title: Tc-99m HMPAO to demonstrate diffuse cortical necrosis in vivo.
abstract: Tc-99m hexamethylpropylene amineoxime (HMPAO) is a novel radiopharmaceutical demonstrated to be a sensitive indicator of abnormalities of cerebral perfusion. Most reports in the literature have evaluated patients with gross perfusion deficits, such as cerebrovascular accidents, and with dementia, where patterns of diffuse perfusion deficit were reported comparable with those seen in PET studies. We report a patient in whom there was the rapid onset of dementia, with the HMPAO images demonstrating diffuse loss of cortical perfusion in a nonfocal, and nonsegmental, fashion. Correlation with postmortem examination demonstrates good concordance between the diffuse nature of HMPAO loss, and diffuse cortical necrosis throughout both cerebral hemispheres. The technique was shown to be more sensitive than transmission CT scanning in demonstrating the extent of the deficit, and it correlated closely with the functional deficits noted in the patient.
authors.affiliation: Department of Nuclear Medicine, Cross Cancer Institute, Edmonton, Alberta, Canada.
authors.forename: A J
authors.initials: AJ
authors.lastname: McEwan
authors.forename: F I
authors.initials: FI
authors.lastname: Jackson
authors.forename: Z
authors.initials: Z
authors.lastname: Catz
authors.forename: R P
authors.initials: RP
authors.lastname: Schmidt
authors.forename: H R
authors.initials: HR
authors.lastname: Hooper
authors.forename: J J
authors.initials: JJ
authors.lastname: Mattjews
mesh_terms: D000208:Acute Disease; D001921:Brain / Q000000981:diagnostic imaging*; D002540:Cerebral Cortex / Q000473:pathology; D002560:Cerebrovascular Circulation; D003704:Dementia / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D015609:Organotechnetium Compounds; D010091:Oximes; D011877:Radionuclide Imaging; D019690:Technetium Tc 99m Exametazime
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime