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02 October 2003 : Letter/Correspondence  

Imaging of mild traumatic brain injury using 57Co and 99mTc HMPAO SPECT as compared to other diagnostic procedures

Kurt Audenaert, Hugo M.L. Jansen, Andreas Otte, Kathelijne Peremans, Myriam Vervaet, Roger Crombez, Leo de Ridder, Cees van Heeringen, Joel Thirot, Rudi A. Dierckx, Jaap Korf

Med Sci Monit 2003; 9(10): MT112-117 :: ID: 13264

Abstract

Background:Traumatic brain injury (TBI) is usually assessed with the Glasgow Coma Scale (GCS), CT and EEG. TBI can result from either the primary mechanical impact or secondary (ischemic) brain damage, in which calcium (Ca) plays a pivotal role. This study was undertaken to compare the applicability of SPECT using [sup]57[/sup]Co as a Ca-tracer in patients with mild traumatic brain injury.Material/Methods:8 patients with mild TBI (GCS 15) were clinically examined and studied with EEG, neuropsychological testing (NPT) and SPECT within 2 days post-TBI. After iv-administration of 37 MBq (1 mCi) [sup]57[/sup]Co (effective radiation dose 0.34 mSv.MBq[sup]–1[/sup]; 1.24 rem.mCi[sup]–1[/sup]; physical half-life 270 days, biological half-life 37.6 h), single-headed SPECT (12 h pi) was performed, consecutively followed by standard 925 MBq (25 mCi) Tc-99m HMPAO SPECT.Results:In 6 of the 8 patients, baseline NPT and SPECT showed focal abnormalities in the affected frontal and temporal brain regions, which were in good topographical accordance. CT and EEG did not detect (structural) lesions in any of these cases.Conclusions:Single-headed [sup]57[/sup]Co-SPECT is able to show the site and extent of brain damage in patients with mild TBI, even in the absence of structural lesions. It may confirm and localize NPT findings. The predictive value of [sup]57[/sup]Co-SPECT should be assessed in larger patient series.

Keywords: Adolescent, Brain - pathology, Brain Injuries - diagnosis, Cobalt Radioisotopes - diagnostic use, Organotechnetium Compounds - diagnostic use, Technetium - diagnostic use, Tomography, Emission-Computed, Single-Photon - methods, Tomography, X-Ray Computed

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