MINOR HEAD INJURY amp; MEDIAL TEMPORAL DAMAGE：轻微头部损伤amp；内侧颞叶损伤.ppt

SPECT IN CONCUSSION, VERTEBRO-BASILAR INSUFFICIENCY AND OTHER NEUROLOGICAL DISORDERS Novel applications and insights LEARNING OBJECTIVES To understand uses of Single Photon Emission Computed Tomography (SPECT) in patients with post-concussion syndrome and vertebrobasilar insufficiency To be familiar with the use of SPECT as an investigative and research tool in neurosciences All India Institute of Medical Sciences, Delhi 1200 bed tertiary centre Annual budget of CAD $250 million Imaging 6 CT scanners 2 1.5 T MRI scanners, a 4.7 Tesla animal MRI/MRS scanner, and a 9.4 Tesla NMR spectrometer. 1 PET, 2 SPECT scanners Imaging Brain function using SPECT IMAGING TECHNIQUES STRUCTURAL- MRI, CT FUNCTIONAL- SPECT, PET, fMRI (SPECT-Single Photon Emission Computed Tomography) Functional Imaging PET- Gold standard SPECT - More widely available - Much cheaper - Still able to provide much of the same information UNDERLYING PRINCIPLES OF SPECT Biochemical interactions between brain tissue and injected substance (HMPAO, ECD, Iophane) These substances are labeled with radioactive tracers (99mTc-HMPAO, 99mTc-ECD, 123I-iophane) UNDERLYING PRINCIPLES Radiopharmaceutical injected IV Crosses BBB proportionate to blood flow Enters Neuronal tissue – stereoisomeric change Become ‘trapped’ inside the neurons UNDERLYING PRINCIPLES Increased neuronal activity = increased neuronal uptake of radiopharmaceutical = Increased perfusion on SPECT This image of cerebral perfusion indirectly reflects cerebral metabolism BRAIN SPECT Brain perfusion - HMPAO,ECD HMPAO-Hexa Methyl Propylene Amine Oxine; ECD-Ethylene Cysteinate Dimer Imaging of neurotransmitter systems - Ioflupane APPLICATIONS Dementias Alzheimers:↓perfusion TP regions B/L Normal perfusion Subcortical region Vascular Dementia:↓perfusion Subcortical regions APPLICATIONS Epilepsy Established role in epilepsy SISCOM (Subtraction Ictal SPECT Coregistered with MRI) APPLICATIONS Trauma Can show abn