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Brain SPECT in Neurology and Psychiatry*

Division of Nuclear Medicine, Department of Radiology, School of Medical Sciences, Campinas State University (Unicamp), Campinas, Brazil

View larger version (132K): [in a new window]   FIGURE 1. From top to bottom, two coronal and two transaxial slices with 99mTc-HMPAO using fanbeam collimator in healthy volunteer. Note symmetric tracer distribution in cerebral cortex. Areas with preferential perfusion include cingulate gyrus, primary visual cortex, basal ganglia, thalami, and cerebellar hemispheres.

View larger version (108K): [in a new window]   FIGURE 2. A 58-y-old right-handed man had 2-y history of progressive memory loss, which became worse over last 7 mo. His father and three cousins had dementia. Transaxial, sagittal, and coronal slices show marked bilateral, symmetric temporoparieto-occipital hypoperfusion, extending to frontal lobes. Basal ganglia, primary visual cortex, and cerebellum are spared.

View larger version (137K): [in a new window]   FIGURE 3. A 62-y-old right-handed, hypertensive man had stroke 2 y ago and now has severe memory impairment, dysarthria, and urinary incontinence. Radionuclide cisternography showed normal findings. Transaxial, sagittal, and coronal slices show multiple scattered focal areas of hypoperfusion involving entire cerebral cortex, a pattern frequently found in vascular dementia. Head CT scan showed white matter infarcts.

View larger version (115K): [in a new window]   FIGURE 4. Transaxial slices of 73-y-old man with FD and 2-y history of progressive short-term memory loss show marked hypoperfusion of anterior cingulate gyrus (arrowhead) and mesial frontal lobes (arrows). MRI showed only mild frontal lobe atrophy, which could not explain brain SPECT findings.

View larger version (88K): [in a new window]   FIGURE 5. A 21-y-old left-handed man had history of tonic–clonic seizures since age 8. Head CT findings were normal. MRI showed T2-weighted hyperintense signal and slightly decreased size of right hippocampus. EEG showed acute waves in right frontal and temporal lobes. Interictal and ictal transaxial and coronal slices show hypoperfusion and hyperperfusion, respectively, of right temporal lobe (arrows).

View larger version (132K): [in a new window]   FIGURE 6. A 13-y-old boy complained of severe anxiety and compulsions (washing hands) over last 4 y. His insight was intact. Transaxial and sagittal slices show hyperperfusion of orbitofrontal area, bilaterally (arrows).