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Technetium-99m-HMPAO brain SPECT evaluation of neurotoxicity due to manganese toxicity
D W Lill1, J M Mountz, J T Darji
1University of Alabama School of Medicine, Department of Radiology, Birmingham.
Unlabelled:
We performed initial and follow-up regional cerebral blood flow (rCBF) studies using 99mTc-hexamethylpropyleneamine oxime (HMPAO) SPECT on a patient with manganese-induced central nervous system (CNS) neurotoxicity.
Methods:
The patient had a history of long-term exposure to manganese at the time of the first scan, while the follow-up scan was performed 9 mo after removal from the toxic environment. The patient's serum level of manganese was five- to tenfold greater than normal at the time of the initial rCBF brain SPECT scan.
Results:
The rCBF brain SPECT scan demonstrated significantly decreased rCBF in the right caudate nucleus and both thalami. A MRI scan obtained at the same time was normal. The follow-up rCBF brain SPECT scan was normal.
Conclusions:
This report supports the utilization of functional rCBF brain SPECT imaging to provide objective evidence of a function CNS abnormality due to neurotoxicity at an early clinical stage. Our results emphasize that rCBF brain SPECT may provide a confirmational test to support the diagnosis of neurotoxicity in the appropriate clinical setting.