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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

 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 
 YONSEI MEDICAL JOURNAL, Vol.43(2) : 211-222, 2002 
Journal Title
Issue Date
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*
Cerebral infarction ; technetium-99m-ethyl cysteinate dimer ; single photon emission computed tomography ; magnetic resonance imaging ; diffusion ; perfusion
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.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 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)
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