Evaluation of cerebral infarction with iodine 123-iomazenil SPECT.
This study evaluates ischemic damage to central benzodiazepine (BZD) receptor binding in the brain with [123]iomazenil SPECT in relation to CT hypodense lesions and blood flow abnormalities.


METHODS
Nine patients with middle cerebral artery territory infarction were studied. Iomazenil images obtained 180 min postinjection were analyzed for BZD receptor binding. The cortical infraction, visualized as CT hypodense area on CT, the peri-infarct area, visualized as normodensity surrounding the infarction on CT, the intrahemispheric remote area and the cerebellum were analyzed by taking the ratio of the lesion to contralateral mirror region (L/C ratio). CT during the chronic stage and perfusion images obtained during the smallest time difference between the two studies were used for comparative analysis.


RESULTS
The mean L/C ratio of iomazenil uptake was 0.53 +/_ 0.08, 0.79 +/- 0.07, 0.98 +/- 0.03 and 1.00 +/- 0.04 in the infarct, peri-infarct and remote areas and the cerebellum, respectively. The infarct and peri-infarct areas showed significant decrease compared with unity. The corresponding mean L/C ratio for blood flow was 0.52 +/- 0.08, 0.73 +/- 0.07, 0.83 +/- 0.09, and 0.80 +/- 0.07, respectively. In all areas, the ratios were significantly decreased compared with unity. There was significant difference between the L/C ratio for blood flow and iomazenil in the remote area and the cerebellum.


CONCLUSIONS
Iodine-123-iomazenil SPECT imaging may provide new information on ischemic damage to the brain, particularly neurons.
Department of Radiology and NUclear medicine, Akita Research Institute of Brain and Blood Vessels, Japan.
J
J
Hatazawa
T
T
Satoh
E
E
Shimosegawa
T
T
Okudera
A
A
Inugami
T
T
Ogawa
H
H
Fujita
K
K
Noguchi
I
I
Kanno
S
S
Miura
D001039:Aphasia, Broca / Q000000981:diagnostic imaging; D001041:Aphasia, Wernicke / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D002544:Cerebral Infarction / Q000000981:diagnostic imaging* / Q000378:metabolism; D002560:Cerebrovascular Circulation / Q000502:physiology; D005260:Female; D005442:Flumazenil / Q000031:analogs & derivatives*; D006801:Humans; D007457:Iodine Radioisotopes; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011963:Receptors, GABA-A / Q000032:analysis; D015899:Tomography, Emission-Computed, Single-Photon
D007457:Iodine Radioisotopes; D011963:Receptors, GABA-A; D005442:Flumazenil; C063038:iomazenil