Statistical parametric mapping in brain single photon computed emission tomography after carbon monoxide intoxication

• Published in: Nuclear medicine communications Vol. 23; no. 4; pp. 355 - 366
• Main Authors: WATANABE, N, NOHARA, S, MATSUDA, H, SUMIYA, H, NOGUCHI, K, SHIMIZU, M, TSUJI, S, KINUYA, S, SHUKE, N, YOKOYAMA, K, SETO, H
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-04-2002; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Biological and medical sciences; Brain - diagnostic imaging; Carbon Monoxide Poisoning - complications; Carbon Monoxide Poisoning - diagnostic imaging; Carbon Monoxide Poisoning - physiopathology; Carbon Monoxide Poisoning - psychology; Case-Control Studies; Cerebrovascular Circulation; Female; Humans; Image Processing, Computer-Assisted; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Mental Disorders - etiology; Middle Aged; Nervous system; Organotechnetium Compounds; Oximes; Radionuclide investigations; Radiopharmaceuticals; Retrospective Studies; Technetium Tc 99m Exametazime; Tomography, Emission-Computed, Single-Photon - methods; Tomography, Emission-Computed, Single-Photon - statistics & numerical data; Radionuclide study; Human; Mapping; Regional; Photon; Retrospective; Blood flow; Statistical parameter; Influence; Poisoning; Hemodynamics; Carbon monoxide; Diagnosis; Emission tomography
• ISSN: 0143-3636; 1473-5628
• DOI: 10.1097/00006231-200204000-00009

The purpose of this retrospective study was to assess regional cerebral blood flow in patients after carbon monoxide intoxication by using brain single photon emission computed tomography and statistical parametric mapping. Eight patients with delayed neuropsychiatric sequelae and ten patients with no neuropsychiatric symptoms after carbon monoxide intoxication were studied with brain single photon emission tomography imaging with Tc-hexamethyl-propyleneamine oxime. Forty-four control subjects were also studied. We used the adjusted regional cerebral blood flow images in relative flow distribution (normalization of global cerebral blood flow for each subject to 50 ml.100 g.min with proportional scaling) to compare these groups with statistical parametric mapping. Using this technique, significantly decreased regional cerebral blood flow was noted extensively in the bilateral frontal lobes as well as the bilateral insula and a part of the right temporal lobe in the patients with delayed neuropsychiatric sequelae as compared with normal volunteers (P< 0.005). In the patients with no neuropsychiatric symptoms, significantly decreased regional blood flow in the bilateral frontal lobes particularly on the left side was detected. There was a significantly decreased regional cerebral blood flow in the right frontal lobe and insula in the patients with delayed neuropsychiatric sequelae as compared to those with no neuropsychiatric sequelae. It is concluded that statistical parametric mapping is a useful technique for highlighting differences in regional cerebral blood flow in patients following carbon monoxide intoxication as compared with normal volunteers. The selectively reduced blood flow noted in this investigation supports the contention that the decrease following carbon monoxide intoxication may be prolonged and further worsen in the frontal lobe. In addition, the present study may help to clarify the characteristics of the pathophysiological alteration underlying delayed neuropsychiatric sequelae.