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Cerebral perfusion deficits in divers with neurological decompression illness
P T Wilmshurst1, M J O'Doherty, T O Nunan
1Department of Cardiology, St Thomas' Hospital, London, UK.
Nuclear Medicine Communications
|February 1, 1993
Summary
Technetium Tc 99m exametazime (HMPAO) scans did not correlate with clinical findings in divers with neurological decompression illness. Perfusion deficits were equally common in divers with and without residual symptoms, questioning the scan's utility.
Area of Science:
- Neurology
- Radiology
- Diving Medicine
Background:
- Neurological decompression illness (NDI) in divers can cause lasting symptoms.
- Single photon emission tomography (SPECT) with 99Tcm-hexamethylpropyleneamine oxime (HMPAO) is proposed to detect cerebral perfusion deficits correlating with NDI severity.
Purpose of the Study:
- To investigate the correlation between cerebral perfusion deficits shown by HMPAO SPECT and clinical findings in divers with NDI.
- To evaluate the utility of HMPAO SPECT in managing patients with NDI.
Main Methods:
- Studied 12 divers diagnosed with NDI.
- Classified divers into two groups: 6 with residual cerebral symptoms (Group 1) and 6 without (Group 2).
- Assessed cerebral perfusion using HMPAO SPECT and correlated findings with clinical presentation and residual symptoms.
Main Results:
- Cerebral perfusion deficits were detected in both groups (with and without residual symptoms).
- The frequency of perfusion deficits was similar between Group 1 and Group 2.
- The location of perfusion deficits did not correlate with initial neurological findings or residual clinical signs.
Conclusions:
- HMPAO SPECT findings did not correlate with clinical outcomes in divers with NDI.
- The study challenges previous claims regarding the correlation between HMPAO scans and clinical findings in NDI patients.
- The use of HMPAO scanning for patient management in NDI appears questionable based on these findings.