Sy. Yim et al., A qualitative analysis of brain SPECT for prognostication of cross motor development in children with cerebral palsy, CLIN NUCL M, 25(4), 2000, pp. 268-272
Purpose: In this report, the authors assessed the clinical significance of
decreased regional cerebral blood flow (rCBF) in the thalamus or cerebellar
hemispheres in relation to gross motor performance in the children with ce
rebral palsy.
Materials and Methods: Thirty-six children with bilateral spastic cerebral
palsy (BSCP) underwent brain SPECT. Visual analysis was used for the brain
SPECT interpretation. The rCBF in the thalamus or cerebellum was graded as
normal, mildly decreased, or severely decreased. A marked decrease or near
absence of rCBF in the thalamus or cerebellum was considered as severely de
creased.
Results: All 36 children with BSCP had hypoperfusion in the thalamus or cer
ebellar hemispheres. Eight of 20 children (40%) with mildly decreased rCBF
on brain SPECT had mild developmental delays. On the other hand, only 1 of
16 children (6.3%) with severe hypoperfusion in the thalamus or cerebellum
had a mild developmental delay, and the remaining 15 of 16 children (93.8%)
had severe developmental delays. There was good correlation between the de
gree of developmental delay and the severity of hypoperfusion in the thalam
us or cerebellum (P = 0.023).
Conclusion: The measurement of rCBF by Tc-99m ethyl cysteinate dimer brain
SPECT appears to be valuable in prognostication of gross motor development
in children with BSCP.