Early serial SPET in acute middle cerebral artery infarction

The size and severity of perfusion defects in acute cerebral ischaemia on s ingle photon emission tomographic (SPET) images may provide useful informat ion regarding long-term (>3 month) stroke outcome. A decreased predictive v alue has been reported with delayed SPET more than 24 h after stroke onset. We examined 20 patients with acute middle cerebral artery (MCA) infarction s using serial Tc-99(m)-ECD or Tc-99(m)-HMPAO SPET (SPET 1 one day and SPET 2 three days after stroke onset). Neurological (NIH, SSS) and functional ( Barthel Rankin) scores were calculated simultaneously and 3 months poststro ke. The two SPET scans correlated equally well with the severity of functio nal and neurological deficits evaluated 3 months after stroke onset. In com parison to clinical assessment, the prognostic value of SPET was relatively better on the first day than the third day. Crossed cerebellar diaschisis correlated with early SPET deficits, but did not predict functional outcome . Our results suggest that SPET, either with Tc-99(m)-ECD or Tc-99(m)-HMPAO , can be used to predict stroke outcome in acute MCA infarction up to 72 h poststroke without significant interference from luxury perfusion. ((C) 200 0 Lippincott Williams & Wilkins).