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Perfusion differences on SPECT and PWI in patients with acute ischemic stroke

  • Functional Neuroradiology
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Abstract

Introduction

The purposes of the present study were to compare the flow defect volumes on perfusion-weighted magnetic resonance imaging (PWI) and 99mTc-labeled ethylcysteinate dimer (99mTc-ECD) single photon emission computed tomography (SPECT) at acute and subacute stages of ischemic stroke and to analyze the relationship between the detected flow defects on the two methods and neurological status and clinical outcomes.

Methods

Perfusion defects on PWI and SPECT were measured within 48 h and on day 8 of the onset of stroke from 22 patients with their first-ever acute supratentorial ischemic stroke. The primary neurological status was evaluated prior to the imaging. Clinical outcome was assessed at 3 months after the onset of the stroke.

Results

The volumes of cerebral blood flow (CBF) defects did not differ between SPECT and PWI within the 48-h examinations. However, the volume of CBF defect was significantly larger on SPECT than on PWI on day 8 (p = 0.03). Within the 48-h examinations, the CBF defect volumes on SPECT and PWI were comparably related to the neurological status. On day 8, the CBF defect volume on SPECT showed higher correlation to the neurological status and more precisely predicted the clinical outcomes at 3 months than PWI.

Conclusions

99mTC-ECD-SPECT and PWI both have ability to detect cerebral hypoperfusion in patients with ischemic stroke but with some differences. The value of SPECT is more accurate in terms of the delayed outcome, such as prognosis and rehabilitation planning.

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Conflict of interest statement

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Neurology, Kuopio University Hospital, University of Kuopio, Kuopio, Finland

    Juho Nuutinen, Yawu Liu & Mikko P. Laakso

  2. Department of Clinical Radiology, Kuopio University Hospital, University of Kuopio, P. O. Box 1777, 70211, Kuopio, Finland

    Yawu Liu, Mikko P. Laakso & Ritva L. Vanninen

  3. Department of Radiology, Mikkeli Central Hospital, Mikkeli, Finland

    Jari O. Karonen

  4. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, University of Kuopio, Kuopio, Finland

    Esko J. Vanninen & Jyrki T. Kuikka

  5. Niuvanniemi Hospital, Kuopio, Finland

    Jyrki T. Kuikka

  6. Department of Radiology, University of Turku, Turku, Finland

    Hannu J. Aronen

Authors
  1. Juho Nuutinen
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  2. Yawu Liu
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  3. Mikko P. Laakso
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  4. Jari O. Karonen
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  5. Esko J. Vanninen
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  6. Jyrki T. Kuikka
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  7. Hannu J. Aronen
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  8. Ritva L. Vanninen
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Corresponding author

Correspondence to Yawu Liu.

Additional information

J. Nuutinen and Y. Liu contributed equally to this work.

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Nuutinen, J., Liu, Y., Laakso, M.P. et al. Perfusion differences on SPECT and PWI in patients with acute ischemic stroke. Neuroradiology 51, 687–695 (2009). https://doi.org/10.1007/s00234-009-0569-9

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  • DOI: https://doi.org/10.1007/s00234-009-0569-9

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