| Single-photon emission computed tomography using hexamethylpropyleneamine oxime in the prognosis of acute cerebral infarction. | |
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MedLine Citation:
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PMID: 8553409 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND PURPOSE: The role of single-photon emission CT (SPECT) in the prognosis of cerebral infarction is controversial, but most studies report that SPECT using a variety of radiopharmaceutical agents gives useful prognostic information. Only one study has questioned whether acute perfusion deficits independently add to a valid clinical prognostic score. This study was limited to middle cerebral artery territory infarcts and was negative. We present data on the prognostic utility of SPECT using 99mTc-hexamethylpropyleneamine oxime (HMPAO) in cerebral infarction, unselected by site. METHODS: Fifty consecutive unselected patients admitted to the hospital with acute cerebral infarction, of whom 10 died and 7 withdrew, had SPECT performed serially at onset and at 1 week and 3 months after stroke onset using 99mTc-HMPAO and the NOVO 810 dedicated high-resolution head tomograph. Clinical severity at presentation and outcome was measured with the Canadian Neurological Scale and the Barthel Index. Infarct volumes were measured from both the SPECT and CT scans. The data for the 43 subjects who completed the study or died were evaluated to determine the most powerful prognostic measures. Predictors were the Canadian Neurological Scale score at onset and 1 week, the Barthel Index at 1 week, the CT infarct volume typically done between 3 and 7 days after stroke onset, and the infarct volumes at the first and second SPECT. Outcome measures were the Canadian Neurological Scale score and Barthel Index score at 3 months, scored as zero for those patients who died. RESULTS: The clinical prognostic indicators correlated with the outcome measures, with coefficients between .617 and .821 (P < .0006 in all cases). The Canadian Neurological Scale score measured at 1 week was the best of these. Infarct volumes measured from SPECT correlated less well (coefficients between -.518 and -.683, P < .0019 in all cases). CT infarct volume was the poorest predictor. Although SPECT infarct volumes predicted outcome, they did so less well than clinical examination. Spontaneous infarct reperfusion did not affect outcome. CONCLUSIONS: Although the measurement of infarct volume on SPECT using 99mTc-HMPAO provides a predictor of stroke outcome, it is not a better predictor than the Canadian Neurological Scale score. |
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Authors:
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J V Bowler; J P Wade; B E Jones; K Nijran; T J Steiner |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 27 ISSN: 0039-2499 ISO Abbreviation: Stroke Publication Date: 1996 Jan |
Date Detail:
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Created Date: 1996-02-22 Completed Date: 1996-02-22 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 82-6 Citation Subset: IM |
Affiliation:
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Regional Neurosciences Centre, Charing Cross Hospital, London, UK. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Adult Cerebral Infarction / radiography, radionuclide imaging* Follow-Up Studies Forecasting Humans Logistic Models Magnetic Resonance Imaging Neurologic Examination Organotechnetium Compounds / diagnostic use* Oximes / diagnostic use* Prognosis Prospective Studies Reperfusion Survival Rate Technetium Tc 99m Exametazime Tomography, Emission-Computed, Single-Photon* Tomography, X-Ray Computed Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Organotechnetium Compounds; 0/Oximes; 100504-35-6/Technetium Tc 99m Exametazime |
| Comments/Corrections | |
Comment In:
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Stroke. 1996 Jul;27(7):1253-4
[PMID:
8685938
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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