Iofetamine HCI I-123 brain scanning in stroke: a comparison with transmission CT

Although IMP scans fail to show fine anatomical details of the brain, because of poor resolution of a single head rotational system, adequate information is offered by the scans to localize most perfusion defects caused by stroke. The following conclusions can be drawn from our study: 1. The planar IMP brain scans processed through the computer are sensitive in the early diagnosis of acute stroke except for small and deeply localized lesions. 2. The SPECT IMP imaging is more sensitive than the planar or transmission CT scans in the early diagnosis of stroke. Semiquantitative evaluations are feasible with IMP SPECT. 3. Neither transmission CT nor IMP SPECT are sensitive in the detection of acute lacunar infarcts. 4. In acute infarction, the transmission CT is usually negative or minimally positive in the early stages, while impaired uptake of IMP occurs immediately after the onset of the stroke. In acute stroke, the extent of the perfusion defect on IMP is usually greater than the abnormality seen on the transmission CT. 5. On followup studies, IMP scans show improved perfusion reflecting physiologic changes, while transmission CT scans show further dense anatomical changes when compared to the initial studies. 6. Hyperemic changes are likely due to collateral circulation or luxury perfusion. This finding suggests that the IMP reflects local cerebral blood flow in strokes.