The Korean Journal of Nuclear Medicine (대한핵의학회지)

The Korean Society of Nuclear Medicine (대한핵의학회)
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Brain SPECT Using $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD in Subacute Cerebral Infarction: Case Report

아급성 뇌경색 환자에서 $^{99m}Tc$-HMPAO 및 $^{99m}Tc$-ECD 뇌 SPECT: 증례보고

  • Ahn, Byeong-Cheol (Department of Nuclear Medicine, Kyungpook National University Hospital) ;
  • Lee, Dong-Soo (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Yoon, Byung-Woo (Departments of Neurology, Seoul National University Hospital) ;
  • So, Young (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Jung, June-Key (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Lee, Myung-Chul (Departments of Nuclear Medicine, Seoul National University Hospital) ;
  • Koh, Chang-Soon (Departments of Nuclear Medicine, Seoul National University Hospital)
  • 안병철 (경북대학교병원 핵의학과) ;
  • 이동수 (서울대학교병원 핵의학과) ;
  • 윤병우 (서울대학교병원 신경과) ;
  • 소영 (서울대학교병원 핵의학과) ;
  • 정준기 (서울대학교병원 핵의학과) ;
  • 이명철 (서울대학교병원 핵의학과) ;
  • 고창순 (서울대학교병원 핵의학과)
  • Published : 1996.12.20
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Abstract

For brain perfusion SPECT imaging, $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD are commonly used. Although these two tracers usually show similar distribution, it is well known that discrepant finding might be noted between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD imaging in some conditions. Luxury perfusion(perfusion/metabolism mismatch) is one of the examples and could be observed in subacute cerebral infarction. We report a case of subacute cerebral infarction that revealed luxury perfusion. Increased perfusion was found in $^{99m}Tc$-HMPAO SPECT and perfusion defect was found in $^{99m}Tc$-ECD SPECT. We found large area of mismatch with a consecutive acquisition-subtraction method. Crossed cerebellar diaschisis was observed in both SPECT images.

우리는 혈전 용해요법을 시행한 뇌경색 환자를 대상으로 과잉관류가 발생한 아급성기에 $^{99m}Tc$-HMPAO SPECT와 $^{99m}Tc$-ECD SPECT를 같은 날 실시하여 $^{99m}Tc$-HMPAO SPECT에서는 과잉관류 소견이 보이나, $^{99m}Tc$-ECD SPECT 에서는 결손으로 나타남을 관찰하였다. 이 환자는 임상적으로 신경학적 이상에 호전이 없이 증상 발생 42일째 사망하였다. 문헌을 검토하여 종합하고 우리 환자예를 분석한 결과 $^{99m}Tc$-HMPAO SPECT가 뇌혈류를 반영하여 관류회복과 과잉관류상태를 나타내었고, $^{99m}Tc$-ECD SPECT는 뇌세포의 대사 및 생존여부를 반영하여 뇌세포 손상이 넓고 심각함을 나타내었다고 보았다.

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