Technetium-99m-HMPAO brain SPECT evaluation of neurotoxicity due to manganese toxicity.
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.
Lill
D W
DW
University of Alabama School of Medicine, Department of Radiology, Birmingham.
Mountz
J M
JM
Darji
J T
JT
D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000139:chemically induced* / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D020149:Manganese Poisoning; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D012039:Regional Blood Flow; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime