SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury

Hussein M. Abdel-Dayem, Hani Abu-Judeh, Mithilesh Kumar, Saadet Atay, Sleiman Naddaf, Hossam El-Zeftawy, Jian Qiao Luo

Research output: Contribution to journalArticle

Abstract

The purpose of this atlas is to present a review of the literature showing the advantages of SPECT brain perfusion imaging (BPI) in mild or moderate traumatic brain injury (TBI) over other morphologic imaging modalities such as x-ray CT or MRI. The authors also present the technical recommendations for SPECT brain perfusion currently practiced at their center. For the radiopharmaceutical of choice, a comparison between early and delayed images using Tc-99m HMPAO and Tc-99m ECD showed that Tc-99m HMPAO is more stable in the brain with no washout over time. Therefore, the authors feel that Tc-99m HMPAO is preferable to Tc-99m ECD. Recommendations regarding standardizing intravenous injection, the acquisition, processing parameters, and interpretation of scans using a ten grade color scale, and use of the cerebellum as the reference organ are presented. SPECT images of 228 patients (age range, 11 to 88; mean, 40.8 years) with mild or moderate TBI and no significant medical history that interfered with the results of the SPECT BP were reviewed. The etiology of the trauma was in the following order of frequency: motor vehicle accidents (45%) followed by blow to the head (36%) and a fall (19%). Frequency of the symptoms was headache (60.9%), memory problems (27.6%), dizziness (26.7%), and sleep disorders (8.7%). Comparison between patients imaged early (3 months) from the time of the accident, showed that early imaging detected more lesions (4.2 abnormal lesions per study compared to 2.7 in those imaged more than 3 months after the accident). Of 41 patients who had mild traumatic injury without loss of consciousness and had normal CT, 28 studies were abnormal. Focal areas of hypoperfusion were seen in 77% (176 patients, 612 lesions) of the group of 228 patients. The sites of abnormalities were in the following order: basal ganglia and thalami, 55.2%, frontal lobes, 23.8%, temporal lobes, 13%, parietal, 3.7%, insular and occipital lobes together, 4.6%.

Original languageEnglish (US)
Pages (from-to)309-317
Number of pages9
JournalClinical Nuclear Medicine
Volume23
Issue number5
DOIs
StatePublished - 1998
Externally publishedYes

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Single-Photon Emission-Computed Tomography
Technetium Tc 99m Exametazime
Perfusion
Brain
Accidents
Occipital Lobe
Parietal Lobe
Perfusion Imaging
Unconsciousness
Radiopharmaceuticals
Atlases
Wounds and Injuries
Dizziness
Frontal Lobe
Motor Vehicles
Temporal Lobe
Basal Ganglia
Thalamus
Neuroimaging
Intravenous Injections

Keywords

  • SPECT Brain Perfusion Imaging
  • Tc-99m ECD
  • Tc-99m HMPAO
  • Traumatic Brain Injury

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Abdel-Dayem, H. M., Abu-Judeh, H., Kumar, M., Atay, S., Naddaf, S., El-Zeftawy, H., & Luo, J. Q. (1998). SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury. Clinical Nuclear Medicine, 23(5), 309-317. https://doi.org/10.1097/00003072-199805000-00009

SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury. / Abdel-Dayem, Hussein M.; Abu-Judeh, Hani; Kumar, Mithilesh; Atay, Saadet; Naddaf, Sleiman; El-Zeftawy, Hossam; Luo, Jian Qiao.

In: Clinical Nuclear Medicine, Vol. 23, No. 5, 1998, p. 309-317.

Research output: Contribution to journalArticle

Abdel-Dayem, HM, Abu-Judeh, H, Kumar, M, Atay, S, Naddaf, S, El-Zeftawy, H & Luo, JQ 1998, 'SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury', Clinical Nuclear Medicine, vol. 23, no. 5, pp. 309-317. https://doi.org/10.1097/00003072-199805000-00009
Abdel-Dayem, Hussein M. ; Abu-Judeh, Hani ; Kumar, Mithilesh ; Atay, Saadet ; Naddaf, Sleiman ; El-Zeftawy, Hossam ; Luo, Jian Qiao. / SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury. In: Clinical Nuclear Medicine. 1998 ; Vol. 23, No. 5. pp. 309-317.
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