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Titolo:
Embolic distribution through patent foramen ovate demonstrated by Tc-99m-MAA brain SPECT after valsalva radionuclide venography
Autore:
Hayashida, K; Fukuchi, K; Inubushi, M; Kukushima, K; Imakita, S; Kimura, K;
Indirizzi:
Natl Cardiovasc Ctr, Dept Radiol, Suita, Osaka 5658565, Japan Natl Cardiovasc Ctr Suita Osaka Japan 5658565 Suita, Osaka 5658565, Japan Natl Cardiovasc Ctr, Dept Med, Suita, Osaka 5658565, Japan Natl CardiovascCtr Suita Osaka Japan 5658565 Suita, Osaka 5658565, Japan
Titolo Testata:
JOURNAL OF NUCLEAR MEDICINE
fascicolo: 6, volume: 42, anno: 2001,
pagine: 859 - 863
SICI:
0161-5505(200106)42:6<859:EDTPFO>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
CEREBRAL BLOOD-FLOW; ATRIAL SEPTAL ANEURYSM; ISCHEMIC STROKE; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; PARADOXICAL EMBOLISM; CRYPTOGENIC STROKE; OVALE; RISK; TOMOGRAPHY; PREVALENCE;
Keywords:
cerebral embolism; patent foramen ovale; radionuclide venography; Tc-99m-microaggregated albumin; brain SPECT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Hayashida, K Natl Cardiovasc Ctr, Dept Radiol, 5-7-1 Fujishirodai, Suita, Osaka 5658565, Japan Natl Cardiovasc Ctr 5-7-1 Fujishirodai Suita Osaka Japan 5658565
Citazione:
K. Hayashida et al., "Embolic distribution through patent foramen ovate demonstrated by Tc-99m-MAA brain SPECT after valsalva radionuclide venography", J NUCL MED, 42(6), 2001, pp. 859-863

Abstract

Cryptogenic stroke might relate to paradoxical embolism stemming from right-to-left shunt caused by patent foramen ovate (PFO). We performed radionuclide venography using the Valsalva maneuver, followed by (99)mTc-macroaggregated albumin (MAA) brain SPECT to investigate the fate of emboli originating from the lower extremities. Methods: Ten patients (9 men, 1 woman; mean age, 61 +/- 17 y) with PFO underwent radionuclide venography with and without the Valsalva maneuver on the whole-body image, followed by brain SPECT with Tc-99m-MAA to determine the cortical uptake that would detect right-to-left shunt. After counts in each region of interest (ROI) were normalized by comparison with the averaged count, the distribution of MAA was compared with that of Tc-99m-hexamethyl-propylene-amine oxime (HMPAO) brain SPECT bydrawing ROIs on frontal, temporoparietal (anterior circulation territory),occipital, and cerebellar areas (posterior circulation territory). Results: The thyroid on the whole-body scan was visualized after the Valsalva maneuver in 2 of the 10 patients. In 7 of 10 patients, 56 ROIs in the visualized cortical uptake showed that the distribution of MAA correlated well with that of HMPAO according to the equation: HMPAO = -71.21 + 1.71 x MAA, (r = 0.575, P < 0.01). The excess difference in the relative counts in the posterior over anterior circulation territory was 5.6% and 16.1% of the HMPAO and MAA values, respectively. Conclusion: Brain SPECT with Tc-99m-MAA was more sensitive than thyroid visualization in detecting right-to-left shunt. The excess flow in the posterior cerebral circulation indicated an increased likelihood of cerebral emboli originating from the lower extremities and indicated that the flow difference between HMPAO and MAA probably resulted from poor linearization of HMPAO in the high-flow area.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/03/20 alle ore 12:40:02