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HMPAO SPECT to assess neurologic deficits during balloon test occlusion

 Young Hoon Ryu  ;  Tae Sub Chung  ;  Jong Doo Lee  ;  Dong Ik Kim  ;  Jung Ho Suh  ;  Chang Yun Park  ;  Won Sang Lee  ;  Kyu Sung Lee 
 JOURNAL OF NUCLEAR MEDICINE, Vol.37(4) : 551-554, 1996-04 
Journal Title
Issue Date
Adolescent ; Adult ; Brain / diagnostic imaging* ; Carotid Artery, Internal / physiology* ; Carotid Stenosis / diagnostic imaging* ; Carotid Stenosis / etiology ; Carotid Stenosis / physiopathology ; Catheterization ; Central Nervous System Diseases / etiology ; Central Nervous System Diseases / prevention & control* ; Cerebrovascular Circulation / physiology* ; Collateral Circulation / physiology ; Feasibility Studies ; Female ; Head and Neck Neoplasms / blood supply ; Head and Neck Neoplasms / diagnostic imaging ; Head and Neck Neoplasms / therapy ; Humans ; Male ; Organotechnetium Compounds* ; Oximes* ; Predictive Value of Tests ; Risk Factors ; Technetium Tc 99m Exametazime ; Tomography, Emission-Computed, Single-Photon*
The purpose of this study was to determine if one could objectively and preoperatively predict the safety of permanent occlusion of an internal carotid artery with 99mTc-HMPAO brain SPECT.
Twenty-four patients underwent balloon test occlusion of the internal carotid arteries because of neck and skull base tumors. We assessed the uptake of both middle cerebral artery territories before and during balloon test occlusion with 99mTc-HMPAO brain SPECT using the semiquantitative analysis. The results were compared with other factors, including neurologic examination, arterial stump pressure and electroencephalogram.
Nineteen patients experienced no neurological deterioration or any problem during balloon test occlusion. The comparative uptake of their middle cerebral artery territories was 95%-101% of the pre-balloon test occlusion state. The remaining five patients showed severe neurologic symptoms, such as transient hemiplegia and unconsciousness. The comparative uptake of their middle cerebral artery territories was 77%-85% of the pre-balloon test occlusion state and was well matched with other factors.
Technetium-99m-HMPAO brain SPECT before and during balloon test occlusion seems to be a simple and objective method for predicting permanent neurologic deficits when the comparative uptake of middle cerebral artery territories during balloon test occlusion is less than 85% of that before balloon test occlusion.
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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
Ryu, Young Hoon(유영훈) ORCID logo https://orcid.org/0000-0002-9000-5563
Lee, Jong Doo(이종두)
Chung, Tae Sub(정태섭)
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