title: Regional cerebral blood flow in patients with sickle cell disease: study with single photon emission computed tomography.
abstract: OBJECTIVE
  Neurological complications have been reported in patients with sickle-cell disease (SCD) using positron emission tomography (PET), magnetic resonance imaging (MRI), and computed tomography (CT), but not with single photon emission computed tomography (SPECT). The objective of this study was to investigate brain perfusion in the patients with SCD using SPECT after technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO), was administered and compare the findings with those of demography, physical examination, MRI and hematological profile.
  
  
  METHODS
  The study involved 21 patients (12 males, 9 females, age at study 8-45 years) who were known to be having SCD for a duration of at least 5 years. The patients were not in acute crisis and had normal neurological assessments with no known history of stroke or transient ischemic episode or previous abnormal CT or MRI brain scan, and were right-handed. The brain SPECT was performed after intravenous injection of 740 MBq (20 mCi) 99mTc-HMPAO in adults or an appropriate dose in pediatric patients. The scans were visually interpreted by two nuclear medicine physicians and a decision was reached by consensus. An MRI done 3 months later was interpreted by a radiologist. The demographic data and hematological profile were obtained from the medical records of the patients.
  
  
  RESULTS
  Of the 21 patients, 7 (age 11-22 years) had brain perfusion deficit mostly in the frontal lobe either alone or in combination with temporal and/or parietal lobe. The MRI was abnormal in 2 patients. The brain perfusion deficit was not associated with the demographic data of the patients or hematological profiles.
  
  
  CONCLUSIONS
  The findings show that SPECT was useful in detecting brain perfusion deficit in SCD patients, and such an early detection may be clinically useful in the subsequent follow-up of such patients, since it is known that cerebral perfusion deficit can lead to silent infarct and/or overt stroke, and affect cognitive skills.
authors.affiliation: Department of Nuclear Medicine, Faculty of Medicine, Health Sciences Center, Kuwait University, and Mubarak Al-Kabeer Hospital, Saafat, 13110, Kuwait.
authors.forename: Fareeda A
authors.initials: FA
authors.lastname: Al-Kandari
authors.forename: Azu
authors.initials: A
authors.lastname: Owunwanne
authors.forename: Ghulam M
authors.initials: GM
authors.lastname: Syed
authors.forename: Rajaa
authors.initials: R
authors.lastname: Ar Marouf
authors.forename: Abdelhamid H
authors.initials: AH
authors.lastname: Elgazzar
authors.forename: Mehraj
authors.initials: M
authors.lastname: Shiekh
authors.forename: Ali M
authors.initials: AM
authors.lastname: Rizui
authors.forename: Jawaher A
authors.initials: JA
authors.lastname: Al-Ajmi
authors.forename: Ahmed M
authors.initials: AM
authors.lastname: Mohammed
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000150:complications* / Q000000981:diagnostic imaging*; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D002561:Cerebrovascular Disorders / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D019275:Radiopharmaceuticals; D019690:Technetium Tc 99m Exametazime