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Significance of 99mTc-ECD SPECT in Acute and Subacute Ischemic Stroke: Comparison with MR Images Including Diffusion and Perfusion Weighted Images

Authors
 Hyun Sook Kim  ;  Dong Ik Kim  ;  Jong Doo Lee  ;  Eun Kee Jeong  ;  Tae Sub Chung  ;  Pyeong Ho Yoon  ;  Seung Koo Lee  ;  Eun Ju Kim  ;  Yong Kyu Yoon  ;  Bum Chun Suh  ;  Byung In Lee 
Citation
 YONSEI MEDICAL JOURNAL, Vol.43(2) : 211-222, 2002 
Journal Title
 YONSEI MEDICAL JOURNAL 
ISSN
 0513-5796 
Issue Date
2002
MeSH
Acute Disease ; Adult ; Aged ; Brain Ischemia/complications* ; Cysteine/analogs & derivatives* ; Diffusion ; Female ; Humans ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Organotechnetium Compounds* ; Perfusion ; Radiopharmaceuticals* ; Stroke/diagnosis* ; Stroke/etiology* ; Tomography, Emission-Computed, Single-Photon*
Keywords
Cerebral infarction ;  technetium-99m-ethyl cysteinate dimer ;  single photon emission computed tomography ;  magnetic resonance imaging ;  diffusion ;  perfusion
Abstract
99mTc-ECD SPECT is valuable for the evaluation of cell viability and function. The purpose of the present study was to evaluate the significance of 99mTc-ECD brain SPECT in ischemic stroke. We compared 99mTc-ECD brain SPECT with perfusion and diffusion weighted images (PWI, DWI). Ten patients with acute and early subacute ischemic stroke were included in this prospective study. T2-weighted images (T2WI), DWI, PWI and 99mTc-ECD SPECT were obtained during both the acute/early subacute and late subacute stages. In the case of PWI, time to peak (TTP) and regional cerebral blood volume (rCBV) maps were obtained. The rCBV map and 99mTc-ECD SPECT images were compared in 8 lesions using Δ AI. The asymmetry index (AI) was calculated as (Ci - Cc) × 200 / (Ci + Cc); where Ci is the mean number of pixel counts of an ipsilateral lesion and Cc is the mean number of pixel counts of the normal contralateral hemisphere. Δ AI was defined as AIacute - AIsubacute in the ischemic core and periphery. PWI and 99mTc-ECD SPECT detected new lesions of the hyperacute stage or of evolving stroke more accurately than T2WI and DWI. 99mTc-ECD SPECT was able to localize the infarct core and peri-infarct ischemia in all lesions in both the acute and the subacute stages. Δ AI was higher in the rCBV map than in the 99mTc-ECD SPECT images in the ischemic core (p = 0.063) and in the periphery (p = 0.091). In the 99mTc-ECD SPECT images, Δ AI was higher in the ischemic core than in the periphery (p = 0.028). During the subacute stage, 99mTc-ECD SPECT detected all the lesions without the pseudonormalization seen in the MR images of 5/11 lesions. Based on this study, 99mTc-ECD SPECT is comparable to PWI in terms of its ability to detect acute stroke and is more useful than PWI in the case of subacute infarction.
Files in This Item:
T200211201.pdf Download
DOI
10.3349/ymj.2002.43.2.211
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dong Ik(김동익)
Kim, Hyun Sook(김현숙)
Suh, Bum Chun(서범천)
Lee, Byung In(이병인)
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Lee, Jong Doo(이종두)
Jeong, Eun Kee(정은기)
Chung, Tae Sub(정태섭)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/144771
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