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HMPAO Brain SPECT in Acute Carbon Monoxide Poisoning

Division of Toxicology, Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung; Department of Nuclear Medicine, Electron Microscope Laboratory, Chung-Shan Medical College Hospital, Taichung; Department of Nuclear Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China, Taipei, Taiwan, Republic of China

Correspondence: For correspondence or reprints contact: Chia-Hung Kao, MD, Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Rd., Section 3, Taichung 40705, Taiwan, Republic of China.

ABSTRACT

Technetium-99m-hexamethylpropylene amine oxime (HMPAO) brain images with fanbeam SPECT, in combination with surface three-dimensional display, were used to detect basal ganglion and cerebral cortex anomalies in the acute phase of carbon monoxide (CO) poisoning. Methods: Ten patients, aged 16–29 yr, with acute CO poisoning and no past history of neurologic disorders were enrolled in this study. After oxygen treatment, all 10 patients were investigated using ^99mTc-HMPAO brain images with fanbeam SPECT and surface three-dimensional display. Meanwhile, 6 of 10 patients also received a brain CT scan. Results: CT scan findins were negative in all 6 patients. Fanbeam SPECT demonstrated unilateral or bilateral hypoactivity of basal ganglia in 6 patients. Local hypoactivity anomalies were found in the brain cortex of 7 patients, using surface three-dimensional display of the brain. Only 2 of 10 patients had normal ^99mTc-HMPAO brain images. Conclusion: This study suggests that, in comparison with traditional brain imaging techniques, ^99mTc-HMPAO brain imaging with fanbeam SPECT in combination with surface three-dimensional display is a better tool for early detection of regional cerebral anomalies in acute CO poisoning.

Key Words: technetium-99m-hexamethylpropylene amine oxime • fanbeam collimator • SPECT • surface three-dimensional display • carbon monoxide poisoning

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