion may dysfunction of the limbic system or the orbito-frontal-limbic axis. (author)

  8. Technetium-99m HMPAO brain SPECT in children with attention deficit hyperactivity disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kaya, G C; Pekcanlar, A; Bekis, R; Ada, E; Miral, S; Emiroglu, N; Durak, H [Dokuz Eylul Univ., Izmir (Turkey). School of Medicine

    2002-12-01

    Attention deficit hyperactivity disorder (ADHD) is a developmental, neurobehavioral syndrome with an onset in childhood. The aim of this study was to investigate the existence of regional perfusion changes in ADHD by means of Tc-99m HMPAO brain SPECT. Thirteen children with a diagnosis of ADHD and 7 healthy, age-matched controls were included in this study. Hypoperfusion was observed on the right temporal cortex in 9, and on the left temporal cortex in 3 children. The distribution of the lesions showed right lateral temporal cortex involvement in 3, right medial temporal cortex in 9 and left medial temporal cortex in 8 children. Asymmetric perfusion was seen on the caudate nucleus in 4, on the thalamus in 3 and on the frontal cortex in 6 children. There was a significant difference between children with ADHD and controls in right medial temporal cortex: cerebellum and right lateral temporal cortex: cerebellum ratios. Hypoperfusion in the right medial temporal cortex was significantly and inversely correlated with Du Paul teachers' questionnaire rating scale (r=-0.71, p=0.006). It has been postulated that difficulty in self regulating response to stimuli in ADHD is mediated by underfunctioning of the orbital frontal cortex and subsequent connection to the limbic system. Decreased temporal cortex perfusion may dysfunction of the limbic system or the orbito-frontal-limbic axis. (author)

  9. Technetium-99m HMPAO brain SPECT in children with attention deficit hyperactivity disorder

    Energy Technology Data Exchange (ETDEWEB)

    Kaya, G.C.; Pekcanlar, A.; Bekis, R.; Ada, E.; Miral, S.; Emiroglu, N.; Durak, H. [Dokuz Eylul Univ., Izmir (Turkey). School of Medicine

    2002-12-01

    Attention deficit hyperactivity disorder (ADHD) is a developmental, neurobehavioral syndrome with an onset in childhood. The aim of this study was to investigate the existence of regional perfusion changes in ADHD by means of Tc-99m HMPAO brain SPECT. Thirteen children with a diagnosis of ADHD and 7 healthy, age-matched controls were included in this study. Hypoperfusion was observed on the right temporal cortex in 9, and on the left temporal cortex in 3 children. The distribution of the lesions showed right lateral temporal cortex involvement in 3, right medial temporal cortex in 9 and left medial temporal cortex in 8 children. Asymmetric perfusion was seen on the caudate nucleus in 4, on the thalamus in 3 and on the frontal cortex in 6 children. There was a significant difference between children with ADHD and controls in right medial temporal cortex: cerebellum and right lateral temporal cortex: cerebellum ratios. Hypoperfusion in the right medial temporal cortex was significantly and inversely correlated with Du Paul teachers' questionnaire rating scale (r=-0.71, p=0.006). It has been postulated that difficulty in self regulating response to stimuli in ADHD is mediated by underfunctioning of the orbital frontal cortex and subsequent connection to the limbic system. Decreased temporal cortex perfusion may dysfunction of the limbic system or the orbito-frontal-limbic axis. (author)

  10. Evolution of technetium-99m-HMPAO SPECT and brain mapping in a patient presenting with echolalia and palilalia.

    Science.gov (United States)

    Dierckx, R A; Saerens, J; De Deyn, P P; Verslegers, W; Marien, P; Vandevivere, J

    1991-08-01

    A 78-yr-old woman presented with transient echolalia and palilalia. She had suffered from Parkinson's disease for 2 yr. Routine laboratory examination showed hypotonic hyponatremia, but was otherwise unremarkable. Brain mapping revealed a bifrontal delta focus, more pronounced on the right. Single photon emission computed tomography (SPECT) of the brain with technetium-99m labeled d,l hexamethylpropylene-amine oxime (99mTc-HMPAO), performed during the acute episode showed relative frontoparietal hypoactivity. Brain mapping performed after disappearance of the echolalia and palilalia, which persisted only for 1 day, was normal. By contrast, SPECT findings persisted for more than 3 wk. Features of particular interest in the presented patient are the extensive defects seen on brain SPECT despite the absence of morphologic lesions, the congruent electrophysiologic changes and their temporal relationship with the clinical evolution.

  11. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    International Nuclear Information System (INIS)

    Sinnatamby, R.; Antoun, N.A.; Freer, C.E.L.; Miles, K.A.; Hodges, J.R.

    1996-01-01

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using 99m Tc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  12. Neuroradiological findings in primary progressive aphasia: CT, MRI and cerebral perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinnatamby, R. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Antoun, N.A. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Freer, C.E.L. [Dept. of Radiology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Miles, K.A. [Dept. of Nuclear Medicine, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom); Hodges, J.R. [Dept. of Neurology, Addenbrooke`s Hospital NHS Trust, Cambridge (United Kingdom)

    1996-04-01

    Primary progressive aphasia (PPA) is defined as progressive decline in language for 2 or more years with preservation of activities of daily living and general cognitive functions. Whereas the clinical features of this syndrome have been well documented, the neuroradiological findings have not been studied systematically. We studied 13 patients with PPA retrospectively: 10 underwent CT, 12 MRI and 12 cerebral perfusion studies using {sup 99m}Tc-HMPAO SPECT. CT and MR images were scored for focal atrophy by two independent assessors. Initial qualitative assessment of SPECT images was confirmed by quantitative analysis. CY was normal in 5 patients. Focal atrophy, affecting predominantly the left temporal lobe, was seen in 4 of 10 patients on CT, and 10 of 12 on MRI. Atrophy was localised primarily to the superior and middle temporal gyri on MRI. All 12 patients who underwent SPECT had unilateral temporal lobe perfusion defects, in 2 patients of whom MRI was normal. CT is relatively insensitive to focal abnormalities in PPA; MRI and SPECT are the imaging modalities of choice. MRI allows accurate, specific localisation of atrophy with the temporal neocortex. SPECT may reveal a functional decrease in cerebral perfusion prior to establishment of structural change. (orig.)

  13. CBF patterns in different types of headache using 99mTc HMPAO and high resolution SPECT

    International Nuclear Information System (INIS)

    Jones, B.E.; Davies, P.G.; Costa, D.C.; Steiner, T.J.; Rose, F.C.; Jewkes, R.F.; Charing Cross Hospital, London

    1988-01-01

    High resolution SPECT studies have been performed using 99m Tc HMPAO on patients suffering from migraine, cluster headache or chronic tension headache. Reduced uptake of tracer in the right parieto-occipital cortex was seen in 6/8 patients suffering from classical or hemiplegic migraine and 2/10 patients suffering from common migraine. A high uptake of tracer was seen in the temporal muscle of some patients with chronic tension headache. Extracerebral uptake of radioactivity was also seen in the tissue surrounding the brain in a case injected with the HMPAO 45 minutes after it had been prepared and in metastatic skull lesions in patients suffering from cancer of the breast. It is therefore important to use high resolution instrumentation to avoid artifacts when using this technique. (orig.)

  14. Usefulness of hybrid SPECT/CT for the {sup 99m}Tc-HMPAO-labeled leukocyte scintigraphy in a case of cranial osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    Bruni, Chiara; Padovano, Federico; Travascio, Laura; Schillaci, Orazio; Simonetti, Giovanni [University of Rome Tor Vergata, Rome (Italy). Dept. of Diagnostic Imaging, Molecular Imaging, Interventional Radiology and Radiotherapy]. E-mail: chiarabruni79@hotmail.com

    2008-12-15

    Cranial osteomyelitis is a potentially fatal lesion. White blood cell scanning (WBC) with {sup 99m}Tc-hexamethylpropylene amine oxime (HMPAO) has proven highly sensitive and specific in the diagnosis and follow-up of patients with suspected osteomyelitis. In this report we show the usefulness of SPECT and transmission CT performed simultaneously using a hybrid imaging device for the functional anatomic mapping of soft tissue and cranial bone infections. {sup 99m}Tc-HMPAO-labeled leukocytes scintigraphy was performed on an elderly diabetic man with an intracranial mass lesion and with suspected temporal bone infection. Planar scans were acquired 30 min, 4 h, and 24 h after injection. SPECT/CT was obtained 6 h after tracer injection, using a dual-head camera coupled with a low-power X-ray tube. The scintigraphic results were matched with the results of surgery and of clinical follow-up. The planar images alone were true-positives for abscess in this patient. SPECT/CT improves the accuracy of {sup 99m}Tc- HMPAO scintigraphy especially in discriminating between soft-tissue and bone involvement. In fact, SPECT/CT also showed temporal bone osteomyelitis. This result indicates that SPECT/CT performed using a hybrid device can improve imaging with {sup 99m}Tc-HMPAO-labeled leukocytes in patients with suspected osteomyelitis by providing accurate anatomic localization and precise definition of the extent of infection. (author)

  15. Usefulness of hybrid SPECT/CT for the 99mTc-HMPAO-labeled leukocyte scintigraphy in a case of cranial osteomyelitis

    Directory of Open Access Journals (Sweden)

    Chiara Bruni

    Full Text Available Cranial osteomyelitis is a potentially fatal lesion. White blood cell scanning (WBC with 99mTc-hexamethylpropylene amine oxime (HMPAO has proven highly sensitive and specific in the diagnosis and follow-up of patients with suspected osteomyelitis. In this report we show the usefulness of SPECT and transmission CT performed simultaneously using a hybrid imaging device for the functional anatomic mapping of soft tissue and cranial bone infections. 99mTc-HMPAO-labeled leukocytes scintigraphy was performed on an elderly diabetic man with an intracranial mass lesion and with suspected temporal bone infection. Planar scans were acquired 30 min, 4 h, and 24 h after injection. SPECT/CT was obtained 6 h after tracer injection, using a dual-head camera coupled with a low-power X-ray tube. The scintigraphic results were matched with the results of surgery and of clinical follow-up. The planar images alone were true-positives for abscess in this patient. SPECT/CT improves the accuracy of99mTc-HMPAO scintigraphy especially in discriminating between soft-tissue and bone involvement. In fact, SPECT/CT also showed temporal bone osteomyelitis. This result indicates that SPECT/CT performed using a hybrid device can improve imaging with 99mTc-HMPAO-labeled leukocytes in patients with suspected osteomyelitis by providing accurate anatomic localization and precise definition of the extent of infection.

  16. Tc99m-HMPAO Neuro--SPECT Assessment of Ischemic Penumbra in Acute Brain Infarct: Control of Intra-arterial Thrombolysis Treatment

    International Nuclear Information System (INIS)

    Mena, Francisco; Mena, Ismael; Ducci, Hector; Soto, Francisco; Pedraza, Luis; Contreras, Andrea; Miranda, Marcelo; Basaez, Esteban; Fruns, Manuel

    2004-01-01

    Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis, an approved therapy, if performed in the first 3 to 6 hours of evolution. Thrombolysis has many benefits, but it also has associated risks, mainly development of intracranial hemorrhage. The selection of which patient should receive this type of treatment had been an important research topic over the last decade. As a consequence neuroimaging of brain infarct has significantly improved during the last few years. A variety of diagnostic studies are now available in the evaluation of brain infarct and in particular of potentially reversible brain ischemia, including magnetic resonance imaging (MRI) diffusion-perfusion, perfusion computed tomography (CT) and functional neuroimaging techniques includes positron emission tomography (PET) and single-photon emission tomography (SPECT). The aim of this study is to present our experience with a group of patients that presented with acute brain ischemia and had a NeuroSPECT evaluation before and after intra-arterial thrombolysis and/or possible stent placement, in the treatment of acute brain infarct. Methods: 16 patients were treated acutely for a significant ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan performed to rule out hemorrhage or established infarct. 3) IV injection of 1100MBq Tc 99m HMPAO (Ceretec tm ) 4) Conventional cerebral angiography and intra-arterial thrombolysis with tPA and /or angioplasty/stent if necessary. 5) NeuroSPECT assessment of ischemic penumbra (Pre-therapy results). 6) 14 of 16 patients received a NeuroSPECT (Post-therapy results) control at 24 hours. NeuroSPECT image acquisition was performed immediately following arterial thrombolysis with a dual Head Camera, Siemens ECAM, SHR collimators and conventional protocol. Image processing was performed using the Neurogam, Segami Corp. Software as previously reported in Alasbimn Journal 2

  17. The EEG, CT and Tc-99m HMPAO SPECT study in patients with epilepsy

    International Nuclear Information System (INIS)

    Tovuudorj, A.; Tsagaankhuu, G.; Onkhuudai, P.; Tsevelmaa, L.; Sereegotov, E.; Enkhtuya, B.

    2007-01-01

    Full text: We have put an objective of studying the EEG and neuroimaging diagnostic indexes (CT, SPECT) in patients with partial seizures during interictal period. Methods: In our study a total of 35 cases were included (20 male and 15 females). In EEG studies we used the diagnostics methodology elaborated by L.R.Zenkov (1996) and in SPECT study by Payne JK (1991) and in CT investigation by Chermissan V.M (2001). Results: By EEG study the cases of interictal period of partial seizure were mostly revealed in the form of sharp waves in temporal lobe (47.62.5%). By CT study the 18 (51.4 ± 2.5 %) cases of partial seizure with normal index, 12 (34.3 ± 1.8 %) cases with dilatation of ventricles and 5 (14.3 ± 2.1%) cases of cerebral atrophy. In SPECT investigation we identified 8 (22.81.8%) cases with normal brain blood flow supply and 27 (77.2 2.0%) cases with variable degrees of hypoperfusion (AI) in the temporal lobe was reaching 233.9% (p<0.01). Conclusion: 1. On EEG analysis during interictal period of partial seizures, there were prevailing sharp-waves (47.6 ± 2.5%) at temporal location of a hemispheres. 2. The brain CT investigation during epilepsy mostly revealed the normal indexes 3. By analyzing brain SPECT during the interictal period of seizures, there were prevailing hypoperfusion degrees (AI) of blood flow to reach 23.0 ± 3.9%. (author)

  18. Evaluation of the effects of methylprednisolone pulse therapy in patients with systemic lupus erythematosus with brain involvement by Tc-99m HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sun, S.S.; Kao, C.H. [Department of Nuclear Medicine, China Medical University Hospital, Taichung (Taiwan); Huang, W.S. [Department of Nuclear Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei (Taiwan); Chen, J.J.H. [Section of Rheumatology, Department of Internal Medicine, China Medicine University Hospital, Taichung (Taiwan); Chang, C.P. [Division of Allergy, Immunology and Rheumatology, Changhua Christian Hospital, Changhua (Taiwan); Wang, J.J. [Department of Medical Research, Chi-Mei Medical Center, Tainan (Taiwan)

    2004-07-01

    Methylprednisolone pulse therapy (MPT) was introduced to avoid life-threatening complications in patients with systemic lupus erythematosus (SLE) with brain manifestations; however, the efficacy of MPT in SLE patients with brain involvement is still uncertain and needs to be objectively evaluated. We enrolled 15 female SLE patients with neuropsychiatric manifestations in this study. All patients had normal brain MRI and abnormal brain HMPAO-SPECT findings. Follow-up HMPAO-SPECT studies were conducted 2 weeks after MPT. Serum levels of anticardiolipin antibodies (ACA) and anti-ribosomal P antibodies (anti-P) were measured before and after MPT. Before MPT, 7 patients were positive for ACA and 7 patients were positive for anti-P. After MPT, none of the 15 patients demonstrated positive serologic findings or neuropsychiatric manifestations. Based on the follow up brain HMPAO-SPECT images following MPT, 13 patients showed disappearance of the perfusion defects and 2 patients showed partial recovery of rCBF. Brain HMPAO-SPECT imaging is a logical and objective tool for measuring the effects of MPT in SLE patients with brain involvement by determining of changes in rCBF. (orig.)

  19. Technetium-99m-HMPAO SPECT, CT and MRI in the evaluation of patients with chronic traumatic brain injury: a correlation with neuropsychological performance.

    Science.gov (United States)

    Ichise, M; Chung, D G; Wang, P; Wortzman, G; Gray, B G; Franks, W

    1994-02-01

    The purposes of this study were: (1) to compare 99mTc-hexamethylpropyleneamineoxime (HMPAO) SPECT with CT and MRI in chronic traumatic brain injury (TBI) patients and (2) to correlate both functional and structural neuroimaging measurements of brain damage with neuropsychological (NP) performance. Twenty-nine patients (minor TBI, n = 15 and major TBI, n = 14) and 17 normal controls (NC) underwent HMPAO SPECT, CT, MRI and NP testing. Imaging data were analyzed both visually and quantitatively. Nineteen (66%) patients showed 42 abnormalities on SPECT images, whereas 13 (45%) and 10 (34%) patients showed 29 abnormalities on MRI and 24 abnormalities on CT. SPECT detected relatively more abnormalities than CT or MRI in the minor TBI subgroup. The TBI group showed impairment on 11 tests for memory, attention and executive function. Of these, the anterior-posterior ratio (APR) correlated with six tests, whereas the ventricle-to-brain ratio (VBR), a known structural index of a poor NP outcome, correlated with only two tests. In evaluating chronic TBI patients, HMPAO SPECT, as a complement to CT or MRI, may play a useful role by demonstrating brain dysfunction in morphologically intact brain regions and providing objective evidence for some of the impaired NP performance.

  20. Development of 99mTc-labelled the d,1-diasteroisomer of HM-PAO for cerebral blood flow imaging

    International Nuclear Information System (INIS)

    Lun Xiao.

    1989-10-01

    The d,1-diastereoisomer of hexamethyl propyleneamine oxime (HM-PAO) was selected as the preferred ligand for Tc-99m as a radiotracer for cerebral perfusion imaging. Further improvement of the synthesis and isolation method of HM-PAO resulted in pure d,1-HM-PAO and pure meso-HM-PAO. The neutral, lipophilic Tc-99m complexes of d,1-HM-PAO and meso-HM-PAO were formed in high yield by stannous reduction of Mo-99/Tc-99m generator eluate, respectively. Two minutes following i.v. administration of Tc-99m-d,1-HM-PAO in mice, 2.24% of the injected dose appears in the brain. Little washout of the tracer is observed up to 24-hour post injection. Two minutes following i.v. administration of Tc-99m-meso-HM-PAO in mice, 1.9% of the injected dose appears in the brain. The radioactivity of Tc-99m-meso-HM-PAO declined faster than that of Tc-99m-d,1-HM-PAO did in the brain up to 24-hour post injection. 12 refs, 5 figs, 5 tabs

  1. Improvements in SPECT technology for cerebral imaging

    International Nuclear Information System (INIS)

    Esser, P.D.

    1985-01-01

    Advancement in three major areas of SPECT (single photon emission computed tomography) technology have resulted in improved image quality for cerebral studies. In the first area, single-crystal camera electronics, extensive use of microprocessors, custom digital circuitry, an data bus architecture have allowed precise external control of all gantry motions and improved signal processing. The new digital circuitry permits energy, uniformity, and linearity corrections to be an integral part of the processing electronics. Calibration of these correlations is controlled by algorithms stored in the camera's memory. The second area of improved SPECT technology is camera collimation and related imaging techniques. In this area, system resolution has been improved without loss of sensitivity by decreasing the air gap between patient and collimator surface. Since cerebral studies characteristically image high-contrast regions less than 1 cm in size, image quality has been improved by increasing collimator resolution even at the expense of sensitivity. Increased resolution also improved image contrast for studies using 123 I-labeled pharmaceuticals with 3% to 4% 124 I contamination. 65 references

  2. Clinical value of scatter correction for interictal brain 99m Tc-HMPAO SPECT in mesial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Sanchez Catasus, C.; Morales, L.; Aguila, A.

    2002-01-01

    Aim: It is well known that some patients with temporal lobe epilepsy (TLE) show normal perfusion during interictal SPECT study. The aim of this research was to evaluate if the scatter radiation has some influence on this kind of result. Materials and Methods: We studied 15 patients with TLE by clinical diagnosis and by video-EEG monitoring with surface electrodes (11 left TLE, 4 right TLE), which showed normal perfusion during interictal brain 99m Tc-HMPAO SPECT. The SPECT data were reconstructed by filtered backprojection without scatter correction (A). The same SPECT data were reconstructed after the projections were corrected by dual energy window method of scatter correction (B). Attenuation was corrected in all cases using first order Chang Method. For A and B images groups, cerebellum perfusion ratios were calculated on irregular regions of interest (ROI) drawn on anterior (ATL), lateral (LTL), mesial (MTL) and whole temporal lobe (WTL). To evaluate the influence of scatter radiation, the cerebellum perfusion ratios of each subject were compared with a normal database of 10 normal subjects, with and without scatter correction, using z-score analysis. Results: In group A, the z-score was less than 2 in all cases. In group B, the z-score was more than 2 in 6 cases, 4 in MTL (3 left, 1 right) and 2 in left LTL, which were coincident with the EEG localization. All images of group B showed better contrast than images of group A. Conclusions: These results suggest that scatter correction could improve the sensitivity of interictal brain SPECT to identify epileptic focus in patients with TLE

  3. Use of 99mTc-HMPAO cerebral tomo-scintigraphy in follow-up of patients afflicted with the Alzheimer's disease and treated by TACRINE

    International Nuclear Information System (INIS)

    Mestas, D.; Catoire, S.; Jalenques, I.; Maublant, J.; Veyre, A.

    1997-01-01

    A simultaneous study of the cognitive functions, single photon emission tomography (SPECT) and quantified electroencephalogram (qEEG) was carried out in 23 patients afflicted with the Alzheimer's disease and pursued during 1 year of treatment by TACRINE. A psycho-metric examination was done at inclusion and one year after; the qEEG was effected at inclusion, 6 months and one year later, while the four SPECT by HMPAO- 99m Tc (925 MBq) examinations were performed at inclusion, 12 weeks, 6 months and one year after. Two qEEG parameters were retained: the posterior average frequency (PAF) and the total spectrum power (TSP). Semi-quantitative measurements of the cerebral blood rate were determined on 4 cortical regions of interest, their average activity being referred to the average maximal activity of the cerebellum. Two variables were analyzed: the lowest value of the ratio (LVR) and the mean value of 4 ratios (MVR). The results produced an evolution significantly correlated to the PAF while psychometric tests and a correlation of the severity of cognitive affliction with the MVR at inclusion and one year after; as for LVR, it occurred in our study the most pertinent for pursuing the evolution of patients. In conclusion, the SPECT and the qEEG applied in parallel to the cognitive functions of the patients treated by TACRINE, appears to be interesting in evaluating the therapeutic response

  4. Contribution of the cerebral SPECT in the field of evaluation of the hemodynamic cerebral vascular accident risk in the Limb shaking syndrome; Apport de la TEMP cerebrale dans le cadre de l'evaluation du risque d'AVC hemodynamique dans le Limb Shaking Syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Lauer, V.; Wolff, V.; Marescaux, C. [CHU de Strasbourg, Unite neurovasculaire, service de neurologie, 67 (France); Namer, I.J. [CHU de Strasbourg, service de biophysique et medecine nucleaire, 67 -Strasbourg (France)

    2010-07-01

    The limb shaking syndrome (L.S.S.) is characterized by uncontrollable shaking of members that are caused by a passage in the upright or by an hyper extension of the neck and occur in a patient with internal carotid stenosis. To investigate the pathophysiology of L.S.S. we used brain SPECT (SPECT-E.C.D. or H.M.P.A.O.) to measure cerebral perfusion in the supine position and standing in three patients. (N.C.)

  5. Intrasubject comparison of regional cerebral blood flow between N-isopropyl-p-[123I]iodoamphetamine SPECT and 99mTc-hexamethylpropyleneamine oxime SPECT in patients with ischemic cerebrovascular disease

    International Nuclear Information System (INIS)

    Isaka, Yoshinari; Yoshikawa, Takuya; Ohe, Yohsuke; Nakayama, Hirofumi; Abe, Tohru; Ashida, Keiichi; Imaizumi, Masatoshi; Tanaka, Seiji

    1995-01-01

    Regional cerebral blood flow (CBF) was compared on CBF-SPECT brain images using two perfusion imaging agents, N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP) and 99m Tc-hexamethylpropyleneamine oxime ( 99m Tc-HMPAO), in the same patients with ischemic cerebrovascular disease. The subjects were 8 healthy volunteers (group A) and 16 patients with chronic cerebral infarction (group B). SPECT data were normalized to the count density of the tracer in the whole brain, and then converted to the absolute units of CBF by multiplying average 113 Xe-CBF in the whole brain. One-way analysis of variance (ANOVA), grouped by right and left hemispheres in group A and the affected and contralateral hemispheres in group B, was used to assess changes in regional CBF patterns in the two groups. CBF in all regions was significantly reduced on SPECT images, irrespective of the tracers, in group B. F value was higher on IMP images than HMPAO images for the frontal, temporal and occipital cortices, thalamus, and striatum); on the contrary, it was higher on HMPAO images than IMP images for the central lobule, parietal cortex, hippocampus, and centrum semiovale. Two-way ANOVA, grouped by the affected hemisphere in group B, tracer, and affected hemisphere x tracer, indicated that effects of tracer and affected hemisphere x tracer for regional CBF were not significant. For cortical infarction (n=8), regional CBF values in the infarct core were 14.8±4.1 ml/100 g/min on IMP images and 17.6±3.8 ml/100 g/min on HMPAO images; the corresponding figures for the contralateral region were 34.7±8.6 ml/100 g/min and 32.6±8.4 ml/100 g/min. Image contrast was better on IMP images than HMPAO images. In conclusion, an intrasubject comparison in ischemic cerebrovascular disease showed that the detectability of HMPAO CBF-SPECT for CBF abnormalities is roughly equivalent to that of IMP-CBF-SPECT. (N.K.)

  6. Analysis of simulataneous I-123-IPT/Tc-99m-HMPAO dual isotope brain SPECT in Parkinson's disease and normal volunteers using SPM

    International Nuclear Information System (INIS)

    Chung, Y. A.; Juh, R. H.; Kim, S. H.; Park, Y. H.; Lee, S. Y.; Sohn, H. S.; Chung, S. K.

    2002-01-01

    The basal ganglia are usually poorly delineated in Parkinson's diseases on IPT images. We have studied simultaneous dual isotope brain SPECTs using I-123-IPT and Tc-99m-HMPAO, in order to overcome this limitation of IPT imaging. 17 patients (M: 7, F: 10) with Parkinson's disease (Idiopathic parkison's disease: 12, Multiple system atrophy: 5) and 4 normal volunteers (N) underwent the dual isotope brain SPECT following simultaneously injection of 370 MBq Tc-99m-HMPAO (energy window: 130-146 keV) and 111 MBq I-123-IPT (energy window: 152-168 keV). We first obtained parameters of spatial normalization during spatial normalization of Tc-99m-HMPAO brain SPECT using SPECT template. Using these parameters, we could spatially normalized I-123-IPT brain PSECT to standard space, because these images were obtained simultaneously. The difference between each groups(N vs IPD, N vs MSA, IPD vs MSA) were compared with t-test (p<0.01). We demonstrated decreased perfusion in the head and body caudate and globus pallidus on MSA compared with IPD. No significant hypo- and hyperperfusion area was observed in the other analysis. The method proposed in this study can effectively evaluate the dopamine function, and is easily applicable to conventional gamma camera system with any dual energy window acquisition modes

  7. Technetium-labeled HM-PAO studies in patients with cerebrovascular disease

    International Nuclear Information System (INIS)

    Smith, F.W.; Sharp, P.F.; Gemmell, H.; Evans, N.T.; MacDonald, A.F.

    1986-01-01

    Technetium-labeled hexamethyl-propyleneamineoxime (HM-PAO) is a promising radiopharmaceutical for the demonstration of cerebral blood flow. Twenty-four patients who had experienced either acute stroke (AS) or transient ischemic attack (TIA) were studied by x-ray CT and SPECT using technetium-labeled HM-PAO total of 26 studies. HM-PAO has a cerebral distribution similar to that of iodoamphetamine, but labeling with technetium allows good SPECT imaging on demand in any nuclear medicine department. In ten of the 16 patients who had experienced AS, findings on HM-PAO and CT studies correlated well. In six patients reduced cortical perfusion was detected on HM-PAO imaging, but only small infarcts in the internal capsule were seen on CT. In four of the eight patients who had experienced TIA, neither study revealed any abnormality. In the remaining four, areas of cortical underperfusion were seen on HM-PAO imaging, whereas the CT examination was normal. The findings in this study suggest that HM-PAO imaging is a more sensitive method for demonstrating the extent of cerebral underperfusion in cases of cerebrovascular accident

  8. Utility of the cerebral SPECT in schizophrenia

    International Nuclear Information System (INIS)

    Heuguerot, C.H.; Lopez-Lerena, J.J.; Quagliata, A.; Hermida, J.C.; Oliveira, M.C.; Anastasia, H.

    2002-01-01

    Objective: To compare cortical and subcortical cerebral perfusion in schizophrenics patients with normal controls, and analyze the relation to clinical patterns and neuroleptic treatment. Method: 18 patients meeting DSM-IV criteria for schizophrenia under neuroleptic treatment (except 3 cases), evaluated with clinical scales (BPRS and PANSS). The control group included 5 subjects in good health. All subjects were studied with single photon emission computed tomography (SPECT) using technetium-99 etilencisteinato (99mTc-ECD) as a tracer. Region of interest (ROI) were defined in cerebral cortex and thalamus-basal ganglia areas. The cortical cerebral blood flow was measured with a quantitative analysis, expressed as a ratio of regional tracer uptake to occipital cortex uptake. In basal ganglia and thalamus, regional blood flow was evaluated with a semiquantitative methodology, defining categories. Results: Schizophrenics patients showed a significant reduction of perfusion on a left anterior frontal cortex ('hipofrontality') and global decrease of perfusion on left hemisphere. The interhemispheric (left/right) ratio of perfusion was incremented respect control group. In thalamic-basal ganglia complex, a significant hypoperfusion was found in neuroleptic-free patients and control group. On the other hand, neuroleptic-treated patients revealed normal or increased regional blood flow in thalamus and basal ganglia. Only the clinical item 'thought disorder' had significant high correlation with perfusion on left structures (left anterior frontal, left lateral frontal, left temporo-parietal); the other items correlated with right structures. Conclusions: The findings suggest a pattern o left cerebral hypoperfusion in patients with an incremented interhemispheric ratio of cerebral blood flow. The pivotal role of thalamic and basal ganglia areas in the pathophysiology of schizophrenia and neuroleptic action was reaffirmed; apparently, perfusion in thalamic-basal ganglia

  9. Functional imaging studies of cognition using 99mTc-HMPAO SPECT: empirical validation using the n-back working memory paradigm

    International Nuclear Information System (INIS)

    Ludwig, Catherine; Ribaupierre, Anik de; Chicherio, Christian; Terraneo, Luc; Magistretti, Pierre; Slosman, Daniel

    2008-01-01

    Functional activation protocols are widely applied for the study of brain-cognition relations. Only few take advantage of the intrinsic characteristics of SPECT, particularly those allowing cognitive assessment outside of the camera, in settings close to the standard clinical or laboratory ones. The purpose of the study was to assess the feasibility of a split-dose activation protocol with 99m Tc-HMPAO using low irradiation dose. A two-scans protocol was applied to 12 healthy young volunteers using 270 MBq of 99m Tc-HMPAO per scan, with each image associated to a particular experimental condition of the verbal n-back working memory task (0-back, 2-back). Subtraction method was used to identify regional brain activity related to the task. Voxel-wise statistical analysis showed left lateralized activity associated with the 2-back task, compared to the 0-back task. Activated regions, mainly prefrontal and parietal, were similar to those observed in previous fMRI and 15 O-PET studies. The results support the use of 99m Tc-HMPAO SPECT for the investigation of brain-cognition relations and demonstrate the feasibility of optimal quality images despite low radiopharmaceutical doses. The findings also acknowledge the use of HMPAO as a radioligand to capture neuro-energetic modulations linked to cognitive activity. They encourage extending the application of the described activation protocol to clinical populations. (orig.)

  10. Functional imaging studies of cognition using {sup 99m}Tc-HMPAO SPECT: empirical validation using the n-back working memory paradigm

    Energy Technology Data Exchange (ETDEWEB)

    Ludwig, Catherine; Ribaupierre, Anik de [University of Geneva, Center for Interdisciplinary Gerontology, Geneva (Switzerland); Chicherio, Christian [Max Planck Institute for Human Development, Center for Lifespan Psychology, Berlin (Germany); Terraneo, Luc [Geneva University Hospitals, Service of Nuclear Medicine, Geneva (Switzerland); Magistretti, Pierre [EPFL, Brain Mind Institute, Lausanne (Switzerland); Slosman, Daniel [Clinique Generale-Beaulieu, Nuclear Medicine Institute, Geneva (Switzerland)

    2008-04-15

    Functional activation protocols are widely applied for the study of brain-cognition relations. Only few take advantage of the intrinsic characteristics of SPECT, particularly those allowing cognitive assessment outside of the camera, in settings close to the standard clinical or laboratory ones. The purpose of the study was to assess the feasibility of a split-dose activation protocol with {sup 99m}Tc-HMPAO using low irradiation dose. A two-scans protocol was applied to 12 healthy young volunteers using 270 MBq of {sup 99m}Tc-HMPAO per scan, with each image associated to a particular experimental condition of the verbal n-back working memory task (0-back, 2-back). Subtraction method was used to identify regional brain activity related to the task. Voxel-wise statistical analysis showed left lateralized activity associated with the 2-back task, compared to the 0-back task. Activated regions, mainly prefrontal and parietal, were similar to those observed in previous fMRI and {sup 15}O-PET studies. The results support the use of {sup 99m}Tc-HMPAO SPECT for the investigation of brain-cognition relations and demonstrate the feasibility of optimal quality images despite low radiopharmaceutical doses. The findings also acknowledge the use of HMPAO as a radioligand to capture neuro-energetic modulations linked to cognitive activity. They encourage extending the application of the described activation protocol to clinical populations. (orig.)

  11. Cerebral postischemic hyperperfusion in PET and SPECT

    International Nuclear Information System (INIS)

    Cho, Inn Ho

    2001-01-01

    Cerebral post-ischemic hyperperfusion has been observed at the acute and subacute periods of ischemic stroke. In the animal stroke model, early post-ischemic hyperperfusion is the mark of recanalization of the occluded artery with reperfusion. In the PET studies to both humans and experimental animals, early post-ischemic hyperperfusion is not a key factor in the development of tissue infarction and indicates the spontaneous reperfusion of the ischemic brain tissue without late infarction or with small infarction. But late post-ischemic hyperperfusion shows the worse prognosis with reperfusion injury associated with brain tissue necrosis. Early post-ischemic hyperperfusion defined by PET and SPECT may be useful in predicting the prognosis of ischemic stroke and the effect of thrombolytic therapy

  12. Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    International Nuclear Information System (INIS)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-01-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.)

  13. Cranial MR imaging and cerebral 99mTc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    International Nuclear Information System (INIS)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-01-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and 99m Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOS) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS=III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (orig.)

  14. Cranial MR imaging and cerebral [sup 99m]Tc HM-PAO-SPECT in patients with subacute or chronic severe closed head injury and normal CT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Prayer, L.; Wimberger, D.; Oder, W.; Kramer, J.; Schindler, E.; Podreka, I.; Imhof, H.

    1993-11-01

    Eighteen patients in the subacute or chronic state following severe closed head injury with normal cranial CT scans were examined by MR and [sup 99m]Tc HM-PAO SPECT. Correlations were sought between these 2 imaging modalities and the clinical outcome, as defined by the Glasgow Outcome Scale (GOX) score. Both MR and SPECT revealed cerebral damage in all patients examined but structural and functional alterations did not coincide topographically in 64.9% of lesions. Nevertheless, complementary injury patterns suggesting poor recovery were found; cortical contusions and diffuse axonal injury (MR) in conjunction with cortical and thalamic hypoperfusion (SPECT) were noticed in 8 out of 12 patients with unfavorable outcome (GOS = III and IV). The synthesis of MR and SPECT information clearly enhanced the ability both to accurately assess posttraumatic brain damage and to improve patients' outcome prediction. (au) (18 refs.).

  15. SPECT in psychiatry. SPECT in der Psychiatrie

    Energy Technology Data Exchange (ETDEWEB)

    Barocka, A. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Feistel, H. (Nuklearmedizinische Klinik, Erlangen (Germany)); Ebert, D. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany)); Lungershausen, E. (Psychiatrische Klinik und Poliklinik, Erlangen (Germany))

    1993-08-13

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D[sub 2] and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.)

  16. Cerebral blood flow and metabolism of the patients with a carotid stenosis evaluated by SPECT and 1H-MRS

    International Nuclear Information System (INIS)

    Uno, Masaaki; Nishi, Kyouko; Shinno, Kiyohito; Nagahiro, Shinji; Ohtsuka, Hideki; Harada, Masafumi

    1998-01-01

    We examined cerebral blood flow (CBF) and metabolic states in patients with a severe carotid stenosis by SPECT and proton MRS ( 1 H-MRS). SPECT using 99m Tc-HMPAO and 1 H-MRS were performed in twenty five patients with over 70% carotid stenosis. Moreover, 10 patients were evaluated by these methods after carotid endarterectomy (CEA). N-acetyl-aspartate (NAA) on the ipsilateral side was reduced in 17 patients (Group A) while NAA of other 8 patients was not reduced (Group B). In Group A, although regional CBF was reduced in only 4 of 17 patients, 11 patients showed decline of cerebral vasoreactivity evaluated by acetazolamide injection. Concentration of NAA and regional CBF showed significant correlations. After CEA, ipsilateral NAA was increased significantly compared to preoperative NAA level. In 6 of 7 patients in Group A, cerebral vasoreactivity also improved postoperatively. These results indicated that ipsilatereal NAA metabolism and cerebral vasoreactivity can be improved after CEA. SPECT and 1 H-MRS were useful to evaluate CBF and metabolism in patients with carotid stenosis. (author)

  17. Study on SPECT image for children with cerebral infarction

    International Nuclear Information System (INIS)

    Xie Wenhuang; Xie Zhichun; Chen Yucai; Lin Haoxue; Zheng Aidong; Xie Hui

    1998-01-01

    To explore the diagnostic value of SPECT image for children with cerebral infarction (CCI), comparative research was made on 26 cases undergoing regional cerebral perfusion (rCP) image between SPECT imaging and CT scanning. The results showed that the rCP in the infarct and its distant area was decreased. The positive rate of SPECT and CT were 92.3% (24/26) and 84.5% (22/26) respectively. The difference was not significant (P = 0.67, P>0.05). But, the positive rate of SPECT image 2 days after onset in 9 CCI was 100% (9/9), significantly higher than 55.6% (5/9) in CT scanning (P = 0.04, P<0.05). These findings suggested that the SPECT imaging is a sensitive method for the early diagnosis of CCI, and also helpful for observation of the therapeutic effect and evaluation of the prognosis

  18. Cerebral blood flow abnormalities induced by transient hypothyroidism after thyroidectomy. Analysis by Tc-99m-HMPAO and SPM96

    International Nuclear Information System (INIS)

    Nagamachi, Shigeki; Jinnouchi, Seishi; Nishii, Ryuichi; Ishida, Yasushi; Fujita, Seigo; Futami, Shigemi; Kodama, Takao; Tamura, Shozo; Kawai, Keiichi

    2004-01-01

    The current study is an investigation of alterations in regional cerebral blood flow (rCBF) distribution in patients with transient hypothyroidism after thyroidectomy. In addition, the effects of thyroxine treatment on rCBF changes were studied. Noninvasive rCBF measurements using 99m Tc-HMPAO SPECT were performed on 24 post-thyroidectomy patients who were in a hypothyroidic state. The measurements were conducted before 131 I therapy and after thyroid hormone (thyroxine) replacement. We used adjusted rCBF images (normalization of global CBF for each subject to 50 ml/100 g/min with proportional scaling) to compare these data with age-matched normal control groups (n=15) using statistical parametric mapping (SPM) 96. We also compared the absolute rCBF value of hypothyroidic patients with those of normal control groups. In addition, the association between rCBF alteration and the severity of depression was also analyzed. Finally, the effect of thyroid hormone replacement on rCBF was investigated individually using the Jack-knife test, in which patient data were compared with those from healthy volunteers. According to the result of this test, all cases were categorized into three subgroups, namely, improved, unchanged group and normal. To prove the reversibility of rCBF alteration after thyroid hormone replacement, a group comparison test between the normal controls and the improved group was done before and after thyroid hormone replacement. Similarly a group comparison test between the unchanged group and normal controls was also performed. In the hypothyroidic condition, there was a significant decrease in the posterior part of the bilateral parietal lobes and in part of the bilateral occipital lobes, including the cuneus. These decreased rCBF areas extended to the bilateral prefrontal cortices as deterioration became more profound. On individual analysis, 16 of 24 patients (66.7%) demonstrated rCBF reduction, while 8 patient did not show significant rCBF change

  19. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    Energy Technology Data Exchange (ETDEWEB)

    So, Young [Nuclear Medicne, Seoul National Univ., Seoul (Korea, Republic of); Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June [College of Medicine, Chungnam National Univ., Taejon (Korea, Republic of)

    2002-08-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). 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 {approx} 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. 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, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI.

  20. The role of Tc-99m HMPAO brain perfusion SPECT in the psychiatric disability evaluation of patients with chronic traumatic brain injury

    International Nuclear Information System (INIS)

    So, Young; Lee, Kang Wook; Lee, Sun Woo; Ghi, Lek Sung; Song, Chang June

    2002-01-01

    We studied whether brain perfusion SPECT is useful in the psychiatric disability evaluation of patients with chronic traumatic brain injury (TBI). 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. 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, SEPCT showed 63% sensitivity (50% for mild TBI) and 88% specificity (85% for malingerers). Brain SPECT has a supplementary role to neuropsychological tests in the psychiatric disability evaluation of chronic TBI patients by detecting more cortical lesions than MRI

  1. Brain SPECT

    International Nuclear Information System (INIS)

    Feistel, H.

    1991-01-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG) [de

  2. Imaging of mild traumatic brain injury using 57Co and 99mTc HMPAO SPECT as compared to other diagnostic procedures.

    Science.gov (United States)

    Audenaert, Kurt; Jansen, Hugo M L; Otte, Andreas; Peremans, Kathelijne; Vervaet, Myriam; Crombez, Roger; de Ridder, Leo; van Heeringen, Cees; Thirot, Joel; Dierckx, Rudi; Korf, Jaap

    2003-10-01

    Traumatic brain injury (TBI) is usually assessed with the Glasgow Coma Scale (GCS), CT and EEG. TBI can result from either the primary mechanical impact or secondary (ischemic) brain damage, in which calcium (Ca) plays a pivotal role. This study was undertaken to compare the applicability of SPECT using 57Co as a Ca-tracer in patients with mild traumatic brain injury. 8 patients with mild TBI (GCS 15) were clinically examined and studied with EEG, neuropsychological testing (NPT) and SPECT within 2 days post-TBI. After i.v.-administration of 37 MBq (1 mCi) 57Co (effective radiation dose 0.34 mSv x MBq(-1); 1.24 rem x mCi(-1); physical half-life 270 days, biological half-life 37.6 h), single-headed SPECT (12 h pi) was performed, consecutively followed by standard 925 MBq (25 mCi) Tc-99m HMPAO SPECT. In 6 of the 8 patients, baseline NPT and SPECT showed focal abnormalities in the affected frontal and temporal brain regions, which were in good topographical accordance. CT and EEG did not detect (structural) lesions in any of these cases. Single-headed 57Co-SPECT is able to show the site and extent of brain damage in patients with mild TBI, even in the absence of structural lesions. It may confirm and localize NPT findings. The predictive value of 57Co-SPECT should be assessed in larger patient series.

  3. SPECT in psychiatry

    International Nuclear Information System (INIS)

    Barocka, A.; Feistel, H.; Ebert, D.; Lungershausen, E.

    1993-01-01

    This review presents Single Photon Emission Computed Tomography (SPECT) as a powerful tool for clinical use and research in psychiatry. Its focus is on regional cerebral blood flow, measured with technetium labelled HMPAO. In addition, first results with brain receptor imaging, concerning dopamin-D 2 and benzodiazepine receptors, are covered. Due to major improvements in image quality, and impressive number of results has been accumulated in the past three years. The authors caution against using SPECT results as markers for disease entities. A finding like 'hypofrontality' is considered typical of a variety of mental disorders. Clearly both, more experience with SPECT and contributions from psychopathology, are needed. (orig.) [de

  4. A clustering model proposal for activity optimization vs. image quality. Application in HMPAO-99mTc brain SPECT

    International Nuclear Information System (INIS)

    Perez, M.; Diaz, O.; Estevez, E.; Roque, R.; Hernandez, C.

    2008-01-01

    A method based on clustering analysis and image quality discriminant functions is tested over HMPAO- 99m Tc -SPECT images to optimize image quality vs. administered activity to patient. Signal-to-Noise ratios and Signal-to-Background ratios in each transaxial slice were measured over the images and used as image quality objective indexes. They were employed to develop image quality classification using a model of three clusters (k-mean Cluster Technique). The mathematical classification was compared with the subjective image quality evaluation, following expert observer criterion. Linear image quality discrimination was developed using the results of the cluster classification and taking as independent variables: the characteristics of the patients (sex, age and weight) and the radiopharmaceutical (labelling yield and administered activity). The dependent variables in the discriminant functions were the cluster centroids. The objective of this procedure was assigning a statistical weight to each image quality determinant variable for the optimization purpose. The method was applied in 30 brain SPECT images, acquired under different activities (400 MBq, 600 MBq, 800 MBq and 1000 MBq as reference), with a Sopha gamma camera, mean-resolution - general purpose - parallel-hole collimator, acquisition matrix 128 x 128 pixels and reconstruction following Filter - Back - Projection Algorithm. We looked for the minimum activity that guaranty most of the cases classified into the cluster with the best image quality (optimization criterion). The value of 800 MBq was the optimum obtained after application of the above methodology for the technology used. The labelling yield and the weight of the patients were the main parameters which determined image quality in clusters, as well as the processing digital filter used. The reduction in the effective dose, as a consequence of this procedure implementation, was also analysed. (author)

  5. Single photon emission computed tomography (SPECT): Clinical routine diagnosis of cerebral malfunction

    International Nuclear Information System (INIS)

    Neidl, K.F.W.

    1993-01-01

    Positron emission tomography is the gold standard for in vivo research in neurophysiology and pathology. The introduction of SPECT and the development of such tracers as 99m Tc-HMPAYO ( 99m Tc-d,l-hexamethylpropylenaminoxim) and, more recently, 123 I-iomazenil and 123 I-IBZM ( 123 I-3-iodo-6-methoxybenzamide) allowed closer examination of the perfusion of the brain and neuroreceptor density mapping in more than the few institutions that can afford PET and the production of special tracers marked with a positron emitting nucleus. Nuclear medicine's future will be based on neuroreceptor density mapping, as further tracers will become commercially available and no other technique can probably show such low concentrations of the receptors. Probably MR techniques will be used for brain's perfusion measurement in future. For examination of a limited cerebral region xenon-enhanced CT is an alternative to perfusion measurements with HMPAO, or a very interesting supplement. Of the old techniques in nuclear medicine, examination of the liquor dynamics is still feasible and well supplemented by SPECT. (orig./MG) [de

  6. Serial studies of cerebral blood flow using 99Tcm-HMPAO

    DEFF Research Database (Denmark)

    Andersen, A R; Friberg, H; Lassen, N A

    1987-01-01

    -HMPAO was measured after i.v. injection. High resolution (HR) and low resolution (LR) studies were performed yielding a resolution of 6 to 10 mm (HR) and 15 to 20 (LR). 99Tcm-HMPAO images showed close resemblance to xenon-133 CBF tomograms. Only about 20% of the (decay corrected) brain counts were lost during...

  7. Computer-assisted superimposition of magnetic resonance and high-resolution technetium-99m-HMPAO and thallium-201 SPECT images of the brain

    International Nuclear Information System (INIS)

    Holman, B.L.; Zimmerman, R.E.; Johnson, K.A.; Carvalho, P.A.; Schwartz, R.B.; Loeffler, J.S.; Alexander, E.; Pelizzari, C.A.; Chen, G.T.

    1991-01-01

    A method for registering three-dimensional CT, MR, and PET data sets that require no special patient immobilization or other precise positioning measures was adapted to high-resolution SPECT and MRI and was applied in 14 subjects [five normal volunteers, four patients with dementia (Alzheimer's disease), two patients with recurrent glioblastoma, and three patients with focal lesions (stroke, arachnoid cyst and head trauma)]. T2-weighted axial magnetic resonance images and transaxial 99mTc-HMPAO and 201Tl images acquired with an annular gamma camera were merged using an objective registration (translation, rotation and rescaling) program. In the normal subjects and patients with dementia and focal lesions, focal areas of high uptake corresponded to gray matter structures. Focal lesions observed on MRI corresponded to perfusion defects on SPECT. In the patients who had undergone surgical resection of glioblastoma followed by interstitial brachytherapy, increased 201Tl corresponding to recurrent tumor could be localized from the superimposed images. The method was evaluated by measuring the residuals in all subjects and translational errors due to superimposition of deep structures in the 12 subjects with normal thalamic anatomy and 99mTc-HMPAO uptake. This method for superimposing magnetic resonance and high-resolution SPECT images of the brain is a useful technique for correlating regional function with brain anatomy

  8. Cerebral SPECT, a new diagnostic marker in depression

    International Nuclear Information System (INIS)

    Galli, Enrique

    2001-01-01

    Over the past twenty years the functional brain imagenology has improved greatly. Today the diagnostic, prognostic and therapeutic response are possible in psychiatry and neurology. The functional denomination in psychiatry has been known for more than a 100 years and it can be evident in the brain images. The relation between the blood brain flux and the brain can be seen as pictures in the Brain SPECT as hyper and hypo function areas. To carry out SPECT a venous injection of Tc-99m Technetium and (HMPAO) or (ECD) is applied in the arm. The images correspond to a period of two minutes after injection. The exam can be done until six hours after the brain fixation. The study is carried out in conditions, with the patient in repose, relaxed and without medication. The final result is an brain in colors. The yellow color gives us 95% of decrease and white color 95% of increase of the brain function. The red color gives a normal perfusion. The object of the study is to find that the Brain SPECT could be used as a new diagnostic marker of depression. The sample was 73 outpatients with major depression Our diagnostic marker is the prefrontal cortex ventral hypoperfusion (orbit frontal) in almost 100% of the patients and only 32% dorsal hypoperfusion (executive area), unlike most authors (Au)

  9. Diagnostic performance of Tc-99m HMPAO SPECT for early and late onset Alzheimer's disease. A clinical evaluation of linearization correction

    International Nuclear Information System (INIS)

    Mitsumoto, Tatsuya; Sakaguchi, Yuichi; Morishita, Junji; Sasaki, Masayuki; Ohya, Nobuyoshi; Abe, Koichiro; Ichimiya, Atsushi; Kiyota, Aya

    2009-01-01

    This study examined the influence of linearization correction (LC) on brain perfusion single-photon emission computed tomography (SPECT) for the diagnosis of Alzheimer's disease (AD). The early onset group (<65 years old) consisted of 10 patients with AD, and the late onset group (≥65 years old) of 13 patients with AD. Age-matched controls included seven younger and seven older normal volunteers. Tc-99m hexamethyl propyleneamine oxine (HMPAO) SPECT images were reconstructed with or without LC [LC (+) or LC (-)] and a statistical analysis was performed using a three-dimensional stereotactic surface projection (3D-SSP). In addition, a fully automatic diagnostic system was developed, which calculated the proportion of the number of abnormal pixels in the superior and inferior parietal lobule, as well as in the precuneus and posterior cingulate gyrus. The areas under the receiver-operating characteristic curve (AUCs) of the early onset group for conventional axial SPECT images, SPECT+3D-SSP images and the fully automatic diagnostic system were 0.71, 0.88, and 0.92 in LC (-) and 0.67, 0.85, and 0.91 in LC (+), respectively. The AUCs of the late onset group were 0.50, 0.61, and 0.79 in LC (-) and 0.49, 0.67, and 0.85 in LC (+), respectively. LC on Tc-99m HMPAO SPECT did not significantly influence the diagnostic performance for differentiating between AD and normal controls in either early or late onset AD. Further examination with individuals suffering from very mild dementia is, therefore, expected to elucidate the effect of LC on minimally hypoperfused areas. (author)

  10. Technetium-99m-HMPAO labeled leukocyte single photon emission computerized tomography (SPECT) for assessing Crohn's disease extent and intestinal infiltration.

