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Evaluation of Cerebral Infarction with Iodine 123-Iomazenil SPECT

Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, Senshuh-Kubota Machi, Akita, Japan

Correspondence: For correspondence or reprints contact: Jun Hatazawa, MD, PhD, Department of Radiology and Nuclear Medicine, Akita Research Institute of Brain and Blood Vessels, 6-10 Senshu-Kubota Machi, Akita City, Japan 010.

ABSTRACT

This study evaluates ischemic damage to central benzodiazepine (BZD) receptor binding in the brain with [¹²³I]iomzenil SPECT in relation to CT hypodense lesions and blood flow abnormalities. Methods: Nine patients with middle cerebralar tery territory in farction were studied. Iomazenil images obtained 180 min postinjection were analyzed for BZD receptor binding. The cortical infarction, visualized as CT hypodense area on CT, the peti-infarct area, visualized as normodensity surrounding the infarction on CT, the intrahemispheric remote area and the cerebellum ware analyzed by taking the ratio of the lesion to contralateral mirror region (L/C ratio). CT during the chronic stage and perfusion images obtained during the smallest time difference between the two studies were used for comparative analysis. Results: The mean L/C ratio of iomazenil uptake was 0.53 ± 0.08,0.79 ± 0.07,0.98 ± 0.03 and 1.00 ± 0.04 in the infarct, pen-infarct and remote areas and the cerebellum, respectively. The infarct and pen-infarct areas showed significant decrease compared with unity. The corresponding mean L/C ratio for blood flow was 0.52 ±0.08, 0.73 ±0.07, 0.83 ±0.09, and 0.80± 0.07, respectively. In all areas, the ratios were significantly decreased compared with unity. There was significant difference between the L/C ratiofor blood flow and iomazenil in the remote area and the cerebellum. Conclusion: Iodine-i23-iomazenil SPECT imaging may provide new information on ischemic damage to the brain, particularly to neurons.

Key Words: single-photon emission computed tomography • benzodiazeoine receptors • iodine-123-iomazenil • cerebral infarction

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