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Correlation of 99mTc-DTPA SPECT of the Blood–Brain Barrier with Neurologic Outcome After Acute Stroke

Mordechai Lorberboym, MD1, Yair Lampl, MD2 and Menahem Sadeh, MD2

1 Department of Nuclear Medicine, Sackler Faculty of Medicine, Edith Wolfson Medical Center, Tel Aviv University, Tel Aviv, Israel
2 Department of Neurology, Sackler Faculty of Medicine, Edith Wolfson Medical Center, Tel Aviv University, Tel Aviv, Israel



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  		FIGURE 1. Tracing of ROI around infarct zone and contralateral hemisphere for calculations of 99mTc-DTPA index.

 


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  		FIGURE 2. ROI analysis for determination of perfusion deficits at level of basal ganglia (left MCA infarct).

 


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  		FIGURE 3. Plot compares change in stroke scale with increasing 99mTc-DTPA ratio.

 


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  		FIGURE 4. Distribution of {Delta} S values for 99mTc-DTPA index <2.5 and >2.5.

 


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  		FIGURE 5. Patient 29: 63-y-old woman with extensive stroke in territory of left MCA. (A) Transaxial CT slice. (B) Transaxial SPECT perfusion slices (left) show diminished perfusion in left temporoparietal regions (perfusion index, 65%) and transaxial slices from 99mTc-DTPA SPECT (right) show normal distribution of 99mTc-DTPA (disruption index, 1). Patient improved significantly on follow-up ({Delta} S value, 18).

 


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  		FIGURE 6. Patient 7: 59-y-old woman with stroke in territory of left MCA. (A) Transaxial CT slice. (B) Transaxial SPECT perfusion slices (left) show diminished perfusion in left temporoparietal regions (perfusion index, 41%) and transaxial slices from 99mTc-DTPA SPECT (right) show intensely increased 99mTc-DTPA uptake in same region (disruption index, 15). Patient showed no improvement on follow-up ({Delta} S value, 0).

 




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