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The Journal of Nuclear Medicine Vol. 38 No. 12 1894-1897
© 1997 by Society of Nuclear Medicine
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Hyperventilation Technetium-99m-HMPAO Brain SPECT in Moyamoya Disease to Assess Risk of Natural Childbirth

Norihiko Kume, Kohei Hayashida, Yoriko Shimotsu and Naofumi Matsunaga

Department of Radiology, National Cardiovascular Center, Osaka Department of Radiology, Yamaguchi University School of Medicine, Yamaguchi, Japan

Correspondence: For correspondence or reprints contact: Kohei Hayashida, MD, National Cardiovascular Center, Department of Radiology, 5-7-1 Fujishirodai, Suita, Osaka, 565 Japan.

ABSTRACT

We report a pregnant 19-yr-old patient with moyamoya disease who had undergone bilateral superficial temporal artery to middle cerebral artery anastomosis and encephalomyosynangiosis at 8 yr with an uneventful postoperative course and who desired natural delivery after becoming pregnant at 18 yr. We determined her cerebral vascular reserve since natural delivery can result in decreased cerebral blood flow during labor. Technetium-99m-HMPAO brain SPECT, with hyperventilation challenge, was performed to assess cerebral vascular reserve since the stress of hyperventilation was thought likely to rehearse that of labor. The brain SPECT images, obtained using 333 MBq 99mTc-HMPAO, revealed maintenance of cerebral vascular reserve. In addition, whole-body images including the 27-wk-old fetus were obtained. These images demonstrated accumulation in the fetal liver. Natural delivery was, thus, considered indicated for this patient, who subsequently delivered a healthy baby girl. Technetium-99m-HMPAO brain SPECT with hyperventilation challenge was useful for estimating cerebral vascular reserve and for determining whether natural delivery was indicated for this patient with moyamoya disease.

Key Words: hyperventilation challenge • cerebral vascular reserve • labor stress • technetium-99m-HMPAO • moyamoya disease






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Copyright © 1997 by the Society of Nuclear Medicine.