RESUMEN
Background: Tc-HMPAO SPECT has a potential diagnostic tool in early diagnosis of ischemic stroke. Several studies have supported the predictive value of SPECT in stroke prognosis
Purpose: studying the role of Tc-HMPAO SPECT in assessment of rCBF changes in acute stroke patients and evaluation of its r9le in early diagnosis and prognosis of stroke
Material and Methods: forty Egyptian patients presented with acute onset of first ever ischemic stroke classified according to The Oxford shire Community Stroke ·Project [OCSP] classification, were subjected to National Institutes of Health Stroke Scale [NIHSS] assessment, CT brain and single photon emission computed · tomography [SPECT] at day one of stroke onset. At day seven, 30 patients were reevaluated by NlHSS to assess the clinical outcome and SPECT to follow the pattern of cerebral perfusion
Results: at Day one: CT scans were positive in only 18 [45%] patients, while SPECT scans were positive in all 40 [100%] patients [p< 0.001]. NIHSS was significantly higher in patients with corticosubcortical hypo perfusion lesions than in patients with cortical hypo perfusion on SPECT [p< 0.01]. NIHSS was worst with large hypo perfusion than small hypo perfusion on SPECT [p< 0.001]. The less the radiotracer uptake on SPECT, the worse the NIHSS [p<0.01]. There was a statistically significant negative correlation between NIHHS and rCBF [r= -0.640]. At Day seven: rCBF was highly significantly better [r = 0.59]. NlHSS at day 7 was worse in patients with corticosubcortical hypo perfusion lesions than in patients with cortical hypo perfusion on SPECT at day 1 [p< 0.01]. The larger the size ofhypoperfusion on SPECT at day 1, the worse the NIHSS at day 7. [p<0.05]. The less the radiotracer uptake on SPECT at day 1, the worse the NIHSS at day 7[p<0.05]. The more the rCBF day 1, the less the NlHSS at day 7 [r=-0.685, p<0.001]
Conclusion: SPECT was more sensitive than CT in detecting acute cerebral ischemia. There was significant relation between clinical assessment of stroke patients and findings on SPECT at day one. Tc-HMP AO SPECT could predicts early clinical outcome of stroke