    Science.gov (United States)

    Biancone, L; Schillaci, O; Capoccetti, F; Bozzi, R M; Fina, D; Petruzziello, C; Geremia, A; Simonetti, G; Pallone, F

    2005-02-01

    Scintigraphy using radiolabeled leukocytes is a useful technique for assessing intestinal infiltration in Crohn's disease (CD). However, limits of planar images include overlapping activity in other organs and low specificity. To investigate the usefulness of (99m)Tc-HMPAO (hexametyl propylene amine oxime) labeled leukocyte single photon emission computerized tomography (SPECT) for assessing CD lesions, in comparison with planar images. Twenty-two inflammatory bowel disease patients (19 CD; 2 ulcerative colitis, UC; 1 ileal pouch) assessed by conventional endoscopy or radiology were enrolled. Leukocytes were labeled with (99m)Tc-HMPAO. SPECT images were acquired at 2 h and planar images at 30 min and 2 h. Bowel uptake was quantitated in nine regions (score 0-3). Both SPECT and planar images detected a negative scintigraphy (score 0) in the UC patient with no pouchitis and a positive scintigraphy (score 1-3) in the 21 patients showing active inflammation by conventional techniques. SPECT showed a higher global score than planar images (0.71 +/- 0.09 vs 0.30 +/- 0.05; p < 0.001), and in particular in the right iliac fossa (p= 0.003), right and left flank (p < 0.001; p= 0.02), hypogastrium (p= 0.002), and mesogastrium (p < 0.001). SPECT provided a better visualization and a higher uptake than planar images in patients with ileal and ileocolonic CD (6.45 +/- 0.82 vs 2.8 +/- 0.55, p < 0.001; 5.5 +/- 1.6 vs 2.6 +/- 0.7, p= 0.03), and with perianal CD (6.6 +/- 1.6 vs 3.4 +/- 1.2; p= 0.03). (99m)Tc-HMPAO labeled leukocyte SPECT provides a more detailed visualization of CD lesions than planar images. This technique may better discriminate between intestinal and bone marrow uptake, thus being useful for assessing CD lesions within the pelvis, including perianal disease.

  11. Advances in regional cerebral blood flow measurement and patho-physiological analysis by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo [Niigata Univ. (Japan). School of Medicine

    1994-04-01

    Recently, two kinds of radiopharmaceuticals have been developed to represent the biodistribution of regional blood flow, which are N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and [sup 99m]Tc-hexamethylpropylene-amine-oxime (HMPAO). The charachteristics, clinical usage and imitation of these two radiolabeled agents are discussed. The advantage of [sup 123]I-IMP is that it has high first-pass extraction and long retention in brain tissue, hence it can be used to measure the absolute values of regional cerebral blood flow (rCBF). When the kinetics of [sup 123]I-IMP is assumed to be freely diffusible in the brain, its behavior is considered by 2-compartment model, especially which is assumed by the microsphere model in the early period after the i.v. injection of [sup 123]I-IMP. Comparing the rCBF measured by [sup 123]I-IMP with that by [sup 133]Xe inhalation SPECT method, we have to consider PaCO[sub 2] when both SPECT studies are performed, because PaCO[sub 2] is one of the big factors which make effects on the alteration of rCBF. [sup 123]I-IMP has an interesting character of the redistribution phenomenon which represrent the degree of ischemia in the cerebrovascular diseases. Distribution volume an important datum obtained by the SPECT study with [sup 123]I-IMP, which represent the degree of retention, i.e. binding potential of [sup 123]I-IMP in the brain tissue. I introduced the usage of the distribution volume of [sup 123]I-IMP, which was constructed in the rate constant square method, in the differential diagnosis of Parkinson's disease and progressive supranuclear palsy (PSP). The clinical usage of [sup 99m] Tc-HMPAT was mentioned, the advantage of which is the rapid fixation in the brain tissue and the distribution does not change for long time after the i.v. injection. Hence [sup 99m]Tc-HMPAO is used for the diagnosis of epileptic foci and certain loading tests such as balloon occlusion test, postural test and acetazolamide loading test. (author).

  12. Advances in regional cerebral blood flow measurement and patho-physiological analysis by SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo (Niigata Univ. (Japan). School of Medicine)

    1994-04-01

    Recently, two kinds of radiopharmaceuticals have been developed to represent the biodistribution of regional blood flow, which are N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) and [sup 99m]Tc-hexamethylpropylene-amine-oxime (HMPAO). The charachteristics, clinical usage and imitation of these two radiolabeled agents are discussed. The advantage of [sup 123]I-IMP is that it has high first-pass extraction and long retention in brain tissue, hence it can be used to measure the absolute values of regional cerebral blood flow (rCBF). When the kinetics of [sup 123]I-IMP is assumed to be freely diffusible in the brain, its behavior is considered by 2-compartment model, especially which is assumed by the microsphere model in the early period after the i.v. injection of [sup 123]I-IMP. Comparing the rCBF measured by [sup 123]I-IMP with that by [sup 133]Xe inhalation SPECT method, we have to consider PaCO[sub 2] when both SPECT studies are performed, because PaCO[sub 2] is one of the big factors which make effects on the alteration of rCBF. [sup 123]I-IMP has an interesting character of the redistribution phenomenon which represrent the degree of ischemia in the cerebrovascular diseases. Distribution volume an important datum obtained by the SPECT study with [sup 123]I-IMP, which represent the degree of retention, i.e. binding potential of [sup 123]I-IMP in the brain tissue. I introduced the usage of the distribution volume of [sup 123]I-IMP, which was constructed in the rate constant square method, in the differential diagnosis of Parkinson's disease and progressive supranuclear palsy (PSP). The clinical usage of [sup 99m] Tc-HMPAT was mentioned, the advantage of which is the rapid fixation in the brain tissue and the distribution does not change for long time after the i.v. injection. Hence [sup 99m]Tc-HMPAO is used for the diagnosis of epileptic foci and certain loading tests such as balloon occlusion test, postural test and acetazolamide loading test. (author).

  13. Preliminary study on the head-injury by using SPECT with 99mTc-HMPAO

    International Nuclear Information System (INIS)

    Guan Yihui; Liu Yongchang; Lin Xiangtong

    1994-01-01

    After the acute period of head trauma some cases of patients may have some symptoms, such as headache, poor memory, vertigo, et al. In this study, among 42 patients most of whom had normal CT or MRI abnormal findings of brain perfusion imaging were seen in 33 patients (78.6%). Multiple perfusion defects were observed in some patients (13/42). These indicate that the head-injury syndrome is closely related to brain blood perfusion. authors' conclusion is that the brain SPECT is able to find out the etiology of head injury syndrome

  14. Subcortical aphasia and cerebral blood flow using SPECT

    International Nuclear Information System (INIS)

    Celsis, P.; Puel, M.; Demonet, J.P.; Bonafe, A.; Cardebat, D.; Viallard, G.; Pujol, T.; Marc-Vergnes, J.P.; Rascol, A.

    1985-01-01

    Possible cerebral blood flow (CBF) alteration in subcortical aphasia was investigated by single-photon emission tomography (SPECT). The results confirm the capsulo-striatal lesions and also point to the high rate of ipsilateral thalamic and cortical dysfunction. (author). 8 refs.; 1 fig.; 1 tab

  15. Therapeutic monitoring of intracerebral perfusion disturbances secondary to subarachnoid haemorrhage (SAH) by means of Tc-99m-HMPAO SPECT

    International Nuclear Information System (INIS)

    Locher, J.T.; Bruehlmeier, M.; Landolt, H.

    2002-01-01

    Aim: Aneurysmal SAH is a devastating illness as two-thirds of the patients are disabled or die. Modern concepts of treatment include the prevention of the most serious complications after a surgical intervention (clipping, coiling) such as re-bleeding, vasospasms and stroke. The follow-up of cerebral perfusion could provide an objective basis for treatment. Material and Methods: In order to control the recently developed ''3H-therapy'' (hypertension-hypervolemia-hemodilution) we use the diagnostic possibilities of trans-cranial Doppler sonography (TCD), Tc-99m-HMPAO SPET (with semiquantitative parametric display) and angiography. Our algorithm includes a daily TCD, and, as a routine, the perfusion SPET on postoperative days 2/3, 8/10 and/or in case of a worsening of TCD results or neurological state. Results: In 20 consecutive cases 51 perfusion SPETs have been performed. Although, in general, a moderate 3H-therapy will be implemented postoperatively even without vasospasms or clinical signs the corrections of dosage highly depends on the TCD and SPET results. Vasospasms were the common reason for increased flow velocities measured by TCD and a (graduate) hypoperfusion on SPET (15 cases), but in three cases SPET showed a local or contra-lateral luxury perfusion indicative for stroke and, therefore, implicating a reduction/termination of the 3H-therapy. Conclusion: Our experiences with the new concept demonstrate not only a diagnostic performance of the used techniques but also an improved effectiveness of cost and benefit

  16. Altered cerebral blood flow in chronic neck pain patients but not in whiplash patients: a 99mTc-HMPAO rCBF study.

    Science.gov (United States)

    Sundström, Torbjörn; Guez, Michel; Hildingsson, Christer; Toolanen, Göran; Nyberg, Lars; Riklund, Katrine

    2006-08-01

    A cross-sectional study to investigate regional cerebral blood flow (rCBF) in patients with chronic whiplash syndrome and chronic neck pain patients without previous history of trauma along with a healthy control group. Chronic neck pain is a common disorder and a history of cervical spine injury including whiplash trauma constitute a risk factor for persistent neck pain. The aetiology of the late whiplash syndrome is unknown with no specific diagnostic criteria based on imaging, physiological, or psychological examination. Earlier studies indicate a parieto-occipital hypoperfusion but it is unclear if the hypoperfusion represents a response to chronic pain. The rCBF was monitored in 45 patients with chronic neck pain: 27 cases with chronic whiplash syndrome and 18 age and gender matched cases with non-traumatic chronic neck pain. The rCBF was estimated with single-photon emission computed tomography (SPECT) using technetium-99m hexamethylpropylene amine oxime (HMPAO). The non-traumatic patients displayed rCBF changes in comparison with the whiplash group and the healthy control group. These changes included rCBF decreases in a right temporal region close to hippocampus, and increased rCBF in left insula. The whiplash group displayed no significant differences in rCBF in comparison with the healthy controls. The present study suggests different pain mechanisms in patients with chronic neck pain of non-traumatic origin compared to those with chronic neck pain due to a whiplash trauma.

  17. A case of Cotard syndrome: (123)I-IBZM SPECT imaging of striatal D(2) receptor binding.

    Science.gov (United States)

    De Risio, Sergio; De Rossi, Giuseppe; Sarchiapone, Marco; Camardese, Giovanni; Carli, Vladimir; Cuomo, Chiara; Satta, Maria Antonietta; Di Giuda, Daniela

    2004-01-15

    A case of 'dèlire de nègation' that suddenly appeared in a 43-year-old male is presented. No alteration in regional cerebral blood, as measured by (99m)Tc-HMPAO-SPECT, was found, but (123)I-IBZM-SPECT analysis showed reduced striatal D(2) receptor binding that further decreased after treatment.

  18. Scintigraphic evaluation of brain death with 99mTc-d,l-hexamethyl-propyleneamine oxime (HMPAO)

    International Nuclear Information System (INIS)

    Takehara, Yasuo; Isoda, Haruo; Sakai, Tsuneo; Tanaka, Tokutaro; Sato, Haruhiko; Yamamoto, Takamichi; Takahashi, Motoichiro; Kaneko, Masao.

    1989-01-01

    Lately, the criteria of brain death is being discussed. Cerebral scintigram, especially scintigraphic evaluation of brain death by dynamic study, has been previously reported. Cerebral imaging using radiolabeled amines such as 123 I-IMP N-isopropyl-p-iodoamphetamin (IMP) or 99m Tc d, l-hexamethyl-propyleneamine oxime (HMPAO) offers a significant information of brain death by the finding of 'non visualized brain'. However, the dynamic scintigram acquired during the bolus injection of 99m Tc-HMPAO provides an additional information of brain death by classical 'hot nose sign'. 99m Tc-HMPAO is able to be administered relatively in a large amount of dose. This cerebral perfusion tracer is lipophilic and remains in the central nervous system, which characterize its role as a reliable indicator of cerebral blood flow. As a result, this compound became suitable for the non-invasive study of brain circulation when the diagnosis of brain death is uncertain. We report a case of brain death in which diagnosis was made by the classical 'hot nose sign' in dynamic scintigraphy performed when 99 mTc-HMPAO was injected as well as the SPECT which showed a lack of cerebral visualization at the equilibrium state. As far as we are informed, this additional procedure used in the diagnosis of brain death has not reported before. The importance of performing a dynamic scintigram at the administration of 99m Tc-HMPAO is also discussed in this report. (author)

  19. Functional regional cerebral blood flow SPECT using 99mTc-HM-PAO by speech memory tasks

    International Nuclear Information System (INIS)

    Tohyama, Junko

    1993-01-01

    Using single photon emission computed tomography (SPECT) with Tc-99m HA-PAO, changes in regional cerebral blood flow (rCBF) by giving word memory and Miyake's tasks were determined for localizatin of speech memory function. Twice injection method of Tc-99m HM-PAO was used to obtain subtraction SPECT images; and positioning of the 1st and 2nd SPECT was determined by phantom study. To prevent artifacts and changes in rCBF as far as possible, the subjects were informed word fluency and Miyake's tasks sufficiently. When giving word fluency approach, an increase in rCBF was observed in both the operculum and the supratemporal convolution of dominant hemisphere. When giving Miyake's approach, it was observed predominantly in the supratemporal convolution of dominant hemisphere. Although it was also observed in the base of frontal lobe and operculum, there was no bilateral difference. An increased rCBF in the basal nucleus was more clearly observed by Miyake's than word fluency tasks without bilateral differences. There was no definitive increase in rCBF in the Papez's circuit responsible for memory and emotion by either word fluency or Miyake's tasks. In mentally mild disorder patients, an increased rCBF was observed in the same areas as those in normal subjects. In such patients having a decreased rCBF at rest, an increased rCBF was seen in the contralateral hemisphere and the surrounding areas of the lesions, suggesting compensatory mechanism. (N.K.) 65 refs

  20. Brain perfusion ratios by 99mTc HMPAO SPECT utilizing a mean value of the visual cortex to the cerebellum ratio derived from normal subjects

    International Nuclear Information System (INIS)

    Sanchez Catasus, C.; Rodriguez, R.; Cisnero, M.; Palmero, R.; Diaz, O.; Aguila, A.

    2002-01-01

    Aim: Previous results shows that the cerebellum (CER) is the best reference to calculate relative indexes of perfusion (IP) by brain SPECT. However, it can not be used on patients with bilateral cerebellar hypoperfusion. In such cases visual cortex (VC) or an average of the whole brain activity is recommended (WB). VC and WB are less reliable than CER, making it difficult to compare SPECT scans that have been normalized with different values. Materials and Methods: To overcome this difficulty, we developed a method to calculate IP utilizing a reference value defined as (VC / ), where is the mean value of the VC/CER ratio derived from a normal database which was assumed to be constant. We called the value VC/ the 'Pseudocerebellum' (PCER). For clinical validation, we first tested statistically the VC/CER ratio on a group of 60 [ 99m Tc]-HMPAO SPECT scans of 20 normal subjects and 40 neurological patients with positive SPECT but without involvement of VC and CER. To demonstrate that IP PCER approx. IP CER , we calculated the mean value of the absolute differences CER - IP PCER vertical bar> on two groups of scans from subjects without involvement of VC and CER: 10 normal subjects (GI); and 40 patients (GII). Finally, using an indirect procedure the method was tested on a third group of SPECT scans of 30 patients with bilateral cerebellar hypoperfusion (G III). Results: The VC/CER ratio was approximately constant with gender and age at a 95% confidence level; CER - IP PCER vertical bar> was 1.22%±0.35 and 1.20%±0.42 for GI and GII, respectively. This is less than the within-subject replicability of the HMPAO SPECT studies; and thus demonstrated by an indirect approach that IP PCER is a valid procedure by which to evaluate relative perfusion on patients with bilateral cerebellar hypoperfusion and quantitatively comparable to using CER as reference region. Conclusion: The VC/CER ratio has very little inter-subject variability in individuals where these regions are not

  1. Regional cerebral blood flow assessed by single photon emission computed tomography (SPECT) in dogs with congenital portosystemic shunt and hepatic encephalopathy.

    Science.gov (United States)

    Or, Matan; Peremans, Kathelijne; Martlé, Valentine; Vandermeulen, Eva; Bosmans, Tim; Devriendt, Nausikaa; de Rooster, Hilde

    2017-02-01

    Regional cerebral blood flow (rCBF) in eight dogs with congenital portosystemic shunt (PSS) and hepatic encephalopathy (HE) was compared with rCBF in eight healthy control dogs using single photon emission computed tomography (SPECT) with a 99m technetium-hexamethylpropylene amine oxime ( 99m Tc-HMPAO) tracer. SPECT scans were abnormal in all PSS dogs. Compared to the control group, rCBF in PSS dogs was significantly decreased in the temporal lobes and increased in the subcortical (thalamic and striatal) area. Brain perfusion imaging alterations observed in the dogs with PSS and HE are similar to those in human patients with HE. These findings suggest that dogs with HE and PSS have altered perfusion of mainly the subcortical and the temporal regions of the brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Cerebral scintigraphy by 99mTc-HMPAO in sleep apnea syndromes (SAS) during the wakeful state

    International Nuclear Information System (INIS)

    Tainturier, C.; Benamor, M.; Hausser-Hauw, C.; Rakotonanahary, D.; Fleury, B.

    1997-01-01

    The SAS is associated to cerebral hemodynamic modifications and to a high frequency of cerebro-vascular accidents. The aim of this study was to verify, during wakeful state, the cerebral hemodynamic in 14 patients afflicted with SAS of various intensity (Apnea Index = 5-120/h). 555 MBq of 99m Tc-HMPAO were injected in patients maintained awake. The images were obtained 20 minutes after injection by mean of a double-head chamber equipped with fan-beam collimators. They were interpreted visually by two independent readers. Anomalies of cerebral fixation were observed in 12/14 patients. They were small sores of diffuse hypo-fixations, with a 'riddly' aspect (4 cases), sores of bi-temporal hypo-fixation with a right- or left- hemispheric predominance (6 cases), or right fronto-temporal hypo-fixations (2 cases). The cerebral fixation anomalies were reported in the SASs. Ficker et al (1997) have shown in-sleep frontal hypo-perfusions in 5/14 apneic patients, reversible under continuous positive airing pressure (CPAP). In conclusion, anomalies of cerebral fixation exist in SAS-carrying patients, even in the wakeful state. Questions about hypoperfusion, pre-lacunar syndrome, atrophy still remain. A check of this study is planned after the CPAP treatment to determine the hemodynamic or anatomic origin and the anomaly reversibility

  3. Evaluation of cerebral vasoreactivity by SPECT and transcranial doppler sonography using the acetazolamide test

    Energy Technology Data Exchange (ETDEWEB)

    Pavics, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Gruenwald, F. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Barzo, P. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Ambrus, E. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Menzel, C. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Schomburg, A. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin; Borda, L. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Mate, E. [Laszlo Kalmar Kibernetic Lab., Attila Jozsef Univ., Szeged (Hungary); Bodosi, M. [Dept. of Neurosurgery, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Csernay, L. [Dept. of Nuclear Medicine, Albert Szent-Gyoergyi Medical Univ., Szeged (Hungary); Biersack, H.J. [Bonn Univ. (Germany). Abt. fuer Nuklearmedizin

    1994-12-01

    rCBF SPECT with {sup 99m}Tc-HMPAO was performed prospectively in 29 patients (3 controls and 26 stroke patients) as well as TCD studies in 20 patients (3 controls and 17 stroke patients) before and after 1 g i.v. acetazolamide. The sensitivity of rCBF SPECT increased from 62% to 77% after acetazolamide provocation in stroke patients. In patients with a reversible neurological deficit, the sensitivity under resting conditions was 50% which increased to 71%, while in cases with a permanent deficit it increased from 75% to 83%. In the evaluation of the cerebrovascular reserve capacity the results of rCBF SPECT and TCD coincided in 91% of the hemispheres. The correlation was statistically significant. (orig.) [Deutsch] Bei 29 Patienten (3 Kontrollpersonen, 26 Patienten mit zerebrovaskulaerer Erkrankung) wurde prospektiv die Hirn-SPECT mit {sup 99m}TC-HMPAO und bei 20 Patienten (3 Kontrollpersonen, 17 Patienten mit ZVK) die transkranielle Dopplersonographie (TCD) vor und nach i.v. Gabe von Azetazolamid durchgefuehrt. Die Sensitivitaet der Hirn-SPECT erhoehte sich mit Azetazolamid von 62% auf 77%. Bei Patienten mit reversiblem neurologischem Defizit wurde eine Verbesserung von 50% auf 71%, bei Patienten mit persistierendem Defizit von 75% auf 83% beobachtet. Die Ergebnisse der Hirn-SPECT und der TCD stimmten in der Beurteilung der zerebrovaskulaeren Reservekapazitaet in 91% der Hemisphaeren ueberein. Die Korrelation zwischen den beiden Methoden war statistisch signifikant. (orig.)

  4. Delayed decrease in hemispheric cerebral blood flow during Wada test demonstrated by 99mTc-HMPAO single photon emission computer tomography

    International Nuclear Information System (INIS)

    Ryding, E.; Sjoeholm, H.; Skeidsvoll, H.; Elmqvist, D.

    1989-01-01

    We describe how brain regions with a flow (and metabolism) decrease can be visualized after an injection of short-acting barbiturate in one of the internal carotid arteries during a Wada test. An intravenous administration of 99mTc-HMPAO was used to mark the relative flow distribution. The 99mTc-HMPAO distribution in the brain was recorded three-dimensionally about 1 h later, by means of a single photon emission computer tomograph. We show that the timing of the intravenous 99mTc-HMPAO administration during the Wada test is important for the visualization of the low-flow regions. The administration of the tracer substance should be delayed at least 30 s after the first signs of the barbiturate effect. The rCBF decrease in the barbiturate-injected cerebral hemisphere was associated with a simultaneous decrease in the contralateral, pharmacologically not directly affected, cerebellar hemisphere (crossed cerebellar diaschisis). (author)

  5. SPECT analysis of recent cerebral infarction

    DEFF Research Database (Denmark)

    Raynaud, C; Rancurel, G; Tzourio, N

    1989-01-01

    already differentiated in the subacute period. The central area presented a short phase of luxury perfusion and a longer phase of IMP hyperfixation. The peripheral area showed both a slight regional cerebral blood flow decrease and an early IMP uptake decrease similar to those previously found...

  6. Reduced contralateral hemispheric flow measured by SPECT in cerebellar lesions

    DEFF Research Database (Denmark)

    Sönmezoğlu, K; Sperling, B; Henriksen, T

    1993-01-01

    Four patients with clinical signs of cerebellar stroke were studied twice by SPECT using 99mTc-HMPAO as a tracer for cerebral blood flow (CBF). When first scanned 6 to 22 days after onset, all had a region of very low CBF in the symptomatic cerebellar hemisphere, and a mild to moderate CBF reduct...

  7. Temporal lobe epilepsy subtypes, differential patterns of cerebral perfusion on ictal SPECT

    NARCIS (Netherlands)

    Ho, SS; Berkovic, SF; McKay, WJ; Kalnins, RM; Bladin, PF

    Purpose: We studied cerebral perfusion patterns in the various subtypes of TLE, as determined by pathology and good outcome after temporal lobectomy (as confirmation of temporal origin). Methods: We studied clinical features and ictal technetium 99m hexamethyl-propyleneamineoxime (Tc-99m-HMPAO)

  8. A comparison between dopamine transporters imaging and perfusion SPECT with HMPAO-99mTc in the diagnosis of dementia with Lewy bodies

    International Nuclear Information System (INIS)

    Voitota, J.B.; Emptaz, A.; Szurhaj, W.; Steinling, M.; Bombois, St.; Pasquier, F.

    2007-01-01

    Scintigraphic imaging of dementia relies today essentially on the study of brain single photo emission computed tomography (SPECT) perfusion, after intravenous injection of 99m Tc radiopharmaceutical. This paper is based on the guidelines published in October 2001 by the European Association of Nuclear medicine (http:// eanm.org). Dementia with Lewy bodies is the second cause of degenerative dementia. Differential diagnosis may be difficult, in spite of the emergence of standardized diagnostic criteria. Tomo-scintigraphy using iodine 123-labelled FP-CIT (DaTSCAN) could play a role in this process. Cerebral perfusion SPECT imaging is an important step of demented patient evaluation. We compared the diagnostic performance of both of these procedures in the diagnosis of dementia with Lewy bodies. We studied 15 patients; ten DaTSCAN and 14 cerebral perfusion studies were performed. Clinical diagnosis at the end of follow-up was established as the diagnostic reference. Cerebral perfusion SPECT showed a very low sensitivity (20%) and a good specificity (89%); considering a prevalence of dementia with Lewy bodies of 20%, positive predictive value (PPV) was 31% and negative predictive value (NPV) 82%. Performances of DaTSCAN tomo-scintigraphy were more encouraging, (sensitivity and specificity of 100%); predictive values are both of 100%. As a conclusion, DaTSCAN tomo-scintigraphy performs better than cerebral perfusion SPECT in the diagnosis of dementia with Lewy bodies and no conjoint or sequential use of those tests can be recommended. (authors)

  9. Potential value of serial cerebral SPECT scanning in the evaluation of psychiatric illness

    International Nuclear Information System (INIS)

    Notardonato, H.; Gonzalez-Avilez, A.; Van Heertum, R.L.; O'Connell, R.A.; Yudd, A.P.

    1989-01-01

    Cerebral SPECT imaging has the potential to make an important contribution to clinical psychiatry. Cerebral SPECT scanning, stimulated by the work with PET, is readily available and much less expensive than PET. This paper reports a case demonstrating the potential value of cerebral SPECT scanning with I-123 IMP, specifically in the serial evaluation of a schizophrenic patient with auditory hallucinations. The initial scan revealed focal areas of increased uptake in the caudate nuclei of the basal ganglia, and in the right temporal lobe. After pharmacological treatment with clinical improvement, the follow-up SPECT scan demonstrated significant improvement in the distribution of the radiopharmaceutical

  10. Cerebral blood flow SPECT scanning in cortico-basal degeneration

    International Nuclear Information System (INIS)

    Slawek, J.; Walczak, A.; Krupa-Olchawa, J.; Lass, P.; Dubaniewicz, M.

    1999-01-01

    Idiopathic Parkinson's disease accounts for ca. 75% of all cases of Parkinsonism. Corticobasal degeneration is a relatively rare example of the so-called ''Parkinson-plus'' syndrome. The authors present the case of a 56-year-old woman with rigidity and atypical tremor of upper extremity followed by gait apraxia, dysarthria, bilateral pyramidal signs and myoclonus. There was no improvement after treatment with L-dopa. The disease has progressed, but the patient is still alive. On the basis of clinical data a diagnosis of corticobasal degeneration has been established. Cerebral blood flow SPECT scanning revealed diffuse hypoperfusion of left frontal lobe, antero-inferior part of the left temporal lobe and left basal ganglia. The case illustrates the usefulness of brain SPECT in atypical forma of Parkinson's disease. (author)

  11. 99mTc-HMPAO SPECT in dementia of the Alzheimer type. Hypoperfusion in the medial temporal region

    International Nuclear Information System (INIS)

    Nakamura, Yu; Kawakatsu, Shinobu; Shinohara, Masao; Nadaoka, Toshihide; Totsuka, Shiro; Komatani, Akio

    1995-01-01

    This study examined regional cerebral blood flow (rCBF) by single photon emission computed tomography (SPECT) using technetium 99m-hexamethyl-propyleneamineoxime and correlated the results with neuropsychological findings in 30 patients with dementia of the Alzheimer type (AT dementia). Ten healthy persons served as controls. The group of mild AT dementia exhibited a significant decrease in rCBF in the lower part of the right lateral frontal lobe and in the right parietal lobe. In the group of moderate AT dementia, the significant decrease in rCBF was noted in the lower part of the bilateral frontal lobes, the parietal part of the temporal lobe, the parietal lobe, and the medial temporal lobe. Factor analysis for neuropsychological test revealed three factors involved in rCBF. There was a significantly positive correlation between the factor responsible for memory and recall and rCBF in the left frontal lobe, the anterior part of the lateral temporal lobe, and the medial temporal lobe. These findings suggested that disturbance of the memory circuit may exist in the medial temporal lobe and others as pathophysiology of AT dementia. (N.K.)

  12. Quantitative 123I IMP and 99mTc HMPAO imaging in the dog following cocaine administration

    International Nuclear Information System (INIS)

    Susskind, Herbert; Weber, David A.; Ivanovic, Marija; Wong, Christopher T.C.; Haan, Constance E. de; Gavin, Patrick R.

    1996-01-01

    SPECT and associated imaging procedures were used in beagle dogs to evaluate the uptake, distribution, and clearance properties of i.v.-injected 123 I IMP (IMP) and 99m Tc HMPAO (HMPAO) in the brain, lungs, liver, and kidneys; (2) quantify the acute effects (after 15 sec) of very low doses (0.5 or 1.0 mg/kg) cocaine on the kinetics and localization properties of IMP and HMPAO; and (3) evaluate comparative imaging properties of IMP and HMPAO for measuring regional cerebral blood flow (rCBF). Regional and global uptake and localization of IMP or HMPAO were evaluated in control studies using dynamic planar (0-30 min) and SPECT imaging (at 35 min). The regional distribution properties of IMP and HMPAO in the brain were estimated from regions of interest (ROIs) drawn around anatomic structures on MR slices and manually registered with corresponding SPECT slices. Cocaine significantly reduced the 30-min IMP uptake in the brain and lungs by ∼15%, but only slightly changed HMPAO uptake in the brain and other organs. In the control studies, the respective uptakes of IMP in the brain and lungs were 9 and 39% greater (p < 0.01) than those of HMPAO. In control SPECT studies, the highest uptake of IMP was observed in the thalamus and progressively less activity was observed in the parietal lobe, frontal lobe, cerebellum, occipital lobe, and entire brain; activity in the olfactory bulb was lower than in all other regions. Cocaine reduced IMP uptake in the cerebellum (p < 0.01), occipital lobe (p < 0.01), and entire brain (p < 0.05). IMP uptake (cpm/pixel-mCi) in the different brain regions was 1.3 to 2.1 times greater than that of HMPAO (p < 0.001). HMPAO uptake was more homogeneous throughout the gray matter of the brain; no significant uptake differences were observed among flagged regions. Results indicate that single, acute doses of cocaine, 0.5 and 1.0 mg/kg, significantly altered the uptake and localization properties of IMP in the dog's brain, lungs, liver, and kidneys

  13. Acetazolamide stimulation test in patients with unilateral internal carotid artery stenosis using Tc-99m HMPAO SPECT and transcranial doppler sonography

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, I. Y.; Na, J. H. [Inha University Hospital, Incheon (Korea, Republic of)

    2007-07-01

    We compared perfusion reserve by acetazolamide (ACZ) challenged brain perfusion SPECT and cerebral vasoreactivity (CVR) by transcranial Doppler sonography (TCD) in patients with unilateral internal carotid artery stenosis. This study was conducted prospectively in 37 consecutive patients with angiographically proven unilateral internal carotid artery stenosis (stenosis> 50%). We estimated % CVR (100? {l_brace}post-ACZ mean velocity (cm/sec) - Pre-ACZ mean velocity (cm/sec){r_brace} / pre-ACZ mean velocity) by TCD. The % CVR was compared with perfusion reserve of SPECT. The % CVR of MCA and ICA was significantly decreased in the ipsilateral side to the carotid stenosis (p<0.05). The CVR impairment was more severe when cerebral infarct is already developed (p<0.01). There was a significant correlation between the degree of carotid stenosis and the CVR (p<0.01). In the area of impaired perfusion reserve on the SPECT, the estimated CVR by TCD was significantly lower (p<0.05), even to the negative value, implying that there is actually steal phenomenon in that area. ACZ challenge can actually decrease cerebral blood flow in the area of impaired perfusion reserve on brain SPECT. So we should be very cautiously performing in ACZ challenge especially when there is a severe carotid stenosis because there is a possibility of developing hemodynamic stroke.

  14. Spectral analysis of 99mTc-HMPAO for estimating cerebral blood flow. A comparison with H215O PET

    International Nuclear Information System (INIS)

    Takasawa, Masashi; Murase, Kenya; Oku, Naohiko

    2004-01-01

    Cerebral blood flow (CBF) can be quantified non-invasively using the brain perfusion index (BPI), which is determined using radionuclide angiographic data obtained through the use of technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO). The BPI is generally calculated using graphical analysis (GA). In this study, BPI was measured using spectral analysis (SA), and the usefulness of SA was compared with that of GA. Thirteen patients with various brain diseases and four healthy male volunteers were examined using radionuclide angiography with 99m Tc-HMPAO. The BPI was measured for each subject using both SA and GA. In the four healthy volunteers, the BPI was examined at rest and after the intravenous administration of 1 g of acetazolamide (ACZ). An H 2 15 O PET examination was also performed in the 13 patients; the BPI S and BPI G values were compared with the CBF measurements obtained using H 2 15 O PET (CBF PET ). The BPI values obtained by SA (BPI S ) (x) and by GA (BPI G ) (y) were correlated (y=0.568x+0.055, r=0.901) in the 13 patients and four healthy volunteers at rest, although the BPI G values were underestimated by 36.1±7.5% (mean±SD) compared with the BPI S values. The degree of underestimation tended to increase with increasing BPL s values. The increase in the BPI S was 32.1±8.0% after the intravenous administration of ACZ, while the increase in BPI G was only 8.1±2.8%. This discrepancy was considered to be the result of the BPI G values being affected by the first-pass extraction fraction of the tracer. Although both BPI S and BPI G values were significantly correlated with the CBF PET values, the correlation coefficient for BPI S was higher than that for BPI G (BPI S :r=0.881;BPI G :r=0.832). These results suggest that SA produces a more reliable BPI for quantifying CBF using 99m Tc-HMPAO than the conventional method using GA. The SA method should be especially useful for activation studies involving pharmacological intervention and

  15. Crossed cerebellar hyperperfusion on ictal Tc-99m HMPAO brain SPECT: clinical significance for differentiation of mesial or lateral temporal lobe epilepsy and related factors for development

    International Nuclear Information System (INIS)

    Park, Soon Ah; Sohn, Myung Hee; Lim, Seok Tae; Lee, Dong Soo; Lee, Sang Gun; Kim, Seok Ki; Jang, Myoung Jin; Chung, June Key; Lee, Myung Chul

    2000-01-01

    The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4±7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class 1, 2). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6±19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propatation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=3D0.01) and age (p=3D0.02) were related to the development of CCH. Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral remporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.=20

  16. Crossed cerebellar hyperperfusion on ictal Tc-99m HMPAO brain SPECT: clinical significance for differentiation of mesial or lateral temporal lobe epilepsy and related factors for development

    Energy Technology Data Exchange (ETDEWEB)

    Park, Soon Ah; Sohn, Myung Hee; Lim, Seok Tae [Chonbuk National Univ. School of Medicine, Chonju (Korea, Republic of); Lee, Dong Soo; Lee, Sang Gun; Kim, Seok Ki; Jang, Myoung Jin; Chung, June Key; Lee, Myung Chul [Seoul National Univ. College of Medicine, Seoul (Korea, Republic of)

    2000-08-01

    The aim of this study was to determine whether crossed cerebellar hyperperfusion (CCH) was helpful in discriminating mesial from lateral temporal lobe epilepsy (TLE) and what other factors were related in the development of CCH on ictal brain SPECT. We conducted retrospective analysis in 59 patients with TLE (M:41, F:18; 27.4{+-}7.8 years old; mesial TLE: 51, lateral TLE: 8), which was confirmed by invasive EEG and surgical outcome (Engel class 1, 2). All the patients underwent ictal Tc-99m HMPAO brain SPECT and their injection time from ictal EEG onset on video EEG monitoring ranged from 11 sec to 75 sec (32.6{+-}19.5 sec) in 39 patients. Multiple factors including age, TLE subtype (mesial TLE or lateral TLE), propatation pattern (hyperperfusion localized to temporal lobes, spread to adjacent lobes or contralateral hemisphere) and injection time were evaluated for their relationship with CCH using multiple logistic regression analysis CCH was observed in 18 among 59 patients. CCH developed in 29% (15/51) of mesial TLE patients and 38% (3/8) of lateral TLE patients. CCH was associated with propagation pattern; no CCH (0/13) in patients with hyperperfusion localized to temporal lobe, 30% (7/23) in patients with propagation to adjacent lobes, 48% (11/23) to contralateral hemisphere. Multiple logistic regression analysis revealed that propagation pattern (p=3D0.01) and age (p=3D0.02) were related to the development of CCH. Crossed cerebellar hyperperfusion in ictal brain SPECT did not help differentiate mesial from lateral remporal lobe epilepsy. Crossed cerebellar hyperperfusion was associated with propagation pattern of temporal lobe epilepsy and age.

  17. Global cerebral blood flow changes measured by brain perfusion SPECT immediately after whole brain irradiation

    International Nuclear Information System (INIS)

    Ohtawa, Nobuyuki; Machida, Kikuo; Honda, Norinari; Hosono, Makoto; Takahashi, Takeo

    2003-01-01

    Whole brain irradiation (WBI) is still a major treatment option for patients with metastatic brain tumor despite recent advances in chemotherapy and newer techniques of radiation therapy. Cerebral blood flow (CBF) of changes induced by whole brain radiation is not fully investigated, and the aim of the study was to measure CBF changes non-invasively with brain perfusion SPECT to correlate with treatment effect or prognosis. Total of 106 patients underwent WBI during April 1998 to March 2002. Both brain MRI and brain perfusion SPECT could be performed before (less than 1 week before or less than 10 Gy of WBI) and immediately after (between 1 week before and 2 weeks after the completion of WBI) the therapy in 17 of these patients. They, 10 men and 7 women, all had metastatic brain tumor with age range of 45 to 87 (mean of 61.4) years. Tc-99m brain perfusion agent (HMPAO in 4, ECD in 13) was rapidly administered in a 740-MBq dose to measure global and regional CBF according to Matsuda's method, which based on both Patlak plot and Lassens' linearity correction. Brain MRI was used to measure therapeutic response according to World Health Organization (WHO) classification as complete remission (CR), partial response (PR), no change (NC), and progressive disease (PD). Survival period was measured from the completion of WBI. Mean global CBF was 40.6 and 41.5 ml/100 g/min before and immediately after the WBI, respectively. Four patients increased (greater than 10%) their global mean CBF, 10 unchanged (less than 10% increase or decrease), and 3 decreased after the WBI. The WBI achieved CR in none, PR in 8, NC in 6, and PD in 3 on brain MRI. Change in global mean CBF (mean±SD) was significantly larger in PR (4.3±2.0 ml/100 g/min, p=0.002) and in NC (-0.1±4.5) than in PD (-3.9±6.4, P=0.002, P=0.016, respectively). Survival was not significantly (p>0.05) different among the patients with CR (20 weeks), NC (48 weeks), and PD (21 weeks). Change in global CBF and survival was

  18. [sup 99m]Tc-ECD SPECT study in dementia and aphasia

    Energy Technology Data Exchange (ETDEWEB)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi (Kyushu Univ., Fukuoka (Japan). Faculty of Medicine)

    1993-09-01

    We studied clinical significance of [sup 99m]Tc-L,L,-ethyl cysteine dimer ([sup 99m]Tc-ECD) SPECT study in dementia and aphasia, and compared it with [sup 99m]Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in [sup 99m]Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in [sup 99m]Tc-HMPAO SPECT. The count rate ratios in [sup 99m]Tc-ECD and [sup 99m]Tc-HMPAO SPECT were correlated well with each other, and the contrast of the [sup 99m]Tc-ECD SPECT image was equivalent or slightly higher as compared with [sup 99m]Tc-HMPAO. Therefore, [sup 99m]Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author).

  19. 99mTc-ECD SPECT study in dementia and aphasia

    International Nuclear Information System (INIS)

    Kuwabara, Yasuo; Ichiya, Yuichi; Otsuka, Makoto; Sasaki, Masayuki; Akashi, Yuko; Fukumura, Toshimitsu; Yoshida, Tsuyoshi; Masuda, Kouji; Ichimiya, Atsushi

    1993-01-01

    We studied clinical significance of 99m Tc-L,L,-ethyl cysteine dimer ( 99m Tc-ECD) SPECT study in dementia and aphasia, and compared it with 99m Tc-HMPAO SPECT study. The subjects consisted of 13 patients, including 10 patients with dementia and 3 patients with aphasia. Hypoperfusion areas were detected in 5 out of 10 patients with dementia and 2 out of 3 patients with aphasia in 99m Tc-ECD SPECT, and in 4 out of 10 patients with dementia and all of 3 patients with aphasia in 99m Tc-HMPAO SPECT. The count rate ratios in 99m Tc-ECD and 99m Tc-HMPAO SPECT were correlated well with each other, and the contrast of the 99m Tc-ECD SPECT image was equivalent or slightly higher as compared with 99m Tc-HMPAO. Therefore, 99m Tc-ECD SPECT study was considered to be useful for the evaluation of cerebral perfusion in dementia and aphasia. (author)

  20. Regional cerebral blood flow pattern in normal young and aged volunteers: a 99mTc-HMPAO SPET study

    International Nuclear Information System (INIS)

    Catafau, A.M.; Lomena, J.; Pavia, J.; Parellada, E.; Bernardo, M.; Setoain, J.; Tolosa, E.

    1996-01-01

    The aim of this study was to investigate the normal pattern of regional cerebral blood flow (rCBF) distribution in normal young and aged volunteers using technetium-99m hexamethylpropylene amine oxime ( 99m -Tc-HMPAO) as a tracer. The region brain perfusion of young and aged subjects was compared, especially regarding rCBF differences due to age and gender, and interhemispheric rCBF asymmetries. Sixty-eight right-handed normal volunteers -40 young (mean age 29.5±6.3 years) and 28 aged (mean age 71.2±4.3 years) - were included in the study. rCBF was estimated on the basis of a semiquantitative approach by means of a left-right index and two region/reference ratios, using the cerebellum and the whole brain activity as references. A good correlation between these two region/reference ratios was found (P<0.005 in all cerebral regions). The highest rCBF ratios corresponded to the cerebellum, followed by the occipital lobe. The remaining cortical regions (temporal, parietal, frontal and basal ganglia) showed slightly lower values. The white matter showed rCBF ratios substantially lower than the grey matter. In neighter young nor aged subjects were significant rCBF differences between the genders found in any of the two region/reference indices employed. Aged sugjects showed significantly lower rCBF ratios than young subjects in the left frontal lobe and in the posterior region of the left temporal lobe. In both young and aged subjects, lower perfusion was found in the left hemisphere, except for the white matter region in both age groups and the frontal lobe in the young subjects. Aged subjects presented a slightly higher interhemispheric asymmetry in the frontal lobe. However, interhemispheric asymmetry was minimal (-1.01% to 3.14%). Consequently, a symmetrical rCBF distribution can be assumed between homologous regions, independent of age. (orig.)

  1. A Comparative Study of SPECT, q-EEG and CT in Patients with Mild, Acute Head Trauma

    International Nuclear Information System (INIS)

    Lee, Suk Ho; Kim, Jin Seok; Moon, Hee Seung

    1993-01-01

    Functional cerebral impairments have been verified objectively by brain SPECT and q-EEG (quantitative electroencephalography). Microcerebral circulatory defects without anatomical changes cannot be detected by the brain CT or MRI. Brain SPECT using 99m Tc-HMPAO (Hexamethyl propyleneamine oxime) as a key radioisotope may be accepted as the useful method for identifying functional cerebral impairments. We studied 25 patients with mild head trauma to define whether the SPECT was helpful in detecting cerebral impairment. The SPECT was positive in 23 patients out of 25, q-EEG positive in 16 patients and brain CT was positive in 3 cases. SPECT and q-EEG were more sensitive than CT. SPECT would be more useful method than brain CT to investigate cerebral function after head injury

  2. Cerebral control of bladder storage in patients with detrusor overactivity: An activation study using SPECT with NEUROSTAT

    International Nuclear Information System (INIS)

    Yafu, Y.; Li, X.; Li, Y.

    2007-01-01

    Full text: The aim of this study was to identify the brain areas which control the bladder storage in the patients with detrusor overactivity (DO) and those without DO by 99mTc-hexamethylpropylene amine oxime (99mTc-HMPAO) SPECT with Neurological Statistical Image Analysis Software (NEUROSTAT). Methods: SPECT scans were performed on fifteen healthy volunteers (Group I) and twenty-five patients with some storage symptoms of lower urinary tract, among whom nineteen patients were with DO (Group II) and six patients were with normal detrusor function (Group III). All the subjects were male and right-handed. Each subject was scanned twice without movement in a supine position. 444MBq and 555MBq 99mTc- HMPAO were separately injected intravenously under the following two conditions: resting state with empty bladder and urine withholding state with full bladder. The final image during urine withholding was obtained by subtracting the first scan data from the second. NEUROSTAT was adopted to analyze the difference in rCBF between groups in resting state and to analyze the change in rCBF between urine withholding and resting states in each group. The results were displayed on Z-score images at a significance threshold of P < 0.05 with correction for multiple comparisons. Results: No region reached significant threshold in comparison of Group II and Group III in resting state, although Group II and III , as compared with Group I, showed decreases in tracer activity in superior temporal gyrus, medial frontal gyrus, inferior frontal gyrus, anterior cingulate and cingulate gyrus. There were significant increases in tracer activity in bilateral inferior frontal gyri and the right middle temporal gyrus in urine withholding state as compared with resting state in Group III. Among the regions, the right inferior frontal gyrus was distinctly prominent at both Z-score and the extent. In Group II, the regions that were activated significantly in Group III did not reach significant

  3. Cerebral blood flow SPECT may be helpful in establishing the diagnosis of progressive supranuclear palsy and corticobasal degeneration

    International Nuclear Information System (INIS)

    Slawek, J.; Lass, P.; Derejko, M.; Dubaniewicz, M.

    2001-01-01

    We present 4 cases, which illustrate the usefulness of neuroimaging studies in atypical forms of Parkinsonism. Progressive Supranuclear Palsy (PSP) and Corticobasal Degeneration (CBD) are rare neurodegenerative progressive disorders of the central nervous system of unknown cause. The clinical accuracy in this diagnosis is not very high even in centres specialising in movement disorders. Functional imaging can be helpful in diagnosing PSP and CBD. We present the results of cerebral blood flow (CBF) SPECT scanning in 2 patients with PSP and 2 patients with CBD. This was performed using a triple-head gammacamera and 99m Tc-HMPAO. In PSP patients a diffuse frontal perfusion deficit was seen, eventually with striatal and occipital hypoperfusion. CT/MRI was either normal or showed a diffuse cortical-subcortical atrophy. In CBD patients left fronto-parieto-temporal cortex and a striatal hypoperfusion were shown. CT scanning was normal in one case and showed an asymmetrical temporo-parietal atrophy in second one. The pattern of diffuse frontal perfusions deficit in PSP and asymmetrical, contralateral to symptoms of CBD, cortico-subcortical hypoperfusion may be helpful in establishing the correct diagnosis. (author)

  4. Regional cerebral blood flow in elderly patients with heart failure evaluated with SPECT

    International Nuclear Information System (INIS)

    Alves, T.C.T.F.; Fraguas, R.; Busatto, G.; Garrido, G.; Buchpiguel, C.A.; Rays, J.; Wajngarten, M.; Robilotta, C.C.; Meneghetti, J.C.

    2002-01-01

    Introduction: Heart failure (HF) may be related to brain dysfunction due to reduced cerebral blood flow (CBF) and white matter lesions. However, no studies have yet used quantitative regional CBF (rCBF) techniques to demonstrate the presence of significant functional abnormalities in representative samples of cardiac patients compared with normal controls. Aim: The purpose of this study was to investigate the rCBF distribution as assessed with SPECT in a group of elderly patients with HF in comparison with a normal control group. The hypothesis were: (1) HF would be associated with rCBF reductions in comparison to healthy controls. Methodology: We studied a group of 36 HF patients functional class II or III from New York Heart Association (NYHA), divided in 19 depressed (74.6 +/- 6.8 years) and 17 non depressed (73.7 +/- 5.4 years), and compared to 19 normal subjects (71.1 +/- 4.8 years), matched for age, sex, cerebral dominance and social level. Brain perfusion was evaluated with a double-headed SPECT system (Sophy-DST) with high-resolution collimators (128x128 matrix, 128 views, 30s/view) after 30mcI 99mTc-HMPAO injection. Group differences were investigated using SPM99, with a p<0.001 statistical threshold (uncorrected for multiple comparisons). Results: Significant rCBF reductions were seen in the HF non depressed group relative to healthy controls in the right lateral temporal lobe, cuneus and precuneus, as well as in a small area of the medial prefrontal cortex. In the HF depressed group, significant cortical rCBF reductions relative to healthy controls were seen in similar locations but more extensively. In addition, the HF depressed group showed significant rCBF reductions relative to controls limbic and subcortical areas, including the right parahypocampal gyrus, posterior cingulate, thalamus and caudate at the border of the lateral ventricle, and bilaterally in the posterior insula. Conclusion: The presence of greater areas of hypoperfusion in the HF

  5. 99mTc-HMPAO perfusion indices and brain-mapping in stroke patients

    International Nuclear Information System (INIS)

    Minchev, D.; Klisarova, A.

    1997-01-01

    It is the purpose of the study to establish correlations between 99mTc-HMPAO (hexamethylpropylenaminoxym) perfusion indices and changes in brain-mapping among patients with acute stroke. Forty-six patients with definitely proved stroke syndrome are investigated in the first 72 hours and 15 days after the onset of cerebrovascular accident using clinical, neuro-physiological and 99mTc-HMPAO SPECT methods. Regional and hemispheric perfusion asymmetry correlate with the brain-mapping cerebral disturbance (p < 0.001). In patients presenting focal hypoperfusion there is a significant correlation between perfusion indices and local EEG disturbance (r = 0.87). The dynamic study demonstrates a significant correlation between perfusion indices and electrical cerebral disturbance in the first 72 hours after the onset of the cerebrovascular accident. Fifteen days later no such correlation is documented. The obtained results demonstrate the essential practical bearing of 99mTc-HMPAO SPECT indices on the objective assessment of perfusion hemispheric and regional asymmetry in stroke patients, and the possibility of being used for indirect estimation of the regional cerebral blood flow in acute stroke patients against the background of visual and quantitative EEG changes (author)

  6. Cerebral perfusion abnormalities in therapy-resistant epilepsy in mentally retarded pediatric patients

    International Nuclear Information System (INIS)

    Abdel-Dayem, H.M.; Nawaz, K.; Hassoon, M.; Rahman, M.; Olofsson, O.E.

    1990-01-01

    This paper identifies sites of cerebral perfusion abnormalities in therapy-resistant epilepsy in mentally retarded pediatric patients (TREMRPP) using Tc-99m HMPAO and to compare it with the results of electroencephalography (EEG) and fluorographic CT. Thirteen children underwent Tc-99m HMPAO single photon emission CT (SPECT) studies; 11 had fluorographic CT, and 12 had EEG (four had EEG twice). All studies for same patients were within 2 weeks of each other. SPECT studies were reviewed twice by two nuclear medicine physicians without any knowledge of the results of other tests. Fluorographic CT results showed cerebral atrophy in only three and were normal in eight. EEG results were abnormal in all 12 patients examined. Epileptogenic spikes (EPS) were seen in eight patients only. Tc-99m HMPAO SPECT studies were abnormal in all patients; they showed 21 foci of decreased perfusion on nine patients and nine foci of increased perfusion in seven patients (three patients had mixed lesions)

  7. Brain SPECT. SPECT in der Gehirndiagnostik

    Energy Technology Data Exchange (ETDEWEB)

    Feistel, H. (Erlangen-Nuernberg Univ., Erlangen (Germany). Nuklearmedizinische Klinik mit Poliklinik)

    1991-12-01

    Brain SPECT investigations have gained broad acceptance since the introduction of the lipophilic tracer Tc-99m-HMPAO. Depending on equipment and objectives in different departments, the examinations can be divided into three groups: 1. Under normal conditions and standardised patient preparation the 'rest' SPECT can be performed in every department with a tomographic camera. In cerebrovascular disease there is a demand for determination of either the perfusion reserve in reversible ischemia or prognostic values in completed stroke. In cases of dementia, SPECT may yield useful results according to differential diagnosis. Central cerebral system involvement in immunologic disease may be estimated with higher sensitivity than in conventional brain imaging procedures. In psychiatric diseases there is only a relative indication for brain SPECT, since results during recent years have been contradictory and may be derived only in interventional manner. In brain tumor diagnostics SPECT with Tl-201 possibly permits grading. In inflammatory disease, especially in viral encephalitis, SPECT may be used to obtain early diagnosis. Normal pressure hydrocephalus can be distinguished from other forms of dementia and, consequently, the necessity for shunting surgery can be recognised. 2. In departments equipped for emergency cases an 'acute' SPECT can be performed in illnesses with rapid changing symptoms such as different forms of migraine, transient global amnesia, epileptic seizures (so-called 'ictal SPECT') or urgent forms like trauma. 3. In cooperation with several departments brain SPECT can be practised as an interventional procedure in clinical and in scientific studies. (orig./MG).

