title: Detection of postural cerebral hypoperfusion with technetium-99m-HMPAO brain SPECT in patients with cerebrovascular disease.
abstract: Seventeen of 19 patients (67 +/- 8 yr, 17 males and 2 females) had more than 75% unilateral stenosis or occlusion of the internal carotid or middle cerebral artery and two patients had carotid endarterectomy that previously had 90% stenosis of the internal carotid artery. They were studied during upright 99mTc-HMPAO brain SPECT. HMPA was injected immediately after arising from a supine position. Patients were classified into Group A (n = 10) with occlusion of the internal carotid or the middle cerebral artery or Group B (n = 9) with more than 75% unilateral stenosis of the internal carotid or the middle cerebral artery and with carotid endarterectomy. Additional cerebral blood flow perfusion abnormalities between upright and supine 99mTc-HMPAO brain SPECT were detected in seven patients in Group A and in only one patient in Group B. Semiquantitative analysis showed that the asymmetric ratios between upright and supine positions changed significantly in Group A from 0.82 +/- 0.15 to 0.89 +/- 0.10 (p < 0.01), but not in Group B, from 0.89 +/- 0.11 to 0.92 +/- 0.12 (ns). Additional perfusion abnormalities were relevant to occlusion of the internal carotid or middle cerebral artery indicated postural cerebral hypoperfusion. We conclude that upright 99mTc-HMPAO brain SPECT visualizes postural cerebral hypoperfusion possibly related to silent cerebral ischemia.
authors.affiliation: Department of Radiology, Medical School, Osaka University, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hayashida
authors.forename: Y
authors.initials: Y
authors.lastname: Hirose
authors.forename: T
authors.initials: T
authors.lastname: Kaminaga
authors.forename: Y
authors.initials: Y
authors.lastname: Ishida
authors.forename: S
authors.initials: S
authors.lastname: Imakita
authors.forename: M
authors.initials: M
authors.lastname: Takamiya
authors.forename: I
authors.initials: I
authors.lastname: Yokota
authors.forename: T
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D011187:Posture; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime