Diagnostic value of cerebral perfusion SPECT/CT combined with brain MRI in patients with ischemic cerebrovascular disease

Abstract

Objective To evaluate the diagnostic value of cerebral perfusion SPECT/CT combined with brain MRI in patients with ischemic cerebrovascular disease. Methods A total of 107 cases with ischemic cerebrovascular disease from August 2011 to August 2013 (71 males, 36 females, age: 33-84 years) were retrospectively studied, including 31 cases with transient ischemic attack, 40 cases with the first onset of cerebral infarction, 36 cases with recurrent cerebral infarction. 99Tcm-ECD SPECT/CT and brain MRI were performed within 7 d after attack. The interval between the two scans was within 5 d. The number of lesions and detection rate by SPECT/CT, SPECT, MRI, CT, and their combination were calculated respectively, and analyzed using χ2 test. Results The detection rate was: SPECT/CT+ MRI (97.20%, 104/107)=SPECT+ MRI (97.2%, 104/107) >SPECT/CT (95.33%, 102/107)>SPECT (90.65%, 97/107)>MRI (85.05%, 91/107)>CT (65.42%, 70/107). No statistically significant difference was observed between the detection rate of SPECT/CT+ MRI and SPECT+ MRI, SPECT/CT (χ2=0.17, 0.13; both P>0.05), while there was statistically significant difference between SPECT/CT+ MRI and SPECT, MRI, or CT (χ2=4.01, 9.76, 35.50; all P<0.05). SPECT/CT detected more ischemic lesions located in brain gray matter and revealed crossed cerebellar diaschisis, while MRI was better for detecting small lacunar lesions in basal ganglia, brainstem and deep white matter. Conclusions SPECT/CT is valuable for the detection of ischemic cerebrovascular disease. Improved assessment may be achieved by the combination of SPECT/CT and MRI. Key words: Brain ischemia; Brain infarction; Tomography, emission-computed, single-photon; Tomography, X-ray computed; Magnetic resonance imaging; ECD