Cerebral blood flow patterns using single photon emission computed tomography in patients with dissociative disorders and healthy controls

To compare the cerebral blood flow [CBF] changes in patients diagnosed to have Dissociative Disorder with healthy controls. Cross Sectional Comparative study. The study was done in the Department of Psychiatry Military Hospital Rawalpindi in collaboration with Nuclear Medical Centre [NMC] Armed Forces Institute of Pathology [AFIP], a tertiary care centre of Pakistan Armed Forces from Dec 2004 to May 2005. This cross sectional comparative study was done at Dept of Psychiatry Military Hospital Rawalpindi in collaboration with nuclear Medical Centre [NMC], at Armed Forces Institute of Pathology [AFIP] which is a tertiary referral center. A sample of 30 patients diagnosed as having Dissociative Disorder was compared with 10 controls for brain perfusion changes using TC-99m HMPAO [Hexamethyl-propylene-amine-oxime] Tc-99m. In group 1 perfusion changes were observed in 27 [90%] cases whereas unremarkable and insignificant changes were noted in 3 [10%] cases but no perfusion were noted in controls [P< 0.001] In patients who were suffering from different types of dissociative disorder marked cerebral hypoperfusion was observed in frontal, frontomotor, orbitofrontal and temporal regions whereas hyperperfusion was noted in frontal and orbitofrontal areas in few cases. Cerebral blood flow changes in the fronto parietal brain are associated with symptomotology in dissociative disorders

Gated spect myocardial perfusion scintigraphy for identifying septal perfusion artifacts in left bundle branch block

To determine the role of gated Single Photon Emission Computed Tomography [SPECT] for accurate assessment of myocardial perfusion scintigraphy [MPS] of patients with left bundle branch block [LBBB]. Analytical study. Punjab Institute of Nuclear Medicine [PINUM], Faisalabad, Pakistan, from June 2002 to April 2003. MPS data of patients with LBBB was analyzed. Resting gated SPECT MPS was performed after an injection of 740 MBq 99mTc-MIBI in 10 normal and 25 subjects with LBBB [with low probability of coronary artery disease]. Visual and quantitative analyses were done on non-gated [NG], end diastolic [ED], end systolic [ES] images. Calculations included septal to lateral wall ratio [SLR], myocardial thickening [MT=% increase in counts during systole] at end systolic phase and myocardial thickening at peak level [% peak MT]. Septal hypoperfusion was noted in 19 [76%] patients on NG images and in only 1 [4%] patient on gated SPECT ED images. On NG images of LBBB group, SLR was lower than in controls [0.68 +/- 0.07 vs. 0.87 +/- 0.05, p<0.001]. SLR of LBBB patients approached to that of control group in gated SPECT ED data [0.86 +/- 0.06 vs 0.88 +/- 0.06, p=ns]. Myocardial thickening at ES for septum was markedly lower in LBBB group than in controls [21.83% ' 10.86 vs. 66.32% ' 20.15, p<0.001]. In patients with LBBB, reduced septal thickening results in artifactual septal perfusion defects. Gating the perfusion scintigraphy and reporting perfusion status on end diastolic frames in LBBB patients can eliminate these artifacts