technetium-tc-99m-exametazime and Calcinosis

A case of idiopathic basal ganglia calcification in a 56-year-old woman with parkinsonism and cognitive impairment is described. The nigrostriatal dopaminergic pathway and regional cerebral blood flow were evaluated using dopamine transporter (DAT) brain single photon emission tomography combined with a low-dose x-ray computerized tomography transmission (hybrid SPECT/CT) and Tc-99m HMPAO brain perfusion SPECT study, respectively. DAT SPECT/CT imaging revealed a reduction in DAT binding in both striatum regions coinciding with bilateral calcifications in the basal ganglia. Brain perfusion scan showed hypoperfusion in basal ganglia regions, posterior parietal cortex bilaterally, left frontopolar and dorsolateral prefrontal cortex, and left temporal lobe. These findings correlated well with the clinical condition of the patient. Mineralization may play a critical role in the pathogenesis of neuronal degeneration. Cortical perfusion changes in patients may better explain the patient's altered cognitive and motor functions.

Topics: Basal Ganglia Diseases; Brain; Calcinosis; Cerebrovascular Circulation; Dopamine Plasma Membrane Transport Proteins; Female; Humans; Middle Aged; Perfusion Imaging; Radiopharmaceuticals; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Tomography, X-Ray Computed

Fahr's disease is a rare neurodegenerative syndrome, characterized by massive symmetrical intracerebral calcifications of the basal ganglia, dentate nuclei of the cerebellum, and the adjacent parenchyma. Computerized tomography (CT) is considerably more sensitive to detect these intracranial calcifications than other imaging modalities. The clinical, CT scan, and 99(m)Tc-D,L-hexamethylpropylene amine oxime (99(m)Tc-HMPAO) brain perfusion single-photon emission computerized tomography (SPECT) findings in a 42-year-old woman with Fahr's disease are reported, and the clinical utility of 99(m)Tc-HMPAO SPECT findings in Fahr's disease is discussed in this article. In conclusion, 99(m)Tc-HMPAO brain perfusion SPECT seems to be useful in the clinical approach to Fahr's disease, and may provide more specific and clinically relevant information when compared with anatomical imaging.

Topics: Adult; Brain; Brain Diseases; Calcinosis; Female; Humans; Neurodegenerative Diseases; Syndrome; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Topics: Basal Ganglia Diseases; Calcinosis; Child; Electroencephalography; Epilepsy; Female; Humans; Hypoparathyroidism; Magnetic Resonance Imaging; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

Fahr's disease is histopathologically characterized by massive bilateral calcifications of the cerebral basal ganglia, the dentate nuclei of the cerebellum and both the cerebral and cerebellar cortices. We report a case of Fahr's disease in which a 99mTc-hexamethyl-propylenamine oxime (99mTc-HMPAO) brain SPECT study was used to evaluate regional cerebral blood flow to the calcified regions. There was markedly decreased perfusion to the basal ganglia bilaterally as well as decreased perfusion to the cerebral cortices that correlated well with the patient's clinical condition.

Topics: Adult; Basal Ganglia; Basal Ganglia Diseases; Brain; Calcinosis; Cerebellar Nuclei; Cerebral Cortex; Cerebrovascular Circulation; Humans; Male; Organotechnetium Compounds; Oximes; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon

CT scan in a 52-year-old woman, admitted because of grand mal seizure, showed striopallidodentate calcifications due to postoperative hypoparathyroidism. This patient report stresses the possibility of cortical metabolic involvement in this disorder, as shown on Tc-99m HMPAO brain SPECT, despite the absence of cognitive defects.

Topics: Brain; Brain Diseases; Calcinosis; Epilepsy, Tonic-Clonic; Female; Humans; Hypoparathyroidism; Middle Aged; Organotechnetium Compounds; Oximes; Postoperative Complications; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon