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Cerebral palsy: initial experience with Tc-99m HMPAO SPECT of the brain
R Denays1, M Tondeur, V Toppet
1Department of Neurology, St. Pierre Hospital, Free Universities of Brussels, Belgium.
Insights
Technetium-99m HMPAO SPECT brain scans reveal reduced blood flow in children with cerebral palsy. This imaging technique aids in assessing the severity of motor impairments and associated disabilities.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Cerebral palsy (CP) prognosis depends on motor deficits and co-occurring disabilities.
- Early detection of CP remains a significant clinical challenge.
Purpose of the Study:
- To evaluate the utility of technetium-99m hexamethylpropyleneamineoxime (Tc-99m HMPAO) single photon emission computed tomography (SPECT) in assessing cerebral palsy.
- To correlate brain perfusion patterns with motor impairment severity in pediatric CP patients.
Main Methods:
- The study involved 13 children diagnosed with cerebral palsy, aged 13 months to 12 years.
- Brain SPECT imaging was performed using Tc-99m HMPAO to assess regional cerebral blood flow.
Main Results:
- SPECT revealed hypoperfusion in the hemisphere contralateral to motor deficits in hemiplegic patients.
- Mild diplegia cases showed normal SPECT findings.
- Moderate to severe di- or tetraplegia correlated with bilateral hypoperfusion in specific cortical areas, including motor, prefrontal, and parietal regions, with increasing severity.
Conclusions:
- Tc-99m HMPAO SPECT is a valuable adjunctive tool for comprehensive neurological evaluation in children with cerebral palsy.
- SPECT findings correlate with the severity and type of motor impairment in CP.
- This imaging modality can aid in understanding the pathophysiology and extent of neurological involvement in pediatric cerebral palsy.
Abstract:
The outlook for children with cerebral palsy is determined by the severity of motor problems and the presence of associated disabilities, in which early detection remains a medical challenge. The authors studied 13 children (aged 13 months to 12 years) with cerebral palsy by means of single photon emission computed tomography (SPECT) of the brain with technetium-99m hexamethylpropyleneamineoxime (HMPAO). In all children with hemiplegia, SPECT demonstrated hypoperfusion in the hemisphere contralateral to the motor deficit. SPECT demonstrated normal findings in patients with mild diplegia; bilateral hypoperfusion in the superior motor cortex in patients with moderate di- or tetraplegia; and bilateral reduction of perfusion in the superior motor, inferior motor, prefrontal, and parietal cortices in patients with severe di- or tetraplegia. Results suggest that Tc-99m HMPAO SPECT of the brain is a valuable complementary tool for thorough neurologic assessment in cerebral palsy.