SEMIQUANTITATIVE ASSESSMENT OF CEREBRAL BLOOD-FLOW WITH TC-99M-HMPAO SPET IN TYPE-I DIABETIC-PATIENTS WITH NO CLINICAL HISTORY OF CEREBROVASCULAR-DISEASE

In 65 type I diabetic patients we prospectively evaluated brain perfus ion by means of single-photon emission tomography after the injection of 740-1110 MBq of technetium-99m hexamethylpropylene amine oxime. Thi rty-five of the patients presented complications secondary to their di abetes. None showed CNS symptoms. A semiquantitative analysis was perf ormed drawing 50 symmetrical regions of interest (ROIs) per patient. T he relative contribution of each ROT to the total blood flow in each s lice was compared with the relative contribution of the same ROI in a control group of ten healthy volunteers. Relative values of any ROI in the study group higher or lower than the mean +/-2 SD in respect of t he same ROI in the control group were considered abnormal. The results revealed hypoperfusion in 207 ROIs in the 65 patients with diabetes m ellitus: of these ROIs, 113 were frontal, 10 frontotemporal, 20 tempor al, 18 parietal, 11 occipital and 35 cerebellar, A total of 137 ROIs s howed hyperperfusion: 17 frontal, 3 frontotemporal, 19 temporal, 18 pa rietal, 19 parietooccipital, 29 occipital and 32 cerebellar, Out of 65 type I diabetic patients, 61 showed at least one hypoperfused ROI (P = 0.0064 vs. controls) and 25 showed more than three hypoperfused ROIs . None of the control subjects showed more than three hypoperfused reg ions (P<0.001), The results obtained demonstrate the existence of subc linical abnormalities of brain blood perfusion in patients with type I diabetes mellitus and no history of cerebrovascular disease, thereby allowing the initiation of intensive preventive measures.