A STUDY OF CEREBRAL PERFUSION USING SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY IN NEONATES WITH BRAIN-LESIONS

In this study we used a single photon emission computed tomography tec hnique (SPECT) with radiolabelled Te-99m HMPAO to assess cerebral perf usion in newborn infants with documented cerebral lesions and to deter mine to what extent brain SPECT might be useful in the neonatal period . A total of 15 newborn infants with the following cerebral pathologie s were enrolled: severe parietal bilateral periventricular leucomalaci a (PVL, n = 6); moderate parietal bilateral PVL (n = 2); intraventricu lar haemorrhage grade II with unilateral parietal parenchymal extensio n (IHV + PE, n = 3); cerebral infarction (CI, n = 2) in the zone of mi ddle cerebral artery; and post-haemorrhagic hydrocephalus (n = 2). Fol low-up was available in all infants. Alterations in cerebral perfusion were seen in only 12 of 15 infants and at the location of severe PVL, PE and CI. We have noted that the regions of diminished perfusion ext ended beyond the apparent extent of cerebral pathology delineated by u ltrasound or magnetic resonance imaging. Markedly diminished perfusion was seen in 1 infant with hydrocephalus, which recovered following pl acement of ventriculo-peritoneal shunt. Regarding outcome, SPECT data failed to provide additional information than that of neuroradiologica l investigations. We conclude that the use of SPECT, under these condi tions, to assess alteration of cerebral perfusion in the neonatal peri od will not provide any additional information than that of neuroradio logical investigations.