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Department of lnternal Medicine, Division of Nuclear Medicine, Department of Psychiatry, Department of Neurology, University of Michigan Medical Center, Ann Arbor, Michigan
Correspondence: For reprints contact: James M. Mountz, MD, PhD, University of Michigan Medical Center, Div. of Nuclear Medicine, 1500 East Medical Center Dr., Ann Arbor, MI 48109-0028.
ABSTRACT
This study investigated the possibility that a relationship between the anatomic defects observed on computed tomography (CT) and the functional defects observed on single photon emission computed tomography (SPECT) might be used as an outcome measure to predict clinical recovery from the neurologic deficits induced by stroke. Twenty-seven patients with stroke location limited primarily to cerebral cortex were included in the study: each patient underwent a cranial CT scan, 99mTc hexamethylpropyleneamineoxime SPECT cerebral perfusion scan, and an initial and 1-yr follow-up neurologic examination. A strongly positive correlation between the ratio of the SPECT to CT volume defect sizes (SPECT ÷ CT) and recovery following stroke was found, such that the greater the SPECT to CT ratio, the better the subsequent recovery of neurological deficits. Discriminant function analysis revealed that the best predictor of clinical outcome following stroke was the log-transformation of SPECT ÷ CT. The results suggest that the relationship between the perfusion defects and tissue loss measured by SPECT and CT imaging may have prognostic utility following stroke limited primarily to cerebral cortex.
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