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Discordance of Technetium-99m-HMPAO and Technetium-99m-ECD SPECT in Herpes Simplex Encephalitis

Departments of Neurology and Neuroradiology, Landesnervenklinik Linz, Linz, Austria

Correspondence: For correspondence or reprints contact Harald Rieck ,MD, Landesnervenklinik Linz, Wagner Jauregg-Weg 15, A-4020 Linz, Austria.

ABSTRACT

Technetium-99m-hexamethyl propyleneamine oxime (HMPAO)and ^99mTc-ethyl cysteinate dimer (ECD) accumulate in brain tissue in proportion to regional cerebral blood flow in healthy subjects and in patients with a variety of neurological diseases. We report on four patients with herpes simplex encephalitis and the discordance between these two approved cerebral perfusion imaging radiopharmaceuticals. Conclusion: SPECT images showed unilateral regional increase of ^99mTc-HMPAO uptake and decrease of ^99mTc-ECD uptake in the affected temporal lobe.

Key Words: SPECT • technetium-99m-hexamethyl propyleneamine oxime • technetium-99m-ethyl cysteinate dimer • herpes simplex encephalitis