  8. Tc-99m-HMPAO-Labeled leukocyte SPECT/CT in pediatrics: detecting Candida albicans tricuspid endocarditis

    Energy Technology Data Exchange (ETDEWEB)

    Calais, Jeremie; Edet-Sanson, Agathe; Gaucher, Stephane; Vera, Pierre; Cloirec, Joseph Le [Henri Becquerel Cancer Center and Rouen Univ. Hospital, Rouen (France)

    2015-12-15

    These results led to performing TEE, which showed tricuspid vegetation. Blood cultures were then positive to Candida albicans. Control blood cultures and TEE performed 6 weeks later after adapted antifungal therapy remained negative. In accordance with the results of Erba and al., this case illustrates the usefulness of late thoracic SPECT-CT acquisition of a WBC scan in a patient with high clinical suspicion of endocarditis and identified risk factors but inconclusive echocardiographic findings.

  9. Tc-99m-HMPAO-Labeled leukocyte SPECT/CT in pediatrics: detecting Candida albicans tricuspid endocarditis

    International Nuclear Information System (INIS)

    Calais, Jeremie; Edet-Sanson, Agathe; Gaucher, Stephane; Vera, Pierre; Cloirec, Joseph Le

    2015-01-01

    These results led to performing TEE, which showed tricuspid vegetation. Blood cultures were then positive to Candida albicans. Control blood cultures and TEE performed 6 weeks later after adapted antifungal therapy remained negative. In accordance with the results of Erba and al., this case illustrates the usefulness of late thoracic SPECT-CT acquisition of a WBC scan in a patient with high clinical suspicion of endocarditis and identified risk factors but inconclusive echocardiographic findings

  10. Cerebral blood flow measurement in patients with impaired consciousness: usefulness of {sup 99m}Tc-HMPAO single-photon emission tomography in clinical practice

    Energy Technology Data Exchange (ETDEWEB)

    Chang Chia-Cheng; Kuwana, Nobumasa; Noji, Masato; Tanabe, Yutaka; Koike, Y. [Department of Neurosurgery, Yokohama Minami Kyosai Hospital, Yokohama (Japan); Ikegami, Tadashi [Department of Radiology, Yokohama Minami Kyosai Hospital, Yokohama (Japan)

    1998-09-01

    The relationship between impairment of consciousness and quantitative cerebral blood flow (CBF) was investigated. The mean CBF of the whole brain was measured by the Patlak-plot method using technetium-99m hexamethylpropylene amine oxime single-photon emission tomography ({sup 99m}Tc-HMPAO SPET) in patients with the following diseases: cerebral infarction, intraparenchymal haemorrhage, subarachnoid haemorrhage, brain tumour and cerebral contusion. The clinical symptoms were evaluated according to the severity of impaired consciousness, aphasia and dementia. Four hundred and eighty-five CBF measurements were performed. Patients with alert consciousness showed an age-related decline in mean CBF. Patients with aphasia showed a significant reduction in mean CBF compared with those without aphasia. Impaired consciousness was proportional to reduction in mean CBF regardless of types of pathology, and the size of lesion did not influence the mean CBF. Patients with dementia showed a significant reduction in mean CBF proportional to the severity of dementia. The quantitative measurement of CBF using {sup 99m}Tc-HMPAO SPET is reliable in clinical evaluations. (orig.) With 3 tabs., 10 refs.

  11. Cerebral blood flow measurement in patients with impaired consciousness: usefulness of 99mTc-HMPAO single-photon emission tomography in clinical practice

    International Nuclear Information System (INIS)

    Chang Chia-Cheng; Kuwana, Nobumasa; Noji, Masato; Tanabe, Yutaka; Koike, Y.; Ikegami, Tadashi

    1998-01-01

    The relationship between impairment of consciousness and quantitative cerebral blood flow (CBF) was investigated. The mean CBF of the whole brain was measured by the Patlak-plot method using technetium-99m hexamethylpropylene amine oxime single-photon emission tomography ( 99m Tc-HMPAO SPET) in patients with the following diseases: cerebral infarction, intraparenchymal haemorrhage, subarachnoid haemorrhage, brain tumour and cerebral contusion. The clinical symptoms were evaluated according to the severity of impaired consciousness, aphasia and dementia. Four hundred and eighty-five CBF measurements were performed. Patients with alert consciousness showed an age-related decline in mean CBF. Patients with aphasia showed a significant reduction in mean CBF compared with those without aphasia. Impaired consciousness was proportional to reduction in mean CBF regardless of types of pathology, and the size of lesion did not influence the mean CBF. Patients with dementia showed a significant reduction in mean CBF proportional to the severity of dementia. The quantitative measurement of CBF using 99m Tc-HMPAO SPET is reliable in clinical evaluations. (orig.)

  12. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    International Nuclear Information System (INIS)

    Fiedler, A.; Aderbauer, J.; Segerer, H.; Marienhagen, J.; Bock, E.; Eilles, C.

    1999-01-01

    A 9 1/2-year-old girl suffered from intermitting tremor and jitteriness of her left hand and oral muscles every 4 to 6 weeks with long lasting episodes. Clinically myoclonias and dystonic positioning of the left arm, hand and facial muscles were seen. No evidence of trauma, infection or inborn errors of metabolism was found. Successful therapy with carbamazepine was initiated while L-DOPA failed. An ictal 99m-Tc-HMPAO-SPECT showed severe asymmetry with focal hyperperfusion of the contralateral right thalamus and basal ganglia as well as of the bifrontal cortex, whereas no anatomical lesions were found by MRI. In contrast, an interictally performed 99m-Tc-HMPAO SPECT showed hypoperfusion or the right thalamus and normalisation of the frontal perfusion under medical treatment. These 99m-Tc-HMPAO-SPECT findings may provide new insights into the localisation and pathophysiological pathways of idiopathic childhood dystonia. (orig.) [de

  13. Comparison of Tc-99m ECD brain SPECT between patients with delayed development and cerebral palsy

    International Nuclear Information System (INIS)

    Cho, I.; Chun, K.; Won, K.; Lee, H.; Jang, S.; Lee, J.

    2002-01-01

    Purpose: In previous study, thalamic or cerebellar hypoperfusion were reported in patients with cerebral palsy. This study was performed to evaluate cerebral perfusion abnormalities using Tc-99m ECD brain SPECT in patients with delayed motor development. Methods: Nineteen patients (9 boys, 10 girls, mean age 25.5 months) with delayed development underwent brain SPECT after injection of 185∼370 MBq of Tc-99m ECD. The imaging was obtained between 30 minutes and 1hr after injection. The patients were divided clinically as follows, patients with delayed development (n=5) and patients with cerebral palsy (n=14) who has delayed development and abnormal movement. The clinical subtypes of cerebral palsy were spastic quadriplegia (n=5), spastic diplegia (n=6) and spastic hemiplegia (n=3). In each group, decrease of cerebral perfusion was evaluated visually as mild, moderate and severe and quantitation of cerebral perfusion after Lassen's correction was also obtained. Results: SPECT findings showed normal or mildly decreased thalamic perfusion in patients with delayed development and severe decrease of thalamic or cerebellar perfusion in patients with spastic quadriplegia. In patients with spastic diplegia, mild decrease of perfusion was observed in thalamus. In quantified data, thalamic perfusion was lowest in patients with spastic quadriplegia and highest in patients with delayed development, but there were no statistically significant differences. Conclusion: Brain SPECT with Tc-99m ECD has a role in the detection of perfusion abnormalities in patients with delayed development and cerebral palsy

  14. SPECT measurements of cerebral blood volume before and after acetazolamide in occlusive cerebrovascular diseases

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Momose, Toshimitsu; Machida, Kikuo; Honda, Norinari; Nishikawa, Junichi; Sasaki, Yasuhito.

    1994-01-01

    Cerebral blood volume before and after acetazolamide was measured by SPECT to evaluate cerebral vasodilatory capacity in eight patients with cerebrovascular disease and five control subjects. Two SPECT measurements were performed serially, and acetazolamide was administered between them. The ratio of increase in hemispheric blood volume was calculated, and it was compared with the results of cerebral blood flow and cerebral blood volume measurements. A cerebral vasodilatory capacity map, the image after acetazolamide minus the baseline image, was also produced. Acetazolamide increased hemispheric blood volume in all subjects. The ratio of increase was lower in the involved hemispheres of the patients with unilateral carotid disease than in the uninvolved hemispheres of the patients and control subjects. The ratio of concordance with blood flow and blood volume measurements was approximated at 80%. Cerebral vasodilatory capacity mapping revealed three defects compatible with the clinical data. SPECT measurements of cerebral blood volume after acetazolamide can be performed following baseline SPECT with no additional radiotracer, and may be helpful to assess hemodynamic status. (author)

  15. Cerebral perfusion changes in traumatic diffuse brain injury. IMP SPECT studies

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Kawashima, Ryuta; Fukuda, Hiroshi; Ishii, Kiyoshi; Onuma, Takehide.

    1997-01-01

    Diffuse brain injury (DBI) is characterized by axonal degeneration and neuronal damage which cause diffuse brain atrophy. We have investigated the time course of abnormalities in cerebral perfusion distribution in cases of DBI by using Iodine-123-IMP SPECT, and the relationship to the appearance of diffuse brain atrophy. SPECT scans were performed on eight patients with diffuse brain injury due to closed cranial trauma in acute and chronic stages. All patients showed abnormalities in cerebral perfusion with decreases in perfusion, even in non-depicted regions on MRI, and the affected areas varied throughout the period of observation. Diffuse brain atrophy appeared in all patients. In some patients, diffuse brain atrophy was observed at or just after the time when the maximum number of lesions on SPECT were seen. The abnormalities in cerebral perfusion in cases of DBI might therefore be related to axonal degeneration and neuronal damage which causes diffuse brain atrophy. (author)

  16. Automatic determination of brain perfusion index for measurement of cerebral blood flow using spectral analysis and {sup 99m}Tc-HMPAO

    Energy Technology Data Exchange (ETDEWEB)

    Takasawa, Masashi [Division of Strokology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita City, Osaka, 565-0871 (Japan); Department of Nuclear Medicine, Osaka University Graduate School of Medicine, Osaka (Japan); Murase, Kenya; Kawamata, Minoru [Department of Allied Health Sciences, Osaka University Graduate School of Medicine, Osaka (Japan); Oku, Naohiko; Imaizumi, Masao; Osaki, Yasuhiro; Paul, Asit K. [Department of Nuclear Medicine, Osaka University Graduate School of Medicine, Osaka (Japan); Yoshikawa, Takuya; Kitagawa, Kazuo; Matsumoto, Masayasu; Hori, Masatsugu [Division of Strokology, Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita City, Osaka, 565-0871 (Japan)

    2002-11-01

    Cerebral blood flow (CBF) can be non-invasively quantified using the brain perfusion index (BPI), determined from radionuclide angiographic data generated by technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO). We previously reported the use of a spectral analysis (SA) method using {sup 99m}Tc-HMPAO to calculate the BPI. In this report, we demonstrate an automatic method for determining the optimal BPI value and compare the optimal BPI values with the absolute CBF values measured using H{sub 2}{sup 15}O positron emission tomography (PET). Bilateral cerebral hemispheres of 11 patients with various brain diseases were examined using {sup 99m}Tc-HMPAO. In the automatic SA procedure, the radioactivity curve for the aortic arch (C{sub a}) was shifted by 0-10 s. The radioactivity curve for the brain (C{sub b}) was estimated using the shifted C{sub a}, and the error value between the actually measured and the estimated C{sub b} (Err) was calculated. When the Err was at a minimum, the BPI value was defined as optimal BPI. The difference in BPI from the optimal BPI was calculated as vertical stroke BPI - optimal BPI vertical stroke / optimal BPI x 100 (%). In all participants, an H{sub 2}{sup 15}O PET examination was also performed, and the BPI values were compared with the absolute CBF values measured using H{sub 2}{sup 15}O PET (mCBF{sup PET}). The difference between BPI and the optimal BPI increased significantly from 4.87%{+-}1.69% to 18.38%{+-}3.93% (mean{+-}SD) when the Err value increased. The optimal BPI value (y) was well correlated with the mCBF{sup PET} value (x) (y=0.21x-0.0075, r=0.800). Our results suggest that this automatic SA method provides an accurate estimate of BPI that can be used for the quantification of CBF using {sup 99m}Tc-HMPAO SA. (orig.)

  17. Single-photon emission computed tomography (SPECT) in oediatric migraine

    International Nuclear Information System (INIS)

    Battistella, P.A.; Pitassi, I.; Ruffilli, R.; Boniver, C.; Suppiej, A.; Casara, G.

    1989-01-01

    Cerebral blood flow in pediatric patients suffering from different types of migraine is analyzed by SPECT with 99m Tc HM-PAO, during the pain free intervals. The results indicate that such studies may give further information toward the understanding of common and classic forms of migraine and the difference in the CBF patterns of these forms support the hypothesis of a possible different pathogenesis. (H.W.). 13 refs.; 1 tab

  18. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul

    2000-01-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.=20

  19. Ictal cerebral perfusion patterns in partial epilepsy: SPECT subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Hyang Woon; Hong, Seung Bong; Tae, Woo Suk; Kim, Sang Eun; Seo, Dae Won; Jeong, Seung Cheol; Yi, Ji Young; Hong, Seung Chyul [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

    2000-06-01

    To investigate the various ictal perfusion patterns and find the relationships between clinical factors and different perfusion patterns. Interictal and ictal SPECT and SPECT subtraction were performed in 61 patients with partial epilepsy. Both positive images showing ictal hyperperfusion and negative images revealing ictal hypoperfusion were obtained by SPECT subtraction. The ictal perfusion patterns of subtracted SPECT were classified into focal hyperperfusion, hyperperfusion-plus, combined hyperperfusion-hypoperfusion, and focal hypoperfusion only. The concordance rates with epileptic focus were 91.8% in combined analysis of ictal hyperperfusion and hypoperfusion images of subtracted SPECT, 85.2% in hyperperfusion images only of subtracted SPECT, and 68.9% in conventional ictal SPECT analysis. Ictal hypoperfusion occurred less frequently in temporal lobe epilepsy (TLE) than extratemporal lobe epilepsy. Mesial temporal hyperperfusion alone was seen only in mesial TLE while lateral temporal hyperperfusion alone was observed only in neocortical TLE. Hippocampal sclerosis had much lower incidence of ictal hypoperfusion than any other pathology. Some patients showed ictal hypoperfusion at epileptic focus with ictal hyperperfusion in the neighboring brain regions where ictal discharges propagated. Hypoperfusion as well as hyperperfusion in ictal SPECT should be considered for localizing epileptic focus. Although the mechanism of ictal hypoperfusion could be an intra-ictal early exhaustion of seizure focus or a steal phenomenon by the propagation of ictal discharges to adjacent brain areas, further study is needed to elucidate it.

  20. Study of regional cerebral blood flow SPECT imaging for sudden sensorineural deafness

    International Nuclear Information System (INIS)

    Xie Changhui; Kui Xixiao; Xiong Qibin; Wen Hui; Xie Jiabiao

    1998-01-01

    Purpose: To study the clinical value of regional cerebral blood flow (rCBF) SPECT imaging for sudden sensorineural deafness (SSD). Methods: 10 normal persons, 19 conductive deafness and 31 SSD patients were examined by rCBF SPECT imaging, and compared with X CT at the same time. All SSD patients were followed up for 6∼12 months with repeated rCBF SPECT imaging. Results: 1) The radioactivity of diseased and normal horizontal temporal gyrus ratio (T/NT) in SSD patients was the lowest among three groups (P < 0.01). 2) The sensitivity (80.6%) and accurate rate (88.3%) of rCBF SPECT imaging in SSD patients were much higher than those of CT (3.2% and 50%, P < 0.01). 3) There was a significant correlation between degree of deafness and T/NT in SSD patients. 4) Good prognosis of SSD patients with normal rCBF SPECT was found. 5) The rCBF SPECT had close concordance between rCBF SPECT imaging and clinical prognosis (84.6%). Conclusions: rCBF SPECT imaging was superior to X CT in diagnosis of SSD and played an important clinical role

  1. Regional cerebral blood flow (rCBF) in schizophrenia during verbal memory activation: a 99mTc-HMPAO single photon emission tomography (SPET) study.

    Science.gov (United States)

    Busatto, G F; Costa, D C; Ell, P J; Pilowsky, L S; David, A S; Kerwin, R W

    1994-05-01

    Regional cerebral blood flow (rCBF) was investigated in a group of medicated DSM-III-R schizophrenic patients and age, sex and handedness matched normal volunteers using a split-dose 99mTc-HMPAO Single Photon Emission Tomography (SPET) protocol. Measures were taken during the performance of a verbal memory task aimed at activating the left medial temporal lobe, a region repeatedly suggested to be structurally abnormal in schizophrenia. In normal subjects, the performance of the task was associated with significant rCBF increases in the left medial temporal, left inferior frontal and anterior cingulate cortices, and right cerebellum. Despite their significantly poorer performance on the memory task, the degree of medial temporal activation measured in the schizophrenic patients was not significantly different from that found in the control group. This finding suggests that memory deficits in schizophrenia do not necessarily imply failure to activate the left medial temporal lobe as assessed by 99mTc-HMPAO SPET.

  2. Comparison of acetazolamide-enhanced brain SPECT using Tc-99m ECD with cerebral angiography in patients with cerebrovascular disease

    International Nuclear Information System (INIS)

    Choi, Y. Y.; Moon, D. H.; Ryu, J. S.; Yang, S. H.; Lee, H. K.; Lee, J. H.; Kim, J. S.; Kim, K. A.

    1997-01-01

    Cerebral vascular reserve can be assessed by development of collateral channels (DCC) on cerebral angiography(CA) or vasoreactivity (VR) on acetazolamide-enhanced brain SPECT (ACZ-SPECT). The purpose of this study was to compare Tc-99m ECD ACZ-SPECT with CA in the evaluation of vascular reserve in patients (pts) with cerebrovascular disease(CVD). Twenty seven patients with CVD, including TIA (n=13), infarction (n=11) and asymptomatic pts (AS, n=3), underwent CA and ACZ-SPECT. Basal and ACZ-SPECT was obtained consecutively, and image subtraction was performed. On CA, degree of DCC was scored 0-3 (0: normal, 3: poor) according to parenchymal staining on delayed film. In ACZ-SPECT, decrease of VR was graded 0-3 (0: normal, 3: more than 30% decrease). The correlation between degree of stenosis, DCC and VR were analyzed. 1) Variable degree of VR or DCC was observed in totally occluded or stenotic cerebral arterial territories. 2) In arterial territories with poor DCC, ACZ-SPECT showed poor VR. However, in 5 out of 11 TIA or AS with good DCC, poor VR was observed. These data suggests that 1) cerebral hemodynamic status cannot be assessed by the degree of stenosis on CA alone. 2) DCC may overestimate the cerebral vascular reserve in patients with TIA or AS. 3) ACZ-SPECT plays a complementary role to CA for evaluation of cerebral hemodynamic status in pts with CVD

  3. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Zhaosheng, Luan; Pengyong,; Xiqin, Sun; Wei, Wang; Huisheng, Liu; Wen, Zhou [88 Hospital PLA, Taian, SD (China). Dept. of Nuclear Medicine

    1992-11-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed.

  4. Preliminary application of SPECT three dimensional brain imaging in normal controls and patients with cerebral infarction

    International Nuclear Information System (INIS)

    Luan Zhaosheng; Pengyong; Sun Xiqin; Wang Wei; Liu Huisheng; Zhou Wen

    1992-01-01

    10 normal controls and 32 cerebral infarction patients were examined with SPECT three-dimensional (3D) and sectional imaging. The result shows that 3D brain imaging has significant value in the diagnosis of cerebral infarction. 3D brain imaging is superior to sectional imaging in determining the location and size of superficial lesions. For the diagnosis of deep lesions, it is better to combine 3D brain imaging with sectional imaging. The methodology of 3D brain imaging is also discussed

  5. SPECT-imaging of activity-dependent changes in regional cerebral blood flow induced by electrical and optogenetic self-stimulation in mice.

    Science.gov (United States)

    Kolodziej, Angela; Lippert, Michael; Angenstein, Frank; Neubert, Jenni; Pethe, Annette; Grosser, Oliver S; Amthauer, Holger; Schroeder, Ulrich H; Reymann, Klaus G; Scheich, Henning; Ohl, Frank W; Goldschmidt, Jürgen

    2014-12-01

    Electrical and optogenetic methods for brain stimulation are widely used in rodents for manipulating behavior and analyzing functional connectivities in neuronal circuits. High-resolution in vivo imaging of the global, brain-wide, activation patterns induced by these stimulations has remained challenging, in particular in awake behaving mice. We here mapped brain activation patterns in awake, intracranially self-stimulating mice using a novel protocol for single-photon emission computed tomography (SPECT) imaging of regional cerebral blood flow (rCBF). Mice were implanted with either electrodes for electrical stimulation of the medial forebrain bundle (mfb-microstim) or with optical fibers for blue-light stimulation of channelrhodopsin-2 expressing neurons in the ventral tegmental area (vta-optostim). After training for self-stimulation by current or light application, respectively, mice were implanted with jugular vein catheters and intravenously injected with the flow tracer 99m-technetium hexamethylpropyleneamine oxime (99mTc-HMPAO) during seven to ten minutes of intracranial self-stimulation or ongoing behavior without stimulation. The 99mTc-brain distributions were mapped in anesthetized animals after stimulation using multipinhole SPECT. Upon self-stimulation rCBF strongly increased at the electrode tip in mfb-microstim mice. In vta-optostim mice peak activations were found outside the stimulation site. Partly overlapping brain-wide networks of activations and deactivations were found in both groups. When testing all self-stimulating mice against all controls highly significant activations were found in the rostromedial nucleus accumbens shell. SPECT-imaging of rCBF using intravenous tracer-injection during ongoing behavior is a new tool for imaging regional brain activation patterns in awake behaving rodents providing higher spatial and temporal resolutions than 18F-2-fluoro-2-dexoyglucose positron emission tomography. Copyright © 2014 The Authors

  6. Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and 123I-IMP with acetazolamide test

    International Nuclear Information System (INIS)

    Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi; Suematsu, Katsumi.

    1989-01-01

    To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl 123 I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25∼50% stenosis), and severe degree(50%cerebral vasodilatory capacity was preserved at the normal level during the period of vasospasm. In eight patients with asymptomatic vasospasm (moderate degree), a transient limitation of cerebral vasodiratory capacity was observed between the 6th and 16th day after a rupture of the cerebral aneurysm. In five patients with symptomatic vasospasm resulting in reversible ischemia, a marked limitation of cerebral vasodilatory capacity was noted between the 7th and 15th day, and a delayed recovery of cerebral vasodilatory capacity was observed. This reversibility of cerebral vasodilatory capacity in patients with cerebral vasospasm suggests that a local decrease of purfusion pressure due to cerebral vasospasm causes compensatory vasodilation of intraparenchymal arteries and the vasodilatory reaction to acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.)

  7. Significance of postoperative crossed cerebellar hypoperfusion in patients with cerebral hyperperfusion following carotid endarterectomy: SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Saito, Hideo; Komoribayashi, Nobukazu; Otawara, Yasunari; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan)

    2008-01-15

    Cerebral hyperperfusion after carotid endarterectomy (CEA) results in cerebral hyperperfusion syndrome and cognitive impairment. The goal of the present study was to clarify the clinical significance of postoperative crossed cerebellar hypoperfusion (CCH) in patients with cerebral hyperperfusion after CEA by assessing brain perfusion with single-photon emission computed tomography (SPECT). Brain perfusion was quantitatively measured using SPECT and the [{sup 123}I]N-isopropyl-p-iodoamphetamine-autoradiography method before and immediately after CEA and on the third postoperative day in 80 patients with ipsilateral internal carotid artery stenosis ({>=}70%). Postoperative CCH was determined by differences between asymmetry of perfusion in bilateral cerebellar hemispheres before and after CEA. Neuropsychological testing was also performed preoperatively and at the first postoperative month. Eleven patients developed cerebral hyperperfusion (cerebral blood flow increase of {>=}100% compared with preoperative values) on SPECT imaging performed immediately after CEA. In seven of these patients, CCH was observed on the third postoperative day. All three patients with hyperperfusion syndrome exhibited cerebral hyperperfusion and CCH on the third postoperative day and developed postoperative cognitive impairment. Of the eight patients with asymptomatic hyperperfusion, four exhibited CCH despite resolution of cerebral hyperperfusion on the third postoperative day, and three of these patients experienced postoperative cognitive impairment. In contrast, four patients without postoperative CCH did not experience postoperative cognitive impairment. The presence of postoperative CCH with concomitant cerebral hyperperfusion reflects the development of hyperperfusion syndrome. Further, the presence of postoperative CCH in patients with cerebral hyperperfusion following CEA suggests development of postoperative cognitive impairment, even when asymptomatic. (orig.)

  8. Significance of postoperative crossed cerebellar hypoperfusion in patients with cerebral hyperperfusion following carotid endarterectomy: SPECT study

    International Nuclear Information System (INIS)

    Ogasawara, Kuniaki; Kobayashi, Masakazu; Suga, Yasunori; Chida, Kohei; Saito, Hideo; Komoribayashi, Nobukazu; Otawara, Yasunari; Ogawa, Akira

    2008-01-01

    Cerebral hyperperfusion after carotid endarterectomy (CEA) results in cerebral hyperperfusion syndrome and cognitive impairment. The goal of the present study was to clarify the clinical significance of postoperative crossed cerebellar hypoperfusion (CCH) in patients with cerebral hyperperfusion after CEA by assessing brain perfusion with single-photon emission computed tomography (SPECT). Brain perfusion was quantitatively measured using SPECT and the [ 123 I]N-isopropyl-p-iodoamphetamine-autoradiography method before and immediately after CEA and on the third postoperative day in 80 patients with ipsilateral internal carotid artery stenosis (≥70%). Postoperative CCH was determined by differences between asymmetry of perfusion in bilateral cerebellar hemispheres before and after CEA. Neuropsychological testing was also performed preoperatively and at the first postoperative month. Eleven patients developed cerebral hyperperfusion (cerebral blood flow increase of ≥100% compared with preoperative values) on SPECT imaging performed immediately after CEA. In seven of these patients, CCH was observed on the third postoperative day. All three patients with hyperperfusion syndrome exhibited cerebral hyperperfusion and CCH on the third postoperative day and developed postoperative cognitive impairment. Of the eight patients with asymptomatic hyperperfusion, four exhibited CCH despite resolution of cerebral hyperperfusion on the third postoperative day, and three of these patients experienced postoperative cognitive impairment. In contrast, four patients without postoperative CCH did not experience postoperative cognitive impairment. The presence of postoperative CCH with concomitant cerebral hyperperfusion reflects the development of hyperperfusion syndrome. Further, the presence of postoperative CCH in patients with cerebral hyperperfusion following CEA suggests development of postoperative cognitive impairment, even when asymptomatic. (orig.)

  9. The baboon model under anaesthesia for in vivo cerebral blood flow studies using single photon emission computed tomographic (SPECT) techniques

    International Nuclear Information System (INIS)

    Dormehl, I.; Redelinghuys, F.; Hugo, N.; Oliver, D.; Pilloy, W.

    1992-01-01

    Single photon computed tomography of the brain can be useful in animal experimentation directed towards cerebral conditions. A well established and understood baboon model, necessarily under anaesthesia, could especially be valuable in such investigations. Six normal baboons were studied under various anesthetic agents and their combinations: ketamine, thiopentone, pentobarbitone and halothane. Cerebral blood flow (CBF) studies were performed with 99m Tc-HMPAO. CBF effects from various anaesthesia were detected, requiring careful choice of the anaesthesia for cerebral investigations. (author). 13 refs, 4 figs, 3 tabs

  10. The baboon model under anaesthesia for in vivo cerebral blood flow studies using single photon emission computed tomographic (SPECT) techniques

    Energy Technology Data Exchange (ETDEWEB)

    Dormehl, I.; Redelinghuys, F.; Hugo, N. [Pretoria Univ. (South Africa); Oliver, D.; Pilloy, W. [Medical Univ. of Southern Africa (MEDUNSA), Pretoria (South Africa)

    1992-12-31

    Single photon computed tomography of the brain can be useful in animal experimentation directed towards cerebral conditions. A well established and understood baboon model, necessarily under anaesthesia, could especially be valuable in such investigations. Six normal baboons were studied under various anesthetic agents and their combinations: ketamine, thiopentone, pentobarbitone and halothane. Cerebral blood flow (CBF) studies were performed with {sup 99m}Tc-HMPAO. CBF effects from various anaesthesia were detected, requiring careful choice of the anaesthesia for cerebral investigations. (author). 13 refs, 4 figs, 3 tabs.

  11. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    International Nuclear Information System (INIS)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J.

    1990-01-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared

  12. Thallium-201 accumulation in cerebral candidiasis: Unexpected finding on SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tonami, N.; Matsuda, H.; Ooba, H.; Yokoyama, K.; Hisada, K.; Ikeda, K.; Yamashita, J. (Kanazawa Univ. (Japan))

    1990-06-01

    The authors present an unexpected finding of Tl-201 uptake in the intracerebral lesions due to candidiasis. SPECT demonstrated the extent of the lesions and a high target-to-background ratio. The regions where abnormal Tl-201 accumulation was seen were nearly consistent with CT scans of those enhanced by a contrast agent. After treatment, most of the abnormal Tl-201 accumulation disappeared.

  13. The cerebral SPECT in the psychiatric dysfunctions in severe atopic dermatitis; El SPECT cerebral en los trastornos psiquiatricos de la dermatitis atopica severa

    Energy Technology Data Exchange (ETDEWEB)

    Ferrando, Rodolfo; Lago, Graciela [Centro de Medicina Nuclear del Hospital de Clinicas, Montevideo (Uruguay); Vignale, Raul [Departamento de Dermatologia del Hospital de Clinicas, Montevideo (Uruguay); Fabius, Bettina; Lyford Pike, Alexander [Consultorio Psiquiatrico Dr. Lyford Pike, Facultad de Medicina. Universidad de la Republica, Montevideo (Uruguay)

    2007-01-15

    Introduction: Severe atopic dermatitis (AD) usually has a psychiatric component that may influence the course of the cutaneous symptoms. Functional neuroimaging could evidence brain dysfunctions in this kind of patients. Objective: Evaluate the presence and characteristics of cerebral perfusion changes in severe AD patients using SPECT. Materials and methods: 11 severe AD patients were subjected to clinical psychiatric evaluation and 99mTc-ECD SPECT. Results: 90.3% of the patients presented a generalized anxiety disorder, 63.6% an obsessive compulsive disorder and 63.6% a depression. The 11 patients presented perfusion changes that prevailed at the prefrontal cortex. The alterations were concordant with the patterns described in those patients in which anxiety disorders and depression coexist. Conclusions: We demonstrate the frequent presence of perfusion changes in severe AD patients with psychiatric symptoms (au)

  14. Validation and the limits of SPECT for patients suffering from cerebrovascular accidents. Evaluations based on simultaneous PET and SPECT examinations

    Energy Technology Data Exchange (ETDEWEB)

    Mizukawa, Norihiko; Yano, Ichiro; Tenjin, Hiroshi (Kyoto Prefectural Univ. of Medicine (Japan)) (and others)

    1989-02-01

    Contemporaneous single photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed in 10 patients with cerebrovascular accidents (CVA), whose ages ranged from 11 to 67 years. I-123-isopropyl-iodoamphetamine (IMP) and/or Tc-99m hexamethylpropyleneamine oxime (HM-PAO) were used for SPECT. Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen (CMRO{sub 2}) were measured by an O-15 labelled gas continuous-inhalation method. SPECT images were quite similar to CBF and CMRO{sub 2} during the chronic stage of CVA. Two patietns with vasospasm during the subacute stage had apparently low CBF and CMRO{sub 2} on PET, but did not have low perfusion on SPECT. Luxury perfusion areas were detected in 4 subacute stage patients and one chronic stage patient. A redistribution of IMP was detected in two patients with infarction during subacute stage. CMRO{sub 2} value in such an area was 2.0 ml/100 g/min. Low CBF and/or CMRO{sub 2} areas were well visualized by IMP rather than by HM-PAO SPECT. (N.K.).

  15. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy; SPECT cerebral interictal em pacientes com epilepsia do lobo temporal de dificil controle

    Energy Technology Data Exchange (ETDEWEB)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  16. Benzodiazepine receptor imaging with iomazenil SPECT in aphasic patients with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Koshi, Yasuhiko; Kitamura, Shin; Ohyama, Masashi [Nippon Medical School, Tokyo (Japan)] (and others)

    1999-08-01

    To investigate the relationship between prognosis of aphasia and neuronal damage in the cerebral cortex, we evaluated the distribution of central-type benzodiazepine receptor (BZR) binding in post-stroke aphasics with [{sup 123}I]iomazenil and SPECT. We performed iomazenil SPECT in six aphasic patients (aged from 45 to 75 years; all right-handed) with unilateral left cerebral infarction. Three patients showed signs of Broca's aphasia and the other three Wernicke's aphasia. Cerebral blood flow (CBF) imaging was performed with [{sup 123}I]iodoamphetamine (IMP). The regions of interest (ROIs) on both images were set in the cerebral cortex, cerebellar cortex and language relevant area in both hemispheres. Three patients were classified in the mild prognosis group and the other three in the moderate prognosis group. The left language-relevant area was more closely concerned with the difference in aphasic symptoms than the right one in both BZR and CBF distribution, but the ipsilateral to the contralateral ratio (I/C ratio) in the language-relevant areas in the BZR distribution was significantly lower in the moderate prognosis group than in the mild prognosis group, although no difference was seen for these values between the two groups in the CBF distribution. These results suggest that BZR imaging, which makes possible an increase in neuronal cell viability in the cerebral cortex, is useful not only for clarifying the aphasic symptoms but also for evaluating the prognosis of aphasia in patients with cerebral infarction. (author)

  17. Benzodiazepine receptor imaging with iomazenil SPECT in aphasic patients with cerebral infarction

    International Nuclear Information System (INIS)

    Koshi, Yasuhiko; Kitamura, Shin; Ohyama, Masashi

    1999-01-01

    To investigate the relationship between prognosis of aphasia and neuronal damage in the cerebral cortex, we evaluated the distribution of central-type benzodiazepine receptor (BZR) binding in post-stroke aphasics with [ 123 I]iomazenil and SPECT. We performed iomazenil SPECT in six aphasic patients (aged from 45 to 75 years; all right-handed) with unilateral left cerebral infarction. Three patients showed signs of Broca's aphasia and the other three Wernicke's aphasia. Cerebral blood flow (CBF) imaging was performed with [ 123 I]iodoamphetamine (IMP). The regions of interest (ROIs) on both images were set in the cerebral cortex, cerebellar cortex and language relevant area in both hemispheres. Three patients were classified in the mild prognosis group and the other three in the moderate prognosis group. The left language-relevant area was more closely concerned with the difference in aphasic symptoms than the right one in both BZR and CBF distribution, but the ipsilateral to the contralateral ratio (I/C ratio) in the language-relevant areas in the BZR distribution was significantly lower in the moderate prognosis group than in the mild prognosis group, although no difference was seen for these values between the two groups in the CBF distribution. These results suggest that BZR imaging, which makes possible an increase in neuronal cell viability in the cerebral cortex, is useful not only for clarifying the aphasic symptoms but also for evaluating the prognosis of aphasia in patients with cerebral infarction. (author)

  18. Cerebral abnormalities in cocaine abusers: Demonstration by SPECT perfusion brain scintigraphy. Work in progress

    International Nuclear Information System (INIS)

    Tumeh, S.S.; Nagel, J.S.; English, R.J.; Moore, M.; Holman, B.L.

    1990-01-01

    Single photon emission computed tomography (SPECT) perfusion brain scans with iodine-123 isopropyl iodoamphetamine (IMP) were obtained in 12 subjects who acknowledged using cocaine on a sporadic to a daily basis. The route of cocaine administration varied from nasal to intravenous. Concurrent abuse of other drugs was also reported. None of the patients were positive for human immunodeficiency virus. Brain scans demonstrated focal defects in 11 subjects, including seven who were asymptomatic, and no abnormality in one. Among the findings were scattered focal cortical deficits, which were seen in several patients and which ranged in severity from small and few to multiple and large, with a special predilection for the frontal and temporal lobes. No perfusion deficits were seen on I-123 SPECT images in five healthy volunteers. Focal alterations in cerebral perfusion are seen commonly in asymptomatic drug users, and these focal deficits are readily depicted by I-123 IMP SPECT

  19. Dynamic study on cerebral perfusion of the pentylenetetrazol kindling cats by SPECT

    International Nuclear Information System (INIS)

    Hou Min; Liu Xingdang; Wang Kaiyan

    2004-01-01

    Objective: To learn the change of cerebral perfusion in the pentylenetetrazol kindling cats during the development of epilepsy. Methods: firstly, we performed 12 basic 99m Tc- ethyl cysteinate dimmer (ECD) SPECT as auto-control before the cats were made into epileptic models. Then, according to seizure level of epileptic model, SPECT was performed when the cats began to seizure in the form of facial tic(level 1), nodding spasm (level 2), limb tonic seizures (level 3) and generalized tonic-clonic seizures(level 4). At the same time, we detected the EEG at each level of seizure in order to contrast with SPECT findings. Results:There is no abnormal SPECT finding of cats before using PTZ. The SPECT at each level of kindling: hyperperfusion in forehead and basal ganglia at level 1; more evident hyperperfusion in forehead at level 2; the hyperperfusion in forehead being weakened and another hyperperfusion appearing in deep parietal lobe at level 3; the hyperperfusion in forehead disappearing and the hyperfusion in deep parietal lobe becoming more obvious and a hypoperfusion beside it appearing at level 4. As the time going on, the hyperperfusion disappeared completely and the hypoperfusion became more and more clear. The SPECT findings are coincided with EEG findings. Conclusion: 1. During the kindling of cats, a regional hyperperfusion appeared in the cats' brain: at the stage of focal seizure, the cerebral perfusion increased in forehead and ganglia; at the stage of generalized seizure, the hyperperfusion region gradually moved from forehead to deep parietal lobe. 2. Once the model animal was completely kindled, there would be a fixed hypoperfusion region instead, which may be the epileptic focus. (authors)

  20. SPECT in patients with cortical visual loss.

    Science.gov (United States)

    Silverman, I E; Galetta, S L; Gray, L G; Moster, M; Atlas, S W; Maurer, A H; Alavi, A

    1993-09-01

    Single-photon emission computed tomography (SPECT) with 99mTc-hexamethylpropyleneamine oxime (HMPAO) was used to investigate changes in cerebral blood flow in seven patients with cortical visual impairment. Traumatic brain injury (TBI) was the cause of cortical damage in two patients, cerebral ischemia in two patients and carbon monoxide (CO) poisoning, status epilepticus and Alzheimer's Disease (AD) each in three separate patients. The SPECT scans of the seven patients were compared to T2-weighted magnetic resonance image (MRI) scans of the brain to determine the correlation between functional and anatomical findings. In six of the seven patients, the qualitative interpretation of the SPECT studies supported the clinical findings (i.e., the visual field defect) by revealing altered regional cerebral blood flow (rCBF) in the appropriate regions of the visual pathway. MR scans in all of the patients, on the other hand, were either normal or disclosed smaller lesions than those detected by SPECT. We conclude that SPECT may reveal altered rCBF in patients with cortical visual impairment of various etiologies, even when MRI studies are normal or nondiagnostic.

  1. Technetium-99m HM-PAO-SPECT study of regional cerebral perfusion in early Alzheimer's disease

    International Nuclear Information System (INIS)

    Perani, D.; Di Piero, V.; Vallar, G.

    1988-01-01

    Regional cerebral perfusion was evaluated by single photon emission computed tomography (SPECT) using technetium-99m hexamethylpropyleneamine oxime ([/sup 99m/Tc]HM-PAO) in sixteen patients with Alzheimer's disease (AD) in early clinical phase and in 16 healthy elderly controls. In all patients transmission computed tomography (TCT) and/or magnetic resonance imaging (MRI) did not show focal brain abnormalities. Relative to normal subjects, AD patients showed significant reductions in cortical/cerebellar activity ratio: cortical perfusion was globally depressed with the largest reductions in frontal and posterior temporo-parietal cortices. Asymmetries of relative perfusion between cerebral hemispheres were also demonstrated when language was affected or visuospatial functions were unevenly impaired. In patients with early AD, SPECT provides functional information to be compared with clinical and psychometric data

  2. Demonstration of cerebral abnormalities in cocaine abusers with SPECT perfusion brain scans

    International Nuclear Information System (INIS)

    Nagel, J.S.; Tumeh, S.S.; English, R.J.; Moore, M.; Lee, V.W.; Holman, L.B.

    1989-01-01

    This paper reports I-123 isopropyl iodoamphetamine (IMP) single-photon emission CT (SPECT) brain scans performed on cocaine users to investigate the effects of cocaine on the cerebral perfusion in a manner similar to previous CT, angiographic and positron-emission tomographic (PET) studies. Ten asymptomatic or mildly symptomatic cocaine users, two users with major neurovascular complications, and five normal subjects were studied with IMP SPECT. Rotating-brain images of the cerebral IMP uptake were displayed by using a distance-weighted surface-projection technique and were visually analyzed for focal cortical perfusion deficits. Eleven cocaine users had multiple scattered cortical IMP defects. Frontal lobe defects were most prominent. One user had confluent defects resembling swiss cheese. Concurrent CT scans available in nine patients were negative in seven and showed infarcts in two. No similar focal findings were visible in normals

  3. In vivo tomographic study of cerebral blood perfusion with SPECT in hemiparkinsonian monkeys

    International Nuclear Information System (INIS)

    Chen Shengdi; Xu Delong

    1994-01-01

    The authors present data on the utility of functional brain imaging with 99m Tc-ECD and SPECT in the study of MPTP induced hemiparkinsonism in monkeys. Injection of MPTP into the right common carotid artery of 10 rhesus monkeys produced hemiparkinsonism in the contralateral limbs which responded to antiparkinsonian medication. The unilateral neurotoxicity of the MPTP treated side was confirmed biochemically by marked reduction of DA contents in the nigrostriatum and histologically by selective neuronal loss in the substantia nigra. These monkeys with hemiparkinsonism were studied with SPECT using 99m Tc-ECD as perfusion marker. The results of brain scanning showed that the cerebral blood perfusion of MPTP treated side was significantly depleted 20∼90 days after MPTP intoxication, and returned to normal 8 months after perfusion. The experiment indicates that abnormal cerebral blood perfusion is involved in the course of parkinsonian pathophysiology

  4. Diagnosis of hemodynamic compromise in patients with chronic cerebral ischemia; Measurement of cerebral blood volume (CBV) with sup 99m Tc-RBC SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kuroda, Satoshi; Sakuragi, Mitsugi; Motomiya, Mineo; Nakagawa, Tango; Mitsumori, Kenji; Tsuru, Mitsuo (Hokkaido Neurosurgical Memorial Hospital (Japan)); Takigawa, Shugo; Kamiyama, Hiroyasu; Abe, Hiroshi

    1990-03-01

    To evaluate the efficacy of tests for selecting patients with hemodynamic compromise, measurement of cerebral blood volume (CBV) with {sup 99m}Tc-RBC single photon emission computed tomography (SPECT) was performed in thirteen patients with occlusive cerebrovascular disease, and was compared with results obtained by {sup 133}Xe SPECT and acetazolamide (Diamox) test. All patients in our study suffered TIA, RIND, or minor completed stroke. Cerebral angiography demonstrated severe stenosis or occlusion in the ipsilateral internal carotid artery or middle cerebral artery, although plain CT scan or MRI revealed no or, if any, only localized infarcted lesions. Regional cerebral blood volume (rCBV) was measured with {sup 99m}Tc-RBC SPECT and regional cerebral blood flow (rCBF) was measured with {sup 133}Xe SPECT before and after intravenous injection of 10 - 12 mg/kg acetazolamide (Diamox). Our results suggest that the ipsilateral rCBV/rCBF (mean transit time) is a more sensitive index of the cerebral perfusion reserve than the use of only rCBV or rCBF of the ipsilateral hemisphere. Also, the ipsilateral rCBV/rCBF is significantly correlated (r= -0.72) with the Diamox reactivity of rCBF, which is considered to represent the cerebral vasodilatory capacity in patients with chronic cerebral ischemia. Postoperative SPECT study revealed remarkable improvement of ipsilateral rCBV/rCBF and Diamox reactivity in four patients who underwent EC/IC bypass surgery to improve the hemodynamic compromise. In conclusion, our results suggest that the measurement of rCBV/rCBF with {sup 133}Xe SPECT and {sup 99m}Tc-RBC SPECT is useful for detecting the hemodynamic compromise in patients with occlusive cerebrovascular disease. (author).

  5. SPECT for smokers brain perfusion evaluation; SPECT para avaliacao da perfusao cerebral em fumantes

    Energy Technology Data Exchange (ETDEWEB)

    Maliska, C.M.; Martins, E.F.; Barros, D.S.; Lopes, M.M.S.; Lourenco, C.; Goncalves, S.; Goncalves, M.B.; Miranda, M.M.B.G.; Neto, L.M.; Penque, E.; Antonucci, J.B. [Instituto Nacional do Cancer, Rio de Janeiro, RJ (Brazil)

    2002-07-01

    Cigarette smoking increases brain stroke risk, however,five to fifteen years after ceasing this habit, brain perfusion recovers normal pattern. We propose to compare brain perfusion patterns performing brain SPECT scans of smokers and non-smokers. Thirteen volunteers age range 20-30 years old) composed of six non-smokers and seven smokers were studied by brain scans (SPECT).We used ECD- {sup 99m} Tc radiolabelled as recommended by the manufacturer. All patients received 740 MBq of the radiopharmaceutical through intravenous injection, with their eyes opened and their ears unplugged, in a quiet room. We used a one head SPECT camera ( General Electric/ StarCam 4000 and Siemens/ E.Cam) with low-energy ultrahigh resolution collimator. Imaging begin 40 minutes after tracer injection. For reconstruction we used a Butterworth filter.The preliminary results showed brain perfusion deficit areas on five of the smokers while all non- smokers had normal brain perfusion scans. We believe that smoking increases the possibility of brain perfusion deficits. (author)

  6. Serial cerebral hemodynamic change after extracranial-intracranial (EC-IC) bypass surgery: evaluated by acetazolamide stress brain perfusion SPECT(acz-SPECT)

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Il Ki; Kim, Jae Seung; Ahn, Jae Sung; Im, Ki Chun; Kim, Euy Nyong; Mun, Dae Hyeog [Asan Medical Center, Seoul (Korea, Republic of)

    2005-07-01

    We evaluated serial cerebral hemodynamic changes after EC-IC bypass surgery in symptomatic pts with atherosclerotic occlusion of internal carotid (lCA) or mid-cerebral artery (MCA) using Acz-SPECT. 25 symptomatic pts (M/F 19/6, 53{+-}10 y) with ICA and MCA occlusion (16 uni - and 9 bilateral) prospectively underwent Acz-SPECT using Tc-99m ECD before and 1 week after EC-IC bypass surgery. Of these, 16 underwent additional f/u Acz-SPECT 5 mo later. Cerebral perfusion and perfusion reserve of MCA territory were evaluated visually and SPECT findings were classified into 4 groups: N/N; R/N; N/R; and R/R (perfusion/perfusion reserve: N = normal, R = reduced). For semiquantitative analysis, all SPECT images were normalized to MNI template and mean counts of MCA territory and cerebellum were obtained by AAL. Cerebral perfusion index (PI =C{sub region}/C{sub cere}) and perfusion reserve index (RI = (PI{sub Acz} - PI{sub basal}) /Pl{sub basal}) were calculated. Preop SPECT findings of ipsilateral MCA in 25 pts were R/N (4%), N/R (12%), and R/R (84% ). Early postop SPECT showed improvement of perfusion (26%) and/or reserve (68%) in ipsilateral MCA. Of 16 pts with 5mo f/u SPECT, 6 (38%) showed further improvement of perfusion or reserve. However, 4 (25%) showed aggravation of perfusion and one of these underwent revision surgery. Preop PI (1.1{+-}0.1) and RI (0.11{+-}0.07) of ipsilateral MCA were significantly lower than those of contralateral hemispheres (p<0.05). After surgery, PIs of bilateral MCA did not change at early postop period but improved in ipsilateral MCA at 5mo. Rls of ipsilateral MCA increased significantly (68%) at early postop period (P<0.001) and then did not changed. Cerebral perfusion and perfusion reserve changed with different manner during 5 mo after bypass surgery and perfusion reserve changed more dramatically than perfusion. Acz-SPECT is a feasible method for evaluating cerebral hemodynamic change after EC-IC bypass surgery.

  7. Tomografía cerebral, SPECT cerebral y neurocognición en trauma craneoencefálico

    OpenAIRE

    Casallo Quiliano, Carlos

    2013-01-01

    Introduccion: La tomografía cerebral (TC) es el examen de elección para evaluar un trauma cráneo encefálico (TCE) agudo. Otras pruebas, como la tomografía computarizada por emisión de fotón único (SPECT) están siendo utilizadas en el TCE, siendo mejor que la TC o la Resonancia magnética (RM) en la evaluación funcional del cerebro. La mayoría de estudios no incluyen, ni relacionan los resultados de la TC y SPECT con la evaluación neuropsicológica, la cual puede estar alterada a pesar de tener ...

  8. Measurement of mean cerebral blood flow using SPECT and dementia rating scales in the memory clinic

    International Nuclear Information System (INIS)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Yoshikawa, Ayumi; Gotoh, Chiharu

    1997-01-01

    We investigated the association between mean cerebral blood flow (mCBF) values using single photon emission computed tomography (SPECT) and cognitive performance scores of three dementia rating scales (ADAS, MMSE, HDS-R). Mean CBF was measured by the 123 I-IMP-ARG method in a selected group of 51 out-patients aged 41 to 90 years and by the 99m Tc-ECD method in the other group of 57 out-patients aged 51 to 91 years. Simple regressions were calculated for each of the neuropsychological clusters and mCBF values. In 123 I-IMP-ARG-SPECT study, there was a significant correlation between the mCBF values and HDS-R scores (R=0.37, p=0.01). 99m Tc-ECD-SPECT study revealed statistically significant correlations between the mCBF values and ADAS scores (R=-0.48, p 123 I-IMP-ARG-SPECT study and 99m Tc-ECD-SPECT study showed the progressive declines of mCBF with advancing cognitive dysfunctions. Using the cut-off point study (23/24 scores in MMSE and 20/21 scores in HDS-R), we have found that the patients with cognitive dysfunctions had lower mCBF values than the patients with those in each group of aged 60-69 years, 70-79 years, and 80-89 years. However, the difference of mCBF values between the groups with cognitive dysfunctions and without those had decreased gradually with advancing age. The present study suggests that SPECT can provide important functional informations to assess the cognitive impairment in patients with the memory disturbance. (author)

  9. Examination of attenuation correction method for cerebral blood Flow SPECT Using MR imaging

    International Nuclear Information System (INIS)

    Mizuno, Takashi; Takahashi, Masaaki

    2009-01-01

    Authors developed a software for attenuation correction using MR imaging (MRAC) (Toshiba Med. System Engineer.) based on the idea that precision of AC could be improved by the head contour in MRI T2-weighted images (T2WI) obtained before 123 I-iofetamine (IMP) single photon emission computed tomography (SPECT) for cerebral blood flow (CBF) measurement. In the present study, this MRAC was retrospectively evaluated by comparison with the previous standard AC methods derived from transmission CT (TCT) and X-CT which overcoming the problem of sinogram threshold Chang method but still having cost and patient exposure issues. MRAC was essentially performed in the Toshiba GMS5500/PI processor where 3D registration was conducted with images of SPECT and MRI of the same patient. The gamma camera for 123 I-IMP SPECT and 99m TcO 4 - TCT was Toshiba 3-detector GCA9300A equipped with the above processor for MRAC and with low energy high resolution (LEHR) fan beam collimator. Machines for MRI and CT were Siemens-Asahi Meditech. MAGNETOM Symphony 1.5T and SOMATOM plus4, respectively. MRAC was examined in 8 patients with images of T1WI, TCT and SPECT, and in 18 of T2WI, CT and SPECT. Evaluation was made by comparison of attenuation coefficients (μ) by the 4 methods. As a result, the present MRAC was found to be closer to AC by TCT and CT than by the Chang method since MRAC, due to exact imaging of the head contour, was independent on radiation count, and was thought to be useful for improving the precision of CBF SPECT. (K.T.)

