Perfusion differences on SPECT and PWI in patients with acute ischemic stroke.
BACKGROUND
The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and (99m)Tc-labeled ethylcysteinate dimer ((99m)Tc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes.


METHODS
Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke.


RESULTS
The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI.


CONCLUSIONS
(99m)TC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning.
Nuutinen
Juho
J
Department of Neurology, Kuopio University Hospital, University of Kuopio, Kuopio, Finland.
Liu
Yawu
Y
Laakso
Mikko P
MP
Karonen
Jari O
JO
Vanninen
Esko J
EJ
Kuikka
Jyrki T
JT
Aronen
Hannu J
HJ
Vanninen
Ritva L
RL
D000208:Acute Disease; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002545:Brain Ischemia / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D002533:Cerebral Angiography; D002560:Cerebrovascular Circulation; D002941:Circle of Willis / Q000000981:diagnostic imaging / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D055420:Perfusion Imaging / Q000379:methods; D020521:Stroke / Q000000981:diagnostic imaging* / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome