A PROSPECTIVE-STUDY COMPARING SPET WITH MRI AND CT AS PROGNOSTIC INDICATORS FOLLOWING SEVERE CLOSED-HEAD INJURY

Ten patients were studied prospectively after severe closed head injur y to determine the relationship between long-term clinical outcome and abnormalities detected by single photon emission tomography (Tc-99(m) -HMPAO SPET), CT and MRI obtained within 60 days of injury. The abilit y of SPET to detect abnormalities not visualized by CT or MRI after ce rebral trauma is confirmed by the results of this study. Changes detec ted by SPET [global cerebral Mood flow (gCBF) and number of regional c erebral blood flow (rCBF) deficits] soon after trauma were shown to be more closely correlated with long-term outcome than changes detected by MRI or CT. Templates were used to classify lesions by site and a mu ltivariate analysis was undertaken to establish the importance of defe ct position in predicting clinical outcome. The results suggest that l esions in the temporal lobes, frontal lobes and basal ganglia are rela ted to poor prognosis, and that SPET yields more useful prognostic dat a than the other methods.