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Title: Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging

Abstract

Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyondmore » ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.« less

Authors:
; ;  [1]
  1. Loyola Univ. Medical Center, Maywood, IL (United States); and others
Publication Date:
OSTI Identifier:
198059
Report Number(s):
CONF-940605-
Journal ID: JNMEAQ; ISSN 0161-5505; TRN: 95:007029-0210
Resource Type:
Journal Article
Journal Name:
Journal of Nuclear Medicine
Additional Journal Information:
Journal Volume: 35; Journal Issue: Suppl.5; Conference: 41. annual meeting of the Society of Nuclear Medicine, Orlando, FL (United States), 5-8 Jun 1994; Other Information: PBD: May 1994
Country of Publication:
United States
Language:
English
Subject:
55 BIOLOGY AND MEDICINE, BASIC STUDIES; CEREBRUM; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; BLOOD FLOW; IMAGES; TECHNETIUM 99; BLOOD VESSELS; INTRAVENOUS INJECTION

Citation Formats

Shirazi, P, Konopka, L, and Crayton, J W. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging. United States: N. p., 1994. Web.
Shirazi, P, Konopka, L, & Crayton, J W. Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging. United States.
Shirazi, P, Konopka, L, and Crayton, J W. 1994. "Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging". United States.
@article{osti_198059,
title = {Differential diagnosis of regional cerebral hyperfixation of TC-99m HMPAO on SPECT imaging},
author = {Shirazi, P and Konopka, L and Crayton, J W},
abstractNote = {Accurate diagnostic evaluation of patients with neurologic and neuropsychiatric disease is important because early treatment may halt disease progression and prevent impairment or disability. Cerebral hyperfixation of HMPAO has been ascribed to luxury perfusion following ischemic infarction. The present study sought to identify other conditions that also display radiotracer hyperfixation in order to develop a differential diagnosis of this finding on SPECT imaging. Two hundred fifty (n=250) successive cerebral SPECT images were reviewed for evidence of HMPAO hyperfixation. Hyperfixation was defined as enhanced focal perfusion surrounded by a zone of diminished or normal cerebral perfusion. All patients were scanned after intravenous injection of 25 mCi Tc-99m HMPAO. Volume-rendered and oblique images were obtained with a Trionix triple-head SPECT system using ultra high resolution fan beam collimators. Thirteen (13/250; 5%) of the patients exhibited regions of HMPAO hyperfixation. CT or MRI abnormalities were detected in 6/13 cases. Clinical diagnoses in these patients included intractable psychosis, post-traumatic stress disorder, alcohol and narcotic dependence, major depression, acute closed-head trauma, hypothyroidism, as well as subacute ischemic infarction. A wide variety of conditions may be associated with cerebral hyperfixation of HMPAO. These conditions include neurologic and psychiatric diagnoses, and extend the consideration of hyperfixation beyond ischemic infarction. Consequently, a differential diagnosis of HMPAO hyperfixation may be broader than originally considered, and this may suggest a fundamental role for local cerebral hyperperfusion. Elucidation of the fundamental mechanism(s) for cerebral hyperperfusion requires further investigation.},
doi = {},
url = {https://www.osti.gov/biblio/198059}, journal = {Journal of Nuclear Medicine},
number = Suppl.5,
volume = 35,
place = {United States},
year = {Sun May 01 00:00:00 EDT 1994},
month = {Sun May 01 00:00:00 EDT 1994}
}