SPET brain scan with (99m)Tc-ECD and CT, MRI in traumatic brain injury with chronic symptoms.

74-76 we would like to note the importance of single photon emission tomography (SPET) as a diagnostic tool of nuclear medicine, often better than other anatomical modalities. Anatomical imaging methods , especially computerized tomography (CT) and magnetic resonance imaging (MRI) are helpful in the diagnosis of acute traumatic brain injuries (ATBI) [1]; however they are not as efficient as SPET for the diagnosis of traumatic brain injury with chronic symptoms (TBICS) [2, 3]. We have compared brain perfusion SPET and CT or MRI findings in 92 patients with a history of traumatic brain injury with chronic symptoms (THICS) followed up for more than a year. Sixty-two of our patients had a history of a mild brain disease (Group A) while the remaining 30 cases had a history of moderate to severe brain disease (Group B). The age of our patients ranged between 19-66 y, with mean age 40.55 ± 11.96 y. The mean post-traumatic period was 1.22 ± 0.43 y. In order to compare sensitivity between two of the imagining modalities, we considered possible brain locations of patients' symptoms as follows: For personality disorders the frontal lobes [4]; for dizziness and vertigo the temporal lobes [5]; for disequilibrium, the cerebellum [6]. These patients presented with various neurological signs and symptoms especially due to hypofrontality and hypotem-poralism. Brain perfusion SPET with technetium 99m-ethyl cysteinate dimer (99m Tc-ECD) and CT or MRI were obtained in all patients with a maximal interval of one month between the two last procedures. The brain was divided into ten areas including five regions in each hemisphere. Our findings showed that brain perfusion SPET revealed more lesions than CT and/or MRI (50% vs. 42.3%) out of a total of 920 brain regions, P<0.05 (Table 1). In both groups (A, B) more abnormal findings were seen in the SPET scan vs the CT scan and/or MRI imaging. In 63 patients with both MRI and CT tests, 22 (34.9%) and 27(42.85%) cases demonstrated abnormal findings in CT and MRI respectively. The SPET showed a significantly higher number of perfusion abnormalities in patients with personality disorders, dizziness and vertigo and also disequilibrium compared with anatomical imaging in patients with these symptoms (P<0.05; Table 2). According to the present study, in a significant percentage of patients with ATBI, additional information could be provided by SPET, and this may result in changes in their clinical management. Also, SPET brain perfusion imaging in …