Brain Scanning in Cerebral Vascular Disease: A Reappraisal

Welch, Dennis M.; Coleman, Robert E.; Hardin, William B.; Siegel, Barry A.

doi:10.1161/01.str.6.2.136

Cited by 14 publications

(6 citation statements)

References 15 publications

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“…In our experience 12 abnormal RN images were seen in 43% of patients with intracerebral hematoma. The results in the current study show a lower percentage (28%) and confirm the superiority of CT over RN imaging in this group of patients.…”

Section: Illmentioning

confidence: 56%

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Comparison of computerized tomography and radionuclide imaging in "stroke".

Gado¹,

Coleman²,

Merlis³

et al. 1976

Stroke

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SUMMARY Forty patients were studied by computerized tomography and by radionuclide brain imaging. The final diagnosis was infarction in 29 patients, intracerebral hematoma in seven, acute SAH in one, and old cerebrovascular accidents in three. CT was far superior to RN in detecting intracerebral hematomas and distinguishing them from cerebral infarction. The results of CT and RN tests were comparable regarding the percentage of abnormalities. However, the results in the same patients were not identical in 55% of the cases, indicating a complementary role for the two tests. There was no relationship between the frequency of abnormalities on CT and the time lapse after the onset of cerebral infarction. RN uptake was not seen in patients with old cerebrovascular accidents.SINCE THE INTRODUCTION of computerized tomography (CT) as a noninvasive technique for brain imaging, several reports have discussed its usefulness in patients with stroke. The purpose of this communication is to compare CT and radionuclide brain scanning in patients with cerebrovascular disease. MethodsThere were 40 patients with a final diagnosis of cerebrovascular accident. Each patient was examined by CT and radionuclide (RN) brain imaging. There were 29 cases of recent infarction (28 in the cerebral hemisphere and one in the cerebellum), seven cases of intracerebral hemorrhage, and one with subarachnoid hemorrhage (SAH). The diagnosis of cerebral infarction was made on clinical grounds. The diagnosis of intracerebral hematoma was confirmed by surgery in three cases and by autopsy in two. There were two cases in this series in which the diagnosis of a hematoma was based on the CT scan. The interval between the onset of symptoms and the diagnostic imaging in this group of patients is shown in table 1. The time lapse between CT and RN brain imaging was less than one week in the same patient, with a mean of 1.8 days. As shown in table 1, CT was done in the first two days in 15 patients, between two and seven days after the onset in 13 patients, between seven and 21 days in six patients, and more than 21 days after the onset in six patients. RN studies were done in the first two days in 18 patients, between two and seven days after the episode in 13 patients, between seven and 21 days in four patients, and more than 21 days after the episode in five patients. Three patients admitted for evaluation of late sequelae of a cerebrovascular accident that had occurred one year earlier are included in the last column of table 1. In this study there was a slight inadvertent selection of patients resulting in a slight artificial bias in the results. During the greater part of the period covered in this study there was a single CT unit in operation at our institute. As a result of the inevitable waiting list, some patients with a negative RN study were not studied by CT. It is quite possible, therefore, that a group of patients with negative isotope studies and positive CT was inadvertently omitted from the study. This will be discussed later.CT scans were pe...

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Section: Illmentioning

confidence: 56%

“…Welch et al 12 in a study of 169 radionuclide studies in patients with thromboembolic cerebral infarction reported 32% positive studies during the first week after the ictus and 52% positive findings in studies done later than one week after the ictus. They also indicated a 27% incidence of abnormal studies in the first two days after the episode.…”

Section: Illmentioning

confidence: 99%

Comparison of computerized tomography and radionuclide imaging in "stroke".

Gado¹,

Coleman²,

Merlis³

et al. 1976

Stroke

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“…A number of studies compasing CT and 99mTc radionuclide imaging have indicated a similar time course for visualisation of BBB dysfunction in cases of cerebral infarction [19][20][21][22]. The acute phase was most likely to yield negative results and the 10-to 14-day period was considered optimal for obtaining CT enhancement or 99mTc accumulation.…”

Section: Discussionmentioning

confidence: 99%

Tumour-like thallium-201 accumulation in brain infarcts, an unexpected finding on single-photon emission tomography

1994

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Thallium-201 brain single-photon emission tomography (201Tl-SPET) is widely used to detect viable tumour tissue with increased metabolic activity. When reperfusion takes place early in cerebrovascular lesions of embolic origin, the presence of tissue areas with increased regional blood flow and preserved metabolic activity can also be assumed. In the present study our purpose was to investigate whether or not foci of 201Tl accumulation occur in reperfused areas with sustained morphological integrity indicated by computed tomography (CT) scans not showing hypodensity in the acute or subacute period. In 16 stroke patients with possible cortical embolic infarction, dual 201Tl and technetium-99m hexamethylpropylene amine oxime (99mTc-HMPAO) SPET was performed in both the acute and the subacute period. 99mTc-HMPAO SPET was performed to detect reperfusion. Follow-up CT scans from the same period were also available. In five cases 99mTc-HMPAO SPET ruled out reperfusion and 201Tl SPET was also negative. In four cases 99mTc-HMPAO studies indicated reperfusion early in the acute phase (24-72 h), and comparative CT, without showing hypodensity in the acute or subacute period, also favoured the possibility of sustained metabolic activity. In these cases 201Tl SPET was negative in both the acute and the subacute period. In seven cases CT already showed necrosis in 99mTc-HMPAO hypoperfused areas in the acute period, with negative results on corresponding 201Tl SPET. Later reperfusion occurred in the subacute period (8-14 days) as indicated by 99mTc-HMPAO SPET, at which time an unexpected focal accumulation of 201Tl was detected.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Bone imaging agents such as strontium-85, strontium-87m, fluorine-18, technetium-99m-phosphate compounds have been shown to concentrate in pulmonary metastases of osteogenic sarcoma [4,5]. This phenomenon, as in cases 1 and 2, does not appear to be related to radiographically apparent calcification.…”

Section: Discussionmentioning

confidence: 99%

“…The factors influencing the presence or absence of radionuclide uptake are not clear. Localization of bone imaging agents in pulmonary metastases has recently been reported in 80% [5] and 100% [4] of patients. Thus, bone scintigraphy is useful in selected patients with osteogenic sarcoma metastatic to lung.…”

Section: Discussionmentioning

confidence: 99%

The value of radionuclide bone imaging in selected patients with osteogenic sarcoma metastatic to lung

et al. 1980

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Bone scintigraphic findings are presented in three pediatric patients with osteogenic sarcoma metastatic to lung. The bone imaging radionuclide was concentrated to a variable degree within the pulmonary metastases. Radionuclide bone imaging was valuable in confirming the presence of metastatic disease to lung in two patients and diagnosing previously unsuspected pulmonary metastatic disease in one patient.

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Brain Scanning in Cerebral Vascular Disease: A Reappraisal

Cited by 14 publications

References 15 publications

Comparison of computerized tomography and radionuclide imaging in "stroke".

Comparison of computerized tomography and radionuclide imaging in "stroke".

Tumour-like thallium-201 accumulation in brain infarcts, an unexpected finding on single-photon emission tomography

The value of radionuclide bone imaging in selected patients with osteogenic sarcoma metastatic to lung

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