Tc-99m HMPAO Brain SPECT for ischemic strokes

-Abstract- Major advantage of Tc-99m HMPAO SPECT was easy availability at every Nuclear Medicine laboratories and high quality of images by many favorable character of Tc-99m labeled agent. 8 patients of non ischemic neurologic disorders and 15 patients of neurosis as controls and 38 patients of ischemic strokes were studied for how much decrease % of activity (DPA) is abnormal for ischemic strokes. Mean DPA of neurologic control compared to contralateral side was 5.7±4.14% and mean DPA of neurotic control patients was 10.3±2.3%. Higher than DPA 15% was counted as abnormal (above mean value+2 s.d.). Detection sensitivity of ischemic strokes was 100%. DPA more than 20% was adequate for prediction of ischemic strokes with acceptable false negative rate and DPA more than 15% for TIA with expected high false positive rate. DPA more than 30% was prone to be complete strokes (prediction 90%) and would be critical level for prospect of prognosis. The complete strokes with cerebral atrophy and/or by old infarcts were prone to show the hypoperfusion less contrast to have DPA less than 20%. Tc-99m HMPAO SPECT was found to have much superiority in detection of ischemic strokes, compared to XCT (detection rate : 46.4% ) and invasive digital angiography ( detection rate : 58.8%).