[Usefulness of FDG-PET in the diagnosis of patients with chronic severe brain injury].
BACKGROUND
To describe the changes in cerebral glucose metabolism after a severe traumatic brain injury (TBI), at the beginning of the rehabilitation, to analyze its diagnostic agreement with morphologic neuroimaging technologies (MR/CT) and to correlate the neuroimaging findings with the intensity of the TBI and the functional ability for daily activities.


METHODS
Prospective study of 55 patients who had sustained a severe TBI (GCS < or = 8) by means of 18F-FDG PET and MR/CT. The agreement between anatomical and functional neuroimagen studies was measured. Correlation between cerebral injury severity in neuroimaging, clinical functional evaluation assessed with Barthel-M Index and GCS were tested.


RESULTS
100 % of patients showed changes in cerebral metabolism, being the thalamus the area more frequently affected. 60 % of patients showed injuries in MR/CT, more frequently in frontal areas. The agreement for the diagnosis of pathology between morphologic and functional neuroimagen was very low. The TBI severity showed significant statistical correlation with the degree of cerebral metabolism and the level of disability.


CONCLUSIONS
18F-FDG PET allows to know the cerebral glucose metabolism at the beginning of the rehabilitation, being correlated with the TBI severity and the level of patient's disability for daily activities. 18F-FDG PET diagnoses major number of injuries that traditional neuroimaging and demonstrates a high thalamic vulnerability, with injuries in up to 76 % of patients with severe TBI.
de la Cueva
L
L
Servicio PET-Medicina Nuclear, Hospital 9 de Octubre, Valencia. leticiacueva@jazzfree.com
Noé
E
E
López-Aznar
D
D
Ferri
J
J
Sopena
R
R
Martínez
C
C
Chirivella
J
J
Abreu
P
P
Uruburu
E
E
D000293:Adolescent; D000328:Adult; D001479:Basal Ganglia / Q000000981:diagnostic imaging / Q000378:metabolism; D001925:Brain Damage, Chronic / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism / Q000534:rehabilitation; D001930:Brain Injuries / Q000000981:diagnostic imaging* / Q000378:metabolism; D002531:Cerebellum / Q000000981:diagnostic imaging / Q000378:metabolism; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D016037:Single-Blind Method; D013788:Thalamus / Q000000981:diagnostic imaging / Q000378:metabolism; D014057:Tomography, X-Ray Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18