  10. Cerebral blood flow imaging with thallium-201 diethyldithiocarbamate SPECT

    NARCIS (Netherlands)

    van Royen, E. A.; de Bruïne, J. F.; Hill, T. C.; Vyth, A.; Limburg, M.; Byse, B. L.; O'Leary, D. H.; de Jong, J. M.; Hijdra, A.; van der Schoot, J. B.

    1987-01-01

    Thallium-201 diethyldithiocarbamate ([201TI]DDC) was studied in humans as an agent for cerebral blood flow imaging. Brain uptake proved to be complete 90 sec after injection with no appreciable washout or redistribution for hours. Intracarotid injection suggested an almost 100% extraction during the

  11. Cerebral perfusion gammagraphy in neurology and neurosurgery

    International Nuclear Information System (INIS)

    Cardenas, Rene; Duran de Cardenas, Rosalia

    1998-01-01

    This paper describes six methods for measuring rCBF: 1) PET through 77 Kr, 15 O-water, 18 F-antipirine, 18 F-methane and 11 C-alcohols, 2) Wash measure of 133 Xe through SPECT or multidetectors, 3) CT contrasted through xenon, 4) planar gammagraphy or SPECT through 123 I-IMP or 123 I-HIPDM, 5) planar gammagraphy or radioisotopic tomography (SPECT) through 201 Tl-dietiltiocarbamate, and 6) planar gammagraphy or SPECT through 99m Tc lipofilics complex, 99m Tc-HMPAO and 99m Tc-ECD. They have been used for rCBF, , 133 Xe, 123 I-IMP 99m Tc-HMPAO studies, the two last ones are been used at the moment, the film performance is around 0.7 to 1.1 cm. The most useful radioisotopic techniques for gammagraphic study of cerebral perfusion have used HMPAO and 131 I-IMP labelled with 99m Tc

  12. Follow-up findings in regional cerebral blood flow (r-CBF)-SPECT in a case of idiopathic childhood hemidystonia. Functional neuroimaging and pathophysiological implications

    Energy Technology Data Exchange (ETDEWEB)

    Fiedler, A.; Aderbauer, J.; Segerer, H. [St. Hedwig Hospital, Regensburg (Germany). Dept. of Pediatrics; Marienhagen, J.; Bock, E.; Eilles, C. [Univ. Hospital, Regensburg (Germany). Dept. of Nuclear Medicine

    1999-05-01

    A 9 1/2-year-old girl suffered from intermitting tremor and jitteriness of her left hand and oral muscles every 4 to 6 weeks with long lasting episodes. Clinically myoclonias and dystonic positioning of the left arm, hand and facial muscles were seen. No evidence of trauma, infection or inborn errors of metabolism was found. Successful therapy with carbamazepine was initiated while L-DOPA failed. An ictal 99m-Tc-HMPAO-SPECT showed severe asymmetry with focal hyperperfusion of the contralateral right thalamus and basal ganglia as well as of the bifrontal cortex, whereas no anatomical lesions were found by MRI. In contrast, an interictally performed 99m-Tc-HMPAO SPECT showed hypoperfusion or the right thalamus and normalisation of the frontal perfusion under medical treatment. These 99m-Tc-HMPAO-SPECT findings may provide new insights into the localisation and pathophysiological pathways of idiopathic childhood dystonia. (orig.) [Deutsch] Ein 9 1/2jaehriges Maedchen litt an rezidivierenden, langdauernden Schueben von Tremor und Zittern der linken Hand und der perioralen Muskulatur links. Klinisch fanden sich eine dystone Haltung des linken Armes und unerschoepfliche Myoklonien des Armes, der Hand und der Gesichtsmuskulatur links. Trauma, Infektion oder ein Stoffwechseldefekt als Ursache lagen nicht vor. Ein Therapieversuch mit L-DOPA war erfolglos. Unter Gabe von Carbamazepin wurde Beschwerdefreiheit bleibend erreicht. Ein iktuales 99m-Tc-HMPAO-SPECT zeigte eine fokale Hyperperfusion des rechtsseitigen Thalamus und der Basalganglien, sowie des bifrontalen Kortex. Ein interiktuales 99m-Tc-HMPAOSPECT ergab dann eine deutliche Hypoperfusion des rechtseitigen Thalamus bei normalisierter Perfusion des bifrontalen Kortex. Eine kranielle Magnetresonanztomographie (MRI) ergab einen unauffaelligen Befund. Der Vergleich der iktualen und interiktualen Perfusionsverhaeltnisse weist auf neue pathophysiologische Zusammenhaenge bei idiopathischer kindlicher Dystonie hin. (orig.)

  13. Tl-201 and Tc-99m-DTPA neuro-SPECT in cerebral radiation necrosis

    International Nuclear Information System (INIS)

    Cleto, E.M. Jr.; Holmes, R.A.; Gumerlock, M.K.; Cabeen, M.; Logan, K.W.; Hoffman, T.J.

    1992-01-01

    The results in 3 cases of radiation necrosis demonstrate that by using both radionuclides Tl-201 and Tc-99m-DTPA, one can provide a semi-quantitative method to differentiate recurrent tumor from radiation necrosis. Focally increased cerebral Tl-201 activity in irradiated brain tumor patients is not specific for tumor recurrence, but when used in combination with DTPA, one is able to estimate the amount of Tl-201 activity resulting from increased blood-brain barrier permeability. If the average Tl-201 index is less than the average Tc-99m-DTPA index it suggests that the increased Tl-201 activity results primarily from blood-brain barrier breakdown. Tc-99m-DTPA SPECT, in addition to Tl-201 SPECT, or serial Tl-201 SPECT imaging may increase the accuracy of brain scintigraphy in differentiating radiation necrosis from tumor recurrence. To verify these preliminary findings, we are in the process of analyzing additional SPECT data on 9 more patients with malignant brain tumors. Using a slightly different method of quantifying Tl- 201/Tc-99m-DTPA ratios (computing the ratio of intralesional Tl-201 or Tc-99m-DTPA activity compared to adjacent scalp activity), patients with tumor recurrence have higher Tl-201/Tc-99m-DTPA ratios compared to those with radiation necrosis (verbal communication with Dr. Mary K. Gumerlock). (orig.) [de

  14. Special applications of [sup 99m]Tc-HM-PAO SPECT in the evaluation of cerebral hemodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Shigeki; Kageyama, Yuhsuke (Chiba Emergency Medical Center (Japan)); Namba, Hiroki (and others)

    1991-12-01

    [sup 99m]Tc-HM-PAO has been widely used as a brain-perfusion tracer. It is known that this lipophilic tracer crosses the blood-brain barrier with a high-pass extraction fraction, is deposited in the brain proportional to the cerebral blood flow, and shows a nearly constant maintenance of the regional distribution over several hours. Taking advantage of these characteristics of the tracer, we evaluated changes in the cerebral blood flow before and after recanalization therapy in the acute stage of stroke. Recent advances in catheterization technique have made it possible to introduce a catheter superselectively into smaller cerebral vessels, such as anterior, middle, and posterior cerebral arteries and external carotid artery branches. We ourselves evaluated the areas and concentrations of anti-cancer agents by injecting HM-PAO through the microcatheter used for superselective intra-arterial chemotherapy. We also visualized the areas supplied by the grafted vessels after bypass surgery for ischemic cerebrovascular diseases by the superselective infusion of HM-PAO. We found these techniques to be useful in clinical neurosurgery. (author).

  15. Research on the relationship between SPECT and cognitional potential of patients with cerebral infarction

    International Nuclear Information System (INIS)

    Zhao Heqing; Bao Shiyao; He Guangren

    1995-01-01

    The relationships among the regional cerebral blood flow (rCBF), the diaschisis and the change of cognitional potential in cerebral infarction are discussed. In 46 patients the ratio of rCBF was obtained by brain blood perfusion SPECT imaging. The cognitional potential was produced by evoking P300 wave with auditory Oddball model. The rCBF in infarct and its surrounding area decreased. The ratio of rCBF was less than 0.9. The detection of cognitional potential showed that the latency of P300 was delayed or negative. There was a significant correlation between the change of rCBF and the latency of P300 (r s = 0.876, P<0.001). The hypoperfusion of cerebral blood flow and diaschisis resulted in the cognitive impairment. There was a positive correlation between the cognitive impairment and the site and magnitude of decreased rCBF

  16. Brain perfusion SPECT in the mouse: normal pattern according to gender and age.

    Science.gov (United States)

    Apostolova, Ivayla; Wunder, Andreas; Dirnagl, Ulrich; Michel, Roger; Stemmer, Nina; Lukas, Mathias; Derlin, Thorsten; Gregor-Mamoudou, Betina; Goldschmidt, Jürgen; Brenner, Winfried; Buchert, Ralph

    2012-12-01

    Regional cerebral blood flow (rCBF) is a useful surrogate marker of neuronal activity and a parameter of primary interest in the diagnosis of many diseases. The increasing use of mouse models spawns the demand for in vivo measurement of rCBF in the mouse. Small animal SPECT provides excellent spatial resolution at adequate sensitivity and is therefore a promising tool for imaging the mouse brain. This study evaluates the feasibility of mouse brain perfusion SPECT and assesses the regional pattern of normal Tc-99m-HMPAO uptake and the impact of age and gender. Whole-brain kinetics was compared between Tc-99m-HMPAO and Tc-99m-ECD using rapid dynamic planar scans in 10 mice. Assessment of the regional uptake pattern was restricted to the more suitable tracer, HMPAO. Two HMPAO SPECTs were performed in 18 juvenile mice aged 7.5 ± 1.5weeks, and in the same animals at young adulthood, 19.1 ± 4.0 weeks (nanoSPECT/CTplus, general purpose mouse apertures: 1.2kcps/MBq, 0.7mm FWHM). The 3-D MRI Digital Atlas Database of an adult C57BL/6J mouse brain was used for region-of-interest (ROI) analysis. SPECT images were stereotactically normalized using SPM8 and a custom made, left-right symmetric HMPAO template in atlas space. For testing lateral asymmetry, each SPECT was left-right flipped prior to stereotactical normalization. Flipped and unflipped SPECTs were compared by paired testing. Peak brain uptake was similar for ECD and HMPAO: 1.8 ± 0.2 and 2.1 ± 0.6 %ID (p=0.357). Washout after the peak was much faster for ECD than for HMPAO: 24 ± 7min vs. 4.6 ± 1.7h (p=0.001). The general linear model for repeated measures with gender as an intersubject factor revealed an increase in relative HMPAO uptake with age in the neocortex (p=0.018) and the hippocampus (p=0.012). A decrease was detected in the midbrain (p=0.025). Lateral asymmetry, with HMPAO uptake larger in the left hemisphere, was detected primarily in the neocortex, both at juvenile age (asymmetry index AI=2.7 ± 1

  17. The cerebral SPECT in the psychiatric dysfunctions in severe atopic dermatitis

    International Nuclear Information System (INIS)

    Ferrando, Rodolfo; Lago, Graciela; Vignale, Raul; Fabius, Bettina; Lyford Pike, Alexander

    2007-01-01

    Introduction: Severe atopic dermatitis (AD) usually has a psychiatric component that may influence the course of the cutaneous symptoms. Functional neuroimaging could evidence brain dysfunctions in this kind of patients. Objective: Evaluate the presence and characteristics of cerebral perfusion changes in severe AD patients using SPECT. Materials and methods: 11 severe AD patients were subjected to clinical psychiatric evaluation and 99mTc-ECD SPECT. Results: 90.3% of the patients presented a generalized anxiety disorder, 63.6% an obsessive compulsive disorder and 63.6% a depression. The 11 patients presented perfusion changes that prevailed at the prefrontal cortex. The alterations were concordant with the patterns described in those patients in which anxiety disorders and depression coexist. Conclusions: We demonstrate the frequent presence of perfusion changes in severe AD patients with psychiatric symptoms (au)

  18. Regional cerebral blood flow in Parkinson's disease by [sup 123]I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Yoshihiro [Okayama Univ. (Japan). School of Medicine

    1994-06-01

    Regional cerebral blood flow (rCBF) was evaluated in 63 patients with Parkinson's disease (PD) by single-photon emission computed tomography (SPECT) using N-isopropyl-p-[sup 123]I-iodoamphetamine ([sup 123]I-IMP) as a tracer. Evaluation of the SPECT images was performed in accordance with the rCBF quantification method using a microsphere model. Patients in stage IV demonstrated significantly lower rCBF than those in stage II at the frontal, temporal, parietal, occipital regions and in the thalamus and cerebellum. Subjects with mental symptoms demonstrated decreased rCBF in every region in the brain. The present study indicates that clinical exacerbation and manifestation of dementia and other psychiatric symptoms in Parkinson's disease are associated with decreased blood flow in various brain regions. (author).

  19. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    International Nuclear Information System (INIS)

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W.

    1997-01-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84±17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78±10.36), mild defect ( 2 test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients

  20. Clinical significance of brain SPECT abnormalities of thalami and cerebellum in cerebral palsy with normal MRI

    Energy Technology Data Exchange (ETDEWEB)

    Park, C. H.; Lim, S. Y.; Lee, I. Y.; Kim, O. H.; Bai, M. S.; Kim, S. J.; Yoon, S. N.; Cho, C. W. [College of Medicine, Ajou Univ., Suwon (Korea, Republic of)

    1997-07-01

    The cerebral palsy(CP) encephalopathies are often of uncertain etiology and various functional image findings comparing with anatomical image findings have been reported. However, only a few have mentioned its clinical implications. The purpose of our report is to compare clinical severity and functional SPECT abnormalities of thalami and cerebellum in CP patients with normal MRI. Thirty six CP patients with bilateral spastic palsy who had normal MRI and brain SPECT were studied from July 1996 to September 1997. The patients' age at the time of SPECT was 22.84{+-}17.69 months. The patients were divided into two groups according to motor quotient(MQ); moderate defect (>50MQ : n=27 MQ=22.78{+-}10.36), mild defect (<50MQ : n=9, MQ=66.11{+-}13.87). The degree of rCBF decrease between the two groups was evaluated by {chi}{sup 2} test. Brain SPECT was performed following IV administration of 0.05-0.1 mCi/kg (minimum 2.0 mCi) of Tc-99m ECD and chloral hydrate sedation (50-80 mg/kg p.o) using a triple head system (MS 3, Siemens). Interpretation of brain SPECT was visual analysis: severe decrease is defined when the defect is moderate to marked and mild decrease in rCBF as mild. Seven of 36 (19.4%) showed unilateral or bilateral moderate decrease in rCBF in thalami, 20(55.6%) showed mild decrease, and 9(25.0%) showed no decreased rCBF. All 7 who had moderate thalamic defect reveled moderate motor defect clinically. Ten of 36(27.9%) revealed unilateral or bilateral moderate rCBF defect, 23 (63.9%) depicted mild defect, and 3(8.3%) showed no defect. Sixteen with moderate thalamic rCBF defect showed moderate motor defect in 15 patients. There was statistically significant (p=0.02605) relationship between rCBF defect and motor defect in our CP patients. In conclusion, brain SPECT appears sensitive, non-invasive tool in the evaluation as well as in the prognostication of bilateral spastic cerebral palsy patients and deserves further study using larger number of patients.

  1. Regional Cerebral Blood Flow and Executive Control Dysfunction in Alzheimer's Disease and Frontotemporal Dementia : A Combined fMRI and SPECT Study

    International Nuclear Information System (INIS)

    Rimbu, A.; Guyot, M.; Allard, M.; Amieva, H.; Fabrigoulle, C.

    2006-01-01

    Full text: Introduction: Every motor act requires a fine tuned balance between initiatory and inhibitory processes in order to provide appropriate preparation, initiation, on-line control and timely inhibition of this act. A decline of executive control seems to occur early in the course of Alzheimer's disease (AD) and in fronto-temporal dementia (FTD). Purpose: To investigate the relationship between Go/noGo activation pattern (executive function task) and regional cerebral flow in AD and FTD patients using functional magnetic resonance imaging (fMRI), SPECT and statistical parametric mapping (SPM99). Material and methods: fMRI data during Go/noGo task (that required response inhibition) and rCBF SPECT were performed from twelve AD patients (mean age 70), seven FTD patients (mean age 68) and twelve healthy elderly controls (mean age 72).The cognitive decline was measured using Mini-Mental State Examination (MMSE). All patients presented a MMSE score > 17 and healthy elderly controls > 25. SPECT imaging was performed 1 hour post-injection of 740 MBq Tc-99m HMPAO, using a dual-head gamma camera, according to standard protocols. Go/noGo task, in which a motor response to a visual stimulus had to be executed or inhibited, consisted of 7 interleaved rest and activation periods (30s each). Activation periods consisted of randomized presentation of red full circle (Go trials, 75%) and blue full triangle (NoGo trials, 25%). Results: All AD and FTD patients as well as controls performed well the Go/noGo task, making few commission and omission errors. The correlation of neural brain activation related to response inhibition and competition and temporal hypoperfusion degree in AD and FTD patients was studies. A significant correlation was observed, for AD patients in: bilateral anterior cingulate cortex (BA32), right insula (BA13), right middle frontal gyrus (BA9), right precuneus (BA31), right posterior cingulate (BA23), bilateral cuneus (BA18), right thalamus and for FTD

  2. A review SPECT in neuropsychiatric disorders: neuro biological background, methodology, findings and future perspectives

    International Nuclear Information System (INIS)

    Gardner, Ann; Pagani, Marco

    2003-01-01

    The origin of altered radiotracer uptake and distribution in functional brain imaging studies, often considered to reflect regional cerebral blood flow (rCBF), in psychiatric disorders is unknown. Interpreting the magnitude of changes as changes in the magnitude of neuronal activity may be reasonable during normal circumstances, but less reliable in pathologic states. Results of published 99mTc-HMPAO SPECT studies in unmedicated patients with schizophrenia and major depression are discussed in the light of 99mTc-HMPAO properties, and reported findings of altered cell morphology and biochemistry, with emphasis on energy metabolism. We conclude that the SPECT technique using radiotracers with known biochemical properties will become useful in the understanding of cellular dysfunctions at different phases of neuropsychiatric disorders, and that use of automatic interpretation of three-dimensional volumes will allow for easier identification of regional neural correlates of the different psychiatric symptoms (Au)

  3. The validation and the limits of SPECT for patients suffering from cerebrovascular accidents

    International Nuclear Information System (INIS)

    Mizukawa, Norihiko; Yano, Ichiro; Tenjin, Hiroshi

    1989-01-01

    Contemporaneous single photon emission computed tomography (SPECT) and positron emission tomography (PET) were performed in 10 patients with cerebrovascular accidents (CVA), whose ages ranged from 11 to 67 years. I-123-isopropyl-iodoamphetamine (IMP) and/or Tc-99m hexamethylpropyleneamine oxime (HM-PAO) were used for SPECT. Cerebral blood flow (CBF), oxygen extraction fraction (OEF), and cerebral metabolic rate for oxygen (CMRO 2 ) were measured by an O-15 labelled gas continuous-inhalation method. SPECT images were quite similar to CBF and CMRO 2 during the chronic stage of CVA. Two patietns with vasospasm during the subacute stage had apparently low CBF and CMRO 2 on PET, but did not have low perfusion on SPECT. Luxury perfusion areas were detected in 4 subacute stage patients and one chronic stage patient. A redistribution of IMP was detected in two patients with infarction during subacute stage. CMRO 2 value in such an area was 2.0 ml/100 g/min. Low CBF and/or CMRO 2 areas were well visualized by IMP rather than by HM-PAO SPECT. (N.K.)

  4. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    International Nuclear Information System (INIS)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui

    2007-01-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr ∼ 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1∼9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI

  5. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr {approx} 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1{approx}9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI.

  6. Clinical Significance of Brain SPECT in Zipeprol Abusers

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil [Kyung Hee University College of Medicine, Seoul (Korea, Republic of)

    1993-03-15

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  7. Clinical Significance of Brain SPECT in Zipeprol Abusers

    International Nuclear Information System (INIS)

    Cho, Dai Ok; Kim, Jae Phil; Kim, Deog Yoon; Yang, Hyung In; Koh, Eun Mi; Kim, Kwang Won; Choi, Young Kil

    1993-01-01

    Drug abuse is widespread in worldwide and has been associated with neurologic complication. Zipeprol is one of drugs which been abused for psychological satisfaction in some adolescents. This agent is non-opioid antitussive agent, which is not legally considered as being capable of creating dependence or abuse liability at therapeutic serum levels. But it has been reported that acute or chronic overdose create neurologic complication such as convulsion as well as dependence. Recently we experienced six zipeprol abusers who admitted due to convulsion and variable neurologic symptoms. The aim of our study was to determine the role of Tc-99m- HMPAO brain SPECT in those patients. EEG and brain CT showed no abnormal finding, but brain SPECT showed focal or multiple perfusion abnormalities in frontal, parietal, occipital cortex, basal ganglia, thalamus and especially at temporal cortex. These results suggest that brain SPECT may be a useful diagnostic tool to evaluate the cerebral dysfunction induced by zipeprol abuse.

  8. Regional cerebral blood flow in various pediatric neurological patients using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-01-01

    The recent development of a new radiopharmaceutical 123 I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using 123 I-IMP SPECT may reveal functional abnormalities as well as organic lesions. 123 I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases. (author)

  9. Quantitation of cerebral blood volume by 99mTc-DTPA-HSA SPECT

    International Nuclear Information System (INIS)

    Inoue, Yusuke; Machida, Kikuo; Momose, Toshimitsu

    1992-01-01

    The characteristics of technetium-99m diethylenetriaminepentaacetic acid human serum albumin ( 99m Tc-DTPA-HSA) as an agent for quantitation of cerebral blood volume (CBV) were examined. The radioactivity after decay correction as a percentage of the activity at 10 minutes was 84.3±1.3% at 120 minutes after the injection of 99m Tc-DTPA-HSA. Radioactivity was found exclusively in plasma, with little in blood cells. The blood retention of 99m Tc-DTPA-HSA is sufficient, and its use in the quantitation of CBV omits the need for centrifugation of the blood sample. CBV quantified using the tracer and a SPECT system with a single-head rotating gamma camera was 4.09±0.60 ml/100g brain, similar to values reported previously. Two serial SPECT scans provided similar images, and the CBV values determined by the two scans were closely correlated (p 99m Tc-DTPA-HSA has useful properties for quantitative CBV measurement and that quantitation of CBV by 99m Tc-DTPA-HSA SPECT is feasible using a system with a single-head rotating gamma camera. (author)

  10. Deficits in Regional Cerebral Blood Flow on Brain SPECT Predict Treatment Resistant Depression.

    Science.gov (United States)

    Amen, Daniel G; Taylor, Derek V; Meysami, Somayeh; Raji, Cyrus A

    2018-03-22

    Depression remains an important risk factor for Alzheimer's disease, yet few neuroimaging biomarkers are available to identify treatment response in depression. To analyze and compare functional perfusion neuroimaging in persons with treatment resistant depression (TRD) compared to those experiencing full remission. A total of 951 subjects from a community psychiatry cohort were scanned with perfusion single photon emission computed tomography (SPECT) of the brain in both resting and task related settings. Of these, 78% experienced either full remission (n = 506) or partial remission (n = 237) and 11% were minimally responsive (n = 103) or non-responsive (11%. n = 106). Severity of depression symptoms were used to define these groups with changes in the Beck Depression Inventory prior to and following treatment. Voxel-based analyses of brain SPECT images from full remission compared to the worsening group was conducted with the statistical parametric mapping software, version 8 (SPM 8). Multiple comparisons were accounted for with a false discovery rate (p <  0.001). Persons with depression that worsened following treatment had reduced cerebral perfusion compared to full remission in the multiple regions including the bilateral frontal lobes, right hippocampus, left precuneus, and cerebellar vermis. Such differences were observed on both resting and concentration SPECT scans. Our findings identify imaging-based biomarkers in persons with depression related to treatment response. These findings have implications in understanding both depression to prognosis and its role as a risk factor for dementia.

  11. Regional cerebral blood flow in various pediatric neurological patients using /sup 123/I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Konishi, Tohru; Naganuma, Yoshihiro; Hongou, Kazuhisa; Murakami, Miyako; Yamatani, Miwa; Okada, Toshio

    1988-03-01

    The recent development of a new radiopharmaceutical /sup 123/I-isopropyl-iodoamphetamine (IMP), which is taken up by the brain from the blood flow, has offered a possibility of constructing scintigraphy maps of regional cerebral blood flow (rCBF) using single photon emission CT. We used this mehtod in various pediatric neurological diseases. Six patients with cerebro-vascular disorders (moya-moya disease 2, infarction 3 and HHE syndrome 1), 6 patients with infectious diseases of CNS (acute encephalitis 4, septic meningitis 1 and SSPE 1) and a miscellaneous group of six patients were studied. The rCBF abnormalities in cerebro-vascular diseases were more extensive and frequent than x-ray CT abnormalities. Repeated studies of IMP-SPECT revealed usefulness for the understanding of changeable hemodynamic pathophysiology and for the judgment of theraptic effectiveness and prognosis. The rCBF decrease in infectious diseases tended to be more diffuse and slight than that in cerebro-vascular diseases. In almost all patients, the area of rCBF decrease coincided with the area of EEG slowing evaluated by EEG topographic analysis. Brain imaging using /sup 123/I-IMP SPECT may reveal functional abnormalities as well as organic lesions. /sup 123/I-IMP SPECT has introduced a new era for the useful application of nuclear medicine to the investigation of pediatric neurological diseases.

  12. The value of rCBF brain SPECT in assessing visual function of patients with honeymoons hemianopia

    International Nuclear Information System (INIS)

    Xie Ruiman; Yao Jingli; Qing Zheng

    1995-01-01

    Comparison of 99m Tc-HMPAO brain SPECT imaging of 8 cases with honeymoons hemianopia (HH) was taken before and after a course of oriented dynamic color photic stimulation (ODCPS). It was suggested that ODCPS in patients with HH was an effective method for increasing visual field and improving visual function. Cerebral metabolic patterns reflected the mechanism of ODCPS effecting the patients with HH. The retinal midbrain-occipital visual path-way may play an important role in mediating the increase of visual field and restoration of visual function. It was also concluded that brain SPECT imaging was an useful method for the studying of brain function

  13. Dementia and functional cerebral imaging a reevaluation

    International Nuclear Information System (INIS)

    Steinling, M.; Lecouffe, P.; Pham, T.; Charpentier, P.; Delebvre, L.; Lavenu, I.; Pasquier, F.; Charpentier, P.; Duhamel, A.

    2000-01-01

    New concepts which concerned especially the nosologic classification of dementia as for example Dementia with Lewy Bodies (DLB) incite to revalue the main characteristics of the regional cerebral blood flow measurements studied by SPECT in several forms of dementia. SPECT analysis with 99m-Technetium HMPAO (555 MBq) was performed to 20 patients with probable DLB, 20 patients with probable Alzheimer's disease (AD) and 20 patients with Fronto-Temporal dementia (FTD). Ten pairs of regions of interest were analysed. Tracer uptake was expressed as a cortico-cerebellar activity ratio. Statistical analysis of index of fixation was performed using an univariate analysis of variance, and a selection of significative ROIs was performed using two cut-off values (80 and 82.5 %). In the FTD group, a decrease of HMPAO uptake in frontal cortical regions of interest (internal, lateral and posterior) was observed. In the DLB group the decrease of HMPAO uptake was widespread and concerned all the cortical regions of interest except the posterior frontal and occipital regions. Finally in the AD group there was a limited temporal and parietal hypoperfusion more marked on the left side without frontal hypoperfusion. This last result was obtained whatever the cognitive impairment. Consequently it seems that the frontal hypoperfusion previously reported in AD groups was induced by the fact that patients with DLB were also included because the diagnosis was not established. In conclusion we estimate that SPECT studies could be used more often in clinical research especially for a classification approach of dementia. (authors)

  14. Cerebral scintigraphy by {sup 99m}Tc-HMPAO in sleep apnea syndromes (SAS) during the wakeful state; Scintigraphie cerebrale au Tc99m-HMPAO dans les syndromes d`apnees du sommeil (SAS) pendant l`etat de veille

    Energy Technology Data Exchange (ETDEWEB)

    Tainturier, C.; Benamor, M.; Hausser-Hauw, C.; Rakotonanahary, D.; Fleury, B. [CMC FOCH 92150 SURESNES (France)

    1997-12-31

    The SAS is associated to cerebral hemodynamic modifications and to a high frequency of cerebro-vascular accidents. The aim of this study was to verify, during wakeful state, the cerebral hemodynamic in 14 patients afflicted with SAS of various intensity (Apnea Index = 5-120/h). 555 MBq of {sup 99m}Tc-HMPAO were injected in patients maintained awake. The images were obtained 20 minutes after injection by mean of a double-head chamber equipped with fan-beam collimators. They were interpreted visually by two independent readers. Anomalies of cerebral fixation were observed in 12/14 patients. They were small sores of diffuse hypo-fixations, with a `riddly` aspect (4 cases), sores of bi-temporal hypo-fixation with a right- or left- hemispheric predominance (6 cases), or right fronto-temporal hypo-fixations (2 cases). The cerebral fixation anomalies were reported in the SASs. Ficker et al (1997) have shown in-sleep frontal hypo-perfusions in 5/14 apneic patients, reversible under continuous positive airing pressure (CPAP). In conclusion, anomalies of cerebral fixation exist in SAS-carrying patients, even in the wakeful state. Questions about hypoperfusion, pre-lacunar syndrome, atrophy still remain. A check of this study is planned after the CPAP treatment to determine the hemodynamic or anatomic origin and the anomaly reversibility

  15. Prediction of language and neurologic recovery after cerebral infarction with SPECT imaging using N-isopropyl-p-(I-123) iodoamphetamine

    International Nuclear Information System (INIS)

    Bushnell, D.L.; Gupta, S.; Mlcoch, A.G.; Barnes, W.E.

    1989-01-01

    Fourteen patients (10 with left-sided and 4 with right-sided cerebral infarction) were prospectively studied with single-photon emission computed tomography (SPECT) using N-isopropyl-p-(I-123) iodoamphetamine (IMP, SPECTamine) to determine its usefulness in predicting neurologic/language recovery after cerebral infarction. All neuro-SPECT imaging was performed within 30 days after infarction. Detailed assessment of neurologic and/or language recovery (after 3 months) was carried out prospectively in each patient. Patients with smaller volume IMP defects in the region of infarction demonstrated significantly better neurologic and language recovery than patients with large IMP defects. Analysis of the IMP ''redistribution'' phenomenon failed to demonstrate definitively a relationship with clinical recovery. It was concluded that the volume of the IMP defect can aid in predicting recovery potential after cerebral infarction

  16. Cerebral blood flow of the non-affected brain in patients with malignant brain tumors as studied by SPECT

    International Nuclear Information System (INIS)

    Araki, Yuzo; Imao, Yukinori; Hirata, Toshifumi; Ando, Takashi; Sakai, Noboru; Yamada, Hiroshi

    1990-01-01

    In 40 patients (age range, 20-69 years) receiving radiation and chemotherapy for brain tumors, the mean cerebral blood flow (mCBF) in the non-affected area has been examined by single photon emission CT (SPECT) with Xe-133. Forty volunteers (age range, 25-82 years) served as controls. Although mCBF during external irradiation was transiently increased, it was significantly decreased at 3 months after beginning of external irradiation compared with that in the control group. Factors responsible for the decrease in mCBF were radiation doses, lesion volume, the degree of cerebral atrophy, and age; this was more pronounced when chemotherapy such as ACNU was combined with radiation. A decreased mCBF was independent of intraoperative radiation combined with external radiation and either local or whole brain irradiation. SPECT with Xe-133 was useful in determining minute changes in cerebral blood flow that precedes parenchymal brain damage. (N.K.)

  17. Memory-provoked rCBF-SPECT as a diagnostic tool in Alzheimer's disease?

    International Nuclear Information System (INIS)

    Sundstroem, Torbjoern; Riklund, Katrine Aa.; Elgh, Eva; Naesman, Birgitta; Larsson, Anne; Nyberg, Lars

    2006-01-01

    Alzheimer's disease (AD) is a primary degenerative disease that progressively affects all brain functions, with devastating consequences for the patient, the patient's family and society. Rest regional cerebral blood flow (rCBF) could have a strategic role in differentiating between AD patients and normal controls, but its use for this purpose has a low discriminatory capacity. The purpose of this study was to evaluate whether the diagnostic sensitivity of rCBF single-photon emission computed tomography (SPECT) could be increased by using an episodic memory task provocation, i.e. memory-provoked rCBF-SPECT (MP-SPECT). Eighteen persons (73.2±4.8 years) with mild AD and 18 healthy elderly (69.4±3.9 years) were included in the study. The subjects were injected with 99m Tc-hexamethylpropylene amine oxime (HMPAO) during memory provocation with faces and names, followed by an rCBF-SPECT study. The rCBF 99m Tc-HMPAO SPECT images were analysed using statistical parametric mapping (SPM2). Peaks with a false discovery rate corrected value of 0.05 were considered significant. On MP-SPECT, the AD group showed a significant rCBF reduction in the left parietal cortex in comparison with healthy elderly. At rest, no significant group differences were seen. Memory provocation increased the sensitivity of rCBF-SPECT for the detection of AD-related blood flow changes in the brain at the group level. Further studies are needed to evaluate MP-SPECT as a diagnostic tool at the individual level. If a higher sensitivity for AD at the individual level is verified in future studies, a single MP-SPECT study might be sufficient in the clinical setting. (orig.)

  18. Cerebral perfusion inhomogeneities in schizophrenia demonstrated with single photon emission computed tomography and Tc99m-hexamethylpropyleneamineoxim

    International Nuclear Information System (INIS)

    Bajc, M.; Basic, M.; Topuzovic, N.; Babic, C.; Medved, V.

    1989-01-01

    Cerebral blood flow was measured in relative terms with Tc99m-hexamethylpropyleneamineoxim (HMPAO) and single photon emission computed tomography (SPECT) in 28 female schizophrenic patients (20 acute and 8 chronic) classified according to DSM-III. Eleven normals served as controls. The acute patients were classified according to positive and negative symptoms. Patients with predominantly positive symptoms showed by and large normal and homogeneous cerebral isotope uptake. Those with negative symptoms, and the chronic patients, showed inhomogeneous tracer uptake with multiple regions of hypoperfusion in slices 4-6 cm above the orbitomeatal line. The findings support in principle the notion that schizophrenia with negative or chronic symptoms does not affect the whole brain homogeneously. Brain imaging with Tc99m-HMPAO and SPECT might be used to distinguish various types of schizophrenia. (author)

  19. Effects of scatter correction on regional distribution of cerebral blood flow using I-123-IMP and SPECT

    International Nuclear Information System (INIS)

    Ito, Hiroshi; Iida, Hidehiro; Kinoshita, Toshibumi; Hatazawa, Jun; Okudera, Toshio; Uemura, Kazuo

    1999-01-01

    The transmission dependent convolution subtraction method which is one of the methods for scatter correction of SPECT was applied to the assessment of CBF using SPECT and I-123-IMP. The effects of scatter correction on regional distribution of CBF were evaluated on a pixel by pixel basis by means of an anatomic standardization technique. SPECT scan was performed on six healthy men. Image reconstruction was carried out with and without the scatter correction. All reconstructed images were globally normalized for the radioactivity of each pixel, and transformed into a standard brain anatomy. After anatomic standardization, the average SPECT images were calculated for scatter corrected and uncorrected groups, and these groups were compared on pixel by pixel basis. In the scatter uncorrected group, a significant overestimation of CBF was observed in the deep cerebral white matter, pons, thalamus, putamen, hippocampal region and cingulate gyrus as compared with scatter corrected group. A significant underestimation was observed in all neocortical regions, especially in the occipital and parietal lobes, and the cerebellar cortex. The regional distribution of CBF obtained by scatter corrected SPECT was similar to that obtained by O-15 water PET. The scatter correction is needed for the assessment of CBF using SPECT. (author)

  20. Cerebral perfusion and automated individual analysis using SPECT among an obsessive-compulsive population

    Directory of Open Access Journals (Sweden)

    Euclides Timóteo da Rocha

    2011-01-01

    Full Text Available OBJECTIVE: To make individual assessments using automated quantification methodology in order to screen for perfusion abnormalities in cerebral SPECT examinations among a sample of subjects with OCD. METHODS: Statistical parametric mapping (SPM was used to compare 26 brain SPECT images from patients with OCD individually with an image bank of 32 normal subjects, using the statistical threshold of p < 0.05 (corrected for multiple comparisons at the level of individual voxels or clusters. The maps were analyzed, and regions presenting voxels that remained above this threshold were sought. RESULTS: Six patients from a sample of 26 OCD images showed abnormalities at cluster or voxel level, considering the criteria described above, which represented 23.07%. However, seven images from the normal group of 32 were also indicated as cases of perfusional abnormality, representing 21.8% of the sample. CONCLUSION: The automated quantification method was not considered to be a useful tool for clinical practice, for analyses complementary to visual inspection.

  1. SPECT determination of regional cerebral blood flow in hypertensive patients before and after clonidine

    International Nuclear Information System (INIS)

    Devous, M.D.; Reed, W.G.; Chehabi, H.H.; Bonte, F.J.

    1985-01-01

    Regional cerebral blood flow (rCBF) was determined by SPECT of 133-Xe inert gas washout in 18 hypertensive patients (PTS) upon admission and after treatment with oral clonidine (CL, 0.2 mg, then 0.1 mg/hr until diastolic pressure reached 105 mm Hg or fell by 30 mm Hg). CL reduced mean arterial pressure (MAP) from 160 (200/140) to 133 (150/100) mm Hg over 4-6 hr. RCBF was quantitated in 14 gray matter regions from cross-sectional images and analyzed for differences from normal controls and changes with CL. Initial rCBF was lower in HI PTS than in either normal controls of LO PTS in all brain regions. CL lowered MAP in HI PTS by 52 +- 15 mm Hg and caused reduction in all gray matter regions except right frontal and right temporal (mean reduction 5 +- 2 ml/min/100 g, rho<.05). RCBF images were also evaluated by two trained observers for initial regional defects and for changes with CL. LO PTS were more likely to have defects in rCBF images at rest which would resolve with CL. HI PTS frequently had normal images at rest and developed defects with CL. In summary, the study suggests that SPECT may be useful in detecting rCBF abnormalities in hypertensive PTS at rest and following reductions in MAP

  2. Regional cerebral blood flow in Parkinson's disease measured with N-isopropyl-p-[123I]iodoamphetamine (IMP) SPECT

    International Nuclear Information System (INIS)

    Odano, Ikuo; Nishihara, Mamiko; Hayashi, Hiroko; Higuchi, Shoichi; Sakai, Kunio; Ishikawa, Atsushi; Ibayashi, Katsuhiko.

    1992-01-01

    N-isopropyl-p-[ 123 I]iodoamphetamine (IMP) SPECT studies were performed on 21 patients (13 females; 45-73 yrs) with idiopathic Parkinson's disease (PD) and 10 age-matched normal controls (39-69 yrs). Regional cerebral blood flow (rCBF) was quantitatively measured by the arterial blood sampling method. When compared with normal controls, global CBF, and rCBF in the frontal cortex and in the basal ganglia were reduced 22.1% (p 123 I-IMP SPECT imaging is useful for evaluation and follow-up of patients with PD. (author)

  3. Prediction of cerebral ischemia due to cerebral vasospasm in SAH using SPECT and sup 123 I-IMP with acetazolamide test

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawara, Jyoji; Wada, Keiji; Takeda, Rihei; Usami, Takashi; Hashimoto, Ikuo; Shimazaki, Mitsuteru; Tanaka, Chiharu; Nakamura, Jun-ichi (Nakamura Memorial Hospital, Sapporo (Japan)); Suematsu, Katsumi

    1989-11-01

    To investigate the possibility of predicting cerebral ischemia due to cerebral vasospasm in subarachnoid hemorrhage (SAH), serial evaluation of the cerebral vasodilatory capacity by the acetazolamide test was conducted, using single photon emission computed tomography (SPECT) and N-isopropyl {sup 123}I-p-iodoamphetamine (IMP), in 17 patients with cerebral vasospasm following early surgery for ruptured aneurysms. The degree of vasospasm measured on the angiograms was classified into the following three types; mild degree (25%>stenosis), moderate degree (25{approx}50% stenosis), and severe degree(50%cerebral vasodilatory capacity was preserved at the normal level during the period of vasospasm. In eight patients with asymptomatic vasospasm (moderate degree), a transient limitation of cerebral vasodiratory capacity was observed between the 6th and 16th day after a rupture of the cerebral aneurysm. In five patients with symptomatic vasospasm resulting in reversible ischemia, a marked limitation of cerebral vasodilatory capacity was noted between the 7th and 15th day, and a delayed recovery of cerebral vasodilatory capacity was observed. This reversibility of cerebral vasodilatory capacity in patients with cerebral vasospasm suggests that a local decrease of purfusion pressure due to cerebral vasospasm causes compensatory vasodilation of intraparenchymal arteries and the vasodilatory reaction to acetazolamide was limited until the release of the cerebral vasospasm. Therefore, assessment of cerebral vasodilatory capacity in SAH by the acetazolamide test might predict the appearance and continuation of potential ischemia of the brain caused by the reduction of perfusion pressure due to cerebral vasospasm. (J.P.N.).

  4. Regional cerebral blood flow in epileptic foci using [I-123] IMP-SPECT

    International Nuclear Information System (INIS)

    Konishi, Tohru

    1989-01-01

    Fifty-six epileptic patients, whose ages ranged from 6 months to 16 years (a mean age, 8 years and 2 months), were examined by single photon emission computed tomography (SPECT) with [I-123] N-isopropyl p-iodoamphetamine (IMP). Of these patients, 44 had partial seizures (PS) and 12 had generalized seizures (GS). SPECT revealed abnormality of regional cerebral blood flow (rCBF) in 24 PS patients (54.5%), being correlated with EEG abnormality. Among the 24 patients, 22 had a decreased rCBF and 2 others had an increased rCBF. According to the PS type, rCBF abnormality in the foci was less frequently observed for benign age-related partial epilepsy (2/9) than for the other types of partial epilepsy (22/35). Among 35 patients with the other types of partial epilepsy, SPECT showed foci in the frontal (12), central (3), parietal (4), temporal (6), and occipital (6) regions, and diffuse spike-wave or the lack of paroaxysmals (4). The EEG foci was of the left hemisphere in 12 patients, and of the right hemisphere in 18 patients. Higher incidence of rCBF abnormality was associated with the temporal, partietal, and frontal foci than with the occipital foci. There was no correlation between the incidence of rCBF abnormlaity and the frequency of seizure activities on EEG. Complex partial seizures had a tendency to be associated with rCBF abnormality. In comparing IMP uptake in evaluable 17 patients with a decreased rCBF, a mean %CBF in foci compared to that in the contralateral area was 91.9%. All of the 12 GS patients showed no focal reduction of rCBF around the cortex. Patients with tonic-clonic seizure and myoclonic seizure had almost normal IMP images. The IMP images of organic lesions were a marked reduction of rCBF. IMP-SPECT may also be suitable for evaluating the underlying organic and secondary involving disorders with epilepsy. (N.K.)

  5. Increased rCBF in gray matter heterotopias detected by SPECT using 99mTc hexamethyl-propylenamine oxime

    International Nuclear Information System (INIS)

    Henkes, H.; Klinikum Rudolf Virchow, Berlin; Hosten, N.; Cordes, M.; Neumann, K.; Hansen, M.L.

    1991-01-01

    Imaging findings of morphology and regional cerebral blood flow in two patients suffering from epileptic seizures are presented. CT and MRI revealed heterotopic gray matter as a probable structural correlate, causing the seizure disorder. 99m Tc hexamethyl-propylenamine oxime (HM-PAO) SPECT demonstrated focally increased regional cerebral blood flow in both patients in the areas of their heterotopic lesions. Heterotopic and orthotopic gray matter seem to have similar features in terms of regional perfusion. A focally increased brain perfusion in interictal epileptic patients may indicate an underlying migration anomaly. (orig.)

  6. SPECT and PET in cerebrovascular diseases. SPECT und PET bei cerebrovaskulaeren Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, W.H. (Herzzentrum Nordrhein-Westfalen, Bad Oeynhausen (Germany). Inst. fuer Nuklearmedizin)

    1993-02-01

    Investigations using recently emerged perfusion tracers for SPECT, Tc-99m-HMPAO in particular, and studies of local glucose metabolism and oxygen utilisation with PET have deepened our knowledge of the pathophysiology in development and in the sequel of stroke. Studies of local cerebral blood flow and cerebrovascular reserve capacity are indicated in case of neurological symptoms suspected to be caused by transient ischemic attacks or in case of significant narrowing of the cerebral arteries. PET investigations of local metabolism (at the present state) are indicated in patients with incompleted stroke or with infarction and extended ischemic border zone. The differential diagnosis between multi-infarct-dementia and primarily neurodegenerative dementias is facilitated, in some individuals, by the characteristic topography of reduced flow. (orig./MG).

  7. Investigation of regional cerebral blood flow in alcoholic Korsakoff's syndrome with 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Nakamura, Makoto; Nomura, Soichiro; Kato, Motoichiro; Nakazawa, Tsuneyuki.

    1995-01-01

    Regional cerebral blood flow (rCBF) was determined quantitatively by single photon emission computed tomography (SPECT) using N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP) in 6 patients with alcoholic Korsakoff's syndrome (A group). The findings were compared with concurrently available findings from 6 alcoholic patients with no evidence of cerebral disordres such as Korsakoff's syndrome and dementia (B group) and 4 healthy persons (C group). In both A and B groups, diffuse decrease in blood flow was significantly observed in the entire brain, as compared with the C group; no significant difference in the decreased blood flow existed between the A and B groups. According to the WAIS results, the patients in the A group were classified as 'typical Korsakoff's syndrome' (full IQ of 90 or more) and as 'serious Korsakoff's syndrome' (full IQ of 89 or less). rCBF in the thalamus was significantly lower in the A group of patients with typical Korsakoff's syndrome than the B group. These findings may reflect the variety of alcoholic Korsakoff's syndrome. This may also have an implication for the possible classification of several types in this syndrome. (N.K.)

  8. Culturated rat cerebral cortex explants and their application in the study of SPECT scan radiopharaceuticals

    International Nuclear Information System (INIS)

    Jong, B.M. de.

    1989-01-01

    In this thesis mechanics that result in the distinct localization of radiopharmaceuticals within the brain have been investigated. In order to 'get more insight' in uptake and binding of radiopharmaceuticals bu brain tissue, use has been made of the tissue culture technique. Tissue culture privides the opportunity of doing experiments with brain tissue under stable conditions, in the absence of a blood-brain barrier, and without interference by cerebral blood flow. The present thesis is presented in two sections. The first part focusses on longterm culture of 'organotypic' cerebral neocortex tissue, obtained from neonatal rat brain and explanted into a chemically defined medium. Procedures were developed which enabled culturing of this tissue without the occurence of central necrosis and with the preservation of a characteristic histiotypic organization. Morphological characteristics of the cultures were described and measured at various ages in vitro. In the second part, the cultures were used to study mechanisms that might contribute to the tissue uptake of radiopharmaceuticals which are in clinical use for SPECT brain imaging. (author). 369 refs.; 50 figs.; 13 tabs

  9. Cerebral blood flow measurement using 123I-IMP graph plot method with SPECT. Comparison with autoradiography method

    International Nuclear Information System (INIS)

    Shinohara, Yuki; Kamitani, Hideki; Ishibashi, Minako; Ito, Satoru; Ogawa, Toshihide

    2011-01-01

    The purpose of this study was to evaluate quantification of cerebral blood flow (CBF) values using 123 I-iodoamphetamine (IMP) graph plot (GP) method with single photon emission computed tomography (SPECT), compared with autoradiography (ARG) method. IMP-SPECT by GP combined with ARG method at rest was performed in 40 patients to determine the equation of linear regression for GP method in our institution. In addition, we compared regional CBF (rCBF) values at rest between GP and ARG methods in 10 other patients. Among all 50 patients, acetazolamide (ACZ)-challenged SPECT by GP combined with ARG method using 2-day protocol was performed in 10 patients. We also compared the rCBF values after ACZ challenge between GP and ARG methods in these 10 patients. The equation of linear regression for GP method in our institution was y=1.945x+20.36 (R 2 =0.586, P 2 =0.624, P 2 =0.150, P<0.001). IMP-SPECT by GP method at rest is useful to measure reliable rCBF values without arterial blood sampling, although we need pay attention to interpret the result of 2-day protocol ACZ-challenged SPECT by GP method. (author)

  10. Quantitative measurement of regional cerebral blood flow using {sup 99m}Tc-HM-PAO SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Hisashi; Nakamura, Yusaku; Yagi, Yuji; Miura, Kosuke; Takahashi, Mitsuo [Kinki Univ., Osaka-Sayama, Osaka (Japan)

    1994-10-01

    This study examined a simple method for measuring the regional cerebral blood flow (rCBF) using {sup 99m}Tc-HM-PAO SPECT. The mean CBF (mCBF) was determined by the Patlack plot method and rCBF was calculated with Lassen`s correction algorithm, as reported by Matsuda et al. The cerebral hemisphere was employed as the reference region for Lassen`s correction. The reference RI count rate was calculated from the left cerebral hemisphere at the basal ganglia level and the correction factor {alpha} was fixed at 2.0. As a result, rCBF could be measured more easily than by Matsuda`s method. The contribution of age, laterality and gender to the CBF of normal subjects were studied. The mCBF value of 26 normal subjects was 53.8{+-}6.4 ml/100 g/min and showed a significant correlation with advancing age (R=0.644, p=0.0004, n=26). The mean values for rCBF of the cerebellum, frontal area, temporal area, occipital area and parietal area were 77.3{+-}6.6 ml/100 g/min, 70.2{+-}9.1 ml/100 g/min, 72.3{+-}7.5 ml/100 g/min, 71.8{+-}6.2 ml/100 g/min and 73.8{+-}8.6 ml/100 g/min, respectively. There were no gender or laterality differences in the mCBF or respective rCBF values. Each of the above listed regions, except for the occipital area, demonstrated a significant correlation with advancing age. The most remarkable decrease in rCBF with age was noted in the frontal area (R=0.757, p=0.001, n=26). (author).

