scholarly journals Use of single photon emission computed tomography (SPECT) in the follow-up of carbon monoxide poisoned patients treated with HBO therapy: a case report

Critical Care ◽  
10.1186/cc202 ◽  
1998 ◽  
Vol 2 (Suppl 1) ◽  
pp. P072
Author(s):  
M Maione ◽  
L Socciarelli ◽  
S Falini ◽  
G Scalmani ◽  
G Poggi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Carbon Monoxide ◽  
Case Report ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Single Photon Emission ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

Contribution of Single-Photon Emission Computed Tomography in the Diagnosis and Follow-Up of CNS Toxicity of a Cytarabine-Containing Regimen in Pediatric Leukemia

1999 ◽  
Vol 17 (9) ◽  
pp. 2804-2804 ◽  
Author(s):  
Pierre Véra ◽  
Pierre Rohrlich ◽  
Jean Louis Stiévenart ◽  
Monique Elmaleh ◽  
Michel Duval ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Single Photon ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
High Dose ◽  
Single Photon Emission ◽  
Mri Scans ◽  
Single Photon Emission Computed ◽  
Photon Emission Computed Tomography

PURPOSE: Cytarabine (ara-C) is one of the most effective chemotherapeutic agents in patients with acute leukemia (AL), with a clear dose effect. Use of high-dose ara-C is hampered, however, by a noticeable toxicity, particularly to the CNS. We investigated the usefulness of CNS perfusion imaging with technetium-99m (99mTc)-hexamethyl-propylene-amine oxime (HMPAO) single-photon emission computed tomography (SPECT) concurrent to magnetic resonance imaging (MRI) to specifically assess the effects of standard- and high-dose ara-C in children with AL. PATIENTS AND METHODS: Twenty-six perfusion studies using 99mTc-HMPAO SPECT were performed in 12 children (age range, 4 to 15 years) with AL after induction therapy, which consisted of a standard-dose ara-C, immediately after consolidation with high-dose ara-C, and later during follow-up (range, 6 to 44 months). The chemotherapy-related adverse events were monitored and correlated to SPECT and MRI. RESULTS: After the induction phase, all children were neurologically normal on MRI. On SPECT imaging, four children displayed a slightly heterogeneous perfusion. After high-dose ara-C (4 to 36 g/m2), five children had regressive neurologic signs of potential toxic origin. Of these five children, only one had an abnormal MRI scan, whereas all patients showed evidence of diffuse cerebral and/or cerebellar heterogeneous perfusion on SPECT. The seven other patients without any neurologic symptoms had normal MRI scans; SPECT was normal for three patients and abnormal for four patients. On follow-up, for four children who had presented with clinical neurologic toxicity, SPECT improved in three patients and remained unchanged in one patients. In two of these four children, delayed abnormalities (T2 white matter hypersignal and cerebellar atrophy) appeared on MRI scans. CONCLUSION: In our series, diffuse heterogeneous brain hypoperfusion is often the sole early objective imaging feature identified by SPECT of high-dose ara-C neurotoxicity, where MRI still demonstrates normal pictures.

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