EVALUATION OF CEREBRAL INFARCTION WITH IODINE-123-IOMAZENIL SPECT

This study evaluates ischemic damage to central benzodiazepine (BZD) r eceptor binding in the brain with [I-123]iomazenil SPECT in relation t o CT hypodense lesions and blood flow abnormalities. Methods: Nine pat ients with middle cerebral artery territory infarction were studied, l omazenil images obtained 180 min postinjection were analyzed for BZD r eceptor binding. The cortical infarction, visualized as CT hypodense a rea on CT, the peri-infarct area, visualized as normodensity surroundi ng the infarction on CT, the intrahemispheric remote area and the cere bellum were analyzed by taking the ratio of the lesion to contralatera l mirror region (L/C ratio). CT during the chronic stage and perfusion images obtained during the smallest time difference between the two s tudies were used for comparative analysis, Results: The mean L/C ratio of iomazenil uptake was 0.53 +/- 0.08, 0.79 +/- 0.07, 0.98 +/- 0.03 a nd 1.00 +/- 0.04 in the infarct, peri-infarct and remote areas and the cerebellum, respectively. The infarct and peri-infarct areas showed s ignificant decrease compared with unity. The corresponding mean VC rat io for blood flow was 0.52 +/- 0.08, 0.73 +/- 0.07, 0.83 +/- 0.09, and 0.80 +/- 0.07, respectively. In all areas, the ratios were significan tly decreased compared with unity. There was significant difference be tween the VC ratio for blood flow and iomazenil in the remote area and the cerebellum. Conclusion: Iodine-123-iomazenil SPECT imaging may pr ovide new information on ischemic damage to the brain, particularly to neurons.