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Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping
10:25

Brain Infarct Segmentation and Registration on MRI or CT for Lesion-symptom Mapping

Published on: September 25, 2019

Incomplete brain infarction

Yuichiro Inatomi1, Toshiro Yonehara, Teruyuki Hirano

  • 1Department of Neurology, Stroke Center, Saiseikai Kumamoto Hospital. y.inatomix@silk.ocn.ne.jp

Internal Medicine (Tokyo, Japan)
|May 15, 2010
PubMed

Insights

Incomplete infarction can cause critical brain lesions without complete infarction. Technetium-99m-ECD SPECT imaging detected these lesions when MRI was unclear, aiding diagnosis.

Area of Science:

  • Neurology
  • Radiology
  • Nuclear Medicine

Background:

  • Diagnosing incomplete infarction can be challenging with conventional imaging like MRI.
  • Early detection of ischemic brain lesions is crucial for timely intervention.

Observation:

  • A 70-year-old man experienced two episodes suggestive of incomplete infarction.
  • Initial MRI (including Diffusion-Weighted Imaging - DWI) was inconclusive for the first event.
  • Technetium-99m-Ethylcysteinate Dimer (99mTc-ECD) SPECT showed high uptake in the acute phase of the first attack.
  • The lesion became atrophic with low SPECT uptake in the chronic phase.
  • The second attack showed subtle DWI hyperintensities but was better visualized with SPECT and angiography.
  • Angiography revealed capillary blush during the acute phase of the second attack.

Findings:

  • 99mTc-ECD SPECT effectively identified acute ischemic lesions not clearly seen on DWI.
  • Incomplete infarction alone can lead to significant and clinically critical brain damage.
  • Lesion characteristics on SPECT evolved from acute (high uptake) to chronic (low uptake).

Implications:

  • 99mTc-ECD SPECT may be a valuable tool for diagnosing incomplete infarction when MRI is equivocal.
  • This case highlights the potential severity of incomplete infarcts, emphasizing the need for accurate diagnostic methods.
  • Understanding the imaging characteristics of incomplete infarction can improve patient management and outcomes.

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