Comparison of Tc-99m-HMPAO SPECT and MRI in cerebral infarction

ABSTRACT

Cerebral infarction is caused by decreased perfusion to the brain. In the evaluation of the infarction, CT has been widely used but MRI ans SPECT recently tend to increase in use. The purpose of this study is to compare the efficacy of MR imaging with that of 99mTc-hexamethylpropylene amine(HMPAO) single photon emission computed tomography(SPECT) in the patients with cerebral infarction in the points of (1) number of detected lesion, (2) size of the lesion, and (3) correlation with clinical neurologic deficits. Sixty-one patients with cerebral infarctions(acute 23, subacute30, chronic8) were reviewed. In all patients, MRI and corresponding 99mTc-HMPAO SPECT examinations were performed within a reasonable time span. We analyzed the fiadings of (1) clinical neurologic examination, (2) MR and, (3) Tc-99m-HMPAO SPECT independently they were compared later on. The lesion of SPECT was larger than the seen on MRI in 9 of 23 acute cases, 13 of 30 subacute cases, and 3 of 8 chronic cases. The lesion on MRI was larger than that on SPECT in seven acute cases, six subacute, and only one case in chronic stage. In the remaining cases, the size of the lesion was similar to that on both SPECT and MRI. For the detection of lesion, MRI was superior to SPECT in 15 acute cases, 13 subacute cases, and four chronic cases, while SPECT was super or to MRI in four of 30 cases at subacute stage, and one of 8 cases at chronic stage. In conclusion, there was a tendency that the detection rate of the lesion was higher on MRI but the lesion was larger on SPECT. The lesions detected on both MRI and SPECT correlated well with clinical symptoms.