• Title/Summary/Keyword: $^{99m}$Tc-HMPAO

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Prediction of Infarction in Acute Cerebral Ischemic Stroke by Using Perfusion MR Imaging and $^{99m}Tc-HMPAO$ SPECT (급성 허혈성 뇌졸중에서 관류 자기공명영상과 99mTC-HMPAO 단광자방출단층촬영술을 이용한 뇌경색의 예측)

  • Ho Cheol Choe;Sun Joo Lee;Jae Hyoung Kim
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.55-63
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    • 2002
  • Purpose : We investigated the predictive values of relative CBV measured with perfusion MR imaging, and relative CBF measured with SPECT for tissue outcome in acute ischemic stroke. Material and Methods : Thirteen patients, who had acute unilateral middle cerebral artery occlusion, underwent perfusion MR imaging, and $^{99m}Tc-HMPAO$ SPECT within 6 hours after the onset of symptoms. Lesion-to-contralateral ratios of perfusion parameters were measured, and best cut-off values of both parameter ratios with their accuracy to discriminate between regions with and without evolving infarction were calculated. Results : Mean relative CBV ratios in regions with evolving infarction and without evolving infarction were $0.58{\pm}0.27$ and $0.9{\pm}0.17$ (p < 0.001), and mean relative CBF ratios in those regions were $0.41{\pm}0.22$ and $0.71{\pm}0.14$ (p < 0.001). The best cutoff values to discriminate between regions with and without evolving infarction were estimated to be 0.80 for relative CBV ratio and 0.56 for relative CBF ratio. The sensitivity, specificity and efficiency of each cutoff value were 80.6, 87.5, 82.7% for relative CBV ratio, and 72.2, 75.0, 73.0% for relative CBF ratio (p > 0.05 between two parameters). Conclusion Measurement of relative CBV and relative CBE may be useful in predicting tissue outcome in acute ischemic stroke.

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Thalamic Syndrome with Related Cortical Hypoperfusion on $^{99m}Tc-HMPAO$ Brain SPECT (시상 증후군에 동반된 대뇌 피질 혈류 변화에 대한 $^{99m}Tc-HMPAO$ Brain SPECT)

  • Kim, Eun-Kyung;Chung, Tae-Sub;Suh, Jung-Ho;Kim, Dong-Ik;Lee, Jong-Doo;Park, Chang-Yoon;Hong, Yong-Kook;Lee, Myung-Sik
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.33-39
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    • 1992
  • Spontaneous pain and painful overreaction to external stimuli resulting from lesion confined central nervous system (CNS) were named as thalamic syndrome. Thalamic lesion and decreased regional cortical perfusion thought to the pathogenesis of thalamic syndrome due to decreased function of thalamocortical tract. We performed $^{99m}Tc-HMPAO$ regional cerebral perfusion in 10 patients with clinical diagnosis of thalamic syndrome due to thalamic lesion or near the thalamic lesion at Yonsei University Hospital, from January 1989 to August 1991. In contrast to five patients with lesions near the thalamus who did not show secondarily decreased perfusion at cerebral cortex, four among the five patients with thalamic lesions revealed decreased cortical perfusion in the ipsilateral cerebral cortex on brain SPECT. These phenomena may suggest the loss of afferent activating stimuli from the thalamus led to decreased neuronal activity and the followitng hypoperfusion of cerebral cortex, and might be one of the indirect signs for suggesting presence of the thalamocortical tract. A causal relationship between cortical hypoperfusion and neuropsychological deficit is strongly suggested.

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Quantitative Analysis of Regional Cerebral Blood Flow using $^{99m}Tc-HMPAO$ SPECT in Parkinson's Disease (파킨슨병에서 $^{99m}Tc-HMPAO$ SPECT를 이용한 국소뇌혈류의 정량적 분석)

  • Lee, Myung-Chul;Bae, Sang-Kyun;Lee, Myung-Hae;Chung, June-Key;Koh, Chang-Soon;Roh, Jae-Kyu;Myung, Ho-Jin
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.251-256
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    • 1992
  • Regional cerebral blood flow were measured in 10 patients with Parkinson's disease and 12 normal persons using $^{99m}Tc-HMPAO$ SPECT. Reconstructed images were interpreted qualitatively and were compared with those findings of CT. For the quantitative analysis, six pairs of region of interest matched with the perfusion territories of large cerebral arteries and cerebellar hemisphere were determined. From the count values, indices showing the degree of asymmetry between right and left cerebral or cerebellar hemisphere, cerebral asymmetry index (ASI) and percent index of cerebellar asymmetry (PIA), and an index showing change of each region, region to cerebellum ratio (RCR) were obtained. ASI of normal persons and patients were $0.082{\pm}0.033$ and $0.108{\pm}0.062$, respectively and PIA were $-0.4{\pm}0.7%$ and $-0.7{\pm}1.0%$, respectively, which showed no statistically significant difference between normal persons and patients. Among 10 RCR's, those of both regions of basal ganglia and both regions of anterior cerebral artery were significantly reduced. We concluded that the most significant reduction of regional cerebral blood flow in patients with Parkinson's disease was observed in the regions of basal ganglia and in the regions of anterior cerebral artery, and the degree of change in hemispheric blood flow was similar in both hemisphere.

