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Sequential assessment of cerebral blood flow in diffuse brain injury by 123I-iodoamphetamine single-photon emission
G Shiina1, T Onuma, M Kameyama
1Department of Neurosurgery, Sendai City Hospital, Japan.
Purpose:
Our goal was to elucidate the temporal profile of cerebral circulation and its relationship to prognosis in patients with diffuse brain injury by using single-photon emission CT (SPECT) and 123I-iodoamphetamine (IMP).
Methods:
A total of 67 assessments were made in 26 patients with diffuse brain injury (Glasgow Coma Scale score < or = 8). The microsphere method was used for quantifying cerebral blood flow (CBF). The hemispheric CBF was defined as a mean regional CBF (rCBF), and the total cerebral hemispheric CBF (tCBF) as a mean of the bilateral hemispheric CBF. The relationship between patient outcome and tCBF was investigated.
Results:
The rCBF in patients with diffuse brain injury showed dynamic and global changes with little regional differences. The tCBF values increased in 1 to 3 days, and they were higher in the poor-outcome group than in the good-outcome group. During the period of 14 to 42 days, the tCBF values stayed within normal range in the good-outcome group, whereas they were below normal range in the poor-outcome group.
Conclusion:
Our results revealed a good correlation between patient outcome and CBF values. Quantitative and sequential CBF studies with IMP SPECT are promising for helping to determine the prognosis for patients with diffuse brain injury.