Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on NINCDS-ADRDA, we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-SSP program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution.

The Japanese EC-IC bypass trial (JET study) was established to evaluate the validity of MCA-STA anastomosis in intracranial arterial occlusive disease aiming at stroke prevention. This study must use an objective method to reliably estimate hemodynamic brain ischemia. We devised a method of objectively classifying the severity of hemodynamic ischemia using quantitatively analytical and display software, stereotactic extraction estimation for stereotactic brain coordinates and three-dimensional stereotactic surface projections (3D-SSP). We analyzed data from 16 patients registered in the JET study. Our method offers quantitative information and 3-dimensional displays of the CBF at rest and after Diamox challenge, vascular reserve and the severity of the hemodynamic brain ischemia. We compared the maximal projection counts with ROI data from tomographic images in the anterior commissure-posterior commissure plane. The maximal counts data correlated closely with the ROI data of rest and with Diamox SPECT images (both p < 0.0001). The slopes of the linear regression line were 1.15 and 1.12, respectively. The results of this study indicated that our method could simply and objectively evaluate the severity of impaired brain circulation. This procedure should support the evaluation of hemodynamic ischemia in the JET study although validation is required by several institutions using more study subjects.

Tc-99m gated SPECT imaging soon after exercise is superior to conventional late imaging to discriminate patients with single-vessel disease and postexercise stunning.

A rare case of chondroblastoma arising from the temporal bone that occurred in a 60-year-old woman is reported. The tumor appeared well demarcated and osteolytic on the radiographs. CT scan clearly depicted marginal and central calcification in the tumor. MR imaging demonstrated two components in the tumor: a solid component with predominantly low signal intensities on both T1- and T2-weighted sequences, and a multilocular cystic component with T1- and T2-elongation and fluid-fluid levels on the T2-weighted images. Postcontrast MR imaging revealed marked enhancement in the solid component and the septa of the cystic component.

These results indicate that resting BMIPP imaging has prognostic value and may have a role in the risk stratification of patients with known or suspected CAD.