High resolution SPECT with [99mTc]-d,l-HMPAO in normal pressure hydrocephalus before and after shunt operation
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High resolution SPECT with [99mTc]-d,l-HMPAO in normal pressure hydrocephalus before and after shunt operation. / Waldemar, G; Schmidt, J F; Delecluse, F; Andersen, A R; Gjerris, F; Paulson, O B.
I: Journal of neurology, neurosurgery, and psychiatry, Bind 56, Nr. 6, 06.1993, s. 655-64.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - High resolution SPECT with [99mTc]-d,l-HMPAO in normal pressure hydrocephalus before and after shunt operation
AU - Waldemar, G
AU - Schmidt, J F
AU - Delecluse, F
AU - Andersen, A R
AU - Gjerris, F
AU - Paulson, O B
PY - 1993/6
Y1 - 1993/6
N2 - Cranial CT and high resolution measurements of regional cerebral blood flow (rCBF) with brain dedicated single photon emission computer tomography (SPECT) and [99mTc]-d,l-hexamethylpropyleneamine oxime ([99mTc]-d,l-HMPAO) were performed before and after shunt operation in 14 consecutive patients with dementia and normal pressure hydrocephalus (NPH). When compared with a control group of 14 age matched healthy volunteers, the group of NPH patients was characterised by an enlarged subcortical low-flow region, significantly reduced rCBF and enhanced side-to-side asymmetry of rCBF in the central white matter, and enhanced side-to-side asymmetry in the inferior and mid-temporal cortex. Global CBF was normal. Shunt operation reduced the mean area of the ventricles on CT and of the subcortical low-flow region on SPECT. Global CBF was unchanged. All 14 patients had an abnormal pre-shunt rCBF pattern with enlargement of the subcortical low flow region, focal cortical blood flow deficits, or both. Shunt operation improved the clinical status in 11 patients, and the area of the subcortical low flow region correctly classified 3/3 unimproved and 10/11 improved patients. Shunt operation normalised or reduced the area of the subcortical low flow region in nine of 10 patients. It is concluded that SPECT with [99mTc]-d,l-HMPAO is a useful supplement in the diagnosis of NPH versus normal ageing, and that SPECT may help to identify patients not likely to benefit clinically from surgery.
AB - Cranial CT and high resolution measurements of regional cerebral blood flow (rCBF) with brain dedicated single photon emission computer tomography (SPECT) and [99mTc]-d,l-hexamethylpropyleneamine oxime ([99mTc]-d,l-HMPAO) were performed before and after shunt operation in 14 consecutive patients with dementia and normal pressure hydrocephalus (NPH). When compared with a control group of 14 age matched healthy volunteers, the group of NPH patients was characterised by an enlarged subcortical low-flow region, significantly reduced rCBF and enhanced side-to-side asymmetry of rCBF in the central white matter, and enhanced side-to-side asymmetry in the inferior and mid-temporal cortex. Global CBF was normal. Shunt operation reduced the mean area of the ventricles on CT and of the subcortical low-flow region on SPECT. Global CBF was unchanged. All 14 patients had an abnormal pre-shunt rCBF pattern with enlargement of the subcortical low flow region, focal cortical blood flow deficits, or both. Shunt operation improved the clinical status in 11 patients, and the area of the subcortical low flow region correctly classified 3/3 unimproved and 10/11 improved patients. Shunt operation normalised or reduced the area of the subcortical low flow region in nine of 10 patients. It is concluded that SPECT with [99mTc]-d,l-HMPAO is a useful supplement in the diagnosis of NPH versus normal ageing, and that SPECT may help to identify patients not likely to benefit clinically from surgery.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Brain/diagnostic imaging
KW - Cerebrospinal Fluid Shunts
KW - Cerebrovascular Circulation/physiology
KW - Female
KW - Humans
KW - Hydrocephalus, Normal Pressure/diagnostic imaging
KW - Male
KW - Middle Aged
KW - Organotechnetium Compounds
KW - Oximes
KW - Prognosis
KW - Technetium Tc 99m Exametazime
KW - Time Factors
KW - Tomography, Emission-Computed, Single-Photon
U2 - 10.1136/jnnp.56.6.655
DO - 10.1136/jnnp.56.6.655
M3 - Journal article
C2 - 8509780
VL - 56
SP - 655
EP - 664
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
SN - 0022-3050
IS - 6
ER -
ID: 279847770