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Noninvasive evaluation of ischemic stroke with SPECT
C R Gomez1, M M Malik, S M Gomez
1Department of Neurology, St. Louis University Medical Center, MO 63110.
Southern Medical Journal
|October 1, 1988
Summary
Technetium Tc 99m DTPA SPECT brain scans showed abnormalities in most acute ischemic stroke patients. This imaging technique offers insights into cerebral infarction and collateral flow dynamics, comparable to CT scans.
Area of Science:
- Neurology
- Radiology
- Nuclear Medicine
Background:
- Acute ischemic stroke diagnosis relies on clinical presentation and imaging.
- Computed tomography (CT) is a standard tool, but its ability to detect early changes or assess perfusion can be limited.
Purpose of the Study:
- To evaluate the utility of Technetium Tc 99m DTPA SPECT brain scans in patients with acute ischemic stroke.
- To compare SPECT findings with clinical data and CT scans.
- To assess SPECT's ability to visualize cerebral infarctions and evaluate cerebral blood flow dynamics.
Main Methods:
- Retrospective review of Technetium Tc 99m DTPA SPECT brain scans from 20 patients with acute ischemic stroke.
- Comparison of SPECT findings with clinical presentation and CT imaging data.
- Analysis of both static and dynamic (flow) SPECT imaging sequences.
Main Results:
- Fourteen out of 20 patients (70%) exhibited abnormal SPECT findings.
- Abnormalities were detected in static views (8/14), flow studies (1/14), or both (5/14).
- SPECT findings correlated with clinical presentation, and two patients with abnormal SPECT had no CT lesions. Six patients had normal SPECT, with CT abnormalities in two and no lesions in four.
Conclusions:
- Technetium Tc 99m DTPA SPECT demonstrates cerebral infarctions with an ability comparable to CT.
- SPECT provides valuable qualitative information on cerebral blood flow dynamics in the affected hemisphere.
- SPECT may objectively demonstrate insufficient collateral flow, a risk factor for ischemic stroke.