sodium-pertechnetate-tc-99m and Cerebral-Infarction

Topics: Adult; Blood Flow Velocity; Brain Death; Brain Injuries; Cerebral Angiography; Cerebral Infarction; Cerebrovascular Circulation; Hematoma, Epidural, Cranial; Humans; Male; Nose; Radiopharmaceuticals; Sodium Pertechnetate Tc 99m; Tomography, X-Ray Computed

A combined measurement of regional cerebral blood flow (r CBF) and volume (r CBV) by SPECT was performed in 15 patients with ischaemic cerebral infarction. For measurement of r CBF 99mTc-HMPAO was used, and for r CBV 99mTc-labelled red blood cells. Patients with acute or subacute cerebral infarction (n = 10) showed elevation of r CBV whereas r CBF was either reduced or elevated. Patients with chronic cerebral infarction (n = 5) showed reduction of both r CBF and r CBV. The combined measurement of both r CBF and r CBV by SPECT allows imaging and semiquantitative evaluation of haemodynamic changes in ischaemic cerebral infarction at various stages. The resulting data may be helpful in describing the pathophysiologic compensatory mechanisms.

Topics: Aged; Aged, 80 and over; Blood Volume; Blood Volume Determination; Brain Ischemia; Cerebral Infarction; Cerebrovascular Circulation; Humans; Middle Aged; Organometallic Compounds; Oximes; Sodium Pertechnetate Tc 99m; Technetium; Technetium Tc 99m Exametazime; Tomography, Emission-Computed

Dynamic cerebral scintigraphy is a widely used, non-invasive procedure for the diagnosis of haemodynamic changes in the supra-aortic arterial territory. Eighty examinations have been carried out using a new method, which depends on demonstrating the time of arrival of the bolus within certain parameters. A definite advantage of the simultaneous demonstration of flow in various vascular territories is the fact that it is easily and rapidly perceived and that it is readily interpreted without depending on the subjective judgement of the operator. In addition, it is unnecessary to measure regions of interest.

Topics: Adult; Aged; Carotid Artery Diseases; Cerebral Infarction; Cerebrovascular Circulation; Cerebrovascular Disorders; Female; Humans; Male; Methods; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Subclavian Steal Syndrome

The qualitative and regional correlations between the EEG and the cerebral circulation time (CCT), obtained by using intravenously injected pertechnetate and a multidetector device, were studied in 75 patients with supratentorial cerebral infarction. Because bolus dispersion and changes in systemic circulation may distort absolute CCT values when intravenous injection of the isotope is used, the inter- and intrahemispheric relative CCT values were used as indices of CCT. Overall good correlations could be demonstrated between both inter- and intrahemispheric CCT abnormalities and the EEG, though not in all patients. The number of patients with pathological CCT findings showed a tendency to increase with increasing severity of the EEG abnormality. The number of abnormal CCT areas per patient (indicating the size of the circulation disturbance) also increased significantly with increasing severity of the EEG disturbance. Interestingly, relative 'hypervelocity' areas occurred in fewer patients with normal or clearly disturbed EEGs than in patients with mildly disturbed EEGs, perhaps due to differences in autoregulatory capacity and collateral circulation. Within the EEG focus the relative number of CCT abnormalities was greater than outside it. In spite of this fairly good overall correlation between the EEG focus and the CCT abnormality, more than 10% of the patients with an EEG focus showed no CCT abnormalities, thus indicating the complementary roles of these methods. The present study on cerebral infarction, though using intravenously injected pertechnetate for the CCT measurement, showed a reasonable correspondence with earlier reports on the relationship between the EEG and either the CBF or the CCT (obtained by intra-arterially injected isotope). This would seem to suggest that the used non-invasive method for regional CCT measurement has potential for evaluation of cerebral haemodynamics.

Topics: Adult; Aged; Brain; Cerebral Infarction; Cerebrovascular Circulation; Electroencephalography; Female; Humans; Male; Middle Aged; Sodium Pertechnetate Tc 99m; Technetium

Topics: Cerebral Angiography; Cerebral Infarction; Humans; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Tomography, X-Ray Computed

The uptake of 99mTc-pertechnetate (TcO4), 99mTc-iron-ascorbic acid (Feasc), 99mTc-Solcocitran (Solcocitran), 99mTc-diphosphonate (HEDP) and 67Ga-citrate (Ga) in various brain lesions was compared. Influence of time from injection was also studied on the first three compounds. A rank correlation method was used to compare the scans which were judged visually by three independent observers. There was good agreement between the observers, as measured by Kendall's tau, but the concordance between rankings within the same type of lesion, as measured by Kendall's W, was rather poor. There was no significant difference in the uptake of TcO4, Feasc and Solcocitran. Ga showed generally poor uptake and its uptake in tumours and infarcts did not differ significantly. However, when HEDP and TcO4 were compared in two groups (I: Infarcts, haemorrhages and bone invading meningiomas, and II: Tumours not invaded into bone) a highly significant difference was obtained with much higher uptake of HEDP in Group I.

Topics: Adult; Ascorbic Acid; Brain Diseases; Brain Neoplasms; Cerebral Hemorrhage; Cerebral Infarction; Citrates; Diphosphonates; Gallium Radioisotopes; Humans; Organotechnetium Compounds; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Technetium Compounds

The case described concerns the clinical diagnosis of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries. Up to now both carotid and vertebral angiography were required. Nontraumatic CT and radionuclide studies have allowed demonstration of the etiology of the disease in the occipital and cerebellar region without further neuroradiology examinations with contrast. Clinical diagnosis by using neuroradiological methods in the detection of infarct in the region of the posterior cerebral and cerebellar artery is seldom observed. The case of a vascular focus in the distribution of the posterior cerebral and superior cerebellar arteries was diagnosed using the above methods.

Topics: Cerebellum; Cerebral Cortex; Cerebral Infarction; Encephalomalacia; Humans; Male; Middle Aged; Radionuclide Imaging; Sodium Pertechnetate Tc 99m; Technetium; Tomography, X-Ray Computed