Serial changes in regional blood flow in the cerebrum and cerebellum of stroke patients imaged by 99Tcm-HMPAO SPET.
Luxury perfusion is a well-known phenomenon that can mask ischaemic lesions in patients with cerebral infarction, thus making diagnosis difficult. In this study, we evaluated the incidence of luxury perfusion over a 3-week period following a stroke episode. The usefulness of crossed cerebellar diaschisis (CCD) as a complementary feature in the diagnosis of cerebral infarction was also evaluated using 99Tcm-hexamethylpropyleneamine oxime (99TcmHMPAO) brain single photon emission tomography (SPET). Twelve patients diagnosed as having a hemispheric ischaemic stroke of the middle cerebral arterial territory were enrolled in the study. Each patient underwent a total of four 99Tcm-HMPAO brain SPET examinations, 1 day, 1 week, 2 weeks and 3 weeks following the stroke episode. Our results show that the incidence of luxury perfusion was 67% (8/12) after 1 week, 75% (9/12) after 2 weeks and 83% (10/12) after 3 weeks. The incidence of CCD was 33% (4/12) after 1 day, 50% (6/12) after 1 week, 42% (5/12) after 2 weeks and 33% (4/12) after 3 weeks. We conclude that the detection of cerebral infarction is difficult 2 weeks or more after a stroke episode. The interval between the stroke episode and examination must be considered when reading the 99Tcm-HMPAO image. In addition, CCD may be helpful for the diagnosis of cerebral infarction within the first week after a stroke episode, especially in cases of an unidentified ischaemic region on the 99Tcm-HMPAO hemispheric image. However, the value of CCD is limited 2 weeks or more following the stroke episode.
Lin
W Y
WY
Department of Nuclear Medicine, Taichung Veterans General Hospital, Taiwan, Republic of China.
Kao
C H
CH
Wang
P Y
PY
Changlai
S P
SP
Wang
S J
SJ
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging*; D002531:Cerebellum / Q000098:blood supply*; D002536:Cerebral Arteries; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D010091:Oximes; D012039:Regional Blood Flow; D019690:Technetium Tc 99m Exametazime; D013997:Time Factors; D014055:Tomography, Emission-Computed
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime