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Department of Nuclear Medicine, Virga Jesse Hospital, Hasselt, Belgium
Department of Nuclear Medicine, Free University of Brussels (V. U.B), Jette, Belgium
Correspondence: For correspondence and reprints contact: Axel Jacobs, MD, Nucleaire Geneeskunde In Vivo Virga Jesse Hospital, Stadsomvaart 11, B-3500 Hasselt, Belgium.
ABSTRACT
We prospectively evaluated the contribution of 99mTc-HMPAO SPECT in patients who have sustained acute, mild or moderate head trauma Methods: Forty-two patients formed the first subgroup of moderate trauma (ModTr) and 25 patients formed the second subgroup of mild trauma (MilTr). All 67 patients underwent an initial SPECT (Tinit) within 4 wk after a closed cranial trauma. After a mean interval of 3 mo from the time of Tinit, all patients were clinically re-evaluated; those with an abnormal Tinit underwent a repeat SPECT (Trpt) as well. All SPECT studies were visually graded by agreement of three observers adjudging a score ranging from 0 (no lesions) to 4. Results: For the group as a whole (ModTr + MilTr), the following results could be derived: (1) in 32/33 Tinit negative cases, clinical symptoms had resolved; (2)the positive predictive value of Tinit was only 20/34 (59%);(3) the sensitivity for the repeat SPECT was 19/20 (95%). Conclusion: Our results show that: (1) SPECT alterations correlate well with the severity of the trauma; (2) a negative initial SPECT study is a reliable predictor of a favorable clinical outcome; (3) in cases with a positive initial SPECT, a follow-up consisting of a combination of SPECT and clinical data is necessary; (4) in patients suffering from postconcussive symptoms, SPECT offers an instrument to objectivate sequalae.
Key Words: technetium-99m-HMPAO • traumatic brain injury • SPECT
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