  11. Quantitative measurement of regional cerebral blood flow using 99mTc-HM-PAO SPECT

    International Nuclear Information System (INIS)

    Tanaka, Hisashi; Nakamura, Yusaku; Yagi, Yuji; Miura, Kosuke; Takahashi, Mitsuo

    1994-01-01

    This study examined a simple method for measuring the regional cerebral blood flow (rCBF) using 99m Tc-HM-PAO SPECT. The mean CBF (mCBF) was determined by the Patlack plot method and rCBF was calculated with Lassen's correction algorithm, as reported by Matsuda et al. The cerebral hemisphere was employed as the reference region for Lassen's correction. The reference RI count rate was calculated from the left cerebral hemisphere at the basal ganglia level and the correction factor α was fixed at 2.0. As a result, rCBF could be measured more easily than by Matsuda's method. The contribution of age, laterality and gender to the CBF of normal subjects were studied. The mCBF value of 26 normal subjects was 53.8±6.4 ml/100 g/min and showed a significant correlation with advancing age (R=0.644, p=0.0004, n=26). The mean values for rCBF of the cerebellum, frontal area, temporal area, occipital area and parietal area were 77.3±6.6 ml/100 g/min, 70.2±9.1 ml/100 g/min, 72.3±7.5 ml/100 g/min, 71.8±6.2 ml/100 g/min and 73.8±8.6 ml/100 g/min, respectively. There were no gender or laterality differences in the mCBF or respective rCBF values. Each of the above listed regions, except for the occipital area, demonstrated a significant correlation with advancing age. The most remarkable decrease in rCBF with age was noted in the frontal area (R=0.757, p=0.001, n=26). (author)

  12. Quantification of cerebral blood flow and its clinical usefulness. Application of SPECT to psychiatry

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Uema, Takeshi; Kogure, Daisuke; Takano, Harumasa; Terada, Tomo [National Center Hospital for Mental, Nervous and Muscular Disorders, Kodaira, Tokyo (Japan)

    1998-10-01

    Brain perfusion SPECT using {sup 99m}Tc-ethyl-cysteinate dimer ({sup 99m}Tc-ECD) was applied to psychiatric diseases with aid of statistical parametric mapping (SPM) for analysis of data. To evaluate influence of aging on brain perfusion, noninvasive measurements of cerebral blood flow using {sup 99m}Tc-ECD were performed in 53 normal volunteers, aged 18 to 87 years old. Mean cerebral blood flow (mCBF) was 43.9{+-}5.0 ml/100 g/min and showed weak negative correlation with aging (r=-0.451). Perisylvian cerebral cortices and medial frontal areas including anterior cingulate gyri showed greater negative correlation than other areas. These findings suggest the necessity of age-matched control regional CBF (rCBF) data to investigate rCBF abnormality in patients. Four drug-naive schizophrenic patients showed flow decrease in bilateral frontal and superior temporal areas and a left infero-posterior temporal area. Haloperidol administration induced flow decrease in bilateral frontal and left parietal areas, while flow increase in bilateral striatal and right hippocampal areas. Ten aged depressive patients showed flow decrease in bilateral frontal and left temporo-parietal areas. Even after remission patients showed flow decrease in the left frontal area as compared with normal subjects. Remission induced flow increase in the right frontal, right parietal, and right orbitofrontal areas compared with depression. These results suggest that CBF measurements using {sup 99m}Tc-ECD are useful for objective evaluation of regional abnormality in brain function in psychiatric diseases. (author)

  13. Memory-provoked rCBF-SPECT as a diagnostic tool in Alzheimer's disease?

    Energy Technology Data Exchange (ETDEWEB)

    Sundstroem, Torbjoern; Riklund, Katrine Aa. [Umeaa University, Umeaa University Hospital, Department of Radiation Sciences, Diagnostic Radiology, Umeaa (Sweden); Elgh, Eva; Naesman, Birgitta [Umeaa University, Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeaa (Sweden); Larsson, Anne [Umeaa University, Department of Radiation Sciences, Radiation Physics, Umeaa (Sweden); Nyberg, Lars [Umeaa University, Department of Psychology, Umeaa (Sweden)

    2006-01-01

    Alzheimer's disease (AD) is a primary degenerative disease that progressively affects all brain functions, with devastating consequences for the patient, the patient's family and society. Rest regional cerebral blood flow (rCBF) could have a strategic role in differentiating between AD patients and normal controls, but its use for this purpose has a low discriminatory capacity. The purpose of this study was to evaluate whether the diagnostic sensitivity of rCBF single-photon emission computed tomography (SPECT) could be increased by using an episodic memory task provocation, i.e. memory-provoked rCBF-SPECT (MP-SPECT). Eighteen persons (73.2{+-}4.8 years) with mild AD and 18 healthy elderly (69.4{+-}3.9 years) were included in the study. The subjects were injected with{sup 99m}Tc-hexamethylpropylene amine oxime (HMPAO) during memory provocation with faces and names, followed by an rCBF-SPECT study. The rCBF{sup 99m}Tc-HMPAO SPECT images were analysed using statistical parametric mapping (SPM2). Peaks with a false discovery rate corrected value of 0.05 were considered significant. On MP-SPECT, the AD group showed a significant rCBF reduction in the left parietal cortex in comparison with healthy elderly. At rest, no significant group differences were seen. Memory provocation increased the sensitivity of rCBF-SPECT for the detection of AD-related blood flow changes in the brain at the group level. Further studies are needed to evaluate MP-SPECT as a diagnostic tool at the individual level. If a higher sensitivity for AD at the individual level is verified in future studies, a single MP-SPECT study might be sufficient in the clinical setting. (orig.)

  14. A study of cerebral circulation in elderly patients with dementia using sup 123 I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Arai, Hisayuki [Tokyo Medical Coll. (Japan)

    1991-03-01

    In order to elucidate the pathogenesis of senile dementia of Alzheimer type (SDAT) and multi-infarct dementia (MID), 18 age-matched controls, 22 SDAT cases, 10 MID cases, and 15 multiple infarction without dementia (MI) cases, totaling 65 cases, were enrolled into a study of cerebral blood flow using single photon emission CT (SPECT) with N-isopropyl-p-({sup 123}I)iodoamphetamine (IMP). The diagnosis of dementia was made based on the clinical history, findings of brain CT, MRI, and Hachinski's ischemic score. Lateral asymmetric perfusion was evaluated by using the asymmetry index (AI). Quantitative cerebral blood flow was analyzed by using the venous blood sampling method with IMP SPECT. Cerebral infarction, ischemic changes, and brain atrophy were diagnosed by CT and MRI. mCBF values were significantly lower in SDAT and MID than in those of controls, while rCBF values were lowest at the frontal lobes in MID and at the parietal lobes in SDAT. Hasegawa's dementia score was correlated with the rCBF at the frontal lobes in MID. In MID, there was a greater number of infarction, and atrophic changes were significantly remarkable, while the rCBF values were significantly lower at the frontal lobes compared to the MI group. Multi-variate analysis suggested that among the factors contributing to MID, brain atrophy was most relevant to dementia. In SDAT, rCBF values showed the most lateral asymmetry at the parietal lobes, the least, at the occipital lobes. The lateral asymmetry of the cerebral blood flow at the parietal lobes showed an association with clinical symptoms. There was a negative coefficiency between the cerebellum and the cerebral hemisphere in the evaluation of lateral asymmetry. These results suggest that rCBF estimation by IMP SPECT is useful in the differential diagnosis between MID and SDAT, and may also contribute to the classification of these two diseases. (author).

  15. Benzodiazepine receptor and cerebral blood flow in early Alzheimer's disease. SPECT study using 123I-Iomazenil and 123I-IMP

    International Nuclear Information System (INIS)

    Kitamura, Shin; Koshi, Yasuhiko; Komiyama, Tasuku; Sakayori, Osamu; Komaba, Yuichi; Ohyama, Masashi; Mishina, Masahiro; Tsuganesawa, Toshikazu; Terashi, Akiro

    1996-01-01

    This study was designed to investigate benzodiazepine receptors (BZR) and cerebral blood flow (CBF) in patients with early Alzheimer's disease. Imaging of BZR and measurement of CBF were performed by SPECT using 123 I-Iomazenil (IMZ) and 123 I-IMP respectively, in seven patients with early Alzheimer's disease and five patients with unilateral left cerebral infarction as controls. The values for the normal cerebral hemisphere (ratio to the contralateral cerebellum) in patients with cerebral infarction were adopted as control values. In patients with Alzheimer's disease, the CBF (ratio to cerebellum) decreased significantly in the frontal cortex and the parietal cortex compared with the control values. There was no significant difference in late IMZ SPECT counts (ratio to cerebellum) and washout (the ratio of late-to-early IMZ SPECT counts) between patients with Alzheimer's disease and the controls. However, the late IMZ SPECT counts and washout decreased in one patient with moderate dementia. There was a significant correlation between the severity of dementia and the late IMZ SPECT counts in the temporal cortex and the parietal cortex. These results suggest that benzodiazepine binding sites are relatively well preserved in patients with early Alzheimer's disease, and reduction of the CBF is caused by neuronal dysfunction rather than by neuronal loss. IMZ SPECT study is useful and necessary for clarifying the pathophysiological state in Alzheimer's disease. (author)

  16. Thrombocytopenic thrombotic purpura: severe clinic with no CT, minor MRI, but a SPECT correlate

    Energy Technology Data Exchange (ETDEWEB)

    Baron, Y. [Radiologische Abteilung, Staedtisches Krankenhaus Kiel, Chemnitzstr. 33, Kiel 24116 (Germany); Bargemann, T. [Abteilung Internistische Intensivmedizin und Dialyse am Staedtischen Krankenhaus Kiel, Chemnitzstr. 33, Kiel 24116 (Germany); Harten, P. [Zweite Medizinische Universitaetsklinik und Poliklinik der Christian-Albrechts-Universitaet zu Kiel, Chemnitzstr. 33, Kiel 24116 (Germany); Gutschmidt, H.-J. [Abteilung Internistische Intensivmedizin und Dialyse am Staedtischen Krankenhaus Kiel, Chemnitzstr. 33, Kiel 24116 (Germany)

    1999-07-01

    A 28-year-old woman with primarily therapy refractory TTP was followed neuroradiologically over 6 months. Despite pronounced neurological and neuropsychiatric symptoms including hemiparesis and aphasia she had unremarkable CT scans on two occasions. Three MRI exams showed no correlate for her neurological symptoms except a small petechial cortical hemorrhage in the right parietooccipital gyrus which may account for her TTP-related anxiety disorder. A cerebral HMPAO-SPECT showed long-standing right-sided hypoperfusion compatible with residual vasculature changes. The possible causes for the clinico-neuroradiological discrepancies are discussed in view of the literature.

  17. Thrombocytopenic thrombotic purpura: severe clinic with no CT, minor MRI, but a SPECT correlate

    International Nuclear Information System (INIS)

    Baron, Y.; Bargemann, T.; Harten, P.; Gutschmidt, H.-J.

    1999-01-01

    A 28-year-old woman with primarily therapy refractory TTP was followed neuroradiologically over 6 months. Despite pronounced neurological and neuropsychiatric symptoms including hemiparesis and aphasia she had unremarkable CT scans on two occasions. Three MRI exams showed no correlate for her neurological symptoms except a small petechial cortical hemorrhage in the right parietooccipital gyrus which may account for her TTP-related anxiety disorder. A cerebral HMPAO-SPECT showed long-standing right-sided hypoperfusion compatible with residual vasculature changes. The possible causes for the clinico-neuroradiological discrepancies are discussed in view of the literature

  18. Differences in lateral hemispheric asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, Nahoko [Niigata Univ. (Japan). School of Medicine

    1993-12-01

    We studied 21 right-handed patients clinically diagnosed as dementia of Alzheimer type (8 men, 13 women; aged 53-85, mean 71.1 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebro-vascular disease (Hachinski ischemic scores for all patients were 4 or below). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow was evaluated by single photon emission CT (SPECT) with [sup 123]I-N-isopropyl-p-iodoamphetamine ([sup 123]I-IMP), using the Matsuda's quantitative method. The subjects were divided into three groups on the basis of right-left hemispheric asymmetry of cerebral blood flow (leftcerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe were significantly lower than in other groups, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p<0.05). We concluded that cerebral blood flow asymmetry detected by SPECT was related significantly to the deficit of language and constructive function in patients with dementia of Alzheimer type. (author).

  19. Differences in lateral hemispheric asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, Nahoko (Niigata Univ. (Japan). School of Medicine)

    1993-12-01

    We studied 21 right-handed patients clinically diagnosed as dementia of Alzheimer type (8 men, 13 women; aged 53-85, mean 71.1 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebro-vascular disease (Hachinski ischemic scores for all patients were 4 or below). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow was evaluated by single photon emission CT (SPECT) with [sup 123]I-N-isopropyl-p-iodoamphetamine ([sup 123]I-IMP), using the Matsuda's quantitative method. The subjects were divided into three groups on the basis of right-left hemispheric asymmetry of cerebral blood flow (leftcerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe were significantly lower than in other groups, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p<0.05). We concluded that cerebral blood flow asymmetry detected by SPECT was related significantly to the deficit of language and constructive function in patients with dementia of Alzheimer type. (author).

  20. Differences in lateral hemispheric asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type

    International Nuclear Information System (INIS)

    Yoshimura, Nahoko

    1993-01-01

    We studied 21 right-handed patients clinically diagnosed as dementia of Alzheimer type (8 men, 13 women; aged 53-85, mean 71.1 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebro-vascular disease (Hachinski ischemic scores for all patients were 4 or below). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow was evaluated by single photon emission CT (SPECT) with 123 I-N-isopropyl-p-iodoamphetamine ( 123 I-IMP), using the Matsuda's quantitative method. The subjects were divided into three groups on the basis of right-left hemispheric asymmetry of cerebral blood flow (left< right, n=6; right< left, n=3; left=right, n=12). General scores (MMS, T-IQ) were not correlated with asymmetry of cerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe were significantly lower than in other groups, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p<0.05). We concluded that cerebral blood flow asymmetry detected by SPECT was related significantly to the deficit of language and constructive function in patients with dementia of Alzheimer type. (author)

  1. Effects of video game playing on cerebral blood flow in young adults: a SPECT study.

    Science.gov (United States)

    Chou, Yuan-Hwa; Yang, Bang-Hung; Hsu, Ju-Wei; Wang, Shyh-Jen; Lin, Chun-Lung; Huang, Kai-Lin; Chien Chang, Alice; Lee, Shin-Min

    2013-04-30

    To study the impact of video game playing on the human brain, the effects of two video games playing on cerebral blood flow (CBF) in young adults were determined. Thirty healthy subjects comprising 18 males and 12 females who were familiar with video game playing were recruited. Each subject underwent three sessions of single photon emission computed tomography (SPECT) with a bolus injection of 20 mCi (99m)Tc ECD IV to measure their CBF. The first measurement was performed as baseline, the second and third measurements were performed after playing two different video games for 30 min, respectively. Statistic parametric mapping (SPM2) with Matlab 6.5 implemented on a personal computer was used for image analysis. CBF was significantly decreased in the prefrontal cortex and significantly increased in the temporal and occipital cortices after both video games playing. Furthermore, decreased CBF in the anterior cingulate cortex (ACC) which was significantly correlated with the number of killed characters was found after the violent game playing. The major finding of hypo-perfusion in prefrontal regions after video game playing is consistent with a previous study showing reduced or abnormal prefrontal cortex functions after video game playing. The second finding of decreased CBF in the ACC after playing the violent video game provides support for a previous hypothesis that the ACC might play a role in regulating violent behavior. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. The evaluation of the automatic setting of ROI to SPECT measuring cerebral blood flow

    International Nuclear Information System (INIS)

    Mizuno, Hiroshi; Takahashi, Masaaki; Yoshioka, Katsunori

    2007-01-01

    It has been pointed out that the manual settings of region of interest (ROI) to the single-photon-emission-computed-tomography (SPECT) slice lacked objectivity when the fixed quantity value of regional cerebral blood flow (rCBF) was measured previously. Therefore, we jointly developed software Brain ROI'' with Daiichi Radioisotope Laboratories, Ltd. (DRL) that normalized an individual brain to a standard brain template by using Statistical Parametric Mapping 2 (SPM 2) of easy Z-score Imaging System ver. 3.0 (eZIS Ver. 3.0), and, ROI template was set to a specific slice. In this paper, we evaluated the accuracy of this software with ROI template that we made the useful size of the shape, in some clinical samples. As a result, the method of the automatic setting of ROI was the objectively. However, we thought that we should use the shape of ROI template without an influence of Brain atrophy. Moreover, we should see Normalizing individual brain and confirm the accuracy of normalization. When failing in normalization, we should partially correct ROI or set all by the manual operation of the operator. However, it was thought that this software was useful if the tendency was understood because the failure example was few. (author)

  3. Regional cerebral blood flow in vascular depression assessed by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Kimura, Mahito; Shimoda, Kengo; Mizumura, Sunao; Tateno, Amane; Fujito, Tatsuma; Mori, Takao; Endo, Shunkichi

    2003-01-01

    As the prevalence of white matter hyperintensities detected on T2 weighted MRI scans in patients with late-onset depression is higher than that in nondepressed patients, the concept of ''vascular depression'' (VDep) was introduced in 1997. However, the pathology of vascular depression has not been clarified. This study examined the differences in functional imaging between vascular and non-vascular depression (non-VDep). We utilized 123 I-IMP single photon emission computed tomography (SPECT) to compare regional cerebral blood flows (rCBF) between 9 patients with VDep (Krishnan criteria) and 11 age- and sex-matched patients with non-VDep in both depressed and remitted states. In both VDep and non-VDep patients, mean rCBF increased significantly as depression improved, partially aided by changes in left anterior temporal blood flow. In addition, compared to non-VDep patients, the left anterior frontal rCBF for VDep patients was significantly lower in both depressed and remitted states. Left anterior temporal rCBF therefore appears to represent a state marker that increases as symptoms associated with late-onset depression improve, regardless of vascular changes. Furthermore, in VDep patients, left anterior frontal rCBF was low in both states compared to non-VDep patients, and might not only represent a trait marker, but also correlated with the duration of disease and likelihood of recurrence and relapse. (author)

  4. Detection of misery perfusion in the cerebral hemisphere with chronic unilateral major cerebral artery steno-occlusive disease using crossed cerebellar hypoperfusion: comparison of brain SPECT and PET imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yoshiyasu; Ogasawara, Kuniaki; Saito, Hideo; Takahashi, Yoshihiro; Ogasawara, Yasushi; Kobayashi, Masakazu; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Morioka (Japan); Yoshida, Kenji; Beppu, Takaaki; Kubo, Yoshitaka; Fujiwara, Shunrou [Iwate Medical University, Department of Neurosurgery, Morioka (Japan); Tsushima, Eiki [Hirosaki University, Graduate School of Health Sciences, Hirosaki (Japan)

    2013-10-15

    In patients with unilateral internal carotid or middle cerebral artery (ICA or MCA) occlusive disease, the degree of crossed cerebellar hypoperfusion that is evident within a few months after the onset of stroke may reflect cerebral metabolic rate of oxygen in the affected cerebral hemisphere relative to that in the contralateral cerebral hemisphere. The aim of the present study was to determine whether the ratio of blood flow asymmetry in the cerebellar hemisphere to blood flow asymmetry in the cerebral hemisphere on positron emission tomography (PET) and single photon emission computed tomography (SPECT) correlates with oxygen extraction fraction (OEF) asymmetry in the cerebral hemisphere on PET in patients with chronic unilateral ICA or MCA occlusive disease and whether this blood flow ratio on SPECT detects misery perfusion in the affected cerebral hemisphere in such patients. Brain blood flow and OEF were assessed using {sup 15}O-PET and N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) SPECT, respectively. All images were anatomically standardized using SPM2. A region of interest (ROI) was automatically placed in the bilateral MCA territories and in the bilateral cerebellar hemispheres using a three-dimensional stereotaxic ROI template, and affected-to-contralateral asymmetry in the MCA territory or contralateral-to-affected asymmetry in the cerebellar hemisphere was calculated. Sixty-three patients with reduced blood flow in the affected cerebral hemisphere on {sup 123}I-IMP SPECT were enrolled in this study. A significant correlation was observed between MCA ROI asymmetry of PET OEF and the ratio of cerebellar hemisphere asymmetry of blood flow to MCA ROI asymmetry of blood flow on PET (r = 0.381, p = 0.0019) or SPECT (r = 0.459, p = 0.0001). The correlation coefficient was higher when reanalyzed in a subgroup of 43 patients undergoing a PET study within 3 months after the last ischemic event (r = 0.541, p = 0.0001 for PET; r = 0.609, p < 0

  5. Evaluation of reconstruction techniques in regional cerebral blood flow SPECT using trade-off plots: a Monte Carlo study.

    Science.gov (United States)

    Olsson, Anna; Arlig, Asa; Carlsson, Gudrun Alm; Gustafsson, Agnetha

    2007-09-01

    The image quality of single photon emission computed tomography (SPECT) depends on the reconstruction algorithm used. The purpose of the present study was to evaluate parameters in ordered subset expectation maximization (OSEM) and to compare systematically with filtered back-projection (FBP) for reconstruction of regional cerebral blood flow (rCBF) SPECT, incorporating attenuation and scatter correction. The evaluation was based on the trade-off between contrast recovery and statistical noise using different sizes of subsets, number of iterations and filter parameters. Monte Carlo simulated SPECT studies of a digital human brain phantom were used. The contrast recovery was calculated as measured contrast divided by true contrast. Statistical noise in the reconstructed images was calculated as the coefficient of variation in pixel values. A constant contrast level was reached above 195 equivalent maximum likelihood expectation maximization iterations. The choice of subset size was not crucial as long as there were > or = 2 projections per subset. The OSEM reconstruction was found to give 5-14% higher contrast recovery than FBP for all clinically relevant noise levels in rCBF SPECT. The Butterworth filter, power 6, achieved the highest stable contrast recovery level at all clinically relevant noise levels. The cut-off frequency should be chosen according to the noise level accepted in the image. Trade-off plots are shown to be a practical way of deciding the number of iterations and subset size for the OSEM reconstruction and can be used for other examination types in nuclear medicine.

  6. Cerebral Blood Flow Changes after Shunt in Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage: Analysis by statistical Parametric Mapping

    International Nuclear Information System (INIS)

    Hyun, I. Y.; Choi, W. S.; Pak, H. S.

    2003-01-01

    The purpose of this study was to evaluate the changes of regional cerebral blood flow (rCBF) after shunt operation in patients with hydrocephalus after aneurysmal subarachnoid hemorrhage ba statistical parametric mapping (SPM). Seven patients (4 male, mean age 54 years) with hydrocephalus after aneurysmal subarachnoid hemorrhage underwent a shunt operation. Tc-99m HMPAO SPECT was performed within I week before, and 2 weeks after the shunt operation. All of the SPECT images were spatially transformed to standard space, smoothed, and globally normalized. After spatial and count normalization, rCBF of pre- and post- shunting Tc- 99m HMPAO SPECT was estimated at every voxel using t statistics. The voxels with a P value of less than 0.001 were considered to be significantly different. The shunt operation was effective in all patients. Pre-shunting Tc-99m HMPAO SPECT showed hypoperfusion, predominantly in the periventricular area. After shunt operation, periventricular low perfusion was disappeared. The results of this study show that periventricular CBF is impaired in hydrocephalus after aneurysmal subarachnoid hemorrhage. Significant increase of periventricular CBF after shunt operation suggests the evaluation of periventricular CBF by SPM might be of value for the prediction of shunt effectiveness in hydrocephalus

  7. Cerebral Blood Flow Changes after Shunt in Hydrocephalus after Aneurysmal Subarachnoid Hemorrhage: Analysis by statistical Parametric Mapping

    Energy Technology Data Exchange (ETDEWEB)

    Hyun, I. Y.; Choi, W. S.; Pak, H. S. [College of Medicine, Univ. of Inhwa, Incheon (Korea, Republic of)

    2003-07-01

    The purpose of this study was to evaluate the changes of regional cerebral blood flow (rCBF) after shunt operation in patients with hydrocephalus after aneurysmal subarachnoid hemorrhage ba statistical parametric mapping (SPM). Seven patients (4 male, mean age 54 years) with hydrocephalus after aneurysmal subarachnoid hemorrhage underwent a shunt operation. Tc-99m HMPAO SPECT was performed within I week before, and 2 weeks after the shunt operation. All of the SPECT images were spatially transformed to standard space, smoothed, and globally normalized. After spatial and count normalization, rCBF of pre- and post- shunting Tc- 99m HMPAO SPECT was estimated at every voxel using t statistics. The voxels with a P value of less than 0.001 were considered to be significantly different. The shunt operation was effective in all patients. Pre-shunting Tc-99m HMPAO SPECT showed hypoperfusion, predominantly in the periventricular area. After shunt operation, periventricular low perfusion was disappeared. The results of this study show that periventricular CBF is impaired in hydrocephalus after aneurysmal subarachnoid hemorrhage. Significant increase of periventricular CBF after shunt operation suggests the evaluation of periventricular CBF by SPM might be of value for the prediction of shunt effectiveness in hydrocephalus.

  8. Evaluation of the effects of rehabilitation exercise on cerebral infarction with 99Tcm-ECD SPECT brain imaging

    International Nuclear Information System (INIS)

    Jiang Ningyi; Lu Xianping; Liu Xingguang; Xiao Xiuhong; Xu Jianxing

    2003-01-01

    Objective: To investigate the therapeutic effects of motor therapy on hemiplegia with SPECT brain perfusion imaging. Methods: The study population consisted of 59 patients with cerebral infarction, and all patients were treated with motor therapy. Among them, 30 cases were assigned to undertake single bridging exercise and 29 cases passive exercise. SPECT brain perfusion imaging was performed before and after motor therapy under the same condition, and the regional cerebral blood flow (rCBF) changes were compared and analysed with visual and semi-quantitative methods; in addition, the relationship between rCBF changes and scores of Fugl-Meyer or Barthel index were also analysed. Results: After motor therapy, various degrees of radioactivity increase were compared with the pretreatment radioactivity hypoperfusion in patients with cerebral infarction, and showed that motor therapy could evidently improve rCBF of regional hypoperfusion. The posttreatment rCBF was higher than the pretreatment level (P<0.01), and the rCBF of group of single bridging was higher than that of passive exercise group. And the changes of rCBF were all significant after motor therapy. In addition, the variation of the rCBF after motor therapy was positively correlated with the variation of Fugl-Meyer and Barthel score. Conclusions: SPECT brain perfusion imaging can serve as a useful method for evaluating the effectiveness of motor therapy in cerebral infarction rehabilitation. The single bridging exercise and the passive exercise are both beneficial to brain rehabilitation, but the former improves the rCBF in lesions better than the later does

  9. SPECT in Focal Epilepsies

    Directory of Open Access Journals (Sweden)

    Roderick Duncan

    2000-01-01

    Full Text Available Brain perfusion changes during seizures were first observed in the 1930s. Single Photon Emission Computed Tomography (SPECT was developed in the 1970s, and tracers suitable for the imaging of regional cerebral perfusion (rCP became available in the 1980s. The method was first used to study rCP in the interictal phase, and this showed areas of low perfusion in a proportion of cases, mainly in patients with temporal lobe epilepsies. However, the trapping paradigm of tracers such as hexamethyl propyleneamine oxime (HMPAO provided a practicable method of studying changes in rCP during seizures, and a literature was established in the late 1980s and early 1990s showing a typical sequence of changes during and after seizures of mesial temporal lobe origin; the ictal phase was associated with large increases in perfusion throughout the temporal lobe, with first the lateral, then the mesial temporal lobe becoming hypoperfused in the postictal phase. Activation and inhibition of other structures, such as the basal ganglia and frontal cortex, were also seen. Studies of seizures originating elsewhere in the brain have shown a variety of patterns of change, according to the structures involved. These changes have been used practically to aid the process of localisation of the epileptogenic zone so that epilepsy surgery can be planned.

  10. Comparison of the cerebral SPECT and biological markers in the Alzheimer disease; Comparaison de la tomographie cerebrale par emission monophotonique de perfusion et des biomarqueurs dans la maladie d'Alzheimer

    Energy Technology Data Exchange (ETDEWEB)

    Ravasi, L.; Semah, F.; Steinling, M. [Unite imagerie fonctionnelle cerebrale, CHRU de Lille, (France); Bombois, S.; Pasquier, F. [centre memoire de ressources et de recherche, CHRU de Lille, (France); Schraen, S.; Buee, L. [Inserm U837, centre de biologie, CHRU de Lille, (France)

    2009-05-15

    This study aim was to compare the contribution of SPECT of cerebral perfusion and bio markers of the cerebrospinal liquid in the diagnosis of Alzheimer disease. Our preliminary conclusions show that the concordance of the SPECT and cerebrospinal liquid is good in the possible Alzheimer disease. the interest of the cerebral SPECT and bio markers of the cerebrospinal liquid, used alone or conjointly, for a more reliable diagnosis of Alzheimer disease must be evaluated of prospective way. (N.C.)

  11. Evaluation of cerebral perfusion in patients with neuropsychiatric systemic lupus erythematosus using 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Yoshida, Atsuko; Shishido, Fumio; Kato, Kazuo; Watanabe, Hiroshi; Seino, Osamu

    2007-01-01

    In the course of systemic lupus erythematosus (SLE), central nervous system (CNS) complications occur at a high frequency. An accurate diagnosis of CNS lupus, differentiated from secondary CNS involvement, is difficult. CNS lupus is indicative of advancing primary disease and is treated by steroid pulse therapy or increased dosage of steroids. In contrast, if symptoms are caused by secondary CNS complications, it is possible to observe or treat these complications using symptomatic therapy. We examined whether quantitative cerebral blood flow (CBF) measured using cerebral perfusion single photon emission computed tomography (SPECT) can be used to differentiate CNS lupus from secondary CNS involvement. We divided 18 SLE patients with CNS symptoms into a CNS lupus group and a non-CNS lupus group, and then compared the mean cerebral blood flow (mCBF) of each group of patients. SPECT was performed with N-isopropyl-p-[ 123 I] iodoamphetamine (IMP), with quantitation carried out by table look-up and autoradiographic methods. The mCBF of both groups was decreased; however, the mCBF of patients with CNS lupus was significantly lower than that of non-CNS lupus patients. Quantitative CBF may provide a useful tool to distinguish CNS lupus from non-CNS lupus. (author)

  12. Regional cerebral blood flow in neuropediatrics

    International Nuclear Information System (INIS)

    Junik, R.

    2001-01-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  13. Differential diagnosis of MRI detected intra cranial space occupying lesions (ICSOLS)-role of 99MTC tetrofosmin cerebral spect

    International Nuclear Information System (INIS)

    Padmal, S.; Sundaram, P.S.; Kumar, S.

    2004-01-01

    Discriminating the correct etiology of Intra Cranial Space Occupying Lesions (ICSOLs) detected by MRI is of paramount importance in deciding the right therapeutic approach. Functional imaging like 99m Tc Tetrofosmin cerebral SPECT (C SPECT) can be used to differentiate malignant from other benign cerebral pathologies. Objective: Our aim was to assess the efficacy of C SPECT in differentiating various etiologies (i.e. Infective / Inflammatory, Neoplastic and Post Radiotherapy changes) of MRI detected ICSOLs. We also aimed to assess the incremental value of quantitative uptake ratios in identifying the exact nature of ICSOLs. Method: 26 Patients (M:F=20:6), age range 28-76 yrs, mean 42±7 yrs were evaluated by 99mTc Tetrofosmin cerebral SPECT. 14/26 patients were HIV positive cases while remaining 12 were treated patients of intracerebral malignancies. All these patients had one or more discrete MRI detected ICSOLs. 6/4 patients with HIV and 4/12 patients in the non HIV group showed more than 1 discrete ICSOLs. 20 mci of 99mTc Tetrofosmin was injected IV .15 min (early) and 2 hrs (delayed) post injection C SPECT images were acquired on a dual head variable angle Gamma camera. After reconstruction, transverse, coronal and sagittal images were co- registered with DICOM online available MRI images using aco- registration software. Focal Tetrofosmin uptake in MRI detected ICSOL was interpreted as abnormal. Tetrofosmin uptake index (Ix) was calculated in early and delayed images as ratio of counts in lesion to that of contra lateral region. A value of more than 1.3 was considered to be abnormal. Persistent Ix of more than 1.3 in initial and delayed images were considered to be malignant while Ix of more or less than 1.3 in initial but less than 1.3 in delayed images was considered to be benign in both groups. Results: In HIV group (14 pts), 4 patients showed an Ix of less than 1.3 in both early and delayed images and 7 patients showed an Ix of more than 1.3 in early but

  14. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping.

    Science.gov (United States)

    McGoron, Anthony J; Capille, Michael; Georgiou, Michael F; Sanchez, Pablo; Solano, Juan; Gonzalez-Brito, Manuel; Kuluz, John W

    2008-02-29

    Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM). A significant area of hypoperfusion (P TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM. The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.

  15. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    International Nuclear Information System (INIS)

    McGoron, Anthony J; Capille, Michael; Georgiou, Michael F; Sanchez, Pablo; Solano, Juan; Gonzalez-Brito, Manuel; Kuluz, John W

    2008-01-01

    Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. The focal effects of moderate traumatic brain injury (TBI) on cerebral blood flow (CBF) by SPECT cerebral blood perfusion (CBP) imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM). A significant area of hypoperfusion (P < 0.01) was found as a response to the TBI. Statistical mapping of the reference microsphere CBF data confirms a focal decrease found with SPECT and SPM. The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques

  16. Regional Cerebral Blood Flow differences in early and severe Alzheimer Disease as assessed by SPECT and Principal Component Analysis

    International Nuclear Information System (INIS)

    Pagani, M.M.E.; Sanchez-Creaspo, A.; Jonsson, C.; Engelin, L.; Danielsson, A.M.; Larsson, S.A.; Jacobsson, H.; Waegner, A.; Salmaso, D.

    2002-01-01

    Aim: In its development into severe Alzheimer's Disease (AD), early Alzheimer Disease (eAD) involves progressively larger regions of the brain. These regions share close anatomo-functional relationships. The aim of this study was to investigate the rCBF changes occurring in eAD and AD as compared to a group of normal individuals by means of SPECT and Principal Component Analysis. Materials and Methods. Thirty eAD, 17 AD and 66 normal controls (CTR) were included in the study. 99m Tc-HMPAO SPECT, using a three-headed gamma camera, was performed at rest and the uptake in 27 functional bilateral sub-volumes of the brain was assessed by a standardised digitalised brain atlas. Data were grouped into anatomo-functionally connected regions by means of PCA analysis performed on all 113 individuals. Analysis of variance (ANOVA) was used to test the significance of the differences in flow in such functional regions and data were co-variated for age differences. Results. In the global analysis, rCBF significantly differed between groups (0.001) with a progressive reduction of flow from CTR to AD. PCA reduced the 54 variables to 11 anatomo-functional regions that interacted with groups (p<0.001) and gender (p<0.001). In the overall analysis the three groups differed significantly in all functional regions except for bilateral occipital cortex, anterior cingulated cortex, thalamus and putamen. In both CTR/eAD and CTR/AD comparisons the largest rCBF reductions were found in functional regions including left (p<0.0001) and right (p<0.0001) temporo-parietal cortex and associative parietal cortex (p<0.0001). When eAD was compared to AD, this latter showed the largest reductions in right temporo-parietal cortex (p<0.0001) and in right prefrontal cortex (p<0.005). Conclusions. In this study the rCBF was investigated in early and severe Alzheimer's Disease taking into account the functional connectivity among brain regions. Our results confirm previous findings on the progression of

  17. Asymmetry of cerebral blood flow in patients with senile dementia of Alzheimer type by SPECT using I-123 IMP

    Energy Technology Data Exchange (ETDEWEB)

    Arai, Hisayuki; Hanyu, Haruo; Kobayashi, Yasutaka; Hatano, Nobuyoshi; Katsunuma, Hideyo; Suzuki, Takanari; Amino, Saburo [Tokyo Medical Coll. (Japan)

    1990-12-01

    Regional cerebral blood flow (rCBF) was determined by single photon emission CT (SPECT) with N-isopropyl-p-({sup 123}I)iodoamphetamine in 22 patients with clinically diagnosed senile dementia of Alzheimer type (SDAT) and in 18 age matched controls. We calculated asymmetry indices (AIs) of rCBF for matched right-left regions of interest. rCBF of parietal lobe in SDAT patients was significantly most laterally asymmetrycal, but the least in occipital lobe. Lateral asymmetry of rCBF in SDAT patients correlated with asymmetry of language and visuospatial functions; decreased rCBF in the left parietal lobe was associated with language dysfunction, and that in the right parietal lobe, with viduospatial dysfunction. Furthermore cerebellar AIs correlated negatively with those of the cerebral hemisphere and lower frontal region in SDAT patients. The results demonstrate that rCBF measurement by {sup 123}I-IMP SPECT is useful to detect lateral asymmetry in reduction of rCBF in SDAT. (author).

  18. Effect of attenuation by the cranium on quantitative SPECT measurements of cerebral blood flow and a correction method

    International Nuclear Information System (INIS)

    Iwase, Mikio; Kurono, Kenji; Iida, Akihiko.

    1998-01-01

    Attenuation correction for cerebral blood flow SPECT image reconstruction is usually performed by considering the head as a whole to be equivalent to water, and the effects of differences in attenuation between subjects produced by the cranium have not been taken into account. We determined the differences in attenuation between subjects and assessed a method of correcting quantitative cerebral blood flow values. Attenuations by head on the right and left sides were measured before intravenous injection of 123 I-IMP, and water-converted diameters of both sides (Ta) were calculated from the measurements obtained. After acquiring SPECT images, attenuation correction was conducted according to the method of Sorenson, and images were reconstructed. The diameters of the right and left sides in the same position as the Ta (Tt) were calculated from the contours determined by threshold values. Using Ts given by 2 Ts=Ta-Tt, the correction factor λ=exp(μ 1 Ts) was calculated and multiplied as the correction factor when rCBF was determined. The results revealed significant differences between Tt and Ta. Although no gender differences were observed in Tt, they were seen in both Ta and Ts. Thus, interindividual differences in attenuation by the cranium were found to have an influence that cannot be ignored. Inter-subject correlation is needed to obtain accurate quantitative values. (author)

  19. Asymmetry of cerebral blood flow in patients with senile dementia of Alzheimer type by SPECT using I-123 IMP

    International Nuclear Information System (INIS)

    Arai, Hisayuki; Hanyu, Haruo; Kobayashi, Yasutaka; Hatano, Nobuyoshi; Katsunuma, Hideyo; Suzuki, Takanari; Amino, Saburo

    1990-01-01

    Regional cerebral blood flow (rCBF) was determined by single photon emission CT (SPECT) with N-isopropyl-p-[ 123 I]iodoamphetamine in 22 patients with clinically diagnosed senile dementia of Alzheimer type (SDAT) and in 18 age matched controls. We calculated asymmetry indices (AIs) of rCBF for matched right-left regions of interest. rCBF of parietal lobe in SDAT patients was significantly most laterally asymmetrycal, but the least in occipital lobe. Lateral asymmetry of rCBF in SDAT patients correlated with asymmetry of language and visuospatial functions; decreased rCBF in the left parietal lobe was associated with language dysfunction, and that in the right parietal lobe, with viduospatial dysfunction. Furthermore cerebellar AIs correlated negatively with those of the cerebral hemisphere and lower frontal region in SDAT patients. The results demonstrate that rCBF measurement by 123 I-IMP SPECT is useful to detect lateral asymmetry in reduction of rCBF in SDAT. (author)

  20. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    OpenAIRE

    Gonzalez-Brito Manuel; Solano Juan; Sanchez Pablo; Georgiou Michael F; Capille Michael; McGoron Anthony J; Kuluz John W

    2008-01-01

    Abstract Background Assessment of cerebral blood flow (CBF) by SPECT could be important in the management of patients with severe traumatic brain injury (TBI) because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia), or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. Me...

  1. Single-photon emission tomography (SPECT) with 123I-amphetamine in cerebral ischemia

    International Nuclear Information System (INIS)

    Koenig, B.; Donis, J.; Mostbeck, A.; Koehn, H.

    1987-01-01

    The uptake of 123 I-amphetamine (IMP) in brain mainly corresponds to regional perfusion. Distribution of IMP can be visualized in tomographic slices by single-photon emission computed tomography (SPECT). For better evaluation and comparison in follow-up studies, right/left ratios were computed and an asymmetry index calculated. The most sensitive asymmetry index was achieved by 120 average circumferential profiles. In 52 patients with stroke and 16 controls the respective sensitivities of IMP-SPECT, computed tomography (CT), static and dynamic brain scanning and angiography were evaluated. In patients with TIA and PRIND the IMP-SPECT had the highest sensitivity of all non-invasive methods. In patients with completed stroke, the sensitivity of IMP-SPECT was comparable with that of CT (90 vs. 93%). There was a significant correlation between the IMP asymmetry index and the clinical and social score (p [de

  2. Quantitative assessment of cerebral blood flow by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Moriwaki, Hiroshi; Matsumoto, Masayasu; Hashikawa, Kazuo

    1993-01-01

    To establish a noninvasive, quantitative method for measuring regional cerebral blood flow (rCBF) by N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP) SPECT, we attempted to employ continuous venous sampling instead of arterial sampling. Forty two patients with cerebrovascular disease were classified into two groups, with (group II: n=35) and without (group I: n=7) hand warming. In group II, either hand was warmed, wrapping in a hot blanket (group IIA) or immersed in a 44degC water bath (group IIB). Immediately after intravenous bolus injection of 222 MBq IMP, arterial and venous blood samples were collected continuously for 5 min from the radial artery and the cubital vein, respectively. By octanol extraction, IMP was divided into the unmetabolized and metabolized fractions. The ratio of 123 I-IMP of venous blood to arterial blood (pass ratio, referred to as %PR) was calculated in the whole blood, unmetabolized, and metabolized fractions. Using these parameters, we assessed the possibility to estimate the amount of unmetabolized IMP fraction of arterial blood, usually used as an input function, from venous samples. In group I, %PR demonstrated a considerable variation between individuals (whole IMP, 47.5±24.6%; unmetabolized IMP, 46.0±24.5%; metabolized IMP, 51.8±27.4%). In group II, especially in group IIB, both increase of %PR value and the decrease in variation (whole, 77.9±5.6%; unmetabolized, 75.7±5.7%; metabolized, 86.7±8.7%) were observed, permitting the further calculation based on the assumption that %PR value was constant in each IMP fraction. The coefficient of variation of the difference between estimated arterial IMP radioactivity from venous samples and actual arterial IMP was 9.0% and 7.5%. The use of venous sampling coupled with a hand warming technique allowed the estimation of the arterial unmetabolized IMP radioactivity from venous samples with a reliability of 90% or more. (author)

  3. Regional cerebral blood flow and metabolism in patients with transient global amnesia. A study using SPECT and {sup 1}H-MRS

    Energy Technology Data Exchange (ETDEWEB)

    Ishihara, Tetsuya; Hirata, Koichi; Tatsumoto, Muneto; Yamazaki, Kaoru [Dokkyo Univ., Tochigi (Japan). School of Medicine; Sato, Toshihiko

    1997-06-01

    In 13 patients with transient global amnesia (TGA), we studied the clinical course and changes over time by means of imaging techniques such as SPECT. MRI, and proton MR spectroscopy ({sup 1}H-MRS). In the case of SPECT, a cerebral blood flow decrease at the time center of the temporal lobe persisted at least for more than one month. In many patients, no abnormal signs were found on MRI. Despite the presence of intracranial impairment of energy metabolism, no evidence of cerebral ischemia was obtained using {sup 1}H-MRS at the acute and subacute stages. There were thus discrepancies between the symptoms and the findings of SPECT as well as the findings of {sup 1}H-MRS. These data suggest that TGA may not necessarily be caused by cerebra1 ischemia. (author)

  4. Regional cerebral blood flow and metabolism in patients with transient global amnesia. A study using SPECT and 1H-MRS

    International Nuclear Information System (INIS)

    Ishihara, Tetsuya; Hirata, Koichi; Tatsumoto, Muneto; Yamazaki, Kaoru; Sato, Toshihiko.

    1997-01-01

    In 13 patients with transient global amnesia (TGA), we studied the clinical course and changes over time by means of imaging techniques such as SPECT. MRI, and proton MR spectroscopy ( 1 H-MRS). In the case of SPECT, a cerebral blood flow decrease at the time center of the temporal lobe persisted at least for more than one month. In many patients, no abnormal signs were found on MRI. Despite the presence of intracranial impairment of energy metabolism, no evidence of cerebral ischemia was obtained using 1 H-MRS at the acute and subacute stages. There were thus discrepancies between the symptoms and the findings of SPECT as well as the findings of 1 H-MRS. These data suggest that TGA may not necessarily be caused by cerebra1 ischemia. (author)

  5. Evaluation of crossed cerebellar diaschisis in 30 patients with major cerebral artery occlusion by means of quantitative I-123 IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Miyazawa, Nobuhiko; Toyama, Keiji; Arbab, A.S.; Arai, Takao; Nukui, Hideaki [Yamanashi Medical Univ., Tamaho (Japan); Koizumi, Kiyoshi

    2001-12-01

    Quantitative crossed cerebellar diaschisis (CCD) and the correlation with a reduction in supratentorial regional cerebral blood flow (rCBF) and cerebrovascular reserve capacity (CVR) were investigated in clinically stable patients with major cerebral artery occlusion by the iodine-123-N-isopropyl-p-iodoamphetamine (I-123 IMP) single photon emission computed tomography (SPECT) method. Thirty patients with major cerebral artery occlusion underwent SPECT by the I-123 IMP autoradiographic method. Regional CBF was measured in the cerebral hemisphere, frontal and parietal lobes, temporo-parietal lobe, and cerebellum both at rest and after administration of acetazolamide. Eighteen of 30 patients (60%) had CCD. CCD was significantly related to magnetic resonance imaging evidence of infarction. Quantitative CCD was 17% and the CVR in the cerebellum was preserved in patients with CCD. There was a significant difference in CBF and CVR between the affected and normal sides in all regions of interest in the patients without CCD [CBF (ml/100 g/min): hemisphere (H), normal side (N): 31.4{+-}6.8, affected side (A): 27.5{+-}7.4; p<0.05. CVR: H, N: 0.56{+-}0.38, A: 0.42{+-}0.18; p<0.01]. CCD is common in patients with major cerebral artery occlusion, and quantitative I-123 IMP SPECT is helpful in detecting CCD in clinically stable patients with occlusion of major cerebral arteries. (author)

  6. Evaluation of cerebral metabolism in patients with unilateral carotid stenosis by proton MR spectroscopy: a correlative study with cerebral hemodynamics by acetazolamide stress brain perfusion SPECT (acz-SPECT)

    International Nuclear Information System (INIS)

    Kim, Jae Seung; Kim, Geun Eun; Lee, Jeong Hee; Kim, Do Gyun; Kim, Sang Tae; Lee, Hee Kyung

    2001-01-01

    Carotid stenosis may lead not only to cerebral hemodynamic compromise but also cerebral metabolic changes without overt infarction. To investigate the brain metabolic changes as a result of hemodynamic compromise in pts with carotid stenosis, we compared the changes in metabolism of the gray and white matter detected by proton MRS with cortical hemodynamics measured by Acz-SPECT. We prospectively studied symptomatic 18 pts (M/F=15/3, mean ages: 64.4y) with unilateral carotid stenosis. All pts underwent Acz-SPECT and MRS with 3 days. rCBF and rCVR of MCA territory were assessed by Acz-SPECT. Hemodynamic compromise was graded as stage 0 (normal rCBF and rCVR), stage 1 (normal rCBF and reduced rCVR), and stage 2( reduced rCBF and rCVR). Brain metabolism was assessed by measuring the peaks of N-acetyl aspartate (NAA), choline (Cho), and the sum of creatine and phosphocreatine (Cr) from noninfarcted white matter in the both centrum semiovales and gray matter in both MCA territories. On Acz-SPECT, 7 pts showed stage 2 were significantly lower than in pts with stage 0 (p<0.01). The asymmetric ratio of NAA/Cr in pts with state 2 was also significantly lower than in pts with stage 1(p<0.05). The asymmetric ratio of Cho/Cr was increased as hemodynamic stage increased but the differences were not statistically significant among 3 stages. In cortical gray matter, the asymmetric ratios of NAA/Cho and NAA/Cr were decreased statistically significant among 3 stages. In cortical gray matter, the asymmetric ratios of NAA/Cho and NAA/Cr were decreased and that of Cho/Cr was increased as hemodynamic stage increased. However, these differences were not statistically significant among 3 stages. The asymmetric ratios of NAA/Cho of centrum semiovale in pts with reduced rCBF and/or reduced rCVR were lower than in pts with normal perfusion. Our results indicate the metabolic changes detected by proton MRS in patients with carotid stenosis reflect a hemodynamic compromised state

  7. Relations between neuropsychological findings and lateral asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimura, Nahoko; Soma, Yoshiaki; Ootsuki, Mika [Takeda General Hospital, Aizu-Wakamatsu, Fukushima (Japan)

    1993-10-01

    We studied 16 right-handed patients clinically diagnosed as dementia of Alzheimer type (6 men, 10 women; aged 63-85, mean 72.8 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebrovascular disease (Hachinski ischemic scores for all patients were 4 or below 4). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow (rCBF) was evaluated by single photon emission CT (SPECT) with {sup 123}I-N-isopropyl-p-iodoamphetamine ({sup 123}I-IMP), using the Matsuda`s quantitative method. Regional tracer uptake was measured in regions of interests (ROIs) over right and left frontal, temporal, parietal and occipital cortical regions; basal ganglia; and cerebellar hemispheres. The subjects were divided into three groups on the basis of lateral asymmetries in the temporal and parietal cortexes of rCBF (leftcerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe was significantly lower than other group, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p<0.05). We concluded that cerebral blood flow asymmetry by SPECT was related significantly to the deficit of language and constructive function in patients with dementia of Alzheimer type. Decreased rCBF in the left temporoparietal lobe was associated with language dysfunction, and that in the right hemisphere, with constructive dysfunction. (author).

  8. Relations between neuropsychological findings and lateral asymmetries of cerebral blood flow measured by SPECT in dementia of Alzheimer type

    International Nuclear Information System (INIS)

    Yoshimura, Nahoko; Soma, Yoshiaki; Ootsuki, Mika

    1993-01-01

    We studied 16 right-handed patients clinically diagnosed as dementia of Alzheimer type (6 men, 10 women; aged 63-85, mean 72.8 years). The average duration of symptoms was 2.7 years. Dementia ranged from mild to moderately severe. None had clinical or laboratory evidence of cerebrovascular disease (Hachinski ischemic scores for all patients were 4 or below 4). All received the Wechsler Adult Intelligence Scale (WAIS), Mini-mental State Test (MMS) and Western Aphasia Battery (WAB, First Japanese edition, 1986). Regional cerebral blood flow (rCBF) was evaluated by single photon emission CT (SPECT) with 123 I-N-isopropyl-p-iodoamphetamine ( 123 I-IMP), using the Matsuda's quantitative method. Regional tracer uptake was measured in regions of interests (ROIs) over right and left frontal, temporal, parietal and occipital cortical regions; basal ganglia; and cerebellar hemispheres. The subjects were divided into three groups on the basis of lateral asymmetries in the temporal and parietal cortexes of rCBF (left< right, n=5; right< left, n=3; left=right, n=8). We decided that lateral asymmetry was present when rCBF for each ROI between left and right sides differs by more than 10%. General score (MMS, T-IQ) was not correlated with asymmetry of cerebral blood flow. Verbal IQ in patients with predominant hypoperfusion of left temporal and parietal lobe was significantly lower than other group, while performance IQ and WAB constructive scores were lower in those with right hemispheric hypoperfusion (p<0.05). We concluded that cerebral blood flow asymmetry by SPECT was related significantly to the deficit of language and constructive function in patients with dementia of Alzheimer type. Decreased rCBF in the left temporoparietal lobe was associated with language dysfunction, and that in the right hemisphere, with constructive dysfunction. (author)

  9. Psychiatric and subjective symptoms and cerebral blood flow in patients with chronic cerebral infarction after treatment with Ca antagonist (nilvadipine). Quantitative measurement of cerebral blood flow by the 123IMP-SPECT ARG method

    International Nuclear Information System (INIS)

    Sakayori, Osamu; Kitamura, Shin; Mishina, Masahiro; Yamazaki, Mineo; Terashi, Akirou

    1997-01-01

    Psychiatric and subjective symptoms such as headache, dizziness, lack of spontaneity, anxiety, and a depressive state are often found in patients with chronic cerebral infarction. Some Ca antagonists are reported to relieve such symptoms. The purpose of the present study was to investigate the relationship between psychiatric and subjective symptoms and cerebral blood flow (CBF) in cerebral infarction and to evaluate the clinical effects of Ca antagonists from the standpoint of the cerebral circulation. Nilvadipine was administered to is patients with chronic cerebral infarction and their CBF was measured by the 123 IMP-SPECT ARG method before and at 8 weeks after the nilvadipine treatment. The CBF in patients with hypertension was increased by 11% after giving nilvadipine. Patients without hypertension showed no tendency for elevation of their CBF. Patients who were relieved from some psychiatric symptoms revealed a 14% increase of CBF in all cortical regions, and a significant increase was noted in the frontal and temporal regions. In other patients without changes in psychiatric symptoms, the CBF did not increase in any of the cortical regions. No relationship between symptoms and CBF was observed in any of the patients with subjective symptoms. Our study demonstrated a close correlation between psychiatric symptoms and CBF. We speculate that psychiatric symptoms in chronic cerebral infarction may reflect diffuse brain dysfunctions. We also conclude that nilvadipine is more effective in relieving psychiatric symptoms in patients with hypertensive cerebral infarction. It is inferred that nilvadipine may be more effective in relieving psychiatric symptoms in patients with hypertension. (author)

  10. Comparison of brain perfusion SPECT and MRI findings in children with neuronal ceroid-lipofuscinosis and in their families

    International Nuclear Information System (INIS)

    Sayit, E.; Yorulmaz, I; Gumuser, F.G.; Dirik, E.; Bekis, R.; Kaya, G.; Durak, H.

