Regional cerebral blood flow in patients with sickle cell disease: study with single photon emission computed tomography |
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Authors: | Fareeda A Al-Kandari Azu Owunwanne Ghulam M Syed Rajaa Ar Marouf Abdelhamid H Elgazzar Mehraj Shiekh Ali M Rizui Jawaher A Al-Ajmi Ahmed M Mohammed |
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Institution: | (1) Department of Nuclear Medicine, Faculty of Medicine, Health Sciences Center, Kuwait University, PO Box 24923, Saafat, 13110, Kuwait;(2) Department of Pathology, Faculty of Medicine, Kuwait University, and Mubarak Al-Kabeer Hospital, Saafat, 13110, Kuwait;(3) Department of Radiology, Faculty of Medicine, Kuwait University, and Mubarak Al-Kabeer Hospital, Saafat, 13110, Kuwait |
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Abstract: | Objective Neurological complications have been reported in patients with sickle-cell disease (SCD) using positron emission tomography
(PET), magnetic resonance imaging (MRI), and computed tomography (CT), but not with single photon emission computed tomography
(SPECT). The objective of this study was to investigate brain perfusion in the patients with SCD using SPECT after technetium-99m
hexamethylpropylene amine oxime (99mTc-HMPAO), was administered and compare the findings with those of demography, physical examination, MRI and hematological
profile.
Methods The study involved 21 patients (12 males, 9 females, age at study 8–45 years) who were known to be having SCD for a duration
of at least 5 years. The patients were not in acute crisis and had normal neurological assessments with no known history of
stroke or transient ischemic episode or previous abnormal CT or MRI brain scan, and were right-handed. The brain SPECT was
performed after intravenous injection of 740 MBq (20 mCi) 99mTc-HMPAO in adults or an appropriate dose in pediatric patients. The scans were visually interpreted by two nuclear medicine
physicians and a decision was reached by consensus. An MRI done 3 months later was interpreted by a radiologist. The demographic
data and hematological profile were obtained from the medical records of the patients.
Results Of the 21 patients, 7 (age 11–22 years) had brain perfusion deficit mostly in the frontal lobe either alone or in combination
with temporal and/or parietal lobe. The MRI was abnormal in 2 patients. The brain perfusion deficit was not associated with
the demographic data of the patients or hematological profiles.
Conclusions The findings show that SPECT was useful in detecting brain perfusion deficit in SCD patients, and such an early detection
may be clinically useful in the subsequent follow-up of such patients, since it is known that cerebral perfusion deficit can
lead to silent infarct and/or overt stroke, and affect cognitive skills. |
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Keywords: | SPECT Regional cerebral blood flow Sickle cell disease Tc99mHMPAO MRI |
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