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Department of Radiology and Nuclear Medicine, Research Institute of Brain and Blood Vessels-Akita, Akita, Japan
Correspondence: For correspondence and reprints contact: Eku Shimosegawa, MD, Department of Radiology and Nuclear Medicine, 6-10 Senshu-Kubota Machi, Akita 010, Japan.
ABSTRACT
Technetium-99m-HMPAO can be used to evaluate abnormal brain perfusion in the hyperacute stage of stroke. Methods: We investigated cerebral blood flow using 99mTc-HMPAO SPECT in 31 patients within 6 hr after the onset of cerebral infarction and analyzed there relationship between abnormal perfusion and morphological changes on follow-up CT scans. Patients were classified into an infarct group and a noninfarct group, and the lesions on SPECT images were divided into infarct and peri-infarct regions. Results: Among a total of 30 infarct regions, three lesions studied at 1.5, 2.5 and 5 hr after the ictus showed local hyperperfusion suggestive of early postischemic hyperemia, while the other 27 lesions demonstrated local hypoperfusion. All of the peri-infarct regions showed moderate hypoperfusion. The noninfarct group consisted of five patients, four of whom showed no perfusion abnormalities. The lesion-to-contralateral radioactivity ratios for the infarct and peri-infarct regions were respectively 0.48 ± 0.14 and 0.75 ± 0.10 in the patients with hypoperfusion, while the right-to-left ratio in the noninfarct group was 0.97 ± 0.10. Conclusion: This SPECT study of cerebral blood flow demonstrates that local hyperperfusion occurs in some infarcts even within 6 hr of onset and that infarcted and morphological viable brain can be distinguished by a lesion-to-contralateral radioactivity ratio of 0.6 within this time range.
Key Words: cerebral infarction • SPECT • technetium-99m-HMPAO • cerebral blood flow
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