[Single-photon emission tomography (SPECT) using 123I-amphetamine in cerebral ischemic circulatory disorders]

The uptake of 123I-amphetamine (IMP) in brain mainly corresponds to regional perfusion. Distribution of IMP can be visualized in tomographic slices by single-photon emission computed tomography (SPECT). For better evaluation and comparison in follow-up studies, right/left ratios were computed and an asymmetry index calculated. The most sensitive asymmetry index was achieved by 120 average circumferential profiles. In 52 patients with stroke and 16 controls the respective sensitivities of IMP-SPECT, computed tomography (CT), static and dynamic brain scanning and angiography were evaluated. In patients with TIA and PRIND the IMP-SPECT had the highest sensitivity of all non-invasive methods. In patients with completed stroke, the sensitivity of IMP-SPECT was comparable with that of CT (90 vs. 93%). There was a significant correlation between the IMP asymmetry index and the clinical and social score (p less than 0.001). The IMP asymmetry index was significantly correlated to the size of the CT lesion (p less than 0.001). In most patients, the size of the IMP lesion was larger than that of CT. In a prospective study, 28 patients with completed stroke were examined. 14 patients underwent surgical treatment (6 endarterectomies, 5 EIA, 3 combined operations), 14 patients had medical treatment only. Both groups were reexamined after 10 and 6.5 months, respectively. In both groups, neither the IMP asymmetry index nor the size of the CT lesion were changed, but the clinical and social scores improved (p less than 0.01). The outcome in both groups was the same. A positive effect of surgery could not be demonstrated.