Correlation of magnetic resonance imaging findings with hexamethylpropyleneamine oxime brain single photon emission computed tomography in ischemic stroke patients in the subacute stage.

Purpose: To evaluate the correlation between magnetic resonance imaging (MRI) findings and 99mTc-hexamethylpropyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) during the subacute stage in ischemic stroke patients.

Material And Methods: The T1 and T2-weighted images and brain SPECT findings of 84 patients (mean age 60.69 +/- 12.47 years) with subacute cerebral ischemia during the period 1998-2004 were reviewed. All HMPAO SPECT and MRI studies were performed between 3 and 7 days (mean time delay 4.76 +/- 1.29 days) after the onset of stroke symptoms.

Results: An ischemic lesion was seen both in T1 and T2-weighted images with perfusion defects above 60% (severe defect) according to count/pixel data of the lesion in HMPAO SPECT studies in 30 (90.9%) of 33 patients. Otherwise, the ischemic lesion was seen only on T2-weighted images with perfusion defects between 30% and 60% (moderate defect) in HMPAO SPECT studies in 25 (89.3%) of 28 patients. In 20 (87%) of 23 patients who had perfusion defects below 30% (mild defect) on HMPAO SPECT, only non-specific findings such as cerebral atrophy and/or periventricular ischemic-gliotic lesions could be seen in MRI. The difference between these ratios was statistically significant (P < 0.01).

Conclusion: Brain 99mTc-HMPAO SPECT findings indicate good correlation with MRI findings. When the ischemic lesions could be seen in both T1 and T2-weighted images, the patients frequently had severe perfusion defects. When only seen in T2-weighted images, the perfusion defect was moderate. When only non-specific findings were revealed by MRI, only mild perfusion defects were found by SPECT.