technetium-tc-99m-exametazime and Phantom-Limb

We wanted to investigate the somatotropic reorganization occurring in the motor and somatosensory cortex by using 99mTc-HMPAO SPECT analyses, after the extremity revascularization, replantation or amputation.. Twelve patients (11 men, 1 female; mean age 38.9+/-14.7 years) and controls (5 men, mean age 32.2+/-7.9 years) were enrolled in this study. After reconstruction, lower, middle and upper orbitomeatal slices with precentral and postcentral slices were obtained. All images were visually and semi-quantitatively evaluated. Mann-Whitney U-test was used for statistical analysis.. In the revascularization and replantation patients, postcentral and precentral hypoperfusions were seen at dominant hemisphere. In the amputated patients, postcentral (in 3 of 4 cases) and precentral hypoperfusions were seen at non-dominant hemisphere and postcentral hypoperfusion (in 1 of 4 cases) was seen at dominant hemisphere. In our patients, most significant difference in regional cerebral blood flow was found in posterior parietal cortex (somatic associated area).. Changes that take place in precentral and postcentral cortical areas subsequent to the extremity replantation-revascularization of the organ is a good indicator of somatotrophic reorganization.

Topics: Adult; Aged; Amputation, Surgical; Cerebral Cortex; Cerebrovascular Circulation; Female; Humans; Lower Extremity; Male; Middle Aged; Phantom Limb; Pulsatile Flow; Radiopharmaceuticals; Regional Blood Flow; Replantation; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon; Upper Extremity

Phantom limb pain is a common experience for patients who have received amputation. However, the definite mechanism is still not clear. Here, we describe a patient who suffered from phantom limb pain after left above-elbow amputation. The Tc-99m hexamethylpropylene amine oxime (HMPAO) brain single photon emission computed tomography (SPECT) study revealed increased regional cerebral blood flow in the right parietal cortex. This finding may imply the involvement of cerebral cortex in the development of phantom limb pain. Further study is worthwhile to elucidate the utility of SPECT and the role of cortex in phantom limb pain.

Topics: Adult; Cerebrovascular Circulation; Humans; Male; Phantom Limb; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon