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Dynamic and Static ^99mTc-ECD SPECT Imaging of Subacute Cerebral Infarction: Comparison with ¹³³Xe SPECT

Department of Neurosurgery and High-Technology Medical Research Center, Iwate Medical University, Morioka; Department of Intravascular Neurosurgery, Kohnan Hospital, Sendai; and Department of Neurosurgery, Tohoku University School of Medicine, Sendai, Japan

View larger version (18K): [in a new window]   FIGURE 1. Protocol for consecutive 133Xe and dynamic and static 99mTc-ECD SPECT imaging.

View larger version (57K): [in a new window]   FIGURE 2. Patient 24. (A) T2-weighted MR image obtained 7 d after onset of initial symptoms reveals infarction in right MCA territory. (B) Dynamic 99mTc-ECD SPECT images show increased tracer concentration in infarct area in second scan (72 s after injection). Thereafter, 99mTc-ECD activity in lesion rapidly decreases to below that in contralateral area. (C) Static 99mTc-ECD SPECT image (left) shows focal hypoactivity corresponding to lesion detected on MRI. Same region shows marked hyperperfusion on 133Xe tomogram (right).

View larger version (18K): [in a new window]   FIGURE 3. Relationships between relative 99mTc-ECD activity and relative CBF on first dynamic images (36 s after injection) (A), second dynamic images (72 s after injection) (B), and static images (C). Strong linearity between relative 99mTc-ECD activity and relative CBF is observed in first and second dynamic images. In infarct area with CBF > 46.1 mL/100 g/min, relative 99mTc-ECD activity on first dynamic scan exceeds relative CBF. In contrast, relative 99mTc-ECD activity in second dynamic scan is lower than relative CBF. Correlation between these in static images is not significant, whereas significant correlation is observed only in infarct areas with CBF < 46.1 mL/100 g/min. Dashed line represents line of identity. n.s. = not significant.