[Study by I-123-IMP-SPECT before and after surgery for craniosynostosis]

Area of Science:

• Neurology
• Nuclear Medicine
• Pediatric Surgery

Background:

• Craniosynostosis, the premature fusion of cranial sutures, can lead to abnormal brain development and function.
• Assessing cerebral perfusion is crucial for understanding the impact of craniosynostosis and evaluating surgical outcomes.
• Conventional imaging like CT and MRI may not reveal functional deficits associated with craniosynostosis.

Purpose of the Study:

• To evaluate the utility of Iodine-123 N-isopropyl-p-iodoamphetamine (I-123-IMP) SPECT in assessing cerebral perfusion in craniosynostosis.
• To determine if I-123-IMP SPECT can detect functional abnormalities not visible on CT or MRI.
• To assess the changes in cerebral perfusion after surgical correction of craniosynostosis.

Main Methods:

• Single photon emission computed tomography (SPECT) using I-123-IMP was performed on 13 patients with craniosynostosis.
• Imaging was conducted before and after surgical intervention.
• SPECT findings were correlated with CT and MRI results.

Main Results:

• Preoperative SPECT revealed focal low perfusion areas in 62% of patients.
• Low perfusion was observed in various lobes and the cerebellum, depending on the type of craniosynostosis (brachycephaly, scaphocephaly, plagiocephaly, Crouzon disease, Apert disease).
• Post-surgery, 75% of cases showed diminished or resolved perfusion deficits.

Conclusions:

• I-123-IMP SPECT is a valuable tool for identifying functional brain perfusion abnormalities in craniosynostosis.
• SPECT can detect deficits not evident on structural imaging (CT/MRI).
• I-123-IMP SPECT serves as a useful index for evaluating functional recovery after surgical treatment of craniosynostosis.