The role of 99Tcm-HMPAO brain SPET in paediatric traumatic brain injury.
Twenty-eight paediatric patients suffering from chronic sequelae of traumatic brain injury (TBI) were examined by EEG, radionuclide imaging with 99Tcm-hexamethylpropyleneamine oxime (99Tcm-HMPAO), computed tomography (CT) and, when available, magnetic resonance imaging (MRI), the results of which were evaluated retrospectively. Our findings indicate that neuro-SPET (single photon emission tomography) with 99Tcm-HMPAO is more sensitive than morphological or electrophysiological tests in detecting functional lesions. In our group, 15 of 32 CT scans were normal, compared with 3 of 35 SPET studies. SPET identified approximately 2.5 times more lesions than CT (86 vs 34). SPET was found to be particularly sensitive in detecting organic abnormalities in the basal ganglia and cerebellar regions, with a 3.6:1 detection rate in the basal ganglia and a 5:1 detection rate in the cerebellum compared with CT. In conclusion, neuro-SPET appears to be very useful when evaluating paediatric post-TBI patients in whom other modalities are not successful.
Goshen
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Department of Nuclear Medicine, Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, Tel-Aviv University, Israel.
Zwas
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Shahar
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Tadmor
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D000293:Adolescent; D001479:Basal Ganglia / Q000000981:diagnostic imaging; D001921:Brain / Q000000981:diagnostic imaging*; D001930:Brain Injuries / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002531:Cerebellum / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D015609:Organotechnetium Compounds; D010091:Oximes; D012016:Reference Values; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014057:Tomography, X-Ray Computed
D015609:Organotechnetium Compounds; D010091:Oximes; D019690:Technetium Tc 99m Exametazime