Viable neurons with luxury perfusion in hydrocephalus.
A woman with hydrocephalus due to aqueductal stenosis had functional imaging of cerebral perfusion and metabolism to demonstrate the effects of endoscopic third ventriculostomy--a new form of internal surgical shunting. Technetium-99m-ECD SPECT and 18F-FDG PET showed regional luxury perfusion at the left frontal region. Three months after a successful third ventriculostomy, a repeated imaging of cerebral perfusion and metabolism showed resolution of luxury perfusion and global improvement of both perfusion and metabolism. This concurred with postoperative clinical improvement. The paired imaging of cerebral perfusion and metabolism provides more information than just imaging perfusion or metabolism. Thus, the detection of perfusion and metabolism mismatch may open a new window of opportunity for surgical intervention.
Wong
C Y
CY
Department of Nuclear Medicine, The Cleveland Clinic Foundation, Ohio 44143, USA.
Luciano
M G
MG
MacIntyre
W J
WJ
Brunken
R C
RC
Hahn
J F
JF
Go
R T
RT
D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D002560:Cerebrovascular Circulation; D003545:Cysteine / Q000031:analogs & derivatives; D003847:Deoxyglucose / Q000031:analogs & derivatives; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D015609:Organotechnetium Compounds; D014055:Tomography, Emission-Computed; D015899:Tomography, Emission-Computed, Single-Photon; D014696:Ventriculostomy
D005462:Fluorine Radioisotopes; D015609:Organotechnetium Compounds; D019788:Fluorodeoxyglucose F18; D003847:Deoxyglucose; C059659:technetium Tc 99m bicisate; D003545:Cysteine