    2002-01-01

    Neuronal ceroid-lipofuscinoses (NCL) are among the progressive encephalopathies of childhood that are inherited in an autosomal recessive manner. In this study we specifically aimed to investigate any white-matter changes in the carriers (parents) and the healthy siblings of individuals with neuronal ceroid lipofuscinosis disease and whether we may be able to predict the occurrence of any neurological symptoms in healthy children in the future thus enabling early management. Since the NCLs are genetically determined diseases, we investigated fifteen individuals in three families that had diseased children of the juvenile type, with brain perfusion SPECT and MRI. Brain perfusion SPECT was performed after administering 222-555 MBq (6-15 mCi) Tc-99m hexamethyl-propylene amine oxime (HMPAO) intravenously in a dimmed and quiet room. Imaging was performed at least one hour after injection, with a three headed gamma camera equipped with high resolution collimators. A Metz filter (FWHM: 11 mm) was used for processing. Cranial MRI was performed with an imager operating at 1.5 Tesla. Spin-echo T1- and T2-weighted and FLAIR slices were obtained for each individual. In all of the five diseased children we observed pathologic findings both on MRI and Tc-99m HMPAO SPECT. The findings on MRI were mainly features of cerebral and cerebellar atrophy and the observations on Tc-99m HMPAO SPECT were regional perfusion abnormalities. We observed some structural abnormalities on MRI in four of the parents and two of the four healthy siblings. We also noted perfusion abnormalities on Tc-99m HMPAO SPECT in two of the parents and two of the healthy siblings. Because the disease is inherited in an autosomal recessive manner, the parents and the healthy siblings were not supposed to exhibit any demonstrable brain lesions, but the brain perfusion SPECT and MRI examinations clearly revealed multiple lesions in some of the parents and healthy siblings. Detailed neurological examinations of these

  11. Post traumatic brain perfusion SPECT analysis using reconstructed ROI maps of radioactive microsphere derived cerebral blood flow and statistical parametric mapping

    Directory of Open Access Journals (Sweden)

    Gonzalez-Brito Manuel

    2008-02-01

    Full Text Available Abstract Background Assessment of cerebral blood flow (CBF by SPECT could be important in the management of patients with severe traumatic brain injury (TBI because changes in regional CBF can affect outcome by promoting edema formation and intracranial pressure elevation (with cerebral hyperemia, or by causing secondary ischemic injury including post-traumatic stroke. The purpose of this study was to establish an improved method for evaluating regional CBF changes after TBI in piglets. Methods The focal effects of moderate traumatic brain injury (TBI on cerebral blood flow (CBF by SPECT cerebral blood perfusion (CBP imaging in an animal model were investigated by parallelized statistical techniques. Regional CBF was measured by radioactive microspheres and by SPECT 2 hours after injury in sham-operated piglets versus those receiving severe TBI by fluid-percussion injury to the left parietal lobe. Qualitative SPECT CBP accuracy was assessed against reference radioactive microsphere regional CBF measurements by map reconstruction, registration and smoothing. Cerebral hypoperfusion in the test group was identified at the voxel level using statistical parametric mapping (SPM. Results A significant area of hypoperfusion (P Conclusion The suitability of SPM for application to the experimental model and ability to provide insight into CBF changes in response to traumatic injury was validated by the SPECT SPM result of a decrease in CBP at the left parietal region injury area of the test group. Further study and correlation of this characteristic lesion with long-term outcomes and auxiliary diagnostic modalities is critical to developing more effective critical care treatment guidelines and automated medical imaging processing techniques.

  12. Diagnosis of functional loss using with PET or SPECT

    International Nuclear Information System (INIS)

    Maeda, Tetsuya; Nagata, Ken

    2009-01-01

    Described are outlines of positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging, and their application to diagnosis of brain diseases accompanying functional loss. PET imaging by annihilation photons is useful to see the brain metabolic activity with use of compounds labeled by positron emitters like 11 C, 15 O, 13 N and 18 F. Cerebral blood flow (CBF), CB volume and oxygen extraction fraction correlate well with the cerebral activity and can be measured by PET with C 15 O 2 , H 2 15 O or 15 O 2 . 18 F-glucose is usable to measure the cerebral metabolic rate of glucose. SPECT imaging by γ-rays of 133 Xe, 123 I-iofetamine (IMP), 99m Tc-hexamethyl propylene amine oxime (HMPAO) and 99m Tc-ethyl cysteinate dimer (ECD) is useful also to measure CBF in different mechanisms from agent to agent, which often reflect the pathophysiology of the lesion in problem. These imaging techniques are applied to the diagnosis of regional functional loss in ischemic brain diseases like infarction, dementia (Alzheimer and multiple vascular) and Parkinsonism, of which characters and details of actual images are presented herein. Authors say that although the imaging diagnosis for brain functional loss has progressed, the integration of neurological finding, clinical process and simple morphological brain image as well is still important in the routine examination. (K.T.)

  13. Studies on asymptomatic cerebral ischemia in coronary heart disease with special reference to evaluation of postural changes in cerebral blood flow with {sup 99m}Tc-ECD brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Sinozaki, Hideko [Teikyo Univ., Tokyo (Japan). Faculty of Medicine

    2001-03-01

    Postural changes in cerebral blood flow in patients with coronary heart disease (CHD) were evaluated with SPECT to detect asymptomaic cerebral ischemia (ACI). {sup 99m}Tc-ECD was used as a tracer. We developed a new analysis system for the processing of multiple images, making it possible to avoid the spatial shift in ROIs in different positions. The severity of ACI was classified into 3 groups based on SPECT findings in the supine position: group 1 without any abnormalities in cerebral perfusion, group 2 with a single perfusion defect, and group 3 with a number of perfusion defects. No cerebral siteobserved in any group showed a significant difference between the supine and upright positions in cerebral perfusion. Each group in each position, however, revealed a consistent perfusion pattern characterized by a significant decrease in perfusion in the occipital, temporal and frontal lobes. Moreover, the decrease in the latter two sites was significantly greater than in the former site. Concerning clinical profiles, hypertension and the thickness of the intima and media complex (TIMC) of the common carotid artery significantly correlated with the severity of ACI. Furthermore, in multiple regression analysis, only TIMC was identified as a significant determinant of ACI. In conclusion, cerebral blood flow determined with {sup 99m}Tc-ECD SPECT could accurately detect ACI in patients with CHD. (author)

  14. Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

    International Nuclear Information System (INIS)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2004-01-01

    Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5±5.6 years, educational period: 4.5±4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1±4.5 years, educational period: 6.5±4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP

  15. Correlation with neuropsychological assessment and SPM analysis of brain perfusion SPECT in patients with progressive supranuclear palsy

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Young Jin; Kang, Do Young; Park, Kyung Won; Kim, Jae Woo [School of Medicine, Dong-A University, Busan (Korea, Republic of)

    2004-07-01

    Progressive supranuclear palsy (PSP) is a degenerative condition of unknown aetiology that produces an akinetic-rigid form of parkinsonism characterised by early falls, dementia and abnormalities of extraocular movements. The patterns of decreased regional cerebral blood flow and cognitive impairment in PSP compared with normal control have been insufficiently investigated and a limited number of studies have been performed. We evaluated clinical symptoms, functional neuroimaging study using Tc-99m HMPAO SPECT and neuropsychological profiles in patients with PSP. Eleven patients with PSP diagnosed by the clinical criteria of National Institute of Neurological Disorders and Stroke and the Society for PSP (NINDS-SPSP) (mean age: 70.5{+-}5.6 years, educational period: 4.5{+-}4.7 years) and age-matched 10 healthy control subjects (mean age: 68.1{+-}4.5 years, educational period: 6.5{+-}4.1 years) participated in this study were participated. All patients were given a neurologic examination, brain MRI and cerebral perfusion SPECT using Tc-99m HMPAO. We concomittently evaluated several cognitive profiles using the Seoul Neuropsychological Screening Battery. SPM analysis of the SPECT image showed significant perfusion deficits in the left inferior frontal gyrus, left caudate nucleus, left middle frontal gyrus and cingulate gyrus in the patients with PSP compared with age-matched healthy control (uncorrected p<0.01). On neuropsychological assessment, cognitive deficits on verbal and visual memory, word fluency and frontal executive functions were prominent in most patients with PSP compared with healthy control subjects. Our findings suggest that measurement of regional cerebral blood flow by perfusion SPECT and voxel-based SPM analysis with neuropsychological assessment are useful to understanding the correlation between perfusion deficits and abnormal cognitive profiles in patients with PSP.

  16. Comparison between CT perfusion and Tc-99m ECD SPECT in the assessment of cerebrovascular reserve: a case study

    International Nuclear Information System (INIS)

    Crouch, J.; Wood, C.; Campbell, A.; McCarthy, M.; Dunne, M.; Bynevelt, M.; Lenzo, N.

    2003-01-01

    Full text: Brain perfusion is sensitively assessed by cerebral SPECT imaging utilising perfusion agents such as Tc-99m HMPAO and Tc-99m ethyl cysteinate dimer (ECD). Positron emission tomography can accurately assess and quantify brain perfusion and MRI can also be used for perfusion assessment. Both MRI and PET however are currently limited by cost and availability. A new technique utilising CT with contrast has been developed to assess and quantitate cerebral perfusion. The technique utilises arterial input information and deconvolution analysis to develop quantifiable measures of perfusion and contrast transit. The technique has been validated for acute stroke assessment and is being assessed for other possible applications. We present a case study comparison of this technique with cerebral SPECT perfusion using Tc-99m ECD in the assessment of cerebrovasular reserve. In each case, the CT and SPECT studies were performed pre- and post-acetazolamide and the SPECT study was statistically compared with a normal database utilising an automated brain perfusion statistical analysis package (NeurostatT). We discuss the correlation found between techniques, their strengths, weaknesses and possible future roles. Copyright (2003) The Australian and New Zealand Society of Nuclear Medicine Inc

  17. Regional cerebral blood flow in Parkinson's disease measured with N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Odano, Ikuo; Nishihara, Mamiko; Hayashi, Hiroko; Higuchi, Shoichi; Sakai, Kunio [Niigata Univ. (Japan). School of Medicine; Ishikawa, Atsushi; Ibayashi, Katsuhiko

    1992-09-01

    N-isopropyl-p-[[sup 123]I]iodoamphetamine (IMP) SPECT studies were performed on 21 patients (13 females; 45-73 yrs) with idiopathic Parkinson's disease (PD) and 10 age-matched normal controls (39-69 yrs). Regional cerebral blood flow (rCBF) was quantitatively measured by the arterial blood sampling method. When compared with normal controls, global CBF, and rCBF in the frontal cortex and in the basal ganglia were reduced 22.1% (p<0.01), 25.0% (p<0.05) and 25.6% (p<0.01), respectively. The reduction of rCBF in the basal ganglia was significantly correlated (p<0.05) with symptoms such as gait disturbance, frozen gait and motor disability score. However, no significant correlation was observed between the severity of dementia and any regional reduction of CBF, including the frontal or parietal cortices. These data show that the severity of dementia in PD may be related to other factors but not with CBF. Quantification of rCBF with [sup 123]I-IMP SPECT imaging is useful for evaluation and follow-up of patients with PD. (author).

  18. Combining SPECT and Quantitative EEG Analysis for the Automated Differential Diagnosis of Disorders with Amnestic Symptoms

    Directory of Open Access Journals (Sweden)

    Yvonne Höller

    2017-09-01

    Full Text Available Single photon emission computed tomography (SPECT and Electroencephalography (EEG have become established tools in routine diagnostics of dementia. We aimed to increase the diagnostic power by combining quantitative markers from SPECT and EEG for differential diagnosis of disorders with amnestic symptoms. We hypothesize that the combination of SPECT with measures of interaction (connectivity in the EEG yields higher diagnostic accuracy than the single modalities. We examined 39 patients with Alzheimer's dementia (AD, 69 patients with depressive cognitive impairment (DCI, 71 patients with amnestic mild cognitive impairment (aMCI, and 41 patients with amnestic subjective cognitive complaints (aSCC. We calculated 14 measures of interaction from a standard clinical EEG-recording and derived graph-theoretic network measures. From regional brain perfusion measured by 99mTc-hexamethyl-propylene-aminoxime (HMPAO-SPECT in 46 regions, we calculated relative cerebral perfusion in these patients. Patient groups were classified pairwise with a linear support vector machine. Classification was conducted separately for each biomarker, and then again for each EEG- biomarker combined with SPECT. Combination of SPECT with EEG-biomarkers outperformed single use of SPECT or EEG when classifying aSCC vs. AD (90%, aMCI vs. AD (70%, and AD vs. DCI (100%, while a selection of EEG measures performed best when classifying aSCC vs. aMCI (82% and aMCI vs. DCI (90%. Only the contrast between aSCC and DCI did not result in above-chance classification accuracy (60%. In general, accuracies were higher when measures of interaction (i.e., connectivity measures were applied directly than when graph-theoretical measures were derived. We suggest that quantitative analysis of EEG and machine-learning techniques can support differentiating AD, aMCI, aSCC, and DCC, especially when being combined with imaging methods such as SPECT. Quantitative analysis of EEG connectivity could become

  19. Regional Cerebral Blood-Flow with 99mTc-ECD Brain Perfusion SPECT in Landau-Kleffner Syndrome: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Reza Nemati

    2014-01-01

    Full Text Available Landau-Kleffner syndrome (LKS is a rare childhood disorder characterized by acquired aphasia and epilepsy. 99mTc-ECD SPECT imaging was performed in two right-handed children with LKS. A relative decrease in perfusion was found in the left frontal-temporal cortices of both patients as well as in the left and right parietal cortices of one patient with aphasia, without clinical epilepsy. The degree of regional cerebral perfusion impairment did not correlate with the severity of the clinical and EEG abnormalities, but the area of hypoperfusion was compatible with the speech area of the brain. Overall, although asymmetrical temporoparietal perfusion appears as a common finding in LKS, SPECT findings in LKS alone cannot elucidate the pathogenic features of the disorder in the brain. Here, we present two cases of LKS in which we investigated SPECT perfusion scans.

  20. Cerebral arteriovenous malformations. the relationship between clinical related events and rCBF SPECT imaging

    International Nuclear Information System (INIS)

    Sun Bo; Shi Xiangen

    1996-01-01

    To evaluate the relationship between clinical related events and rCBF SPECT imaging in patients with arteriovenous malformations (AVMs), the radioactive counting difference between normal and lesion site was divided by regional pixel considered as ischemic index (II). II was measured in 20 AVM cases and compared with patients' age, sex,neurological history and the size of lesions. The degree of rCBF reduction correlated with clinical neurological manifestation and showed no significant relationship with the age, sex and size of malformed vessels. II in patients with seizures was higher than that in patients with hemorrhage. The rCBF SPECT imaging may be useful for evaluation of the hemodynamics in AVMs

  1. Altered cerebral blood flow in chronic neck pain patients but not in whiplash patients: a 99mTc-HMPAO rCBF study

    OpenAIRE

    Sundström, Torbjörn; Guez, Michel; Hildingsson, Christer; Toolanen, Göran; Nyberg, Lars; Riklund, Katrine

    2006-01-01

    A cross-sectional study to investigate regional cerebral blood flow (rCBF) in patients with chronic whiplash syndrome and chronic neck pain patients without previous history of trauma along with a healthy control group. Chronic neck pain is a common disorder and a history of cervical spine injury including whiplash trauma constitute a risk factor for persistent neck pain. The aetiology of the late whiplash syndrome is unknown with no specific diagnostic criteria based on imaging, physiologica...

  2. The development of 99mTc-d, 1-HM-PAO

    International Nuclear Information System (INIS)

    Bai Lanqin; Huang Jinjie; Fan Li; Bai Suzhen; Li Guoli; Jing Hui; Xiao Lun

    1991-12-01

    The 99m Tc-d,1-HM-PAO is an ideal radiopharmaceutical for regional cerebral blood perfusion imaging. The improvement of synthesis and separation of diastereoisomers leads to obtain high purity (>99%) of d, 1-HM-PAO and meso-HM-PAO. During separation H NMR spectroscopy was used to monitor the relative composition of these two diastereoisomers that can ensure the purity of pligand of d,1-HM-PAO. The intravenous injection of 99m Tc-d,1-HM-PAO was formed by adding fresh 99m Tc washing liquor into a sterile. Pyrogen-free and freeze-dried vial. The radiochemical purity (RCP) of 99m Tc-d,1-HM-PAO was greater than 80%. From the experiments of 99m Tc-d,1-HM-PAO in mice, after two minutes of intravenously (I>V>) administration about 2.24% of injected dose (I.D.)appeared in the brain, and after 24 hours about 72% of radioactivity of injected dose still left in the brain. But for the 99m Tc-meso-HM-PAO after two minutes of i.v. administration, about 1.93% of I.D. appeared in the brain, and 24 hours later, 25% of radioactivity of I.D. was in the brain. This result shows that in the brain the radioactivity of 99m Tc-meso-HM-PAO declines faster than that of 99m Td-d,1-HM-PAO

  3. Evaluation of regional cerebral blood flow changes in normal aging using 99mTc-ECD SPECT and Patlak method

    International Nuclear Information System (INIS)

    Mizuno, Shinji; Nandate, Yuka; Enya, Mayumi; Manabe, Tomoko; Goto, Hiroo; Hoshi, Hiroaki; Takahashi, Yukitoshi; Kato, Zenichiro; Kondo, Naomi

    1998-01-01

    Changes in regional cerebral blood flow (rCBF) were studied using 99m Tc-ECD SPECT and Patlak method in 47 subjects, aged 1 to 79 years (mean 28.5 years). No abnormal finding was found on MR imaging in the subjects. We obtained mean cerebral blood flow (mCBF) by means of Patlak method. rCBF was measured by positioning regions of interest (ROIs) in frontal lobe, parietal lobe, temporal lobe, occipital lobe, cerebellum and thalamus. The correlation coefficient between ages and mCBF was r=-0.897 (p<0.0001). mCBF of children was significantly higher (p<0.05), compared with adults. By dispersion analysis according to the groups of ages, significantly higher rCBF values were available in the frontal, parietal, temporal and occipital lobes during childhood than adulthood (p<0.05), but there were almost no significant differences of rCBF during childhood than adulthood in cerebellum and thalamus. (author)

  4. Investigation of regional cerebral blood flow in alcoholic Korsakoff`s syndrome with {sup 123}I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Makoto; Nomura, Soichiro [Tachikawa Hospital, Tokyo (Japan); Kato, Motoichiro; Nakazawa, Tsuneyuki

    1995-05-01

    Regional cerebral blood flow (rCBF) was determined quantitatively by single photon emission computed tomography (SPECT) using N-isopropyl-p-[{sup 123}I]iodoamphetamine ({sup 123}I-IMP) in 6 patients with alcoholic Korsakoff`s syndrome (A group). The findings were compared with concurrently available findings from 6 alcoholic patients with no evidence of cerebral disordres such as Korsakoff`s syndrome and dementia (B group) and 4 healthy persons (C group). In both A and B groups, diffuse decrease in blood flow was significantly observed in the entire brain, as compared with the C group; no significant difference in the decreased blood flow existed between the A and B groups. According to the WAIS results, the patients in the A group were classified as `typical Korsakoff`s syndrome` (full IQ of 90 or more) and as `serious Korsakoff`s syndrome` (full IQ of 89 or less). rCBF in the thalamus was significantly lower in the A group of patients with typical Korsakoff`s syndrome than the B group. These findings may reflect the variety of alcoholic Korsakoff`s syndrome. This may also have an implication for the possible classification of several types in this syndrome. (N.K.).

  5. Does supplementation of contrast MR imaging with thallium-201 brain SPECT improve differentiation between benign and malignant ring-like contrast-enhanced cerebral lesions?

    International Nuclear Information System (INIS)

    Kita, Tamotsu; Hayashi, Katsumi; Yamamoto, Masayoshi; Kawauchi, Toshio; Sakata, Ikuko; Iwasaki, Yoshie; Kosuda, Shigeru

    2007-01-01

    The objective of this study was to determine whether thallium-201 ( 201 Tl) brain single photon emission computed tomography (SPECT) could supplement magnetic resonance (MR) imaging diagnostic information by visual comparison of two separate data sets from patients with ring-like contrast-enhanced cerebral lesions. A combination of MR imaging and 201 Tl brain SPECT sets obtained from 13 patients (10 men, 3 women) ranging in age from 26 years to 86 years (mean 61.0 years) were retrospectively reviewed. A total of 12 patients had a solitary lesion, and the others had multiple lesions. All but two intracranial foci were pathologically confirmed. The final diagnoses were six glioblastomas, two cerebral metastases from lung cancer, and one each of abscess, resolving hematoma, primary central nervous system lymphoma, toxoplasmosis, and radiation necrosis. The two separate image formats (MR images and SPECT) were shown to ten readers with practical experience. All of the MR images for each patient were shown to each reader first. After interpreting them, the readers were shown the SPECT images. Images were scored in terms of how benign or malignant the foci were on a 5-point scale from ''definitely benign'' to ''definitely malignant.'' The improvement in the performance of all ten readers was from 67.7% to 93.8% in mean accuracy (P=0.0028) and from 0.730 to 0.971 in mean Az value (P=0.0069) after they were shown the 201 Tl brain SPECT images. 201 Tl brain SPECT should substantially increase confidence in the diagnosis of intracranial lesions with ring-like contrast enhancement when MR imaging does not permit differentiation between benign and malignant disease. (author)

  6. Comparison of 18F-FDG PET and 201 thallium chloride SPECT in the evaluation of cerebral glioma prior to surgery

    International Nuclear Information System (INIS)

    Poon, A.M.T.; Cher, L.; Berlangieri, S.U.; Fabinyi, G.; Tochon-Danguy, H.; Chan, J.G.; Scott, A.M.

    2000-01-01

    Full text: The purpose of the study was to compare the accuracy of 18 F-FDG PET and 201 Tl SPECT in detecting and grading primary cerebral glioma through comparison to surgical pathology. A total of 33 patients with primary cerebral glioma had 35 18 F-FDG PET/ 201 Tl SPECT scans prior to surgery. Pre-operative 18 F -FDG PET and 201 Tl SPECT studies were reviewed and compared with histologic tumour grade. Radiological comparisons were also performed when pre-operative studies were available. 17/18 patients with glioblastoma multiforme demonstrated hypermetabolic lesions on 18 F-FDG PET scan and increased thallium uptake on SPECT scan. Increased 18 F -FDG and thallium uptake were also demonstrated in patients with anaplastic astrocytoma, gemistocytic astrocytoma, and one biopsy which was difficult to grade because of small biopsy sample and co-existing radiation necrosis. In general, low grade gliomas had reduced 18 F -FDG uptake and normal thallium uptake (6/7, where two patients had tumour with hypermetabolic and hypometabolic regions). MRI correctly identified 4/7 patients with low to intermediate grade glioma. Pilocytic astrocytoma, protoplastic astrocytoma and oligoastrocytoma all demonstrated hypometabolic PET activity and normal thallium uptake. In conclusion, 18 F-FDG PET and 201 Tl SPECT are very sensitive in pre-operative prediction of high grade glioma. In low grade tumour, 201 Tl SPECT appeared to be less useful in the absence of breakdown of the blood brain barrier. MR imaging accurately identified the presence of tumour but was less accurate in determining the grade of tumour. Copyright (2000) The Australian and New Zealand Society of Nuclear Medicine Inc

  7. Principle of cerebral hemodynamic perfusion in SPECT and new evaluation method of hemodynamic reserve capacity using {sup 99m}Tc tracer

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Masaaki; Mukai, Hironobu; Tada, Motoyuki; Miyazaki, Yoshiharu; Takimoto, Masamori; Shiozaki, Jun; Inoue, Hisashi [Noto General Hospital, Nanao, Ishikawa (Japan)

    2002-07-01

    We performed quantitative measurements of cerebral blood flow (CBF) using {sup 99m}Tc tracer by the Patlak Plot method with reference to normal aging and cerebrovascular reserve (CVR) capacity and then investigated a new evaluation method of CVR. Aging and decrease of ADL were significantly associated with reduction of the mean hemispheric CBF. In the acetazolamide (ACZ) stress test, these retrospective data showed some overlap in each ischemic grade on the relationship between rCBF and CVR response for the predictability of EC/IC bypass surgery. In these controversial problems, we must reconfirm the principle of cerebral hemodynamic perfusion in SPECT. First, retention tracer is distributed via the microcirculatory system to brain tissue. Second, therefore, we should understand not only the circulation of major vessels, but also the dynamics and rheology in parenchymal microcirculation to determine brain SPECT and CVR capacity. In the next step, we approached the new evaluation method of CVR capacity using {sup 99m}Tc tracer by a serial dynamic SPECT with a slip-ring rotational gamma camera. These preliminally findings suggest that a serial dynamic SPECT may be more useful for analyzing the pathophysiology on brain circulation and CVR than conventional approaches. (author)

  8. Brain SPECT imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Krausz, Y.; Yaffe, S.; Atlan, H.; Cohen, D.; Konstantini, S.; Meiner, Z.

    1991-01-01

    Temporal lobe epilepsy is diagnosed by clinical symptoms and signs and by localization of an epileptogenic focus. A brain SPECT study of two patients with temporal lobe epilepsy, using 99m Tc-HMPAO, was used to demonstrate a perfusion abnormality in the temporal lobe, while brain CT and MRI were non-contributory. The electroencephalogram, though abnormal, did not localize the diseased area. The potential role of the SPECT study in diagnosis and localization of temporal lobe epilepsy is discussed. (orig.)

  9. Reduced contralateral hemispheric flow measured by SPECT in cerebellar lesions

    International Nuclear Information System (INIS)

    Soenmezoglu, K.; Sperling, B.; Lassen, N.A.; Henriksen, T.; Tfelt-Hansen, P.

    1993-01-01

    Four patients with clinical signs of cerebellar stroke were studied twice by SPECT using 99m Tc-HMPAO as a tracer for cerebral blood flow (CBF). When first scanned 6 to 22 days after onset, all had a region of very low CBF in the symptomatic cerebellar hemisphere, and a mild to moderate CBF reduction (average 10%) in contralateral hemispheric cortex. In all four cases clinical signs of unilateral cerebellar dysfunction were still present when rescanned 1 to 4 months later and the relative CBF decrease in the contralateral cortex of the forebrain also remained. The basal ganglia contralateral to the cerebellar lesion CBF showed variable alterations. A relative CBF decrease was seen in upper part of basal ganglia in all four cases, but it was not a constant phenomenon. A relative CBF increase in both early and late SPECT scans was seen at low levels of neostriatum in two cases. The remote CBF changes in cerebellar stroke seen in the forebrain are probably caused by reduced or abolished cerebellar output. The term ''Crossed Cerebral Diaschisis'' may be used to describe these CBF changes that would appear to reflect both decreased and increased neuronal activity. (au)

  10. Reduced hypothalamic blood flow after radiation treatment of nasopharyngeal cancer: SPECT studies in 34 patients

    International Nuclear Information System (INIS)

    Chieng, P.U.; Huang, T.S.; Chang, C.C.; Chong, P.N.; Tien, R.D.; Su, C.T.

    1991-01-01

    To determine the effect of cranial irradiation on hypothalamic blood flow, the authors performed 44 regional cerebral blood flow studies with 99mTc hexamethyl propyleneamine oxime (HMPAO) single-photon emission CT (SPECT) on four normal volunteers and 34 patients with pathologically proved nasopharyngeal cancer. Twenty-three men and 15 women, 30-65 years old, were divided into four study groups: group 1 served as a control and consisted of four normal volunteers and six patients studied prior to cranial irradiation; group 2 patients had cranial irradiation half a year before the SPECT study (n = 12, one from group 1); group 3 patients were irradiated 1 year before the study (n = 13, three from group 1 and two from group 2); and group 4 patients were irradiated at least 5 years before SPECT imaging (n = 9). Six patients were studied twice. Quantification of the 99mTc-HMPAO brain SPECT studies was done separately by three radiologists to obtain the hypothalamus/occipital (H/O) and hypothalamus/parasagittal (H/P) ratios. Endocrinologic studies were performed in all cases and the hypothalamus-thyrotroph-thyroid, hypothalamus-gonadotroph-testis (ovary), hypothalamus-lactotroph, hypothalamus-somatotroph, and hypothalamus-corticotroph-adrenal axes were evaluated separately. They determined that regional hypothalamic blood flow was reduced after cranial irradiation in patients with nasopharyngeal cancer. The H/O ratio of groups 3 and 4 did not differ from that of group 2 (one-half year after cranial irradiation). The H/O ratio was significantly reduced 6 months and 1 year after cranial irradiation; mean ± SD = 0.5801 ± 0.0829 (p less than .025), 0.5725 ± 0.0791 (p less than .01) versus 0.6477 ± 0.0458 before cranial irradiation, respectively

  11. Relationship between SPECT regional cerebral blood flow imaging and cognitive function in school-age children with epilepsy

    International Nuclear Information System (INIS)

    Liu Jiangyan; Chen Xuehong; Wang Zhengjiang; Hu Jingui; Feng Jianzhong; Li Yimin; Lu Xiujuan

    2006-01-01

    Objective: To explore the feature of SPECT regional cerebral blood flow(rCBF) imaging, the cognitive functions and the relationship between them in school-age children with primary epilepsy. Methods: 99 Tc m -ethylene cysteinate dimer (ECD) brain imaging was performed on 32 school-age children with primary generalized tonic and (or) clonic seizures(GTCS). Cognitive functions were also evaluated in all patients and normal children. Relationship between cognitive function and rCBF was compared. Results: (1) Thirty of 32 (93.8%) patients were abnormal on SPECT imaging. Fifty areas of 29 cases showed decreased rCBF, the percentage of decreased rCBF was (21.07 ± 7.09)%; 2 areas of 1 case showed increased rCBF, the percentage of increased rCBF was (32.22 ± 4.31)%. 92.3% of the epileptic foci were located in frontal, temporal, parietal and occipital cortexes. (2) Verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full-scale intelligence quotient (FIQ) of children with epilepsy were significantly lower than those of the controls, and there were some cognitive skewnesses in children with epilepsy (VIQ >PIQ). (3)There was negative correlation between the number of foci and VIQ, PIQ, FIQ, the correlation coefficients were -0.543 (P=0.002), -0.469 (P=0.009), -0.578 (P=0.001); there was negative correlation between the extent of foci and VIQ, PIQ, FIQ, the correlation coefficients were -0.560 (P=0.003), -0.142 (P=0.016), -0.582 (P=0.001); there was no significant correlation between all the IQ of cognitive test and the percentage of changed rCBF. Conclusions: SPECT rCBF imaging may be useful for the localization of epileptic focus. Some of school-age children with epilepsy have impairment of the cognitive function, its magnitude is negative correlated with the number and extent of epileptic foci. (authors)

  12. Assessment of changes in regional cerebral blood flow in patients with major depression using the 99mTc-HMPAO single photon emission tomography method

    International Nuclear Information System (INIS)

    Yazici, K.; Kapucu, Oe.; Erbas, B.; Varoglu, E.; Guelec, C.; Bekdik, C.F.; Hacettepe Univ., Ankara

    1992-01-01

    Regional cerebral blood flow was investigated in 14 patients with major depression diagnosed according to the DSM-III-R criteria (six patients with single and eight patients with recurrent episodes) and in ten healthy volunteers. The mean ages of the patients and the controls were 33.5±2.7 and 31.6±2.6 years, respectively. The severity of the depression was assessed using the 17-item Hamiltonian Depression Scale (mean: 23.2±1.5). None of the patients was under medication. After administration of 500 MBq technetium-99m hexamethylpropylene amine oxime, a single photon emission tomography study was performed and then transaxial, sagittal and coronal slices were obtained. For the semiquantitative analysis of the data, the ratios of the mean counts/pixel to the whole slice were calculated for 24 regions on three consecutive transaxial slices in the orbitomeatal plane. Additionally, left/right and frontal/occipital ratios were calculated. Both sides of the temporal region had a significantly decreased cerebral blood flow (CBF) when compared to the controls. The left/right ratio of the prefrontal region was also significantly lower in the patients than in the controls. The Hamilton score had a negative correlation with blood flow in the anterofrontal and left prefrontal regions. According to our results, regional CBF seems to be decreased in the left prefrontal and in both temporal regions in major depression. The severity of depression is correlated with the reduction in CBF in the regions of the anterofrontal and left prefrontal cortex. (orig.)

  13. Cerebral blood flow and volume in sympton-free migraineurs: A SPECT study

    International Nuclear Information System (INIS)

    Maini, C.L.; Turco, G.L.; Castellano, G.; Podio, V.; Cornaglia, G.; Liboni, W.; Chianale, G.

    1990-01-01

    Both CBF and BCV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT. (orig.) [de

  14. Cerebral blood flow and volume in sympton-free migraineurs: A SPECT study

    Energy Technology Data Exchange (ETDEWEB)

    Maini, C.L. (Ancona Univ. (Italy). Chair of Nuclear Medicine); Turco, G.L.; Castellano, G.; Podio, V.; Cornaglia, G. (Turin Univ. (Italy). Chair of Nuclear Medicine); Liboni, W.; Chianale, G. (Turin Univ. (Italy). Dept. of Neurology)

    1990-11-01

    Both CBF and BCV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients. The decreased perfusion was localized in the frontal lobe in 6 patients, the temporal lobe in one, the parietal lobe in 11 and the occipital lobe in 5 patients. The parieto-occipital cortex was involved more often than the frontal cortex; the association of hypoperfusion with parieto-occipital cortex was quite high. The right parieto-occipital regions were affected more often than the left ones. Regional CBV was increased in 8 patients. There was good topographical concordance between decreased CBF and increased CBV, but the increase of CBV was in general more evident at the periphery of the hypoperfusion. It is of interest that the only patient with a normal CBF study had a pathological CBV study. Apparently, CBF derangements are very common in symptom-free patients with classic migraine, a CBF decrease being often accompanied by a CBV increase. In these patients both CT and MRI have a lower diagnostic yield than SPECT. (orig.).

  15. Ictal and interictal SPECT imaging of 8 patients with symptomatic partial epilepsy

    International Nuclear Information System (INIS)

    Motooka, Hiromichi

    1993-01-01

    Although epileptic discharges such as spike, spike and wave complex, sharp wave, and sharp and wave complex can be recorded by interictal scalp electroencephalography (EEG) in many patients with epilepsy, recent studies have demonstrated that no epileptic discharges can be recorded by interictal and ictal scalp EEGs in some patients who clinically exhibit epileptic seizures. Accordingly scalp EEG is not always helpful for diagnosing epilepsy or identifying the epileptic foci in the brain in these patients. Recently, studies using single photon emission computed tomography (SPECT) have been performed for patients with epilepsy and evidence that epileptic foci can be identified by changes in the regional cerebral blood flow (rCBF) seen on SPECT scanning have been accumulated. In the present study, therefore, 8 patients with medically intractable partial seizures were simultaneously or independently investigated by the recordings of scalp EEG and SPECT scanning during the interictal and ictal period. N-isopropyl-p[ 123 I]-iodoamphetamine ( 123 I-IMP) was used for SPECT scanning for 7 patients and 99m Tc-d,l-hexamethyl-propyleneamineoxime ( 99m Tc-HMPAO) for 1 patient. An increase in rCBF (hyperperfusion) or decrease in rCBF (hypoperfusion) were found in 4 patients by interictal SPECT imaging and in all patients by ictal SPECT imaging although epileptic discharges were observed in 3 patients by interictal scalp EEG and 5 patients by ictal scalp EEG. The findings of the present study indicate that ictal SPECT scanning is more useful for diagnosing epilepsy and identifying the epileptic foci in the brain than ictal scalp EEG. (author)

  16. Brain SPECT of chronic fatigue syndrome (CFS): a blinded visual analysis

    International Nuclear Information System (INIS)

    Casse, R.; Chew, G.; Barnden, L.; DelFante, P.; Burnet, R.; Kwiatek, R.; Chew, J.; Behin-Ain, S.; Unger, S.

    2002-01-01

    Full text: Chronic fatigue syndrome (CFS) is a debilitating and complex disorder characterised by profound fatigue and neuropsychiatric dysfunction. Previous studies with cerebral perfusion SPECT (rCBF) scans have yielded conflicting results. Most were performed with inhomogeneous patient populations and the findings were not based on a blinded visual analysis. To address this, HMPAO SPECT on a triple head gamma camera was performed on a group of 59 subjects. This group included 32 subjects (16-61 years, 24F and 8M) with moderate CFS based on the Fukuda criteria not on medication and not depressed and 27 normal volunteers (20-56 years, 16F and 11 M). Two blinded reviewers (RC and GC) separately assessed the SPECT studies. 28 brain structures were scored as either definitely abnormal(1), possibly abnormal(2) or normal(3-5). Abnormal results were only found in the temporal lobes and brainstem. The results (Sensitivity/Specificity) based on scores 1 or 2, show that that abnormal score yielded acceptable specificity but low sensitivity. Scores 1 or 2 improved sensitivity but reduced the specificity. This shows that visual analysis of brain SPECT is not a reliable discriminant test for CFS, although quantitative analysis with statistical parametric mapping (SPM) has demonstrated significant abnormalities. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  17. Regional cerebral blood flow as assessed by principal component analysis and 99mTc-HMPAO SPET in healthy subjects at rest: normal distribution and effect of age and gender

    International Nuclear Information System (INIS)

    Pagani, M.; Salmaso, D.; Jonsson, C.; Hatherly, R.; Larsson, S.A.; Jacobsson, H.; Waegner, A.

    2002-01-01

    The increasing implementation of standardisation techniques in brain research and clinical diagnosis has highlighted the importance of reliable baseline data from normal control subjects for inter-subject analysis. In this context, knowledge of the regional cerebral blood flow (rCBF) distribution in normal ageing is a factor of the utmost importance. In the present study, rCBF was investigated in 50 healthy volunteers (25 men, 25 women), aged 31-78 years, who were examined at rest by means of single-photon emission tomography (SPET) using technetium-99m d,l-hexamethylpropylene amine oxime (HMPAO). After normalising the CBF data, 27 left and 27 right volumes of interest (VOIs) were selected and automatically outlined by standardisation software (computerised brain atlas). The heavy load of flow data thus obtained was reduced in number and grouped in factors by means of principal component analysis (PCA). PCA extracted 12 components explaining 81% of the variance and including the vast majority of cortical and subcortical regions. Analysis of variance and regression analyses were performed for rCBF, age and gender before PCA was applied and subsequently for each single extracted factor. There was a significantly higher CBF on the right side than on the left side (P<0.001). In the overall analysis, a significant decrease was found in CBF (P=0.05) with increasing age, and this decrease was particularly evident in the left hemisphere (P=0.006). When gender was specifically analysed, CBF was found to decrease significantly with increasing age in females (P=0.037) but not in males. Furthermore, a significant decrease in rCBF with increasing age was found in the brain vertex (P=0.05), left frontotemporal cortex (P=0.012) and temporocingulate cortex (P=0.003). By contrast, relative rCBF in central structures increased with age (P=0.001). The ability of standardisation software and PCA to identify functionally connected brain regions might contribute to a better

  18. Regional cerebral blood flow as assessed by principal component analysis and {sup 99m}Tc-HMPAO SPET in healthy subjects at rest: normal distribution and effect of age and gender

    Energy Technology Data Exchange (ETDEWEB)

    Pagani, M. [Inst. of Neurobiology and Molecular Medicine, CNR, Rome (Italy); Dept. of Hospital Physics, Karolinska Hospital, Stockholm (Sweden); Salmaso, D. [Inst. of Psychology, CNR, Rome (Italy); Jonsson, C.; Hatherly, R.; Larsson, S.A. [Dept. of Hospital Physics, Karolinska Hospital, Stockholm (Sweden); Jacobsson, H. [Dept. of Diagnostic Radiology, Karolinska Hospital, Stockholm (Sweden); Waegner, A. [Dept. of Clinical Neuroscience, Karolinska Institutet, Stockholm (Sweden); Dept. of Clinical Neuroscience, Karolinska Hospital, Stockholm (Sweden)

    2002-01-01

    The increasing implementation of standardisation techniques in brain research and clinical diagnosis has highlighted the importance of reliable baseline data from normal control subjects for inter-subject analysis. In this context, knowledge of the regional cerebral blood flow (rCBF) distribution in normal ageing is a factor of the utmost importance. In the present study, rCBF was investigated in 50 healthy volunteers (25 men, 25 women), aged 31-78 years, who were examined at rest by means of single-photon emission tomography (SPET) using technetium-99m d,l-hexamethylpropylene amine oxime (HMPAO). After normalising the CBF data, 27 left and 27 right volumes of interest (VOIs) were selected and automatically outlined by standardisation software (computerised brain atlas). The heavy load of flow data thus obtained was reduced in number and grouped in factors by means of principal component analysis (PCA). PCA extracted 12 components explaining 81% of the variance and including the vast majority of cortical and subcortical regions. Analysis of variance and regression analyses were performed for rCBF, age and gender before PCA was applied and subsequently for each single extracted factor. There was a significantly higher CBF on the right side than on the left side (P<0.001). In the overall analysis, a significant decrease was found in CBF (P=0.05) with increasing age, and this decrease was particularly evident in the left hemisphere (P=0.006). When gender was specifically analysed, CBF was found to decrease significantly with increasing age in females (P=0.037) but not in males. Furthermore, a significant decrease in rCBF with increasing age was found in the brain vertex (P=0.05), left frontotemporal cortex (P=0.012) and temporocingulate cortex (P=0.003). By contrast, relative rCBF in central structures increased with age (P=0.001). The ability of standardisation software and PCA to identify functionally connected brain regions might contribute to a better

  19. Quantitative cerebral blood flow assessment in senile dementia of Alzheimer type and multi-infarct dementia using sup 123 I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Arai, Hisayuki; Hanyu, Haruo; Kobayashi, Yasutaka; Uno, Masanobu; Hatano, Nobuyoshi; Shin, Kouichi; Katsunuma, Hideyo; Suzuki, Takanari; Murayama, Hiroyasu [Tokyo Medical Coll. (Japan)

    1990-06-01

    In order to compare senile dementia of Alzheimer type (SDAT) with multi-infarct dementia (MID) from the standpoint of cerebral blood flow, a study was carried out by using single photon emission CT (SPECT) with N-isopropyl-p-({sup 123}I) iodoamphetamine on 14 healthy aged subjects, 12 patients with SDAT, 8 patients with MID and 7 patients with multiple infarction (MI). The diagnosis of SDAT, MID and MI was based on a clinical history, X-ray CT findings and Hachinski's ischemic score. Venous blood sampling method of Matsuda et al. was used as quantitative cerebral blood flow measurements. The mean cerebral blood flow (mCBF) values in controls was 52.1{plus minus}5.5 ml/100 g/min, while the corresponding values in SDAT, MI and MID were 36.9{plus minus}5.0, 41.0{plus minus}6.2, and 37.7{plus minus}4.3 ml/100 g/min. The regional cerebral blood flow (rCBF) was decreased mainly at bilateral frontal lobes in MID and at temporal and parietal lobes in SDAT. Verbal intelligence score (Hasegawa's dementia score) correlated with rCBF at frontal lobes in MID. These findings suggest that quantitative rCBF measurement by {sup 123}I-IMP SPECT is useful to differentiate MID from SDAT. (author).

  20. Reduction in mean cerebral blood flow measurements using {sup 99m}Tc-ECD-SPECT during normal aging

    Energy Technology Data Exchange (ETDEWEB)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Hara, Shigeru [Narita Memorial Hospital, Toyohashi, Aichi (Japan)

    1997-10-01

    Mean cerebral blood flow (mCBF) was measured by SPECT using the {sup 99m}Tc-ECD-Patlak-Plot method in a selected group of 61 normal non-hospitalized subjects aged 51 to 91 years. The mCBF values showed 48.4{+-}4.7 ml/100 g/min in aged 50-59 years group, 49.9{+-}5.9 ml/100 g/min in aged 60-69 years group, 46.4 {+-}6.5 ml/100 g/min in aged 70-79 group, 38.0{+-}3.7 ml/100 g/min in aged 80-89 years group, 38.9 ml/100 g/min in aged 90-99 years group. There was a statistically significant reduction of mCBF with advancing age (R=-0.41; p=0.001). Women have significantly higher mCBF values than men up to aged 70 years group. In this study, there was no significant laterality in the mCBF between right and left hemispheres in all decade groups. The history of hypertension, alcohol consumption, and cigarette smoking failed to show significant difference in the mCBF values. The present study shows that normal aging is associated with mCBF reduction. (author)

  1. Reduction in mean cerebral blood flow measurements using 99mTc-ECD-SPECT during normal aging

    International Nuclear Information System (INIS)

    Kawahata, Nobuya; Daitoh, Nobuyuki; Shirai, Fumie; Hara, Shigeru

    1997-01-01

    Mean cerebral blood flow (mCBF) was measured by SPECT using the 99m Tc-ECD-Patlak-Plot method in a selected group of 61 normal non-hospitalized subjects aged 51 to 91 years. The mCBF values showed 48.4±4.7 ml/100 g/min in aged 50-59 years group, 49.9±5.9 ml/100 g/min in aged 60-69 years group, 46.4 ±6.5 ml/100 g/min in aged 70-79 group, 38.0±3.7 ml/100 g/min in aged 80-89 years group, 38.9 ml/100 g/min in aged 90-99 years group. There was a statistically significant reduction of mCBF with advancing age (R=-0.41; p=0.001). Women have significantly higher mCBF values than men up to aged 70 years group. In this study, there was no significant laterality in the mCBF between right and left hemispheres in all decade groups. The history of hypertension, alcohol consumption, and cigarette smoking failed to show significant difference in the mCBF values. The present study shows that normal aging is associated with mCBF reduction. (author)

  2. Evaluation of brain perfusion SPECT imaging using 99mTc-ECD

    International Nuclear Information System (INIS)

    Matsuda, Hiroshi; Kinuya, Keiko; Higashi, Sotaro; Kawasaki, Yasuhiro; Sumiya, Hisashi; Shuke, Noriyuki; Hisada, Kinichi; Yamashita, Junkoh; Yamaguchi, Nariyoshi

    1991-01-01

    Fundamental and clinical evaluation was performed on 99m Tc-ethyl cysteinate dimer ( 99m Tc-ECD), that is a new agent for brain perfusion SPECT. Radiochemical purity reaches a plateau of approximately 98% at 30 min after reconstruction and remains stable up to 24 hours later. A biodistribution study showed approximately 5% injected dose in the brain, very slow brain washout of 5.6% per hour on the average, and rapid washout from the other organ mainly through the urinary system. Brain ECD distribution was determined within 2 min postinjection and remained stable for up to 1 hour. Three hours later, slight but significant changes in brain distribution were observed, that were relative reduction of cerebral cortical activity and gray to white matter activity ratio, and relative elevation of white matter and thalamic activities. Comparative studies of ECD images with 123 I-iodoamphetamine (IMP) and 99m Tc-d, l-hexa-methylpro-pyleneamine oxime (HMPAO) images revealed that radioactivity contrast between affected and unaffected areas was less prominent in ECD than in IMP in cerebral and cerebellar cortical lesions, more prominent in ECD than in IMP in striatal and thalamic lesions, and somewhat more prominent in ECD than in HMPAO in both lesions. Imaging around 1 hour postinjection seems to be more appropriate than immediate postinjection imaging because of the clearance of the extracranial radioactivity and somewhat better radioactivity contrast between affected and unaffected areas. (author)

  3. Regional cerebral blood flow in neuropediatrics; Regionalny przeplyw mozgowy krwi w chorobach neuropediatrycznych

    Energy Technology Data Exchange (ETDEWEB)

    Junik, R [Katedra i Klinika Endokrynologii i Diabetologii, Akademia Medyczna, Bydgoszcz (Poland); Katedra i Klinika Endokrynologii i Przemiany Materii, Akademia Medyczna, Poznan (Poland)

    2001-07-01

    Single photon emission computed tomography can effectively and non-invasively measure regional blood flow. Mostly used 99mTc-HMPAO is a safe brain imaging agent for pediatric applications. The radiation dose is acceptable. Knowledge of the normal rCBF pattern, including normal asymmetries and variations due to age, is necessary prerequisite for the evaluation and reporting of the results of 99mTc-HMPAO brain SPECT studies in clinical practice. The interpretation of he rCBF study in a child requires knowledge of normal brain maturation. The aim of the present review is to focus on the contribution to clinical developmental neurology of SPECT The clinical use of SPECT in developmental neurology are epilepsy, brain death, acute neurological loss including stroke, language disorders, cerebral palsy, high-risk neonates, hypertension due to renovascular disease, traumatic brain injury, migraine, anorexia nervosa, autism, Gilles de la Tourette syndrome, attention deficit disorder-hyperactivity, and monitoring therapy. Sedation is not routinely used, rather each child is evaluated. However, drug sedation is mandatory in some uncooperative children. (author)

  4. 99mTc-ECD brain SPECT in patients with Moyamoya disease: a reflection of cerebral perfusion status at tissue level in the disease process

    International Nuclear Information System (INIS)

    Kashyap, Raghava; Mittal, Bhagwant Rai; Sunil, Hejjaji Venkataramarao; Bhattacharya, Anish; Singh, Baljinder; Mukherjee, Kanchan Kumar; Gupta, Sunil Kumar

    2011-01-01

    Moyamoya disease is a rare, progressive cerebrovascular disorder caused by intracranial stenosis of the circle of Willis, resulting in successive ischemic events. Computed tomography (CT) and magnetic resonance imaging (MRI) play a major role in diagnosis. The aim of the study was to describe the spectrum of findings on brain SPECT in patients with Moyamoya disease and to compare the findings with other investigations. 99m Tc-ECD SPECT scans of seventeen patients (7 children and 10 adults) were analysed to study the brain perfusion. Features of Moyamoya disease were detected on DSA in 11 patients, CTA in one, MR angiography in one patient. Brain perfusion SPECT analysis showed unilateral perfusion defects in 11 patients, normal perfusion in 2 and bilateral defects in 4 patients. No perfusion defects despite bilateral vascular changes were noted in one patient. Cerebral infarcts were detected on MRI unilaterally in three subjects while multiple infarcts were identified in one. 99m Tc-ECD Brain SPECT showed perfusion defects that were more extensive compared to those detected on MRI. Post acetazolamide studies for assessment of cerebrovascular reserve were done in three patients. Two of them showed good cerebrovascular reserve (>1). Follow-up studies post-surgical procedures (Myo-dura synangiosis) done in two patients showed partial resolution of perfusion defects in the involved areas. Brain perfusion scintigraphy is an important adjunct in evaluation of patients with Moyamoya disease yielding information about the direct end results of the pathology in the vessels and also prognostic information. (author)

  5. Presurgical evaluation of cerebral perfusion reserve in patients for cardiovascular surgery using {sup 99m}Tc-ECD SPECT with diamox enhancement

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kaname; Nakashima, Hiromichi; Tanaka, Kuniyoshi; Kitano, Tokio; Murashima, Shuichi; Takeda, Kan; Yuasa, Hiroshi; Yada, Isao; Nakagawa, Tsuyoshi [Mie Univ., Tsu (Japan). School of Medicine

    1996-03-01

    Cerebrovascular stroke is one of the major complications in cardiovascular surgery with cardiopulmonary bypass. The purpose of this study was to evaluate the usefulness of preoperative {sup 99m}Tc-ethyl cysteinate dimer (ECD) SPECT and acetazolamide (diamox) enhancement to predict neurological complications in cardiovascular surgery. Eighteen patients with coronary disease, valvular disease or aortic aneurysm were studied before the operations. Regional cerebral blood flow and perfusion reserve were evaluated using ECD SPECT before and after the intravenous administration of diamox (1 g). Three cases with moderate to severe baseline abnormalities and poor perfusion reserve had cerebral infarction postoperatively. Twelve cases with good to fair perfusion reserve had no neurological complication. Three cases having poor perfusion reserve had the operations with more intensive brain protection, in which higher perfusion pressure to the brain was maintained during cardiopulmonary bypass, and no neurological complication was observed. In conclusion, patients who have moderately or markedly abnormal baseline flow with poor perfusion reserve may have some risk of neurological complications in cardiovascular surgery. ECD SPECT with diamox enhancement may give information useful for selection of operation procedures. (author).

