ISSN:1051-2284    

DOI:10.1111/jon19955s1s1

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

The technical aspects of functional brain single‐photon emission computed tomography (SPECT) imaging, referring primarily to the most common SPECT brain function measure‐regional cerebral blood flow‐are reviewed. SPECT images of regional cerebral blood flow are mfluenced by a number of factors unrelated to pathology, including tomographic quality, radiopharmaceuticals, environmental conditions at the t1me of rad1otracer administration, charactenst1cs of the subject (e.g., age, sex), image presentation, and image processing techniques. Modern SPECT scans yield excellent image quality, and instrumentation continues to improve. The armamentarium of regional cerebral blood flow and receptor radiopharmaceuticals 1s rapidly expanding. Standards regarding the environment for patient imaging and image presentation are emerg1ng. However, there 1s still much to learn about the circumstances for performance and evaluation of SPECT functional brain imaging. Challenge tests, primarily established in cerebrovascular disease (i.e , the acetazolamide test), offer great promise in defining the extent and nature of disease, as well as predicting therapeutic responses. Clearly, SPECT brain imaging is a powerful clinical and research tool. However, SPECT will only achieve its full potential in the management of patients with cerebral pathology through close cooperation among members of the nuclear medicine, neurology, psychiatry, neurosurgery, and internal medicine specialties.

ISSN:1051-2284    

DOI:10.1111/jon19955s1s2

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

‐photon emission computed tomography (SPECT) is a helpful tool for the management of stroke patients. Brain perfusion SPECT can help differentiate an ischemic event from peri‐ictal phenomena such as Todd's paresis. Initial data suggest that SPECT may be useful in prognosticating the likelihood of an early stroke after a transient ischemic attack and in distinguishing lacunar from cortical stroke. After an acute stroke, early SPECT depicts the area of ischemia with greater accuracy than either computed tomography or magnetic resonance imaging. When the perfusion defect is large, the likelihood of hemorrhagic complications or herniation increases. Reperfusion of an arterial territory after thrombolysis can be documented more conveniently with SPECT than with angiography. SPECT before and after the inJection of acetazolamide has been used to assess the vascular reserve in patients with severe stenosis of the proximal vessels of the cerebrovascular tree. Combined with transcranial Doppler studies, SPECT is used to document ischemia after subarachnoid hemorrhage. It has also been used to assess the effect of arterial ligation intended to treat arteriovenous malformations or aneurysms on brain perfusion and to evaluate ischemia secondary to pressure from an intracranial hemorrhage.

ISSN:1051-2284    

DOI:10.1111/jon19955s1s14

出版商:Wiley    

年代:2016

数据来源: WILEY

ISSN:1051-2284    

DOI:10.1111/jon19955s1s23

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

The introduction of computed tomography (CT) in the early 1970s effectively replaced radionuclide brain imaging as the main modality to evaluate the structure and morphology of brain tumors. There are, nevertheless, a number of management problems in patients with suspected brain tumors that can be addressed only by functional imaging. There is the need to determine whether a focal mass detected on CT or magnetic resonance imaging (MRI) is benign or malignant. Since the prognosis of the patient is related to the tumor grade, and because stereotactic biopsy recovers only a small fragment of the tumor, there is the need for an imaging technique that reflects the behavior and the malignancy of the tumor. After treatment, it is important to continue to determine the cause of clinical deterioration in patients with glioma who have received high doses of radiation. Progressive radiation necrosis may require surgical debulking. Detection and localization of solid tumor recurrence, on the other hand, may aid in designing treatment. Positron emission tomography (PET) using 1xF‐fluorodeoxyglucose (18FDG) has been the standard functional imaging modality in these patients. With the introduction of single‐photon emitting brain perfusion tracers in the last decade, brain single‐photon emission computed tomography (SPECT) has reemerged as a useful measure of brain function. Other tracers such as thallium‐201 (201TI) chloride have emerged as tumor markers and have also found a role in brain SPECT. This review evaluates the clinical value and potential of201TI and perfusion brain SPECT in patients with brain tumors

ISSN:1051-2284    

DOI:10.1111/jon19955s1s34

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

Brain infections are generally well visualized by contrastenhanced computed tomography or magnetic resonance imaging. However, these modalities are often unrevealing in the encephalopathy produced by the human immunodeficiency virus and in the early stages of herpes simplex encephalitis. Several studies have documented the greater sensitivity of perfusion single‐photon emission computed tomography (SPECT) in human immunodeficiency virus encephalopathy. In herpes simplex encephalitis, a few case reports have documented that SPECT may depict increased perfusion m the characteristically involved temporal and other l1mb1c structures when computed tomography and magnetic resonance imaging are normal.

ISSN:1051-2284    

DOI:10.1111/jon19955s1s40

出版商:Wiley    

年代:2016

数据来源: WILEY

摘要:

Single‐photon emission computed tomography (SPECT) imaging has provided the practicing clinician with a method of studying brain function in patients with dementia. A large and growing number of papers report the experiences of a number of laboratories in the use of this technique in the evaluation of demented patients. Studies from several laboratories comparing patients with Alzheimer's disease to control subjects report sensitivity and specificity of SPECT perfusion imaging to be in the 80% vicinity. In addit1on, a number of studies suggest that the dementias that show the greatest similarities in perfusion patterns to Alzheimer's disease are multi‐Infarct dementia and dementia associated with ParkinSon's d1sease. Although considerable data exist to guide the physician, a rigorous scientific approach to studying patients in a prospective, unselected clinical sample, with autopsy confirmation of the diagnosis, is needed to define clearly the utility of the technique in diagnosing dementias.

ISSN:1051-2284    

DOI:10.1111/jon19955s1s45

出版商:Wiley    

年代:2016

数据来源: WILEY

ISSN:1051-2284    

DOI:10.1111/jon19955s1s53

出版商:Wiley    

年代:2016

数据来源: WILEY