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Comparison of Tc-99m-HMPAO SPECT and MRI after Acute and Subacute Closed-Head Injury (외상후 뇌손상 환자에서 Tc-99m-HMPAO 국소뇌혈류 SPECT와 자기공명영상의 비교)

  • Yoo, Won-Jong;Lee, Sang-Hoon;Sohn, Hyung-Sun;Lee, Han-Jin;Park, Jeong-Mi;Chung, Soo-Kyo;Kim, Choon-Yul;Bahk, Yong-Whee;Shinn, Kyung-Sub
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.301-306
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    • 1994
  • The purpose of this study was to compare Tc-99m-HMPAO SPECT with MRI after acute and subacute closed-head injury. There were thirty two focal lesions in all cases of these. Fifteen lesions(47%) were seen on both MRI and SPECT. Fourteen lesions(44%) were seen only on MRI. Three lesions(9%) were seen only on SPECT. Of the 14 lesions seen only on MRI, one was epidural hematoma, two were subdural hematoma, three were subdural hygroma, one was intracerebral hematoma, four were contusion, and three were diffuse axonal injuries. SPECT detected 52% of the focal lesions found on MRI. For the detection of lesions, MRI was superior to SPECT in fourteen cases, while SPECT was superior to MRI in three cases. In conclusion, there was a tendency that detection rate of the traumatic lesions was higher on MRI, but the SPECT could delineate more wide extent of lesion.

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A Preliminary Quantification of $^{99m}Tc$-HMPAO Brain SPECT Images for Assessment of Volumetric Regional Cerebral Blood Flow ($^{99m}Tc$-HMPAO 뇌혈류 SPECT 영상의 부위별 체적 혈류 평가에 관한 기초 연구)

  • Kwark, Cheol-Eun;Park, Seok-Gun;Yang, Hyung-In;Choi, Chang-Woon;Lee, Kyung-Han;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.27 no.2
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    • pp.170-174
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    • 1993
  • The quantitative methods for the assessment of the cerebral blood flow using $^{99m}Tc$-HMPAO brain SPECT utilize the measured count distribution in some specific reconstructed tomographic slice or in algebraic summation of a few neighboring slices, rather than the true volumetric distribution, to estimate the relative regional cerebral blood flow, and consequently produce the biased estimates of the true regional cerebral blood flow. This kind of biases are thought to originate mainly from the arbitrarily irregular shape of the cerebral region of interest(ROI) which are analyzed. In this study, a semi-automated method for the direct quantification of the volumetric regional cerebral blood flow estimate is proposed, and the results are compared to those calculated by the previous planar approaches. Bias factors due to the partial volume effect and the uncertainty in ROI determination are not considered presently for the methodological comparison of planar/volumetric assessment protocol.

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Effect of Clinical Improvement of Schizophrenic Symptoms on $^{99m}Tc$-HMPAO Brain SPECT (정신분열병 환자의 임상적 증세 호전에 따른 $^{99m}Tc$-HMPAO 뇌 SPECT 소견의 변화)

  • Shin, Chul-Jin;Koong, Sung-Soo;Chung, In-Won
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.310-319
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    • 1997
  • This study investigated regional blood flow changes of frontal, temporal, and basal ganglia in eleven schizophrenic patients on DSM-IV criteria to examine the relationship between rCBF and clinical improvement of symptoms. Single-photon emission computed tomography imaging with $^{99m}Tc$-HMPAO was peformed in baseline and sixth weeks after the treatment, and concurrently psychopathology was assessed by PANSS. Antipsychotics wash-out period was more than 2 weeks, and three patient were drug naive. All patients were finally divided into two groups, the improved or not improved. We examined the difference of the amount of rCBF changes between two groups. Finally, frontal activity shows no significant difference between two groups but both groups show decreased frontal blood flow after antipsychotic treatment. However, the change of right temporal rCBF had positive correlation with the change of the total PANSS score, and the change of left temporal lobe activity was greater in the improved group than in the not improved group. Our results suggest that the temporal lobe activity has relation to the underlying schizophrenic symptoms.

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A Study on Synthesis of $^{99m}Tc-HMPAO$ as A Brain Perfusion Agent and Its Distribution (뇌혈류 평가용 $^{99m}Tc-HMPAO$ 합성 및 분포에 관한 연구)

  • Lee, Myung-Chul;Lee, Bum-Woo;Chung, June-Key;Cho, Bo-Youn;Koh, Chang-Soon;Jeong, Jae-Min;Yeom, Mi-Kyung;Hong, Mee-Kyoung;Choi, Seok-Rye
    • The Korean Journal of Nuclear Medicine
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    • v.24 no.2
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    • pp.215-221
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    • 1990
  • HM-PAO was synthesized by two step reaction. d, 1-HM-PAO was separated from the racemic product by fractional recrystalization in ethylacetate, and the chemical structure and purity was confirmed by proton NMR spectroscopy. The synthesized 0, 1-HM-PAO was labeled with $^{99m}Tc$ and studied the biodistribution in mice. From the results we could find that liver uptake of synthesized $^{99m}Tc$ d, 1-HM-PAO was higher than that of Amersham kit, but no conspicuous difference was found in brain and other tissues (blood, lung, stomach, intestine, muscle, spleen and kidney).

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