Brain SPECT used to evaluate vasospasm after subarachnoid hemorrhage: correlation with angiography and transcranial Doppler.
OBJECTIVE
The primary objective of this study was to correlate Tc-99m HMPAO and ethyl cysteine dimer perfusion brain SPECT imaging with angiography and transcranial Doppler (TCD) to identify vasospasm after subarachnoid hemorrhage.


METHODS
A retrospective analysis of consecutive patients who had cerebral blood flow SPECT imaging for subarachnoid hemorrhage and aneurysm clipping was made. Flow velocity measurements were correlated using TCD and cerebrovascular angiography.


RESULTS
Of the 129 patients were included in this study, 84 were female and 45 were male, with a mean age of 51.9 years and a median age of 51 years (range, 9 to 84 years). Eighty-nine patients had brain SPECT evidence of hypoperfusion. Concordance was found between SPECT and TCD with vasospasm in 57 of 89 (64%) patients and nonconcordance was evident in 32 patients (36%). Eleven patients who had concordance between SPECT and TCD had nonconcordant results of angiography for vasospasm.


CONCLUSIONS
These findings suggest that all three methods are complementary to each other in the evaluation of patients with vasospasm after subarachnoid hemorrhage. Concordance of 64% between SPECT and TCD is acceptable and explicable by the differences in technique and measurement of cerebral blood flow compared with vascular narrowing, respectively.
Rajendran
J G
JG
Department of Radiology, Harborview Medical Center, University of Washington School of Medicine, Seattle 98195, USA. rajan@u.washington.edu
Lewis
D H
DH
Newell
D W
DW
Winn
H R
HR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000000981:diagnostic imaging*; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D017585:Ultrasonography, Doppler, Transcranial; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging* / Q000209:etiology*
D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime