title: The role of brain perfusion SPECT in Moyamoya disease.
abstract: Moyamoya disease (MMD) is a cerebrovascular disorder involving stenosis of brain vessels. Brain perfusion SPECT in MMD demonstrates impaired perfusion in ischemic areas. We present a 6-year-old boy with MMD. The patient had numbness on the right arm and simultaneous electroencephalography changes while studying arms up on the table. To differentiate seizure and ischemic symptoms, brain perfusion SPECT studies were obtained when the patient was asymptomatic (SPECT-A) and during the symptoms-EEG changes (SPECT-B). SPECT-A showed perfusion defect on the right frontal cortex, hypoperfusion on the right parieto-occipital region and slightly increased perfusion on the left parietal cortex. SPECT-B displayed significant hyperperfusion on the left parietal cortex; hypoperfusion on the right parietal, right temporal, right parieto-occipital and left frontal cortex. Additionally, brain perfusion SPECT of the child's younger brother diagnosed with MMD showed decreased regional cerebral perfusion. Physiopathological mechanisms of our patient's SPECT findings and indications of brain perfusion SPECT in MMD were also discussed.
authors.affiliation: Department of Nuclear Medicine, Hacettepe University, Faculty of Medicine, Ankara, Turkey. bilgev@hacettepe.edu.tr
authors.forename: B
authors.initials: B
authors.lastname: Volkan-Salanci
authors.forename: E
authors.initials: E
authors.lastname: Lay Ergün
authors.forename: Ç
authors.initials: Ç
authors.lastname: Genc Sel
authors.forename: D
authors.initials: D
authors.lastname: Yalnizoğlu
authors.forename: G
authors.initials: G
authors.lastname: Turanli
mesh_terms: D000208:Acute Disease; D001132:Arm / Q000098:blood supply; D002545:Brain Ischemia / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D002339:Carotid Arteries / Q000503:physiopathology; D002536:Cerebral Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation; D002648:Child; D003097:Collateral Circulation; D003399:Craniotomy; D003545:Cysteine / Q000031:analogs & derivatives; D003700:Delta Rhythm; D003937:Diagnosis, Differential; D004569:Electroencephalography; D006801:Humans; D006987:Hypesthesia / Q000209:etiology; D009072:Moyamoya Disease / Q000150:complications / Q000000981:diagnostic imaging*; D015609:Organotechnetium Compounds; D055420:Perfusion Imaging; D011187:Posture; D019275:Radiopharmaceuticals; D012640:Seizures / Q000175:diagnosis / Q000000981:diagnostic imaging*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine