Prospective evaluation of technetium-99m-HMPAO SPECT in mild and moderate traumatic brain injury.
We prospectively evaluated the contribution of 99mTc-HMPAO SPECT in patients who have sustained acute, mild or moderate head trauma.


METHODS
Forty-two patients formed the first subgroup of moderate trauma (ModTr) and 25 patients formed the second subgroup of mild trauma (MilTr). All 67 patients underwent an initial SPECT (Tinit) within 4 wk after a closed cranial trauma. After a mean interval of 3 mo from the time of Tinit, all patients were clinically re-evaluated; those with an abnormal Tinit underwent a repeat SPECT (Trpt) as well. All SPECT studies were visually graded by agreement of three observers adjudging a score ranging from 0 (no lesions) to 4.


RESULTS
For the group as a whole (ModTr + MilTr), the following results could be derived: (1) in 32/33 Tinit negative cases, clinical symptoms had resolved; (2) the positive predictive value of Tinit was only 20/34 (59%); (3) the sensitivity for the repeat SPECT was 19/20 (95%).


CONCLUSIONS
Our results show that: (1) SPECT alterations correlate well with the severity of the trauma; (2) a negative initial SPECT study is a reliable predictor of a favorable clinical outcome; (3) in cases with a positive initial SPECT, a follow-up consisting of a combination of SPECT and clinical data is necessary; (4) in patients suffering from postconclusive symptoms, SPECT offers an instrument to objective sequelae.
Jacobs
A
A
Department of Nuclear Medicine, Virga Jesse Hospital, Hasselt, Belgium.
Put
E
E
Ingels
M
M
Bossuyt
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011237:Predictive Value of Tests; D011446:Prospective Studies; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime