Brain single photon emission computed tomography at term age for predicting cerebral palsy after preterm birth

in order to assess the predictive value of neonatal brain perfusion with si ngle photon emission computed tomography (SPET) with regard to neuromotor o utcome at a corrected age of 18 months, 34 infants with birth weight <1,500 g and gestation age <34 weeks underwent brain technetium-99m ethylcysteina te dimer (Tc-99(m)-ECD) SPET at term age. The perfusion defects were estima ted by visual interpretation. Consecutive semiquantitative assessment was m ade in 26 cases and reference values for the tracer were collected from ima ges of 17 preterm infants with normal outcome after the follow-up period. R elative regional cortical (frontal, sensorimotor, parietal and occipital), cerebellar and thalamic perfusion levels were evaluated in middle sagittal slices and hemispheric asymmetries in transaxial slices. Perfusion defects predicted cerebral palsy (CP) (n = 11) with 82% sensitivity, 70% specificit y a nd 74% accuracy, the corresponding figures for ultrasound (US) being 73 , 83 and 79%, respectively. The sensitivity of SPET in predicting moderate or severe CP (n = 7) was 100% and the specificity 67%, the corresponding fi gures for US being 71% and 74%, respectively. Brain SPET seems to identify the most severe forms of CP in preterm infants very well at term age, but c annot identify all mild ones. In addition to a low specificity, the radiati on exposure restricts usefulness of the method for clinical purposes. Copyr ight (C) 2001 S. Karger AG, Basel.