Precise localization of dysfunctional areas in vertebro-basilar infarction by FDG- and O-15-H2O-PET using standardized image analysis and image registration to 3-D MR.
The advantages of standardized multimodal image analysis are demonstrated in a case of symptomatic tremor after basilar thrombosis. Functionally and structurally lesioned areas were mapped in Talairach space using 3-D MRI, cerebral FDG-PET and O-15-H2O-PET. Structural lesions were found in the left midbrain, thalamus, putamen and cerebellar areas. Voxel-based statistics in comparison to a normal data base revealed hypometabolism in the left thalamus, left red nucleus, left cerebellar hemisphere including dentate nucleus and in the left inferior olivary nucleus. The O-15-H2O-PET investigation revealed metabolic uncoupling along the rubroolivocerebellar loop. Given the delicate anatomy of the structures involved, image registration and standardized image analysis techniques are essential for a synoptic multimodality analysis of morphological and functional pathology and should generally be used for cerebral PET investigations.
Juengling
F D
FD
Department of Radiology, University Hospital Freiburg, Germany. juengli@ukl.uni-freiburg.de
Kassubek
J
J
Moser
E
E
Nitzsche
E U
EU
D000328:Adult; D000465:Algorithms; D001488:Basilar Artery / Q000000981:diagnostic imaging* / Q000473:pathology*; D001921:Brain / Q000000981:diagnostic imaging*; D002998:Clonazepam / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D007238:Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D010104:Oxygen Radioisotopes / Q000493:pharmacokinetics; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D014018:Tissue Distribution; D014055:Tomography, Emission-Computed; D014202:Tremor / Q000188:drug therapy / Q000209:etiology; D014715:Vertebrobasilar Insufficiency / Q000000981:diagnostic imaging* / Q000473:pathology
D010104:Oxygen Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002998:Clonazepam