Dynamic single photon emission computed tomography using N-isopropyl-p-[123I]iodoamphetamine for cerebrovascular disease

Continuous sequential single photon emission computed tomography (dynamic SPECT) with N-isopropyl-p-[123I]iodoamphetamine (IMP) was perfomed in 17 patients with cerebrovascular diseases (three with transient ischemic attack, four with cerebral infarction, two with ruptured aneurysms, two with arteriovenous malformations (AVM), one with an unruptured giant aneurysm, and five with moyamoya disease). Dynamic SPECT scans were obtained with a circular-detector array emission CT instrument at a fixed level parallel to the orbitomeatal plane. The scans were taken over a 20-minute period, at 2-minute intervals, immediately after intravenous injection of IMP. Time courses of activity ratio of the affected/non-affected areas were calculated. Accumulation of IMP in ischemic areas was consistently suppressed to approximately 70 to 80% that in the non-affected areas. IMP accumulation in infarcted regions was less than 40 to 50% that in non-affected areas. In the regions of AVM and giant aneurysm, accumulation of IMP was rapid and relatively high, but its removal was prompt. Dynamic IMP SPECT appears useful in the assessment of cerebral perfusion and may have numerous applications in neurosurgery. (author)