  6. A quantitative study of regional cerebral blood flow in childhood using {sup 123}I-IMP-SPECT. With emphasis on age-related changes

    Energy Technology Data Exchange (ETDEWEB)

    Kobayashi, Ayame; Kishi, Kazuko; Sejima, Hitoshi; Haneda, Noriyuki; Uchida, Nobue; Sugimura, Kazuro; Ito, Masatoshi; Shiraishi, Hideyuki [Shimane Medical Univ., Izumo (Japan)

    1996-11-01

    Single photon emission computed tomography (SPECT), using N-isopropyl-p-={sup 123}I= iodoamphetamine ({sup 123}I-IMP) was used for quantitative analysis of regional cerebral blood flow (rCBF) on 26 individuals between 0 and 19 years of age. The rCBF showed age-related changes; it was low in early infancy, increased in late infancy through early childhood, and decreased and remained constant after puberty. The rCBF through cerebral cortex varied more greatly than through thalamus and cerebellum, and seemed to depend more closely on age. In the case of 4 months of age rCBF was very low at the frontal region and was very high at the occipital region. In more older cases, rCBF in the cerebral cortex was higher than in the thalamus. In childhood, rCBF was very inconsistent and showed a great inter-individual variance. (author)

  7. A quantitative study of regional cerebral blood flow in childhood using 123I-IMP-SPECT. With emphasis on age-related changes

    International Nuclear Information System (INIS)

    Kobayashi, Ayame; Kishi, Kazuko; Sejima, Hitoshi; Haneda, Noriyuki; Uchida, Nobue; Sugimura, Kazuro; Ito, Masatoshi; Shiraishi, Hideyuki

    1996-01-01

    Single photon emission computed tomography (SPECT), using N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP) was used for quantitative analysis of regional cerebral blood flow (rCBF) on 26 individuals between 0 and 19 years of age. The rCBF showed age-related changes; it was low in early infancy, increased in late infancy through early childhood, and decreased and remained constant after puberty. The rCBF through cerebral cortex varied more greatly than through thalamus and cerebellum, and seemed to depend more closely on age. In the case of 4 months of age rCBF was very low at the frontal region and was very high at the occipital region. In more older cases, rCBF in the cerebral cortex was higher than in the thalamus. In childhood, rCBF was very inconsistent and showed a great inter-individual variance. (author)

  8. Analysis of cognitive function and regional cerebral blood flow in Parkinson's disease by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Yamamoto, Kiyoshi

    1992-01-01

    To investigate the relationship between alterations of regional cerebral blood flow (rCBF) and cognitive impairment in parkinsonian patients, I studied 41 patients with Parkinson's disease (19 men and 22 women) using single photon emission computed tomography (SPECT) with N-isopropyl-p-[ 123 I]iodoamphetamine ( 123 I-IMP). I evaluated cognitive function with the Mini-Mental State examination (MMS), the Hasegawa's Dementia Scale (HDS), the Kana-pick up test (KT), and the figure drawing test (FDT). I evaluated motor impairment with the Hoehn and Yahr stage. SPECT scanning was performed with a rotating digital gamma camera TOSHIBA 901-A. A semiquantitative method of assessing regional tracer uptake was used. Regions of interest (ROI: 3x3 pixels, 15.9x15.9 mm 2 ) were drawn on the cerebellar hemispheres, cortical regions (frontal, temporal, parietal and occipital), and basal ganglia bilaterally. The RI count index was expressed as a ratio of activity in each ROI to mean counting rate over cerebellar regions. I considered the RI count index as the index of rCBF in each ROI. There were strong positive correlations between MMS and rCBF of frontal, parietal and occipital lobes (p<0.001). There were positive correlations between HDS and rCBF of frontal (p<0.01), parietal (p<0.001) and occipital lobes (p<0.01). There were positive correlations between KT and rCBF of frontal (p<0.01) and occipital (p<0.05) lobes. There were no correlations between FDT and rCBF. There were negative correlations between the Hoehn and Yahr stage and MMS (p<0.001), HDS (p<0.001), KT (p<0.001) and FDT (p<0.05). There seemed to be a relationship between cognitive function and rCBF of frontal, parietal and occipital cortex, between motor impairment and rCBF of frontal lobe and between cognitive and motor impairments in parkinsonian patients. These findings suggest that intellectual deterioration in Parkinson's disease may be caused by a specific mechanism different from Alzheimer's disease. (author)

  9. Analysis of cognitive function and regional cerebral blood flow in Parkinson's disease by sup 123 I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Kiyoshi [Yamaguchi Univ., Ube (Japan). School of Medicine

    1992-01-01

    To investigate the relationship between alterations of regional cerebral blood flow (rCBF) and cognitive impairment in parkinsonian patients, I studied 41 patients with Parkinson's disease (19 men and 22 women) using single photon emission computed tomography (SPECT) with N-isopropyl-p-({sup 123}I)iodoamphetamine ({sup 123}I-IMP). I evaluated cognitive function with the Mini-Mental State examination (MMS), the Hasegawa's Dementia Scale (HDS), the Kana-pick up test (KT), and the figure drawing test (FDT). I evaluated motor impairment with the Hoehn and Yahr stage. SPECT scanning was performed with a rotating digital gamma camera TOSHIBA 901-A. A semiquantitative method of assessing regional tracer uptake was used. Regions of interest (ROI: 3x3 pixels, 15.9x15.9 mm{sup 2}) were drawn on the cerebellar hemispheres, cortical regions (frontal, temporal, parietal and occipital), and basal ganglia bilaterally. The RI count index was expressed as a ratio of activity in each ROI to mean counting rate over cerebellar regions. I considered the RI count index as the index of rCBF in each ROI. There were strong positive correlations between MMS and rCBF of frontal, parietal and occipital lobes (p<0.001). There were positive correlations between HDS and rCBF of frontal (p<0.01), parietal (p<0.001) and occipital lobes (p<0.01). There were positive correlations between KT and rCBF of frontal (p<0.01) and occipital (p<0.05) lobes. There were no correlations between FDT and rCBF. There were negative correlations between the Hoehn and Yahr stage and MMS (p<0.001), HDS (p<0.001), KT (p<0.001) and FDT (p<0.05). There seemed to be a relationship between cognitive function and rCBF of frontal, parietal and occipital cortex, between motor impairment and rCBF of frontal lobe and between cognitive and motor impairments in parkinsonian patients. (author).

  10. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S. [Samsung Medical Center, Seoul (Korea, Republic of); Lee, Kyung Han; Lee, Myung Chul [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    1996-03-15

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p<0.05). There was no correlation between the severity of the motor abnormality and any of the regional cerebral perfusion indices (p>0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  11. 99mTc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

    International Nuclear Information System (INIS)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier; Niboyet, Jean

    2007-01-01

    Neuro-imaging studies with 99m Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. 99m Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using 99m Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82±4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  12. {sup 99m}Tc-ECD brain perfusion SPECT in hyperalgesic fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric; Taieb, David; Cammilleri, Serge; Lussato, David; Laforte, Catherine de; Mundler, Olivier [Assistance Publique des Hopitaux de Marseille, Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 05 (France); Niboyet, Jean [Clinique La Phoceanne, Unite d' Etude et de Traitement de la Douleur, Marseille (France)

    2007-01-15

    Neuro-imaging studies with {sup 99m}Tc-HMPAO SPECT in fibromyalgia (FM) patients have reported only limited subcortical hypoperfusion. {sup 99m}Tc-ECD SPECT is known to provide better evaluation of areas of high cerebral blood flow and regional metabolic rate. We evaluated a homogeneous group of hyperalgesic patients with FM using {sup 99m}Tc-ECD SPECT. The aim of this study was to investigate brain processing associated with spontaneous pain in FM patients. Eighteen hyperalgesic FM women (mean age 49 years, range 25-63 years; American College of Rheumatology criteria) and ten healthy women matched for age were enrolled in the study. A voxel-by-voxel group analysis was performed using SPM2 (p<0.05, corrected for multiple comparisons). Visual Analogue Scale score for pain was 82{+-}4 at the time of the SPECT study. Compared with control subjects, we observed individual brain SPECT abnormalities in FM patients, confirmed by SPM2 analysis, with hyperperfusion of the somatosensory cortex and hypoperfusion of the frontal, cingulate, medial temporal and cerebellar cortices. In the present study, performed without noxious stimuli in hyperalgesic FM patients, we found significant hyperperfusion in regions of the brain known to be involved in the sensory dimension of pain processing and significant hypoperfusion in areas assumed to be associated with the affective-attentional dimension. As current pharmacological and non-pharmacological therapies act differently on the two components of pain, we hypothesise that SPECT could be a valuable and readily available tool to guide individual therapeutic strategy and provide objective follow-up of pain processing recovery under treatment. (orig.)

  13. Usefulness of quantitative determination of cerebral blood flow by 123I-IMP SPECT reference sample method in various cerebrovascular disorders

    International Nuclear Information System (INIS)

    Fukuda, Tadaharu; Hasegawa, Kouichi; Yamanaka, Shigehito; Hasue, Masamichi; Ohtubo, Yutaka; Wada, Atsushi; Nakanishi, Hisashi; Nakamura, Tatuya; Itou, Hiroshi.

    1992-01-01

    Cerebral blood flow (CBF) was quantitatively determined by N-isopropyl-p-[ 123 I] iodo-amphetamine (IMP) single photon emission computed tomography (SPECT) with a rotating gamma camera. A ZLC 7500 unit (SIEMENS Inc.) was used for emission CT, and a SCINTIPAK-2400 (Shimadzu Corp. Ltd.) for data processing. For the quantitative determination of CBF, arterial blood samples were collected for 5 minutes during the intravenous injection of 111 MBq of IMP, and a reference sample method corrected by time-activity curve was used. The determination was carried out in 90 patients with various cerebrovascular diseases and 5 normal volunteers. Mean cerebral blood flow (m-CBF) in the normal cases as determined by the above method was 42.4±6.0 (ml/100g/min). In patients with acute phase subarachnoid hemorrhage (SAH), severity on CT was marked in patients with intracerebral hematomas greater than 45 mm in diameter. Patients with non-hemorrhagic arteriovenous malfomation (AVM) whose nidi were 30 mm or more in diameter showed a decrease in CBF on the afferent side. This decrease was caused by a steal phenomenon affecting CBF around the AVM. The size of cerebral infarction on CT was closely correlated with the decrease in CBF, and CBF in patients with stenosis and obstruction of the main trunks was less than that in patients without them. CBF was increased by 10-20% in patients who underwent carotid endarterectomy or superior temporal artery-middle cerebral artery anastomosis for obstruction or stenosis of the internal carotid artery or the middle cerebral artery. The quantitative determination of CBF by IMP SPECT reference sample method was useful for evaluating the morbid condition and estimating the prognosis of cerebrovascular diseases, and evaluating the effects of therapy. (J.P.N.)

  14. Brain perfusion SPECT of patients with anorexia nervosa. Evaluation using statistical parametric mapping (SPM96)

    International Nuclear Information System (INIS)

    Nakabeppu, Yoshiaki; Nakajoh, Masayuki; Tsuchimochi, Shinsaku; Tani, Atsushi; Umanodan, Tomokazu; Naruo, Tetsuro; Nozoe, Shinichi

    2001-01-01

    Anorexia nervosa (AN) has two subtypes; restricting type (AN-R) and binge-eating/purging type (AN-BP). It is suggested that AN-R is different from AN-BP on psychopathological aspects. We compared regional cerebral blood flows of 7 female patients with AN-R, 7 female patients with AN-BP and 7 age-matched normal volunteers (NV) using Tc99m-HMPAO SPECT processed by SPM96. There were significant decreased perfusions in the anterior cingulate gyrus in AN-R when compared with those of AN-BP and NV. These results suggest that the mechanism of outbreak of AN-R may be different from that of AN-BP. (author)

  15. Brain perfusion SPECT of patients with anorexia nervosa. Evaluation using statistical parametric mapping (SPM96)

    Energy Technology Data Exchange (ETDEWEB)

    Nakabeppu, Yoshiaki; Nakajoh, Masayuki; Tsuchimochi, Shinsaku; Tani, Atsushi; Umanodan, Tomokazu [Kagoshima Univ. (Japan). Faculty of Medicine; Naruo, Tetsuro; Nozoe, Shinichi

    2001-02-01

    Anorexia nervosa (AN) has two subtypes; restricting type (AN-R) and binge-eating/purging type (AN-BP). It is suggested that AN-R is different from AN-BP on psychopathological aspects. We compared regional cerebral blood flows of 7 female patients with AN-R, 7 female patients with AN-BP and 7 age-matched normal volunteers (NV) using Tc99m-HMPAO SPECT processed by SPM96. There were significant decreased perfusions in the anterior cingulate gyrus in AN-R when compared with those of AN-BP and NV. These results suggest that the mechanism of outbreak of AN-R may be different from that of AN-BP. (author)

  16. Changes in cerebral blood flow after cognitive behavior therapy in patients with panic disorder: a SPECT study

    Directory of Open Access Journals (Sweden)

    Seo HJ

    2014-04-01

    Full Text Available Ho-Jun Seo,1 Young Hee Choi,2 Yong-An Chung,3 Wangku Rho,1 Jeong-Ho Chae11Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, South Korea; 2Metta Institute of Cognitive Behavior Therapy, Seoul, South Korea; 3Department of Radiology, Nuclear Medicine, College of Medicine, The Catholic University of Korea, Seoul, South KoreaAim: Inconsistent results continue to be reported in studies that examine the neural correlates of cognitive behavioral therapy (CBT in patients with panic disorder. We examined the changes in regional cerebral blood flow (rCBF associated with the alleviation of anxiety by CBT in panic patients.Methods: The change in rCBF and clinical symptoms before and after CBT were assessed using single photon emission computed tomography and various clinical measures were analyzed.Results: Fourteen subjects who completed CBT showed significant improvements in symptoms on clinical measures, including the Panic and Agoraphobic Scale and the Anxiety Sensitivity Index-Revised. After CBT, increased rCBF was detected in the left postcentral gyrus (BA 43, left precentral gyrus (BA 4, and left inferior frontal gyrus (BA 9 and BA 47, whereas decreased rCBF was detected in the left pons. Correlation analysis of the association between the changes in rCBF and changes in each clinical measure did not show significant results.Conclusion: We found changes in the rCBF associated with the successful completion of CBT. The present findings may help clarify the effects of CBT on changes in brain activity in panic disorder.Keyword: single photon emission computed tomography (SPECT, anxiety, neural correlate, brain activity

  17. Regional cerebral blood flow of the patients with schizophrenia. A study using 99mTc-ECD SPECT at rest and activation

    International Nuclear Information System (INIS)

    Hu Ping; Wu Kening; Zeng Shiquan; Lin Zengtao; Yu Jinlong

    1996-01-01

    Regional cerebral blood flow (rCBF) changes of the patients with schizophrenia were observed. 99m Tc-ECD SPECT was performed on 22 patients with schizophrenia and 10 healthy volunteers at rest and activation with a cognitive task: a modified Wisconsin Card Sorting Test. At rest state, only 4 patients have abnormal rCBF pattern: left hemisphere over-perfusion relative to the right. A significant relative activation deficit in the left inferior prefrontal region was revealed in the patients during activation. The patients with schizophrenia may have frontal lobe dysfunction

  18. Semi-automated brain segmentation method applied to a SPECT study of sup 99m Tc HMPAO uptake in migraine patients. Application d'une methode de sectorisation cerebrale semi-automatique a l'etude tomographique de la fixation du sup 99m Tc-HMPAO chez des migraineux

    Energy Technology Data Exchange (ETDEWEB)

    Bessou, M.; Dupui, P; Geraud, G.; Danet, B. (Centre Hospitalier Universitaire de Rangueil, 31 - Toulouse (France)); Gantet, P. (Centre Hospitalier Universitaire Purpan, 31 - Toulouse (France))

    1992-01-01

    The segmentation method used allows a 2x16 uptake index to be calculated for each transverse section. Significant differences were found in the analogous indexes (ANOVA) between (1) migraine patients during and outside attacks (2) control subjects and migraine patients outside attacks. Highly significant asymmetries were found between posterior cerebral indexes (p<0.01 or p<0.001) in migraine patients during attacks.

  19. Radiopharmaceuticals for brain - SPECT

    International Nuclear Information System (INIS)

    Moretti, J.L.

    1992-01-01

    Perfusion tracers for brain SPECT imaging suitable for regional cerebral blood flow measurement and regional cerebral blood volume determination, with respect to their ability to pass the blood-brain-barrier, are described. Problems related t the use of specific radiotracers to map receptors distribution in the brain are also discussed in this lecture. 9 figs, 6 tabs

  20. Normal regional distribution of cerebral blood flow in dogs: comparison between (99m) Tc-ethylcysteinate dimer and (99m) Tc- hexamethylpropylene amine oxime single photon emission computed tomography.

    Science.gov (United States)

    Adriaens, Antita; Polis, Ingeborgh; Waelbers, Tim; Vandermeulen, Eva; Dobbeleir, André; De Spiegeleer, Bart; Peremans, Kathelijne

    2013-01-01

    Functional imaging provides important insights into canine brain pathologies such as behavioral problems. Two (99m) Tc-labeled single photon emission computed tomography (SPECT) cerebral blood flow tracers-ethylcysteinate dimer (ECD) and hexamethylpropylene amine oxime (HMPAO)-are commonly used in human medicine and have been used previously in dogs but intrasubject comparison of both tracers in dogs is lacking. Therefore, this study investigated whether regional distribution differences between both tracers occur in dogs as is reported in humans. Eight beagles underwent two SPECT examinations first with (99m) Tc-ECD and followed by (99m) Tc-HMPAO. SPECT scanning was performed with a triple head gamma camera equipped with ultrahigh resolution parallel hole collimators. Images were reconstructed using filtered backprojection with a Butterworth filter. Emission data were fitted to a template permitting semiquantification using predefined regions or volumes of interest (VOIs). For each VOI, perfusion indices were calculated by normalizing the regional counts per voxel to total brain counts per voxel. The obtained perfusion indices for each region for both tracers were compared with a paired Student's T-test. Significant (P < 0.05) regional differences were seen in the subcortical region and the cerebellum. Both tracers can be used to visualize regional cerebral blood flow in dogs, however, due to the observed regional differences, they are not entirely interchangeable. © 2013 Veterinary Radiology & Ultrasound.

  1. SPECT study of cerebral blood flow reactivity after acetazolamide in patients with transient ischemic attacks

    International Nuclear Information System (INIS)

    Chollet, F.; Celsis, P.; Clanet, M.; Guiraud-Chaumeil, B.; Rascol, A.; Marc-Vergnes, J.P.

    1989-01-01

    We investigated 15 patients with one or more transient ischemic attacks (TIAs) in the internal carotid artery territory within the month following the most recent TIA. Cerebral blood flow (CBF) was measured by single-photon emission computed tomography, using intravenous xenon-133 before and after injection of 1 g acetazolamide. Six patients had severe carotid stenosis or occlusion; the other nine patients had no significant carotid lesions. Twenty age-matched volunteers free of neurologic symptoms or history were used as controls. Mean CBF in the sylvian region was not significantly different between patients and controls. Seven patients exhibited a focal hypoperfusion at rest in the symptomatic hemisphere, and their hypoperfused areas were hyporeactive after administration of acetazolamide. Seven other patients exhibited hyporeactive areas after acetazolamide administration while their CBF tomograms at rest were normal. Thus, CBF abnormalities were detected in 14 of the 15 patients. Our findings suggest that CBF measured early after acetazolamide administration could be useful to confirm the clinical diagnosis of TIA. In the nine patients with no significant lesion of the internal carotid artery, the areas of hypoperfusion were small and were probably related to the focal ischemic event. In the six patients with severe lesions of the internal carotid artery, abnormalities were of variable size and intensity but were often large and pronounced. The discrepancy between these two subgroups of patients could be ascribed to the hemodynamic influence of the internal carotid artery lesions. Moreover, our findings may provide some insight into the pathophysiology of TIAs

  2. Regional cerebral blood flow changes in schizophrenia and endogenous depression by single photon emission computed tomography (SPECT) using N-isopropyl-p-( sup 123 I)iodoamphetamine (IMP)

    Energy Technology Data Exchange (ETDEWEB)

    Kanaya, Toshinori (Hiroshima Univ. (Japan). School of Medicine)

    1989-06-01

    Regional cerebral blood flows (rCBF) were measured in patients with schizophrenia and endogenous depression by single photon emission computed tomography (SPECT) using N-isopropyl-p-({sup 123}I)iodoamphetamine (IMP). The subjects were 20 patients with shizophrenia, 32 patients with endogenous depression and 20 normal controls. The patients with depression were divided into 3 groups; unmedicated, medicated patients in depressive state, and medicated patients in remited state. The rCBF were calculated by the corticocerebellar ratio (CCR), which was expressed as a ratio of activity per pixel in cortical regions of interest to the activity per pixel in the cerebellum. The results were as follows. In patients with schizophrenia the marked decrease in rCBF in bilateral frontal regions and the lower rCBF in the left than in the right hemisphere were observed. There was no significant correlation between the mean rCBF and BPRS (Brief Psychiatric Rating Scale) in patients with shizophrenia. In patients with depression the decrease in rCBF in overall cerebral regions and the lower rCBF in the left than in the right hemisphere were observed in both groups in depressive state. These changes were normalized in remited state, though there was no significant difference in rCBF between on medication and off medication. There was significantly negative correlation between the mean rCBF and Hamilton Depression Rating Scale in patients with depression. These results support the previously reported 'hypofrontality' and the left hemispheric dysfunction in shizophrenia. In depressive patients the overall cerebral dysfunction was revealed more remarkablly in the left than in the right hemisphere, which was normalized following the improvement of depressive symptoms. Furthermore, it was suggested that the applications of IMP-SPECT could be useful for the diagnosis and research for the cerebral function in mental illness. (author) 59 refs.

  3. Regional cerebral blood flow changes in schizophrenia and endogenous depression by single photon emission computed tomography (SPECT) using N-isopropyl-p-[123I]iodoamphetamine (IMP)

    International Nuclear Information System (INIS)

    Kanaya, Toshinori

    1989-01-01

    Regional cerebral blood flows (rCBF) were measured in patients with schizophrenia and endogenous depression by single photon emission computed tomography (SPECT) using N-isopropyl-p-[ 123 I]iodoamphetamine (IMP). The subjects were 20 patients with shizophrenia, 32 patients with endogenous depression and 20 normal controls. The patients with depression were divided into 3 groups; unmedicated, medicated patients in depressive state, and medicated patients in remited state. The rCBF were calculated by the corticocerebellar ratio (CCR), which was expressed as a ratio of activity per pixel in cortical regions of interest to the activity per pixel in the cerebellum. The results were as follows. In patients with schizophrenia the marked decrease in rCBF in bilateral frontal regions and the lower rCBF in the left than in the right hemisphere were observed. There was no significant correlation between the mean rCBF and BPRS (Brief Psychiatric Rating Scale) in patients with shizophrenia. In patients with depression the decrease in rCBF in overall cerebral regions and the lower rCBF in the left than in the right hemisphere were observed in both groups in depressive state. These changes were normalized in remited state, though there was no significant difference in rCBF between on medication and off medication. There was significantly negative correlation between the mean rCBF and Hamilton Depression Rating Scale in patients with depression. These results support the previously reported 'hypofrontality' and the left hemispheric dysfunction in shizophrenia. In depressive patients the overall cerebral dysfunction was revealed more remarkablly in the left than in the right hemisphere, which was normalized following the improvement of depressive symptoms. Furthermore, it was suggested that the applications of IMP-SPECT could be useful for the diagnosis and research for the cerebral function in mental illness. (author) 59 refs

  4. Clinical use of regional Tc-99m-HMPAO uptake in dementia of the Alzheimer type (DAT). Klinische Wertigkeit des regionalen [sup 99m]Tc-HMPAO Uptake bei der Demenz vom Alzheimer-Typ (DAT)

    Energy Technology Data Exchange (ETDEWEB)

    Gebhardt, U [Nuklearmedizinische Klinik und Poliklinik, TU Muenchen (Germany); Schmauss, F [Nuklearmedizinische Klinik und Poliklinik, TU Muenchen (Germany); Wagner-Manslau, C [Nuklearmedizinische Klinik und Poliklinik, TU Muenchen (Germany); Buttermann, G [Nuklearmedizinische Klinik und Poliklinik, TU Muenchen (Germany); Zimmer, R [Psychiatrische Klinik, TU Muenchen (Germany)

    1993-12-01

    In 46 patients with dementia of the Alzheimer type (DAT) regional cerebral blood flow (rCBF) was compared with cognitive performance (MMSE, CAMCOG). The cortico-cerebellar ratio (CCR), determined by [sup 99m]Tc-HMPAO-SPECT was used as a rCBF-equivalent. In the mild demented group we found a bilateral CCR-reduction parietal posterior, in moderate DAT bilateral temporoparietal and leftsided frontolateral defects were seen. Severe DAT showed an additional perfusion decrease mid frontal. With increasing severity of DAT an asymmetric perfusion occurred in 17/46 patients with accentuated CCR-reduction on the left side (temporal>parietal). High correlations between CCR and MMSE (r[>=]0.70) existed frontolateral, temporal and parietal in the left hemisphere. Significant associations between CCR and CAMCOG were obtained for language in the left temporal posterior region (r=0.64), for memory task left temporal anterior (r=0.59) and for praxis left parietal posterior (r=0.55). In detecting rCBF abnormalities the sensitivity for all 46 DAT patients was 91% and 70% in the mild cases. (orig.)

  5. Regional Cerebral Perfusion in Progressive Supranuclear Palsy

    International Nuclear Information System (INIS)

    Lee, Won Yong; Lee, Ki Hyeong; Yoon, Byung Woo; Lee, Sang Bok; Jeon, Beom S.; Lee, Kyung Han; Lee, Myung Chul

    1996-01-01

    Progressive supranuclear palsy (PSP) is a Parkinson-plus syndrome characterized clinically by supranuclear ophthalmoplegia, pseudobulbar palsy, axial rigidity, bradykinesia, postural instability and dementia. Presence of dementia and lack of cortical histopathology suggest the derangement of cortical function by pathological changes in subcortical structures in PSP, which is supported by the pattern of behavioral changes and measurement of brain metabolism using positron emission tomography. This study was done to examine whether there are specific changes of regional cerebral perfusion in PSP and whether there is a correlation between severity of motor abnormaility and degree of changes in cerebral perfusion. We measured regional cerebral perfusion indices in 5 cortical and 2 subcortical areas in 6 patients with a clinical diagnosis of PSP and 6 healthy age and sex matched controls using Tc-99m-HMPAO SPECT. Compared with age and sex matched controls, only superior frontal regional perfusion index was significantly decreased in PSP (p 0.05). We affirm the previous reports that perfusion in superior frontal cortex is decreased in PSP. Based on our results that there was no correlation between severity of motor abnormality and cerebral perfusion in the superior frontal cortex, nonmotoric symptoms including dementia needs to be looked at whether there is a correlation with the perfusion abnormality in superior frontal cortex

  6. Cerebral perfusion in homogeneity in normal volunteers

    International Nuclear Information System (INIS)

    Gruenwald, S.M.; Larcos, G.

    1998-01-01

    Full text: In the interpretation of cerebral perfusion scans, it is important to know the normal variation in perfusion which may occur between the cerebral hemispheres. For this reason 24 normal volunteers with no neurological or psychiatric history, and who were on no medications, had 99m Tc-HMPAO brain SPECT studies using a single headed gamma camera computer system. Oblique, coronal and sagittal images were reviewed separately by two experienced observers and any differences were resolved by consensus. Semi-quantitation was performed by summing two adjacent oblique slices and drawing right and left mirror image ROIs corresponding to the mid section level of anterior and posterior frontal lobes, anterior and posterior parietal lobes, temporal lobes and cerebellum. From the mean counts per pixel, right: left ROI ratios and ROI: cerebellar ratios were calculated. On qualitative review 6/24 subjects had mild asymmetry in tracer distribution between right and left cerebral lobes. Semi-quantitation revealed a 5-10% difference in counts between right and left ROIs in 12/24 subjects and an additional three subjects had 10-20% difference in counts between right and left temporal lobes. This study demonstrates the presence of mild asymmetry of cerebral perfusion in a significant minority of normal subjects

  7. Relationship between cognitive function and regional cerebral blood flow in stroke patients using 99mTc-ECD SPECT 3DSRT

    International Nuclear Information System (INIS)

    Sasaki, Nobuyuki; Abo, Masahiro

    2006-01-01

    The purpose of this study was to investigate the associations between regional cerebral blood flow (rCBF) and cognitive function in patients having a local stroke within the thalamus or putamen. The Mini-Mental State Examination (MMSE) and the Kohs Block Design Test (KBDT) were used to evaluate cognitive function. Brain single-photon emission computed tomography (SPECT) was performed with 99m Tc-ethyl cysteinate dimer and analyzed with a 3-dimensional stereotactic region-of-interest template. Subjects were divided into subgroups according to the total MMSE score (D [Dementia: 23 points or less] and N [Normal: 24 points or more]) and according to KBDT scores (B [Bad: less than IQ 70] and G [Good: IQ 70 or more]). The rCBF was decreased in the MMSE D subgroup, especially in patients with a left putamen lesion, and in the KBDT B subgroup, especially in patients with a left thalamus lesion. When the lesion was in the right hemisphere, no significant difference in rCBF was found between the MMSE D and N subgroups or between the KBDT B and G subgroups. SPECT is useful for clinical evaluation of cerebral vascular disease, especially in patients with left hemispheric lesions. Additional data and further detailed evaluations are needed. (author)

  8. Semiquantitative regional cerebral blood flow evaluation by the sup 123 I-IMP SPECT before and during medication of bifemelane hydrochloride in patients with cerebrovascular diseases

    Energy Technology Data Exchange (ETDEWEB)

    Tsuda, Yoshiyasu; Ayada, Yoshihide; Kitadai, Masaya; Tanabe, Masatada; Matsuo, Hirohide (Kagawa Medical School, Miki (Japan))

    1992-04-01

    Regional cerebral blood flow (rCBF) by {sup 123}I-IMP SPECT was measured before and 2.8, 10.3 months during medication of bifemelane hydrochloride in 10 patients with cerebrovascular diseases and compared with 5 control patients without medication. Semiquantitative rCBF indices of asymmetry and redistribution (AI, RI) were calculated from mean regional counts/pixel of each region of interest (ROI) in the early and delayed images of IMP SPECT. Before medication, no significant differences of RI and AI were observed between patients with and without medication of bifemelane hydrochloride. Significantly higher RI was observed in the second measurement 2.8 months in mean during medication of bifemelane hydrochloride, while AI was less in patients medicated with bifemelane hydrochloride. In the third measurement 10.3 months in mean during medication of bifemelane hydrochloride, RI was kept to be higher than that in the second measurement of the control patients without medication. The ratio of the number of ROI, where the redistribution being observed, was significantly higher in patients medicated than in control patients. From the results, medication of bifemelane hydrochloride might keep the redistribution phenomenon, which may indicate reversible cerebral ischemia, more persistently and intensively in patients with cerebrovascular diseases. (author).

  9. Clinical use of regional Tc-99m-HMPAO uptake in dementia of the Alzheimer type (DAT)

    International Nuclear Information System (INIS)

    Gebhardt, U.; Schmauss, F.; Wagner-Manslau, C.; Buttermann, G.; Zimmer, R.

    1993-01-01

    In 46 patients with dementia of the Alzheimer type (DAT) regional cerebral blood flow (rCBF) was compared with cognitive performance (MMSE, CAMCOG). The cortico-cerebellar ratio (CCR), determined by 99m Tc-HMPAO-SPECT was used as a rCBF-equivalent. In the mild demented group we found a bilateral CCR-reduction parietal posterior, in moderate DAT bilateral temporoparietal and leftsided frontolateral defects were seen. Severe DAT showed an additional perfusion decrease mid frontal. With increasing severity of DAT an asymmetric perfusion occurred in 17/46 patients with accentuated CCR-reduction on the left side (temporal>parietal). High correlations between CCR and MMSE (r≥0.70) existed frontolateral, temporal and parietal in the left hemisphere. Significant associations between CCR and CAMCOG were obtained for language in the left temporal posterior region (r=0.64), for memory task left temporal anterior (r=0.59) and for praxis left parietal posterior (r=0.55). In detecting rCBF abnormalities the sensitivity for all 46 DAT patients was 91% and 70% in the mild cases. (orig.) [de

  10. Investigations of the cerebral blood flow by means of nuclear medicine in polycythemia vera rubra

    International Nuclear Information System (INIS)

    Franke, W.G.; Unger, L.; Mueller, J.

    1993-01-01

    P.v. represents a ''clinical model'' of diagnostic radionuclide application to evaluate the total and regional perfusion of brain. 107 polycythemians treated by or provided for radiophosphorus were studied by neurologic methods as EEG e.g. and with XCT if necessary. These studies were accomplished repeatedly in 62% of the surveyed patients. We found disturbed perfusion in brain: 32, diminuation of blood flow in vertebral-basilar region: 8, polyneuropathies: 27, psychic abnormalities: 60. Therapeutic effects became ascertained in 34% of hemipareses. The majority of polycythemic patients let recognize a regression of subjective complaints. The diagnostic informations obtained by radionuclide methods were compared to clinical and neurologic results as mentioned above. A good correlation could observed from radionuclide angiography, 133 Xe-studies of total and regional cerebral perfusion and HMPAO-SPECT to neurologic and radiological findings. 66% of studied patients showed abnormal radioactivity distribution at static scintigrams. Disturbances of cerebral perfusion were seen in 20 from 26 patients if radionuclide angiography was used. Especially the inflow to cerebral vessels was found retarded by this method. Even in 3 neurologically inconspicuous persons the cerebral perfusion was restricted. Only 5 patients without signs of decreased flow could be seen. In 9 of 10 cases studied using 133 Xenon referred to diminuation of cerebral perfusion. Both dynamic methods showed changes in perfusion depending from time course. Numerous localized defects of vascularization were detected by SPECT in some corresponding with neurologic symptoms in other patients differing from these ones. (orig./MG) [de

  11. Voxel-based statistical analysis of cerebral blood flow using Tc-99m ECD brain SPECT in patients with traumatic brain injury: group and individual analyses.

    Science.gov (United States)

    Shin, Yong Beom; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Kim, Dong-Soo; Park, Jae Heung; Yeom, Seok-Ran

    2006-06-01

    Statistical parametric mapping (SPM) was applied to brain perfusion single photon emission computed tomography (SPECT) images in patients with traumatic brain injury (TBI) to investigate regional cerebral abnormalities compared to age-matched normal controls. Thirteen patients with TBI underwent brain perfusion SPECT were included in this study (10 males, three females, mean age 39.8 +/- 18.2, range 21 - 74). SPM2 software implemented in MATLAB 5.3 was used for spatial pre-processing and analysis and to determine the quantitative differences between TBI patients and age-matched normal controls. Three large voxel clusters of significantly decreased cerebral blood perfusion were found in patients with TBI. The largest clusters were area including medial frontal gyrus (voxel number 3642, peak Z-value = 4.31, 4.27, p = 0.000) in both hemispheres. The second largest clusters were areas including cingulated gyrus and anterior cingulate gyrus of left hemisphere (voxel number 381, peak Z-value = 3.67, 3.62, p = 0.000). Other clusters were parahippocampal gyrus (voxel number 173, peak Z-value = 3.40, p = 0.000) and hippocampus (voxel number 173, peak Z-value = 3.23, p = 0.001) in the left hemisphere. The false discovery rate (FDR) was less than 0.04. From this study, group and individual analyses of SPM2 could clearly identify the perfusion abnormalities of brain SPECT in patients with TBI. Group analysis of SPM2 showed hypoperfusion pattern in the areas including medial frontal gyrus of both hemispheres, cingulate gyrus, anterior cingulate gyrus, parahippocampal gyrus and hippocampus in the left hemisphere compared to age-matched normal controls. Also, left parahippocampal gyrus and left hippocampus were additional hypoperfusion areas. However, these findings deserve further investigation on a larger number of patients to be performed to allow a better validation of objective SPM analysis in patients with TBI.

  12. Cerebral blood flow and related factors in hyperthyroidism patients by SPECT imaging and statistical parametric mapping analysis

    International Nuclear Information System (INIS)

    Xiu Yan; Shi Hongcheng; Liu Wenguan; Chen Xuefen; Gu Yushen; Chen Shuguang; Yu Haojun; Yu Yiping

    2010-01-01

    Objective: To investigate the cerebral blood flow (CBF) perfusion patterns and related factors in hyperthyroidism patients. Methods: Twenty-five patients with hyperthyroidism and twenty-two healthy controls matched for age, sex, education were enrolled. 99 Tc m -ethylene cysteinate dimer (ECD) SPECT CBF perfusion imaging was performed at rest. Statistical parametric mapping 5.0 software (SPM5) was used and a statistical threshold of P 3 , FT 4 ), thyroid autoimmune antibodies: sensitive thyroid stimulating hormone (sTSH), thyroid peroxidase antibody (TPOAb) and TSH receptor antibody (TRAb) by Pearson analysis, with disease duration by Spearman analysis. Results: rCBF was decreased significantly in limbic system and frontal lobe, including parahippocampal gyrus, uncus (posterior entorhinal cortex, posterior parolfactory cortex, parahippocampal cortex, anterior cingulate, right inferior temporal gyrus), left hypothalamus and caudate nucleus (P 3 (r=-0.468, -0.417, both P 4 (r=-0.4M, -0.418, -0.415, -0.459, all P 4 (r=0.419, 0.412, both P<0.05). rCBF in left insula was negatively correlated with concentration of sTSH, and right auditory associated cortex was positively correlated with concentration of sTSH (r=-0.504, 0.429, both P<0.05). rCBF in left middle temporal gyrus, left angular gyrus was positively correlated with concentration of TRAb while that in right thalamus, right hypothalamus, left anterior nucleus,left ventralis nucleus was negatively correlated with concentration of TRAb (r=0.750, 0.862, -0.691, -0.835, -0.713, -0.759, all P<0.05). rCBF in right anterior cingulate, right cuneus, right rectus gyrus, right superior marginal gyrus was positively correlated with concentration of TPOAb (r=0.696, 0.581, 0.779, 0.683, all P<0.05). rCBF in postcentral gyrus, temporal gyrus, left superior marginal gyrus and auditory associated cortex was positively correlated with disease duration (r=0.502, 0.457, 0.524, 0.440, all P<0.05). Conclusion: Hypoperfusions in

  13. Assessment of cerebral hemodynamics before and after revascularization in patients with occlusive cerebrovascular disease by means of quantitative IMP-SPECT with double-injection protocol

    Energy Technology Data Exchange (ETDEWEB)

    Ueno, Makoto; Nishizawa, Sadahiko; Toyoda, Hiroshi; Shimono, Taro; Miyamoto, Susumu; Hashimoto, Nobuo; Konishi, Junji [Kyoto Univ. (Japan). Graduate School of Medicine

    2001-06-01

    The purpose of this study was to validate a double-injection (DI) method with N-isopropyl-[{sup 123}I]p-iodoamphetamine (IMP) to measure regional cerebral blood flow (rCBF) twice in a single session of dynamic SPECT and to elucidate a possible role of this method to identify patients with occlusive disease of major cerebral arteries, who might benefit from cerebral revascularization procedures (CR). Fourteen patients with occlusion or severe stenosis of the internal carotid or middle cerebral artery were studied before and after CR to assess hemodynamic changes after revascularization treatment. We quantitatively measured rCBF before and after acetazolamide (ACZ) challenge along with cerebrovascular reserve capacity (CVR) with two injections of IMP in a single session of dynamic SPECT scans (DI method). The reliability and reproducibility of the DI method were validated by means of a simulation study and in eight patients who were examined without ACZ challenge to measure baseline rCBF twice. The analysis of simulated noisy data with realistic noise levels showed that the errors of the estimates for the first and the second rCBF and for the increase in rCBF were 2.6%, 8.1% and 10.4%, respectively. In the 8 patients examined by the DI method to measure baseline rCBF twice, the mean and the SD of percentage differences between the two consecutive measurements in rCBF were -1.3% and 5.5%, respectively. Eight out of 14 patients with occlusive disease had at least one region with a CVR less than 10%. They showed a significant increase in resting rCBF after CR, not only in the ipsilateral hemisphere (from 26.1{+-}6.4 to 33.4{+-}4.7) but also in the contralateral one (from 28.3{+-}7.0 to 34.7{+-}4.7) with a recovery of the ipsilateral CVR from 9.3{+-}17.2 to 41.2{+-}20.1%. The remaining six patients with good-moderate CVR did not show an increase in rCBF after CR (from 28.0{+-}2.7 to 28.3{+-}3.4). The three of them with a moderate CVR (10-25%) before CR showed

  14. Regional cerebral blood flow during mechanical hyperventilation in patients with fulminant hepatic failure

    DEFF Research Database (Denmark)

    Strauss, Gitte Irene; Høgh, Peter; Møller, Kirsten

    1999-01-01

    Hyperventilation is frequently used to prevent or postpone the development of cerebral edema and intracranial hypertension in patients with fulminant hepatic failure (FHF). The influence of such therapy on regional cerebral blood flow (rCBF) remains, however, unknown. In this study the CBF......-distribution pattern was determined within the first 12 hours after development of hepatic encephalopathy (HE) stage 4 before and during hyperventilation. Ten consecutive patients (median age 48 [range 33-57] years) with FHF and 9 healthy controls (median age 54 [24-58] years) had rCBF determined by single photon...... emission computed tomography (SPECT) using intravenous injection of 133Xenon. For determination of high resolution CBF pattern, the patients were also studied with 99mTc-hexa-methylpropyleneamine oxime (HMPAO) in the hyperventilation condition. There was no significant difference in the rCBF distribution...

  15. Effect of cerebral blood flow on consciousness and outcome after head injury. Assessment by jugular bulb venous metabolism and IMP-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Imaizumi, Shigeki; Onuma, Takehide; Motohashi, Osamu; Kameyama, Motonobu; Ishii, Kiyoshi [Sendai City Hospital (Japan)

    2002-10-01

    This study was performed to elucidate the therapeutical value of arteriojugularvenous oxygen difference (AVDO{sub 2}) in the ultra-emergent period after head injury. Rational therapeutic strategy after severe head injury needs information concerning the dynamical change of cerebral blood flow (CBF) and metabolism. We monitored the cerebral venous metabolism within 6 hours after head injury until the day IMP-SPECT was performed. Whole brain cerebral blood flow detected by IMP-SPECT and AVDO{sub 2} at the same day was compared, which restored to the period within 6 hours after head injury. From this procedure, we could outline cerebral blood flow conditions by only AVDO{sub 2} without IMP-SPECT in the ultra-emergent period. Eighty-six patients with head injury who were carried to our emergency center in the period of recent 2 years aged ranging from 15 to 94 years were the subjects. They all performed jugular bulb cannulation within 6 hours after the accident (Martin's phase I: day 0) to know saturation of jugular vein (SjO{sub 2}), AVDO{sub 2} and AVL. They were monitored until the day IMP-SPECT was performed (Martin's phase II; day 1-3 or phase III; day 4-15). The correlation between CBF and AVDO{sub 2}. The effect of CBF and cerebral venous metabolism on consciousness and outcome was also analyzed. CBF and AVDO{sub 2} in phase II and III were reversely correlated (p<0.0001). Normal CBF corresponded with 5.0 vol% in AVDO{sub 2}. AVDO{sub 2} in all cases changed 6.2 vol% at phase I, 4.5 vol% at phase II and 5.1 vol% at phase III. Glasgow comascale (GCS) on admission under 8 (n=47) and over 9 (n=39) significantly differed in AVDO{sub 2} and CBF in the period of II and III. The patients with favorable consciousness showed low AVDO{sub 2} and hyperemia afterwards. Dead cases in phase I (n=19) showed high AVDO{sub 2} and low SjO{sub 2}. The patients with severe disability (SD) (n=13) showed high AVDO{sub 2} and low CBF and the patients with good recovery (GR

  16. Computer-assisted system for diagnosing degenerative dementia using cerebral blood flow SPECT and 3D-SSP. A multicenter study

    International Nuclear Information System (INIS)

    Ishii, Kazunari; Ito, Kengo; Nakanishi, Atsushi; Kitamura, Shin; Terashima, Akira

    2014-01-01

    Due to increasing numbers of patients with dementia, more physicians who do not specialize in brain nuclear medicine are being asked to interpret SPECT images of cerebral blood flow. We conducted a multicenter study to determine whether a computer-assisted diagnostic system Z-score summation analysis method (ZSAM) using three-dimensional stereotactic surface projections (3D-SSP) can differentiate Alzheimer's disease (AD)/dementia with Lewy bodies (DLB) and non-AD/DLB in institutions using various types of gamma cameras. We determined the normal thresholds of Z-sum (summed Z-score) within a template region of interest for each single photon emission computed tomography (SPECT) device and then compared them with the Z-sums of patients and calculated the accuracy of the differential diagnosis by ZSAM. We compared the diagnostic accuracy between ZSAM and visual assessment. We enrolled 202 patients with AD (mean age, 76.8 years), 40 with DLB (mean age 76.3 years) and 36 with non-AD/DLB (progressive supranuclear palsy, n=10; frontotemporal dementia, n=20; slowly progressive aphasia, n=2 and one each with idiopathic normal pressure hydrocephalus, corticobasal degeneration, multiple system atrophy and Parkinson's disease) who underwent N-isopropyl-p-[ 123 I] iodoamphetamine cerebral blood flow SPECT imaging at each participating institution. The ZSAM sensitivity to differentiate between AD/DLB and non-AD/DLB in all patients, as well as those with mini-mental state examination scores of ≥24 and 20-23 points were 88.0, 78.0 and 88.4%, respectively, with specificity of 50.0, 44.4 and 60.0%, respectively. The diagnostic accuracy rates were 83.1, 72.9 and 84.2%, respectively. The areas under receiver operating characteristics curves for visual inspection by four expert raters were 0.74-0.84, 0.66-0.85 and 0.81-0.93, respectively, in the same patient groups. The diagnostic accuracy rates were 70.9-89.2%, 50.9-84.8% and 76.2-93.1%, respectively. The diagnostic

  17. Analysis of cognitive function and regional cerebral blood flow in Parkinson's disease by 123I-IMP SPECT

    International Nuclear Information System (INIS)

    Kato, Takayuki; Morohoshi, Toshio; Hasegawa, Yukihiro; Fukui, Toshiya; Kawamura, Mitsuru; Sugita, Koujiro

    2000-01-01

    Several studies have found that the uptake of a radioisotope is reduced in the frontal or parietooccipital lobe on SPECT scans of patients with Parkinson's disease accompanied by cognitive impairment. The present study investigated the relationship between the results of SPECT imaging and those of cognitive function tests in patients with Parkinson's disease accompanied by cognitive impairment. Thirty patients with Parkinson's disease served as subjects, including 9 men and 21 women with an average of 66.1 years. Patients underwent 123 I-IMP SPECT and various cognitive function tests (Japanese alphabet pick-up test, Stroop test, Hasegawa's dementia screening scale, Raven color matrix, and course cube-combination test). Next, three neurologists with no knowledge of the patient's clinical symptoms were asked to analyze the reduced uptake on SPECT scans as follows: frontal lobe, parietooccipital lobe, frontal and parietooccipital lobes, diffused reduction, and no reduced uptake. The results of SPECT imaging and each cognitive function test were compared. Reduced uptake in the frontal and parietooccipital lobes and diffused reduction correlated with decreases in cognitive function. Cognitive impairment is not notable when cortical blood flow is partially reduced, but is notable when cortical blood flow is widely reduced. (author)

  18. NeuroSPECT assessment of ischemic penumbra in acute brain infarct: control of intra-arterial thrombolysis

    International Nuclear Information System (INIS)

    Mena, F.J.; Mena, I.; Contreras, I.; Soto, F.; Ducci, H.; Fruns, M.

    2002-01-01

    Introduction: Brain infarct is the most common cause of incapacity in adults, the second cause of dementia and the 2nd or 3rd cause of death. Acute brain infarct is a medical emergency potentially reversible if treated with thrombolysis in the first hours of evolution. Thrombolysis is now an approved and efficacious method of treatment for acute ischemic stroke. During the first 3 hours of evolution, intravenous administration of plasminogen activator (tPA) can be performed. The window of time of treatment is expanded to 6 hours with the intra-arterial super selective route for thrombolysis. Aim: The aim of this study was to define levels of reversible ischemia (penumbra) demonstrated by statistically evaluated HMPAO Tc99m NeuroSPECT performed before and after intra-arterial thrombolysis in the treatment of acute infarct. Materials and Methods: 21 patients were treated during the first 6 hours of evolution of an acute ischemic stroke with the following protocol. 1) Admission, and complete neurological evaluation. 2) Brain CT scan to rule hemorrhage or established infarct. 3) I.V injection of 1100MBq Tc99m HMPAO (Ceretec tm) 4) Conventional cerebral angiography and intra-arterial thrombolysis and/or angioplasty/stenting if necessary. 5) NeuroSPECT assessment of ischemic penumbra. 6) Control at 24 hrs with NeuroSPECT. NeuroSPECT image acquisition is performed immediately following arterial thrombolysis with a dual Head Camera, SHR collimators and conventional protocol. Image processing was performed using the Segami Software, as previously reported in Alasbimn Journal2 (7): April 2000. http://www.alasbimnjournal.cl. The analysis consists of 1) Tallairach brain volume normalization. 2) Voxel by voxel comparison of the individual brain cortex uptake normalized to the maximum in the cortex with a normal database of 24 age-matched controls. Results: The results are expressed in standard deviations (S.D.) below the normal mean. Normal mean is 72% + 6. Only voxels between

  19. Changes in regional cerebral blood flow correlate with symptoms of depression and severity of fatigue in 99mTc-ECD SPECT study in 45 workers

    International Nuclear Information System (INIS)

    Koyama, Fumihiko; Hojo, Kei; Otsuki, Kenro; Yamamoto, Haruyoshi

    2008-01-01

    We performed single photon emission computed tomography ( 99m Tc-ECD SPECT) of the brain in 25 workers suffering from major depression (22 males and 3 females at the average age of 47.5±7.7 standard deviation (S.D.) years and all patients were right handed) and identified frontal lobe hypoperfusion in 18 cases using the easy Z-score Imaging System (eZIS). During the remission period, which was within ten months of therapy, we observed normalization of the frontal cerebral perfusion in 75% of the patients. In further evaluation of the cerebral blood flow after the addition of 20 healthy volunteer workers (18 males and 2 females at the average age 47.1±9.8 S.D. years and all were right handed) as a control group, reduced cerebral blood flow in the dorsal area of the frontal lobe, which is supposed to be correlated to the severity of the feeling of fatigue estimated based on the self-rating depression scale (SDS), was demonstrated by statistical parametric mapping (SPM). The severity of the fatigue of all workers was estimated using a self-rating checklist disseminated by the Japan Ministry of Health, Labor, and Welfare, which pertains to the accumulation of fatigue due to labor. In the SPM analysis, limbic hypoperfusion, which is correlated to the total severity of fatigue in all worker cases, was estimated based on the reduction in the cerebral blood flow in the lower part of the temporal lobe. Accordingly, the accumulation of fatigue due to, for instance, over work may result in easy fatigue and a pre-depressive state, which are associated with a reduction in the cerebral blood flow. This research is a part of the research and development and the dissemination projects related to the 13 fields of occupational injuries and illnesses of the Japan Labor Health and Welfare Organization. (author)

  20. Usefulness of brain SPECT

    International Nuclear Information System (INIS)

    Raynaud, C.; Rancurel, G.; Kieffer, E.; Ricard, S.; Askienazy, S.; Moretti, J.L.; Bourdoiseau, M.; Rapin, J.; Soussaline, F.

    1983-01-01

    Brain SPECT was not effectively exploited until I-123 isopropyl amphetamine (IAMP), indicator able to penetrate the blood brain barrier, became available. Although the experience of research teams working with IAMP is quite restricted due to the high cost of the indicator, some applications now appear to be worth the cost and in some cases provide data which cannot be obtained with routine techniques, especially in cerebrovascular patients, in epilepsy and some cases of tumor. Brain SPECT appears as an atraumatic test which is useful to establish a functional evaluation of the cerebral parenchyma, and which is a complement to arteriography, X-ray scan and regional cerebral blood flow measurement

  1. Local fibrinolytic therapy for patients with cerebral embolism and reversibility of cerebral ischemia in ultra-acute stage

    International Nuclear Information System (INIS)

    Koizumi, Takayuki

    1993-01-01

    The present study was undertaken to determine candidates for fibrinolytic therapy in cerebral embolism. Forty-three patients were examined by single photon emission computed tomography (SPECT) using 99m c-d, hexamethyl-propylene-amine oxime (HM-PAO) or N-isopropyl p[ 123 I]-iodoamphetamine ( 123 I-IMP) just before and after intra-arterial local fibrinolytic therapy. Regional cerebellar ratio (R/Ce) and asymmetry index (AI) were calculated just before the treatment (n=9). Quantitative analysis was performed after the treatment (n=all). SPECT images taken within 24 hours after the treatment fell into three patters: normal perfusion, hypoperfusion, and hyperperfusion. Patients showing normal perfusion pattern after complete recanalization developed no or smaller infarction on CT scans. However, patients showing either hypoperfusion or hyperperfusion developed large infarction. Regions with R/Ce ratio of 0.3 or smaller and/or AI of 1.5 or greater were irreversible, which was associated with cerebral infarction regardless of the duration of ischemia. On the other hand, regions with R/Ce of 0.5 or greater or AI of 1.2 or smaller were reversible with no association of infarction. Intra-arterial local fibrinolytic therapy seems to be helpful for patients with slight reduction of regional cerebral blood flow (i.e., R/Ce>0.5, AI 1.5). These findings indicate that SPECT is capable of determining reversibility of ischemic region, thereby contributing to better management of patients with acute cerebral embolism. (N.K.)

