technetium-tc-99m-bicisate and Cerebral-Palsy

In this report, the authors assessed the clinical significance of decreased regional cerebral blood flow (rCBF) in the thalamus or cerebellar hemispheres in relation to gross motor performance in the children with cerebral palsy.. Thirty-six children with bilateral spastic cerebral palsy (BSCP) underwent brain SPECT. Visual analysis was used for the brain SPECT interpretation. The rCBF in the thalamus or cerebellum was graded as normal, mildly decreased, or severely decreased. A marked decrease or near absence of rCBF in the thalamus or cerebellum was considered as severely decreased.. All 36 children with BSCP had hypoperfusion in the thalamus or cerebellar hemispheres. Eight of 20 children (40%) with mildly decreased rCBF on brain SPECT had mild developmental delays. On the other hand, only 1 of 16 children (6.3%) with severe hypoperfusion in the thalamus or cerebellum had a mild developmental delay, and the remaining 15 of 16 children (93.8%) had severe developmental delays. There was good correlation between the degree of developmental delay and the severity of hypoperfusion in the thalamus or cerebellum (P = 0.023).. The measurement of rCBF by Tc-99m ethyl cysteinate dimer brain SPECT appears to be valuable in prognostication of gross motor development in children with BSCP.

Topics: Brain; Cerebellum; Cerebral Palsy; Cerebrovascular Circulation; Cysteine; Developmental Disabilities; Female; Humans; Infant; Male; Motor Skills; Organotechnetium Compounds; Predictive Value of Tests; Radiopharmaceuticals; Thalamus; Tomography, Emission-Computed, Single-Photon

Hypoxic brain injury is one of the major causes of cerebral palsy. Therefore, this study was performed to evaluate cerebral perfusion impairments in these patients using 99mTc-ECD brain SPECT.. Fifty-one patients (31 boys, 20 girls; age range 6 mo to 6 yr, 11 mo) with clinical manifestations of cerebral palsy underwent brain SPECT after intravenous injection of 99mTc-ECD. The clinical subtypes of cerebral palsy were spastic diplegia (n = 35), spastic quadriplegia (n = 11), spastic hemiparesis (n = 2), choreoathetoid (n = 2) and mixed (n = 1). Transaxial, coronal and sagittal images obtained with a brain-dedicated annular crystal gamma camera were qualitatively analyzed and compared with the findings of magnetic resonance imaging (MRI).. In SPECT, thalamic hypoperfusion was seen in all patients except one (98%), followed by hypoperfusion in the temporal lobe (52.9%, n = 27), basal ganglia (41.2%, n = 21), cerebellum (39.2%, n = 20) and extratemporal cortices (21.6%, n = 11). However, MR imaging demonstrated thalamic abnormality in seven (13.7%), basal ganglia in two (3.9%), extratemporal cortical defect in five (9.8%) and cerebellar atrophy in one (1.9%). Instead, white matter changes such as periventricular leukomalacia or ischemia (56.9%, n = 25) and thinning of corpus callosum (49%, n = 25) were the major findings.. Brain SPECT is useful in the diagnosis of cerebral palsy and is more sensitive in the detection of cortical, subcortical nuclei and cerebellar abnormalities. MRI is superior in the detection of white matter changes.

Topics: Brain; Cerebral Palsy; Cerebrovascular Circulation; Child; Child, Preschool; Cysteine; Female; Humans; Infant; Magnetic Resonance Imaging; Male; Organotechnetium Compounds; Radiopharmaceuticals; Tomography, Emission-Computed, Single-Photon