[Perfusion SPECT with (99m)Tc-HMPAO in type I diabetics with no background of central neurologic symptoms. A study of activation with acetazolamide].
OBJECTIVE
This study aimed to assess if activation with acetazolamide increases the diagnostic capacity of baseline SPECT with (99m)Tc-HMPAO in the study of brain perfusion in type I diabetic patients with no history of neurological symptoms.


METHODS
A baseline SPECT was carried out in 11 diabetes mellitus type I patients with no neurological symptoms with 555 MBq of (99m)Tc-HMPAO; 1 g of acetazolamide was administered during the examination and a second SPECT was obtained 20' later with the same methodology used in the baseline SPECT. The images were visually analyzed. The post-acetazolamide studies were analyzed with (CBS) and without (WBS) baseline image subtraction and both methods were compared.


RESULTS
The baseline SPECT showed 48 hypoperfused cortical areas. The post-acetazolamide SPECT analyzed without baseline image subtraction detected 14 new hypoperfused areas and those analyzed with it detected 26 areas. 69% of the baseline hypoperfused areas were hyporeactive in the WBS analysis and 54% in the CBS analysis.


CONCLUSIONS
The perfusion SPECT with acetazolamide improves the diagnostic capacity of the baseline perfusion (99m)Tc-HMPAO SPECT, and makes it possible to classify the abnormalities as metabolic or vascular, with a preference for the post-acetazolamide CBS imaging analysis.
Jiménez-Bonilla
J
J
Servicio de Medicina Nuclear, Hospital Universitario Marqués de Valdecilla, Santander, España.
Carril
J M
JM
Quirce
R
R
Amado
J A
JA
Hernández
A
A
Vallina
N K
NK
Uriarte
I
I
Montero
A
A
D000086:Acetazolamide / Q000494:pharmacology*; D000328:Adult; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D001928:Brain Diseases, Metabolic / Q000000981:diagnostic imaging* / Q000209:etiology; D002560:Cerebrovascular Circulation; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000000981:diagnostic imaging*; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging* / Q000209:etiology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D011292:Premedication; D019275:Radiopharmaceuticals / Q000008:administration & dosage / Q000493:pharmacokinetics; D013382:Subtraction Technique; D019690:Technetium Tc 99m Exametazime / Q000008:administration & dosage / Q000493:pharmacokinetics; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*; D014665:Vasodilator Agents / Q000494:pharmacology*
D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D019690:Technetium Tc 99m Exametazime; D000086:Acetazolamide