EARLY AND DELAYED BRAIN SPECT WITH TECHNETIUM-99M-ECD AND IODINE-123-IMP IN SUBACUTE STROKES

The brain distribution of Tc-99m-ECD versus I-123-IMP was compared in patients with subacute stroke in order to compare diagnostic accuracy. Methods: A total of 25 patients with subacute stroke underwent early and delayed SPECT imaging with Tc-99m-ECD and I-123-IMP. Washout of Tc -99m-ECD was calculated and a differential percentage of activity (DPA ) of ischemic versus normal zones was assessed. Images were analyzed t wice by five independent observers. Results: Technetium-99m-ECD cleara nce was 12.5% from the whole brain during early imaging. Ischemic pari etal zones had higher clearance than normal parietal zones. Technetium -99m-ECD images showed larger differences between abnormal and normal brain activity than I-123-IMP images. Detection accuracy was slightly, but not significantly, higher for Tc-99m-ECD and I-123-IMP (sensitivi ty: 73.8% as 66.6%; specificity: 81.7% as 81.6%). Reproducibility amon g observers was similar for Tc-99m-ECD and early I-123-IMP. Conclusion : Technetium-99m-ECD demonstrates high diagnostic accuracy during suba cute stroke, similar to I-123-IMP, but with more intense, better delin eation of the perfusion defects.