  2. Cerebral blood flow of patients with age-associated memory impairment and the early stage of Alzheimer`s disease. A study by SPECT using the ARG method

    Energy Technology Data Exchange (ETDEWEB)

    Ishiwata, Akiko; Kitamura, Shin; Nagazumi, Atushi; Terashi, Akiro [Nippon Medical School, Tokyo (Japan)

    1998-04-01

    In order to further understand the pathology of Alzheimer`s disease (AD), we have utilized image analysis in diagnosing the early stages of AD in patients with cognitive disorders. CT and MRI, however, have not been feasible since only atrophy is seen and it is difficult to differentiate the changes in AD from age associated changes. In this study we tried to determine whether regional cerebral blood flow (rCBF) measurements using single photon emission CT (SPECT) are feasible for the early diagnosis of AD. Regional CBF (rCBF) was measured using SPECT in three subject groups: Age-associated memory impairment (AAMI, n=9), mild AD (n=16), and normal aged patients (mean age=68.3; n=20). The subjects were then observed for three years. The region of interest (ROI) for the medial temporal lobe was set at OM-30deg to cover the maximum area of the hippocampus. The absolute values of rCBF in the frontal, temporal, and parietal lobes and the cerebellum were significantly lower in the mild AD subjects than in the normal aged subjects. A significant decrease in rCBF was also seen in the medial temporal lobe in both the AD and the AAMI subjects compared to the normal controls. During the three years of follow up, no cases of dementia were seen in the AAMI subjects. However, there were two patients who appeared to have difficulty in adapting to daily life due to amnesia, one with a decrease in rCBF of the medial temporal lobe on the second SPECT, and the other showing a low rCBF the first time. This study suggests that AAMI subjects may comprise both AD and normal subjects. Therefore a more prospective study is needed. (author)

  3. Cerebral blood flow of patients with age-associated memory impairment and the early stage of Alzheimer's disease. A study by SPECT using the ARG method

    International Nuclear Information System (INIS)

    Ishiwata, Akiko; Kitamura, Shin; Nagazumi, Atushi; Terashi, Akiro

    1998-01-01

    In order to further understand the pathology of Alzheimer's disease (AD), we have utilized image analysis in diagnosing the early stages of AD in patients with cognitive disorders. CT and MRI, however, have not been feasible since only atrophy is seen and it is difficult to differentiate the changes in AD from age associated changes. In this study we tried to determine whether regional cerebral blood flow (rCBF) measurements using single photon emission CT (SPECT) are feasible for the early diagnosis of AD. Regional CBF (rCBF) was measured using SPECT in three subject groups: Age-associated memory impairment (AAMI, n=9), mild AD (n=16), and normal aged patients (mean age=68.3; n=20). The subjects were then observed for three years. The region of interest (ROI) for the medial temporal lobe was set at OM-30deg to cover the maximum area of the hippocampus. The absolute values of rCBF in the frontal, temporal, and parietal lobes and the cerebellum were significantly lower in the mild AD subjects than in the normal aged subjects. A significant decrease in rCBF was also seen in the medial temporal lobe in both the AD and the AAMI subjects compared to the normal controls. During the three years of follow up, no cases of dementia were seen in the AAMI subjects. However, there were two patients who appeared to have difficulty in adapting to daily life due to amnesia, one with a decrease in rCBF of the medial temporal lobe on the second SPECT, and the other showing a low rCBF the first time. This study suggests that AAMI subjects may comprise both AD and normal subjects. Therefore a more prospective study is needed. (author)

  4. Regional cerebral blood flow study of aphasic patients while reading aloud using N-isopropil-p-[123I]-iodoamphetamine SPECT

    International Nuclear Information System (INIS)

    Kishikawa, Yusuke

    1995-01-01

    N-isopropil-p-[ 123 I]-indoamphetamine SPECT (IMP-SPECT) image study was performed on seventeen aphasic patients (seven motor aphasics, seven sensory aphasics and three conduction aphasics) and eight normal controls to compare regional cerebral blood flow (rCBF) change between at rest and while reading aloud. Comparative analysis focused on the brain areas of Broca and Wernicke and their anatomically equivalent areas in the right hemisphere. The Wernicke area showed a higher rCBF change while reading aloud even in the sensory aphasic group, while the Broca area showed a lower rCBF change in the motor aphasic group compared to the normal control group. The anatomical equivalent of the Broca area in the right hemisphere appeared to play some role while reading aloud in the motor and conduction aphasic groups. As for the Wernicke area, the anatomically equivalent area in the right hemisphere showed no significant change in any aphasic group. Differences between the results obtained in these two areas suggested different functional specificities in the network of language function in the brain. (author)

  5. Statistical parametric mapping and statistical probabilistic anatomical mapping analyses of basal/acetazolamide Tc-99m ECD brain SPECT for efficacy assessment of endovascular stent placement for middle cerebral artery stenosis

    International Nuclear Information System (INIS)

    Lee, Tae-Hong; Kim, Seong-Jang; Kim, In-Ju; Kim, Yong-Ki; Kim, Dong-Soo; Park, Kyung-Pil

    2007-01-01

    Statistical parametric mapping (SPM) and statistical probabilistic anatomical mapping (SPAM) were applied to basal/acetazolamide Tc-99m ECD brain perfusion SPECT images in patients with middle cerebral artery (MCA) stenosis to assess the efficacy of endovascular stenting of the MCA. Enrolled in the study were 11 patients (8 men and 3 women, mean age 54.2 ± 6.2 years) who had undergone endovascular stent placement for MCA stenosis. Using SPM and SPAM analyses, we compared the number of significant voxels and cerebral counts in basal and acetazolamide SPECT images before and after stenting, and assessed the perfusion changes and cerebral vascular reserve index (CVRI). The numbers of hypoperfusion voxels in SPECT images were decreased from 10,083 ± 8,326 to 4,531 ± 5,091 in basal images (P 0.0317) and from 13,398 ± 14,222 to 7,699 ± 10,199 in acetazolamide images (P = 0.0142) after MCA stenting. On SPAM analysis, the increases in cerebral counts were significant in acetazolamide images (90.9 ± 2.2 to 93.5 ± 2.3, P = 0.0098) but not in basal images (91 ± 2.7 to 92 ± 2.6, P = 0.1602). The CVRI also showed a statistically significant increase from before stenting (median 0.32; 95% CI -2.19-2.37) to after stenting (median 1.59; 95% CI -0.85-4.16; P = 0.0068). This study revealed the usefulness of voxel-based analysis of basal/acetazolamide brain perfusion SPECT after MCA stent placement. This study showed that SPM and SPAM analyses of basal/acetazolamide Tc-99m brain SPECT could be used to evaluate the short-term hemodynamic efficacy of successful MCA stent placement. (orig.)

  6. Noninvasive quantitative assessment of cerebral blood flow (CBF) using Tc-99m ECD SPECT with adjunctive radionuclide angiography in ischemic stroke

    International Nuclear Information System (INIS)

    Yim, Jun Sung; Choi, Yun Young; Kim, Seung Hyun; Kim, Myung Ho; Cho, Suk Shin

    1999-01-01

    Quantitative CBF measurements are essential for diagnosing ischemic lesion, evaluating the therapeutic effects and predicting the prognosis of cerebral ischemia. Even though several methods have been introduced, these techniques are too cumbersome and invasive to be applied to routine studies. In this study, a non-invasive simple method for the quantitative angiography. Fifteen normal controls and 27 patients with unilateral carotid ischemic stoke were selected. Brain perfusion index (BPI) of each hemisphere was measured in each subject by acquisition of serial radionuclide angiography after injection of 20mCi of Tc-99m ECD. With Lassen's correction algorithm of curve-linear relationship between the brain activity and blood flow, rCBF on transaxial SPECT slice corresponding with MRI lesion sites (ischemic core, border zone and contralateral mirror locus) were calculated. BPI values for normal controls showed a significant negative correlation with advantage age (r=-0.64, p=0.021) and hemisphric BPI were 11.02±1.6 and 7.8±1.4 for normal controls and patient, respectively. Significant differences were observed between two groups (p=0.0012). rCBF obtained from core zone (12±2.5 ml/100/min), boneder zone (29.2±8.1) and contralateral mirror locus (52.1±15.1) were clearly defined in each subject of patient group. Measurement of BPI and rCBF using Tc-99m ECD SPECT with adjunctive radionuclide angiography could be an useful, simple and non-invasive method in evaluation of the cerebral flood in the ischemic stroke

  7. Role of 99mTc-ECD brain SPECT in the detection of cerebral perfusion abnormality in cases of Attention Deficit Hyperactivity Disorder

    International Nuclear Information System (INIS)

    Kumar, A.; Phom, H.; Thomas, E.J.; Tripathi, M.; Chandrashekar, N.; Bal, C.S.; Zamir, H.; Gulati, S.; Kalra, V.

    2002-01-01

    Aim: A randomized placebo controlled drug trial with Mentat, a herbal pharmacological agent, was initiated in January 2000 in the department of pediatrics at AIIMS, New Delhi, to compare the efficacy of Mentat with a placebo in school children with Attention Deficit Hyperactivity Disorder (ADHD). Materials and Methods: Contact was established with 12 Public schools in Delhi, to identify poor performers in classes I-V (age 6-12 yrs.). About 195 children with poor school performance were recruited in the study. They were screened for causes of poor performance, which included attention problems, hyperactivity, behavior problems, emotional problems, mental sub-normality and learning disability. ADHD suspected children were identified using the Malin's WISC, Connor's rating scale, Problem Behavior checklist, Bender Gestalt test and some sub tests of the Kaufman's Assessment Battery for Children (K-ABC). Sixty children diagnosed as ADHD (using DSM-IV criteria), with an IQ between 90-110, were enrolled into the study. Of the 60 children randomized in the study, 30 received Mentat and 30 received an identical looking placebo. The drug/Placebo was given for a six-month period. 99mTC-ECD brain SPECT was performed in a subset of 34 children with ADHD. Results: Abnormal cerebral perfusion was seen in 23/34; thalamic hypoperfusion in 11, basal ganglia hypoperfusion in 9, thalamus and basal ganglia hypoperfusion in 2 and basifrontal hypoperfusion in 1. So far, in ten children with abnormal pretreatment scans, post treatment scans have also been done. In mentat group, 2/5 children showed normalization of perfusion abnormality after treatment whereas in placebo group, 1/5. Conclusion: This study suggests that there is selective focal cerebral hypoperfusion in cases of ADHD and 99mTc-ECD brain SPECT can be used for evaluation and further monitoring of therapeutic outcome in such cases

  8. Brain regions associated with cognitive impairment in patients with Parkinson disease: quantitative analysis of cerebral blood flow using 123I iodoamphetamine SPECT.

    Science.gov (United States)

    Hattori, Naoya; Yabe, Ichiro; Hirata, Kenji; Shiga, Tohru; Sakushima, Ken; Tsuji-Akimoto, Sachiko; Sasaki, Hidenao; Tamaki, Nagara

    2013-05-01

    Cognitive impairment is a representative neuropsychiatric presentation that accompanies Parkinson disease (PD). The purpose of this study was to localize the cerebral regions associated with cognitive impairment in patients with PD using quantitative SPECT. Thirty-two patients with PD (mean [SD] age, 75 [8] years; 25 women; Hoehn-Yahr scores from 2 to 5) underwent quantitative brain SPECT using 123I iodoamphetamine. Parametric images of regional cerebral blood flow (rCBF) were spatially normalized to the standard brain atlas. First, voxel-by-voxel comparison between patients with PD with versus without cognitive impairment was performed to visualize overall trend of regional differences. Next, the individual quantitative rCBF values were extracted in representative cortical regions using a standard region-of-interest template to compare the quantitative rCBF values. Patients with cognitive impairment showed trends of lower rCBF in the left frontal and temporal cortices as well as in the bilateral medial frontal and anterior cingulate cortices in the voxel-by-voxel analyses. Region-of-interest-based analysis demonstrated significantly lower rCBF in the bilateral anterior cingulate cortices (right, 25.8 [5.5] vs 28.9 [5.7] mL per 100 g/min, P left, 25.8 [5.8] vs 29.1 [5.7] mL per 100 g/min, P left frontal and temporal cortices as well as in the bilateral medial frontal and anterior cingulate cortices. The results suggested dysexecutive function as an underlining mechanism of cognitive impairment in patients with PD.

  9. [Differences in cerebral blood flow following risperidone treatment in children with autistic disorder].

    Science.gov (United States)

    Ozdemir, Dilşad Foto; Karabacak, Neşe Ilgin; Akkaş, Burcu; Akdemir, Ozgür; Unal, Fatih; Senol, Selahattin

    2009-01-01

    Functional changes in the brains of autistic children due to risperidone treatment and theirs relationship to the symptom clusters are yet unknown. In this autistic disorder case series we aimed to comparatively evaluate the clinical findings before and after risperidone treatment, and regional cerebral blood flow (rCBF) findings with 99mTc-hexamethylpropyleneamine oxime (HMPAO) brain SPECT. Eleven autistic patients (age range: 6-7 years; 4 girls, 7 boys) received risperidone therapy (1.5-2.5 mg d(-1)) and were followed-up for 3 months. All the patients underwent neurologic examinations, psychometric examinations, and SPECT imaging, both at the start of risperidone treatment and 3 months after the treatment started. Clinical observations, and the observations of parents and teachers were recorded. These results were compared with cerebral perfusion indices obtained from SPECT data. After 3 months of treatment changes in rCBF were observed in various regions and to varying degrees. We observed relationships between clinical symptoms and pre-therapy rCBF findings, and between clinical improvement and rCBF changes. Findings in the present case series are the first to demonstrate a relationship between clinical improvement and regional perfusion patterns after risperidone treatment. We think that these findings may contribute to the understanding of the neurofunctional mechanisms and hypothetical models of autism.

  10. Regional cerebral blood flow in fibromyalgia

    International Nuclear Information System (INIS)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K.

    1998-01-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  11. Regional cerebral blood flow in fibromyalgia

    Energy Technology Data Exchange (ETDEWEB)

    Kwiatek, R.; Barnden, L.; Rowe, C.; McKinnon, J.; Pile, K. [The Queen Elizabeth Hospital , Adelaide, SA (Australia)

    1998-06-01

    Full text: Little is known of the aetiology of fibromyalgia (FM), a condition diagnosed on the basis of widespread chronic pain and multiple tender points. We have used Tc-99m HMPAO SPECT to compare regional cerebral bloodflow (rCBF) in 17 women who fulfill American College of Rheumatology criteria for FM to 22 age, sex and education matched controls. Both Statistical Parametric Mapping (SPM95) and coregistered MRI guided ROI were used for analysis. SPM95 revealed statistically significant hypoperfusion in the pontine tegmentum (p=0.048) and a trend to hypoperfusion in the left putamen (p=0.07). MRI guided ROI placement by an operator blinded to clinical information and the coregistered SPECT images, confirmed significant hypoperfusion of the left thalamus (p<0.0001) and the pontine tegmentum (p=0.001) and revealed trends towards hypoperfusion in the caudate nuclei and right thalamus. These results are consistent with the hypothesis that FM is due to dysfunction of central pain pathways. Spinothalamic neurones are known to be involved in pain perception and there are synapse connections to the thalamus in the gigantocellular part of the medulla and pons

  12. Serial SPECT in children with partial epilepsy

    International Nuclear Information System (INIS)

    Hosoya, Machiko; Ushiku, Hideo

    1995-01-01

    We performed serial single-photon emission CT (SPECT) with N-isopropyl-p-( 123 I)-Iodoamphetamine to measure the regional cerebral blood flow (rCBF) in 15 children with partial epilepsy. SPECT showed focal changes in 14 cases. Ten cases had abnormalities in the initial SPECT and another four cases in the second test. The cases with normal rCBF in initial SPECT had been tested in an early phase after the onset, and then decreased rCBF were observed in the second SPECT. The cases with both abnormal rCBF in the initial SPECT and improved rCBF in the second SPECT showed good prognosis in clinico-electrophysiological evolutions. In cases with abnormal changes of rCBF in the second SPECT, clinical prognosis was found to be not so good. These findings suggest that serial SPECT may be used to follow the course of epilepsy. (author)

  13. Regional cerebral blood flow in children with autism spectrum disorders: a quantitative 99mTc-ECD brain SPECT study with statistical parametric mapping evaluation

    Institute of Scientific and Technical Information of China (English)

    YANG Wen-han; JING Jin; XIU Li-juan; CHENG Mu-hua; WANG Xin; BAO Peng; WANG Qing-xiong

    2011-01-01

    Background Autism spectrum disorders (ASD), which include autism, asperger syndrome (AS) and pervasive developmental disorder-not otherwise specified (PDD-NOS), are devastating neurodevelopmental disorders of childhood resulting in deficits in social interaction, repetitive patterns of behaviors, and restricted interests and activities. Single photon emission computed tomography (SPECT) is a common technique used to measure regional cerebral blood flow (rCBF). Several studies have measured rCBF in children with ASD using SPECT, however, findings are discordant. In addition, the majority of subjects used in these studies were autistic. In this study, we aimed to investigate changes in rCBF in children with ASD using SPECT.Methods A Technetium-99m-ethyl cysteinate dimmer (99mTc-ECD) brain SPECT study was performed on an ASD group consisting of 23 children (3 girls and 20 boys; mean age (7.2±3.0) years) who were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-Ⅳ) criteria and an age-matched control group with 8children (1 girl and 7 boys, mean age (5.5±2.4) years). Image data were evaluated with Statistical Parametric Mapping,5th version (SPM5). A Student's t test for unpaired data was used to compare rCBF and asymmetry in the autism and corresponding control group. The covariance analysis, taking age as covariance, was performed between the ASD and control group.Results There was a significant reduction in rCBF in the bilateral frontal lobe (frontal poles, arcula frontal gyrus) and the bilateral basal ganglia in the autism group, and a reduction in the bilateral frontal, temporal, parietal, legumina nucleus and cerebellum in the AS group compared to the control. In addition, asymmetry of hemispheric hypoperfusion in the ASD group was observed. Inner-group comparison analysis revealed that rCBF decreased significantly in the bilateral frontal lobe (42.7%), basal nucleus (24.9%) and temporal lobe (22.8%) in the autism

  14. The role of brain SPECT in children with epilepsy

    International Nuclear Information System (INIS)

    Liu Xingdang; Liu Yongchang; Lin Xiangtong

    1996-01-01

    The rCBF brain SPECT with 99m Tc-HMPAO was performed in 15 children with interictal epilepsy, and some cases were compared with EEG, X-ray CT and MRI. The results showed that the positive rate of SPECT was the highest (93.33%,), then the EEG (92.31%), and the CT and MRI were the lowest (66.67% and 75%). This study indicated that brain SPECT was an effective method for diagnosis and foci localization in epileptic children, and also was useful to the study of prognosis and relationship between changes of rCBF and progress in clinical pictures

  15. Assessment of Cerebral Hemodynamic Changes in Pediatric Patients with Moyamoya Disease Using Probabilistic Maps on Analysis of Basal/Acetazolamide Stress Brain Perfusion SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ho Young; Lee, Jae Sung; Kim, Seung Ki; Wang, Kyu Chang; Cho, Byung Kyu; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2008-06-15

    To evaluate the hemodynamic changes and the predictive factors of the clinical outcome in pediatric patients with moyamoya disease, we analyzed pre/post basal/acetazolamide stress brain perfusion SPECT with automated volume of interest (VOIs) method. Total fifty six (M:F=33:24, age 6.7{+-}3.2 years) pediatric patients with moyamoya disease, who underwent basal/acetazolamide stress brain perfusion SPECT within 6 before and after revascularization surgery (encephalo-duro-arterio-synangiosis (EDAS) with frontal encephalo-galeo-synangiosis (EGS) and EDAS only followed on contralateral hemisphere), and followed-up more than 6 months after post-operative SPECT, were included. A mean follow-up period after post-operative SPECT was 33{+-}21 months. Each patient's SPECT image was spatially normalized to Korean template with the SPM2. For the regional count normalization, the count of pons was used as a reference region. The basal/acetazolamide-stressed cerebral blood flow (CBF), the cerebral vascular reserve index (CVRI), and the extent of area with significantly decreased basal/acetazolamide- stressed rCBF than age-matched normal control were evaluated on both medial frontal, frontal, parietal, occipital lobes, and whole brain in each patient's images. The post-operative clinical outcome was assigned as good, poor according to the presence of transient ischemic attacks and/or fixed neurological deficits by pediatric neurosurgeon. In a paired t-test, basal/acetazolamide-stressed rCBF and the CVRI were significantly improved after revascularization (p<0.05). The significant difference in the pre-operative basal/acetazolamide-stressed rCBF and the CVRI between the hemispheres where EDAS with frontal EGS was performed and their contralateral counterparts where EDAS only was done disappeared after operation (p<0.05). In an independent student t-test, the pre-operative basal rCBF in the medial frontal gyrus, the post-operative CVRI in the frontal lobe and the parietal

  16. Relationship between brain perfusion SPECT and MMSE score in dementia of Alzheimer's type: a statistical parametric mapping analysis

    International Nuclear Information System (INIS)

    Kang, Hye Jin; Kang, Eun Joo; Lee, Jae Sung

    2002-01-01

    The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Tc-99m HMPAO brain SPECT was performed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5-24) and the mean MMSE score of the follow-up was 8.1 (range: 0-17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was performed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Significant correlation was found between the blood-flow decrease in left inferior prefrontal region(BA 47) and left middle temporal region (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed and similar trends. A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's diseases (AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease

  17. The need of appropriate brain SPECT templates for SPM comparisons

    International Nuclear Information System (INIS)

    Morbelli, S.; Altrinetti, V.; Piccardo, A.; Rodriguez, G.; Brugnolo, A.; Nobili, F.; Mignone, A.; Pupi, A.; Koulibaly, P.M.

    2008-01-01

    Statistical parametric mapping (SPM) is used worldwide to compare brain perfusion single photon emission computed tomography (SPECT) data. The default template within the SPM package used for SPECT image normalization includes images of a group of healthy subjects studied with 99m TcHMPAO. Since [ 99m Tc] HMPAO and [ 99m Tc] ECD have shown to distribute differently in SPECT studies, we formulated the hypothesis that comparing set of [ 99m Tc]ECD data normalized by means of a [ 99m Tc]HMPAO template may lead to incorrect results. A customized [ 99m Tc]ECD template was built with SPECT and magnetic resonance imaging (MRI) images of 22 neurologically healthy women. Then, two sets of subjects, i.e. a group of patients with very early Alzheimer's disease (eAD) and a matched control group, studied by means of [ 99m Tc]ECD SPECT, were chosen for comparisons. The same statistical approach (t-test between eAD patients and controls and correlation analysis between brain SPECT and a cognitive score) was applied twice, i.e. after normalization with either the default [ 99m Tc]HMPAO template or the customized [ 99m Tc]ECD template. In the comparison between eAD and controls, a cluster of difference in the posterior-cingulate gyrus of both hemispheres was only highlighted when using the customized [ 99m Tc]ECD template, but was missed when using the default [ 99m Tc]HMPAO template. In the correlation between brain perfusion and a cognitive score, the significant cluster was more significant and far more extended, also including the right superior temporal gyrus, using the customized [ 99m Tc]ECD template than using the default [ 99m Tc]HMPAO template. These data suggest the need of customized, radiopharmaceutical-matched SPECT templates to be used within the SPM package. The present customized [ 99m Tc]ECD template is now freely available on the web. (authors)

  18. Clinical usefulness of scatter and attenuation correction for brain single photon emission computed tomography (SPECT) in pediatrics

    International Nuclear Information System (INIS)

    Adachi, Itaru; Doi, Kenji; Komori, Tsuyoshi; Hou, Nobuyoshi; Tabuchi, Koujirou; Matsui, Ritsuo; Sueyoshi, Kouzou; Utsunomiya, Keita; Narabayashi, Isamu

    1998-01-01

    This investigation was undertaken to study clinical usefulness of scatter and attenuation correction (SAC) of brain SPECT in infants to compare the standard reconstruction (STD). The brain SPECT was performed in 31 patients with 19 epilepsy, 5 cerebro-vascular disease, 2 brain tumor, 3 meningitis, 1 hydrocephalus and psychosis (mean age 5.0±4.9 years old). Many patients was necessary to be injected sedatives for restraining body motion after Technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO) was injected at the convulsion or rest. Brain SPECT data were acquired with triple detector gamma camera (GCA-9300 Toshiba Japan). These data were reconstructed by filtered backprojection after the raw data were corrected by triple energy windows method of scatter correction and Chang filtered method of attenuation correction. The same data was reconstructed by filtered backprojection without these corrections. Both SAC and STD SPECT images were analyzed by the visual interpretation. The uptake ratio of cerebral basal nuclei was calculated by the counts of the thalamus or lenticular nuclei divided by the cortex. All images of SAC method were excellent than that of STD method. The thalamic uptake ratio in SAC method was higher than that of STD method (1.22±0.09>0.87±0.22 p 1.02±0.16 p<0.01). Transmission scan is the most suitable method of absorption correction. But the transmission scan is not adequate for examination of children, because this scan needs a lot of time and the infants are exposed by the line source radioisotope. It was concluded that these scatter and absorption corrections were most suitable method for brain SPECT in pediatrics. (author)

  19. Clinical usefulness of scatter and attenuation correction for brain single photon emission computed tomography (SPECT) in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Itaru; Doi, Kenji; Komori, Tsuyoshi; Hou, Nobuyoshi; Tabuchi, Koujirou; Matsui, Ritsuo; Sueyoshi, Kouzou; Utsunomiya, Keita; Narabayashi, Isamu [Osaka Medical Coll., Takatsuki (Japan)

    1998-01-01

    This investigation was undertaken to study clinical usefulness of scatter and attenuation correction (SAC) of brain SPECT in infants to compare the standard reconstruction (STD). The brain SPECT was performed in 31 patients with 19 epilepsy, 5 cerebro-vascular disease, 2 brain tumor, 3 meningitis, 1 hydrocephalus and psychosis (mean age 5.0{+-}4.9 years old). Many patients was necessary to be injected sedatives for restraining body motion after Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO) was injected at the convulsion or rest. Brain SPECT data were acquired with triple detector gamma camera (GCA-9300 Toshiba Japan). These data were reconstructed by filtered backprojection after the raw data were corrected by triple energy windows method of scatter correction and Chang filtered method of attenuation correction. The same data was reconstructed by filtered backprojection without these corrections. Both SAC and STD SPECT images were analyzed by the visual interpretation. The uptake ratio of cerebral basal nuclei was calculated by the counts of the thalamus or lenticular nuclei divided by the cortex. All images of SAC method were excellent than that of STD method. The thalamic uptake ratio in SAC method was higher than that of STD method (1.22{+-}0.09>0.87{+-}0.22 p<0.01). The lenticular nuclear uptake ratio in SAC method was higher than that of STD method (1.26{+-}0.15>1.02{+-}0.16 p<0.01). Transmission scan is the most suitable method of absorption correction. But the transmission scan is not adequate for examination of children, because this scan needs a lot of time and the infants are exposed by the line source radioisotope. It was concluded that these scatter and absorption corrections were most suitable method for brain SPECT in pediatrics. (author)

  20. Regional cerebral blood flow in patients with sickle cell disease: study with single photon emission computed tomography

    International Nuclear Information System (INIS)

    Al-Kandari, F.A.; Owunwanne, A.; Syed, G.M.; Elgazzar, A.H.; Rizui, A.M.; Al-Ajmi, J.A.; Mohammed, A.M.; Ar Marouf, R.; Shiekh, M.

    2007-01-01

    Neurological complications have been reported in patients with sickle-cell disease (SCD) using positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT), but not with single photon emission computed tomography (SPECT). The objective of this study was to investigate brain perfusion in the patients with SCD using SPECT after technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO), was administered and compare the findings with those of demography, physical examination, MRI and hematological profile. The study involved 21 patients (12 males, 9 females, age at study 8-45 years) who were known to be having SCD for a duration of at least 5 years. The patients were not in acute crisis and had normal neurological assessments with no known history of stroke or transient ischemic episode or previous abnormal CT or MRI brain scan, and were right-handed. The brain SPECT was performed after intravenous injection of 740 MBq (20 mCi) 99m Tc-HMPAO in adults or an appropriate dose in pediatric patients. The scans were visually interpreted by two nuclear medicine physicians and a decision was reached by consensus. An MRI done 3 months later was interpreted by a radiologist. The demographic data and hematological profile were obtained from the medical records of the patients. Of the 21 patients, 7 (age 11-22 years) had brain perfusion deficit mostly in the frontal lobe either alone or in combination with temporal and/or parietal lobe. The MRI was abnormal in 2 patients. The brain perfusion deficit was not associated with the demographic data of the patients or hematological profiles. The findings show that SPECT was useful in detecting brain perfusion deficit in SCD patients, and such an early detection may be clinically useful in the subsequent follow-up of such patients, since it is known that cerebral perfusion deficit can lead to silent infarct and/or overt stroke, and affect cognitive skills. (author)

  1. Quantification of regional cerebral blood flow (rCBF) measurement with one point sampling by sup 123 I-IMP SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Munaka, Masahiro [University of Occupational and Enviromental Health, Kitakyushu (Japan); Iida, Hidehiro; Murakami, Matsutaro

    1992-02-01

    A handy method of quantifying regional cerebral blood flow (rCBF) measurement by {sup 123}I-IMP SPECT was designed. A standard input function was made and the sampling time to calibrate this standard input function by one point sampling was optimized. An average standard input function was obtained from continuous arterial samplings of 12 healthy adults. The best sampling time was the minimum differential value between the integral calculus value of the standard input function calibrated by one point sampling and the input funciton by continuous arterial samplings. This time was 8 minutes after an intravenous injection of {sup 123}I-IMP and an error was estimated to be {+-}4.1%. The rCBF values by this method were evaluated by comparing them with the rCBF values of the input function with continuous arterial samplings in 2 healthy adults and a patient with cerebral infarction. A significant correlation (r=0.764, p<0.001) was obtained between both. (author).

  2. Comparative analysis of {sup 99m}Tc-MDP three-phase bone scan with SPECT/CT and {sup 99m}Tc-HMPAO-labeled WBC SPECT/CT in the differential diagnosis of clinically suspicious post-traumatic osteomyelitis

    Energy Technology Data Exchange (ETDEWEB)

    KIm, Chan Woo; Lee, Soo Jin; Kim, Ji Young; Hwang, Kyu Tae; Choi, Yun Young [Hanyang University Medical CenterSeoul (Korea, Republic of)

    2017-03-15

    To identify differences between three-phase bone scan and SPECT/CT (TBS) and WBC SPECT/CT (WS) and compare diagnostic accuracies of each modality in patients with suspicious post-traumatic osteomyelitis (OM). Twenty-one patients with suspicious post-traumatic OM were enrolled. All patients performed TBS and WS within 1 week. Foci of MDP and WBC accumulation were divided into three categories: bone (OM), soft tissue (soft tissue inflammation; STI), negative for inflammation (NI). Confirmative diagnosis was made upon operative pathology or long-term clinical follow-up. Of 21 patients, four OM, eight STI, nine NI were finally diagnosed. TBS diagnosis was correct in three of four positive cases and nine of 17 negative cases. Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV) of TBS were 75 %, 52.9 %, 57.1 %, 27.3 %, 90 %. WS diagnosis was correct in two of four positive cases and 17 of 17 negative cases. Sensitivity, specificity, accuracy, PPV, NPV were 50 %, 100 %, 81.0 %, 100 %, 89.5 %. Twelve of 21 cases showed agreement between TBS and WS. TBS misdiagnosed nine cases (six STI and two NI as eight OM; one OM as one STI), while WS misdiagnosed four cases (two OM as two STI; two STI as two NI). Combining results from TBS and WS led to better diagnostic accuracy (91.7 %) than either TBS or WS alone. TBS and WS showed moderate agreement in assessment of clinically suspected post-traumatic OM. WS better evaluated inflammation than TBS. WS tended to underestimate inflammation whereas TBS tended to overestimate inflammation. Combining TBS and WS enhanced diagnostic accuracy.

  3. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    International Nuclear Information System (INIS)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young

    2003-01-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value

  4. Visual and SPM analysis of regional cerebral perfusion with Tc-99m ECD brain SPECT in patients with developmental language disorder

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Joon Kee; Lee, Myung Hoon; Joh, Chul Woo; Yoon, Seok Nam; Oh, Eun Young [College of Medicine, Univ. of Ajou, Suwon (Korea, Republic of)

    2003-07-01

    Developmental language disorder (DLD) refers to inadequate language acquisition at the expected age in children with otherwise normal development. However, language delay can be observed in patients with other developmental disoder (ODD). We, therefore, evaluated regional cerebral perfusion pattern in patients with DLD and ODD by means of visual and SPM analysis. Twelve patients, who underwent Tc-99m ECD brain SPECT within 3 weeks of their first visit, were included in the study. Psychological and language tests classified the patients into 2 groups ; 6 with DLD (3-7 yr, 5 male and I female) and 6 with ODD (2-6 yr, 6 male). Visual analysis for regional cerebral perfusion was done in each patient. SPM with 7 controls (age=7) was performed to evaluate difference between 2 groups using t-test. P value of less than 0.005 was considered to be significant. All patients had significant language delay for their age (9 month 3.5 yr). Among 6 patients with ODD, 4 had pervasive developmental disorder, 1 mental retardation and 1 attachment disorder. Visual analysis revealed significant perfusion decrease in only 1 patient with DLD and 2 with ODD ; the regions were left parieto-temporal cortex, both frontal and cerebellar cortices, and right temporal cortex respectively. Nine of 12 patients showed normal perfusion. SPM demonstrated perfusion decrease in left inferior frontal cortex and left superior parietal cortex (Wernicke's area) in patients with DLD, while, in patients with ODD, perfusion decrease was mostly located in the right hemisphere (lateral frontoorbital gyrus, occipitotemporal gyrus, cuneus and cerebellum). Corpus callosum showed no significant perfusion abnormality in both groups. Regional cerebral perfusion of patients with DLD, which was mainly located in the speech area, is quite different from that of ODD-patients with language delay. While SPM successfully revealed this difference in perfusion pattern, visual analysis had limited value.

  5. Interictal rCBF SPECT, MRI and Surgical Outcome of Intractable Temporal Lobe Epilepsy

    International Nuclear Information System (INIS)

    Zeon, Seok Kil; Joo, Yang Goo; Lee, Sang Doe; Son, Eun Ik; Lee, Young Hwan

    1994-01-01

    Interictal single photon emission computed tomography of regional cerebral blood flow (rCBF SPECT) in 18 intractable temporal lobe epilepsy patients (8 male and 10 female patients: average 23.5 years old) were compared with 2.0 T magnetic resonance imaging (MRI). And surgical outcome was analysed with the findings, symptom duration and lateralization of temporal lobe. Preoperatively rCRF SPECT was done in all 18 patients with intravenous injection of 740 MRq 99 m T c-HMPAO. MRI was also done preoperatively in 13 patients. Surgical outcome was classified by Engel's outcome classification (four part classification recommended at the first Palm Desert conference). rCRF SPECT detected correctly lateralising abnormality of temporal lobe hypoperfusion in 13/ 18 (72.2%), contralateral temporal lobe hypoperfusion in 2/18 (11.1%) and showed no definite abnormality in 3/18 (16.7%). The positive predictive value of unilateral temporal lobe hypoperfusion was 87%. MRI detected correct localising abnormality in 8/13 (61.5%), such as hippocampal atrophy (7/13), asymmetric temporal horn (6/13), anterior temporal lobe atrophy (1/13), increased signal intensity from hippocampus (1/13) and calcific density (1/13), and no abnormal finding was noted in 5/13 (38.5%), There was no false positive findings and the positive predictive value of MRI was 100%, Only 2 cases showed same lateralization findings in rCBF SPECT and MRI. There was no significant correlation between symptom duration and no abnormal findings on SPECT or MRI. Surgical outcome showed class I in 15/18 (83.3%), and class II in 2/18 (11.1%). One case of no abnormal finding in both SPECT and MRI showed class III surgical outcome. No class IV surgical out.come was noted. Surgical outcome, lateralization of epileptic focus in temporal lobe and abnormal findings in rCBR SPECT or MRI were not significantly correlated.

  6. Characteristics of Cerebral Blood Flow in Vascular Dementia using SPM Analysis Compared to Normal Control and Alzheimer's Dementia

    International Nuclear Information System (INIS)

    Kang, Do Young; Park, Kyung Won; Kim, Jae Woo

    2003-01-01

    Cerebral perfusion pattern of vascular dementia (VD) was not well established and overlap of cerebral perfusion pattern was reported between VD and Alzheimer's dementia (AD). The aim of this study is to assess the specific patterns of SPECT finding in VD compared with normal control subjects and to disclose differences of cerebral blood flow between subjects with VD and AD were investigated using statistic parametric mapping analysis. Thirty-two VD (mean age ; 67.86.4 years, mean CDR ; 0.980.27), 51 AD (mean age ; 71.47.2 years, CDR ; 1.160.47), which were matched for age and severity of dementia, and 30 normal control subjects (mean age ; 60.17.7 years) participated in this study. The Tc-99m HMPAO brain perfusion SPECT data were analyzed by SPM99. The SPECT data of the patients with VD were compared to those of the control subjects and then compared to the patients with AD. SPM analysis of the SPECT image showed significant perfusion deficits in the both frontal (both cingulate gyrus, both inferior frontal gyrus, B no.47, right frontal rectal gyrus, left frontal subcallosal gyrus, B no.25), both temporal (right insula, B no.13, left superior temporal gyrus, left parahippocampal gyrus, B no.35), occipital (occipital lingual gyrus), right corpus callosum and right cerebellar tonsil regions in subjects with VD compared with normal control subjects (uncorrected p<0.01). Comparison of the two dementia groups (uncorrected p<0.01) revealed significant hypoperfusion in both parietal posterior central gyrus, right inferior frontal gyrus (B no.47), left insula, right thalamus (ventral lateral nucleus), right claustrum and right occipital cuneus regions in VD group compared with AD. There were no typical confined regional hypoperfusion areas but scattered multiple perfusion deficits in VD compared AD. These findings may be helpful to reflect the pathophysiological mechanisms of VD and to disclose differences of cerebral blood flow between subjects with VD and AD

  7. Changes in regional cerebral blood flow correlate with symptoms of depression, severity of fatigue, and sleep disorders in 99mTc-ECD SPECT study in 45 workers

    International Nuclear Information System (INIS)

    Koyama, Fumihiko; Matsuura, Naoyuki; Kageyama, Junichi; Otsuki, Kenro

    2010-01-01

    We performed single photon emission computed tomography ( 99m Tc-ECD SPECT) of the brain in 25 workers suffering from major depression (22 males and 3 females at the average age of 47.5±7.7 standard deviation (S.D.) years and all patients were right handed) and identified frontal lobe hypoperfusion in 18 cases using the easy Z-score Imaging System (eZIS). During the remission period, which was within ten months of therapy, we observed normalization of the frontal cerebral perfusion in 75% of the patients. In further evaluation of the cerebral blood flow after the addition of 20 healthy volunteer workers (18 males and 2 females at the average age 47.1±9.8 S.D. years and all were right handed) as a control group, reduced cerebral blood flow in the dorsal area, which is supposed to be correlated to the severity of the feeling of fatigue estimated based on the self-rating depression scale (SDS), was demonstrated by statistical parametric mapping (SPM). The severity of the fatigue of all workers was estimated using a self-rating checklist disseminated by the Japan Ministry of Health, Labor, and Welfare, which pertains to the accumulation of fatigue due to labor. In the SPM analysis, limbic hypoperfusion, which is correlated to the total severity of fatigue in all worker cases, was estimated based on the reduction in the cerebral blood flow in the lower part of the temporal lobe. We also estimated the severity of insomnia in 21 cases (8 depressive, the 8 remitted and 5 controls), referred to as the Insomnia Score in this study, using the Structured Interview Guide for the Hamilton Depression Rating Scale (SIGH-D). The severity of the insomnia statistically correlates with frontoparietal hypoperfusion, and this region is situated very close to the region correlated to the feeling of fatigue expressed by the patients in the SDS. Accordingly, prolonged sleep disturbance due to, for instance, overwork may result in easy fatigability and a pre-depressive state which are

  8. Tracking of In-111-labeled human umbilical tissue-derived cells (hUTC) in a rat model of cerebral ischemia using SPECT imaging

    International Nuclear Information System (INIS)

    Arbab, Ali S; Chopp, Michael; Thiffault, Christine; Navia, Bradford; Victor, Stephen J; Hong, Klaudyne; Zhang, Li; Jiang, Quan; Varma, Nadimpalli RS; Iskander, ASM

    2012-01-01

    In order to increase understanding of how infused cells work, it becomes important to track their initial movement, localization, and engraftment efficiency following transplantation. However, the available in vivo cell tracking techniques are suboptimal. The study objective was to determine the biodistribution of intravenously administered Indium-111 (In-111) oxine labeled human umbilical tissue-derived cells (hUTC) in a rat model of transient middle cerebral occlusion (tMCAo) using single photon emission computed tomography (SPECT). Rats received 3 million In-111 labeled hUTC (i.v.) 48 hrs after tMCAo. Following the administration of either hUTC or equivalent dose of In-111-oxine (18.5 MBq), animals underwent SPECT imaging on days 0, 1, and 3. Radioactivity in various organs as well as in the stroke area and contralateral hemisphere was determined, decay corrected and normalized to the total (whole body including head) radioactivity on day 0. Immunohistochemical analysis was also performed to confirm the beneficial effects of hUTC on vascular and synaptic density, and apoptosis. Most of the radioactivity (43.36±23.07% on day 0) trafficked to the lungs immediately following IV administration of In-111 labeled hUTC (day 0) and decreased drastically to 8.81±7.75 and 4.01±4.52% on days 1 and 3 post-injection, respectively. In contrast, radioactivity measured in the lung of animals that received In-111-oxine alone remained relatively unchanged from day 0 to day 1 (18.38±5.45% at day 0 to 12.59±5.94%) and decreased to 8.34±4.25% on day 3. Significantly higher radioactivity was observed in stroke areas of animals that received In-111 labeled hUTC indicating the presence of cells at the site of injury representing approximately 1% of total administered dose. In addition, there was significant increase in vascular and synaptophysin immunoreactivity in stroke areas of rats that received In-111 labeled hUTC. The present studies showed the tracking of In-111 labeled h

  9. The change of cerebral blood flow after heart transplantation in congestive heart failure: a voxel-based and automatic VOl analysis of Tc-99m ECD SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Hong, I. K.; Kim, J. J.; Lee, C. H.; Lim, K. C.; Moon, D. H.; Rhu, J. S.; Kim, J. S. [Asan Medical Center, Seoul (Korea, Republic of)

    2007-07-01

    To investigate the change of global and regional cerebral blood flow after heart transplantation (HT) in congestive heart failure (CHF) patients. Twenty-one patients with CHF who underwent HT (45{+-}12 yrs, M/F=19/2) and 10 healthy volunteers (39{+-}13 yrs, M/F = 7/3) were prospectively included. All patients underwent echocardiography and radionuclide angiography including brain and aorta with brain SPECT which was performed after iv bolus injection of Tc-99m ECD (740MBq) before (175{+-}253 days) and after (129{+-}82 days) HT. Patients were divided into two groups according to the interval between HT and postoperative SPECT [early follow-up (f/u): <6 mo, n=14; late f/u: >6 mo, n=7]. Global CBF (gCBF) of bilateral hemispheres were calculated by Patlak graphical analysis. Absolute rCBF map was obtained from brain SPECT by Lassen's correction algorithm. Age-corrected voxel-based analysis using SPM2 and automatic VOl analysis were performed to assess the rCBF change. Cardiac ejection fraction of all patients improved after HT (20.8%{yields}64.0%). gCBF was reduced compared to normal before HT (35.7{+-}3.9 vs. 49.1{+-}3.0 ml/100g/min; p<0.001) and improved postoperatively (46.6{+-}5.4, p<0.001). The preoperative gCBFs of early and late f/u group were not different (34.6{+-}3.2 vs. 38.0{+-}4.4, p=0.149) but postoperative gCBF (43.9{+-}3.7) of late f/u group was higher than those (52.0{+-}4.0) of early f/u group (p<0.001). On voxel-based analysis, preoperative rCBF was reduced in entire brain but most severely in bilateral superior and inferior frontal cortex, supplementary motor area, precuneus and anterior cingulum, compared to normals (uncorrected p<0.001). After HT, rCBF of these areas improved more significantly in late f/u group than in early f/u group but still lower than normals. Global CBF was significantly reduced in CHF patients and improved after HT. rCBFs of the frontal cortex, precuneus and cingulum were most severely reduced and slowly improved after

  10. Database of normal human cerebral blood flow measured by SPECT. II. Quantification of I-123-IMP studies with ARG method and effects of partial volume correction

    International Nuclear Information System (INIS)

    Inoue, Kentaro; Ito, Hiroshi; Shidahara, Miho

    2006-01-01

    The limited spatial resolution of SPECT causes a partial volume effect (PVE) and can lead to the significant underestimation of regional tracer concentration in the small structures surrounded by a low tracer concentration, such as the cortical gray matter of an atrophied brain. The aim of the present study was to determine, using 123 I-IMP and SPECT, normal cerebral blood flow (CBF) of elderly subjects with and without PVE correction (PVC), and to determine regional differences in the effect of PVC and their association with the regional tissue fraction of the brain. Quantitative CBF SPECT using 123 I-IMP was performed in 33 healthy elderly subjects (18 males, 15 females, 54-74 years old) using the autoradiographic method. We corrected CBF for PVE using segmented MR images, and analyzed quantitative CBF and regional differences in the effect of PVC using tissue fractions of gray matter (GM) and white matter (WM) in regions of interest (ROIs) placed on the cortical and subcortical GM regions and deep WM regions. The mean CBF in GM-ROIs were 31.7±6.6 and 41.0±8.1 ml/100 g/min for males and females, and in WM-ROIs, 18.2±0.7 and 22.9±0.8 ml/100 g/min for males and females, respectively. The mean CBF in GM-ROIs after PVC were 50.9±12.8 and 65.8±16.1 ml/100 g/min for males and females, respectively. There were statistically significant differences in the effect of PVC among ROIs, but not between genders. The effect of PVC was small in the cerebellum and parahippocampal gyrus, and it was large in the superior frontal gyrus, superior parietal lobule and precentral gyrus. Quantitative CBF in GM recovered significantly, but did not reach values as high as those obtained by invasive methods or in the H 2 15 O PET study that used PVC. There were significant regional differences in the effect of PVC, which were considered to result from regional differences in GM tissue fraction, which is more reduced in the frontoparietal regions in the atrophied brain of the elderly

  11. Heterogeneity of neocortical cerebral blood flow deficits in dementia of the Alzheimer type

    DEFF Research Database (Denmark)

    Waldemar, G; Bruhn, P; Kristensen, M

    1994-01-01

    Regional cerebral blood flow (rCBF) was measured with high resolution brain dedicated single photon emission computer tomography (SPECT) and [99mTc]-d,l-hexamethyl-propylene-amine-oxime (HMPAO) in 25 patients with probable Alzheimer's disease and in 25 control subjects, selected according...... to rigorous inclusion and exclusion criteria. The aim was to analyse the topography of rCBF deficits in individual patients. In the group of patients with Alzheimer's disease as a whole, global CBF was reduced, but a factorial analysis of variance did not show disproportionate reduction of rCBF in any brain...... combination of two, three, or four, of four major brain regions (a left and right frontal and a left and right posterior region). All patients with Alzheimer's disease and none of the control subjects had an abnormal rCBF pattern. Eleven of the 13 different patterns were seen in the patients. Frontal changes...

  12. Regional cerebral blood flow (RCBF) measurements by SPECT analysis of Xenon-133 transit: Validation of technique and clinical correlation

    International Nuclear Information System (INIS)

    Rezai, K.; Kirchner, P.; Armstrong, C.; Ehrhardt, J.; Damasio, H.; Adams, H.; Damasio, A.

    1984-01-01

    The SPECT system (Tomomatic-64) developed by a previous study for rCBF measurements with Xe-133 was validated with phantom simulations and clinical studies. A bi-compartmental flow phantom was developed consisting of a Xenon-133 pump connected in series to head and lung compartments. Flow rates between 0.2 and 1.4 brain volumes/min (20-140 cc/100ml/min) were tested against Tomomatic measurements by linear regression. Correlation was excellent (r=1.0) in the range of 0.2-1.2 (20-120 cc/100ml/min), representing flow rates which are most likely to be encountered in clinical studies. Flow rates above 1.2 (120 cc/100 ml/min) were significantly underestimated. 32 studies on 20 volunteers gave a mean normal flow of 72 (SD=12) cc/ 100g/min. Mean regional flow ranged from 62 in frontal lobes to 75 in central gray matter. Right-to-left variation was less than 5%. The lowest regional flow in a normal subject was 45 cc/100g/min. 68 studies were performed on 30 stroke patients. In 27 rCBF was less than 45 in affected brain areas for a sensitivity of 90% which improved to 97% when comparisons with contralateral brain were included. Initial CT scans were normal or non-diagnostic in 10, but showed CVA's in regions of reduced rCBF in 17 patients. rCBF abnormalities involved greater portions of brain than CT changes, often (8/17) including distant regions, unpredicted by CT or clinical studies but known to be strongly interconnected to the area of structural damage. SPECT estimates of rCBF appear to be a sensitive research and diagnostic tool and complement the structural information provided by CT

  13. Stabilization of Tc-99m D,L-HMPAO preparations as a leucocyte labelling agent

    International Nuclear Information System (INIS)

    Kao, C.H.; Huang, W.T.; Tsai, C.S.

    1998-01-01

    An attempt was made to use stabilized Tc-99m D,L-HMPAO (S-HMPAO) to label leucocytes. The radiochemical purity of Tc-99m D,L-HMPAO, labelling efficiency of leucocytes, cell viability of labelled leucocytes, and stability of S-HMPAO labelled leucocytes were calculated. In comparison with commercial Tc-99m D,L-HMPAO (C-HMPAO) without stabilization, immediately, at 0.5, 1, 2, 4, and 6 h after HMPAO preparation, the radiochemical purity of S-HMPAO and the labelling efficiencies of S-HMPAO labelled leucocytes were higher. S-HMPAO is more stable than C-HMPAO and can provide higher leucocyte labelling efficiency. S-HMPAO, therefore, has the potential to replace C-HMPAO as a leucocyte-labelling agent

  14. Tc-99m HMPAO brain uptake patterns in patients with dementia of Alzheimer type

    International Nuclear Information System (INIS)

    Costa, D.C.; Burns, A.; Philpot, M.; Levy, R.; Ell, P.J.

    1988-01-01

    Conventional gamma camera SPECT with Tc-99m HMPAO (10 MBq/kg patient weight) was carried out in 21 patients with dementia of Alzheimer type (DAT), fulfilling the criteria established by the National Institute of Neurological and Communicative Disorders and Stroke and the ADRDA criteria (nine with amnesia as the main symptom [group 1], 12 with amnesia, aphasia, and/or apraxia and agnosia [group 2], and eight age-matched control subjects. Perfusion was quantitatively studied by means of cerebrum-cerebellum activity ratios. In group 1, perfusion deficits in the mesial cortex of the temporal lobes (right, 0.70; left, 0.68) were found, and ratios were significantly lower than in the control group (right, 0.77; left, 0.76 [P < .05]). Group 2 showed low ratios throughout both temporal lobes (mesial and lateral cortex), bilaterally in the posterior parietal cortex (right, 0.69; left, 0.66 [control: right, 0.80; left, 0.81] [P < .001]), and left frontal cortex (0.75 [control, 0.79] [P < .05]). In conclusion, SPECT with Tc-99m HMPAO identifies perfusion deficits in patients with DAT, and these correlate well with the clinical findings and are significantly different from those in the control group

  15. Regional cerebral blood flow abnormalities in patients with primary hyperparathyroidism

    International Nuclear Information System (INIS)

    Cermik, Tevfik F.; Kaya, Meryem; Bedel, Deniz; Berkarda, Sakir; Yigitbasi, Oemer N.; Ugur-Altun, Betuel

    2007-01-01

    We assessed the alterations in regional cerebral blood flow (rCBF) in patients with primary hyperparathyroidism (PHP) before parathyroidectomy by semiquantitative analysis of brain single photon emission computed tomography (SPECT) images. Included in this prospective study were 14 patients (mean age 47.6 ± 10.4 years; 3 male, 11 female) and 10 control subjects (mean age 36.0 ± 8.5 years, 6 male, 4 female) were SPECT imaging was performed using a dual-headed gamma camera 60-90 min after intravenous administration of 925 MBq Tc-99m HMPAO. The corticocerebellar rCBF ratios were calculated from 52 brain areas and reference lower values (RLVs) were calculated from the rCBF ratios of control subjects. The regional ratios that were below the corresponding RLV were considered abnormal (hypoperfused). Hypoperfusion was shown in 171 out of 728 regions (23%) and there was a significant correlation between serum calcium, PTH levels and the sum of hypoperfused regions in the patient group (R = 0.75 and P = 0.001, and R = 0.75, P = 0.001, respectively). Significantly reduced rCBF were found in the following cortical regions: bilateral cingulate cortex, superior and inferior frontal cortex, anterior temporal cortex, precentral gyrus, postcentral gyrus and parietal cortex, and right posterior tempo