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Brain SPECT imaging using three different tracers in subacute cerebral infarction
J Hashimoto1, T Sasaki, Y Itoh
1Department of Radiology, School of Medicine, Keio University, Tokyo, Japan.
Clinical Nuclear Medicine
|May 22, 1998
Summary
Sequential imaging with I-123-iomazenil in subacute cerebral infarction reveals increased uptake in infarcted areas and contralateral cerebellar hypoperfusion. This technique aids in assessing brain viability and perfusion deficits.
Area of Science:
- Neurology
- Nuclear Medicine
- Radiology
Background:
- Assessing subacute cerebral infarction requires detailed imaging of both perfusion and neuronal function.
- Benzodiazepine receptor imaging and perfusion imaging are crucial for understanding infarct evolution.
Observation:
- Two patients with subacute cerebral infarction were evaluated using I-123-iomazenil for benzodiazepine receptor imaging and Tc-99m HMPAO/Tc-99m ECD for cerebral perfusion imaging.
- Early I-123-iomazenil images showed increased uptake in the infarct, similar to Tc-99m HMPAO findings.
- Delayed I-123-iomazenil and Tc-99m ECD images demonstrated reduced accumulation in the infarcted area, indicating impaired viability.
Findings:
- Crossed cerebellar diaschisis was noted on early I-123-iomazenil, Tc-99m HMPAO, and Tc-99m ECD images.
- Delayed I-123-iomazenil imaging did not show significant crossed cerebellar diaschisis.
- Sequential I-123-iomazenil imaging effectively visualized increased uptake with impaired viability in the infarct and hypoperfusion with preserved viability in the contralateral cerebellum.
Implications:
- Sequential I-123-iomazenil imaging offers unique insights into infarct evolution, complementing standard perfusion imaging.
- This approach can identify hypoperfusion in the contralateral cerebellum, a phenomenon not always evident with other methods.
- Combined use of perfusion and benzodiazepine receptor imaging is valuable for comprehensive assessment in the subacute phase of cerebral infarction.