Combined Radionuclide Circulation and Static Imaging of the Brain

Summary

Combined static and dynamic imaging of the brain was performed in 398 patients with suspected space occupying lesions. The imaging findings were analyzed from two points of view: Firstly, the radionuclide results were compared with pathological anatomical findings and, secondly, the diagnostic yield in patients with various symptoms was evaluated. Thus we obtained the number of false positive and false negative results. The findings of the combined imaging procedure were correctly negative in 85% of the patients with non-focal symptoms and false positive in only 1%. The circulation study alone gave false positive results in 7% and so did the static study alone. The combined imaging procedure was pathologic in 46 of 83 cases of space-occupying lesions (55%). There were only three patients in whom a pathologic circulation study was the only indication of a space-occupying lesion (4%). The static study alone gave correct positive findings in 23 more cases (28%). We conclude that a pathologic blood flow study alone is of limited interest. In the presence of a pathologic static study the circulation procedure gives additional information, especially in meningioma and subdural hematoma. In patients with symptoms indicative of supratentorial space- occupying lesions of the brain combined imaging is recommended.

Zusammenfassung

Eine kombinierte statische und dynamische Radionukliduntersuchung des Gehirns wurde bei 398 Patienten mit dem Verdacht auf einen raumfordernden Prozeß durchgeführt. Die erhaltenen Resultate wurden teilweise mit den pathologisch-anatomischen Befunden und teilweise mit den klinischen Daten verglichen. An Hand dieser Daten konnten die Ergebnisse auch in falsch negative und falsch positive eingeteilt werden. Die kombinierte Untersuchungsmethode war in 85% korrekt negativ bei Patienten ohne fokale Symptome, und falsch positiv in nur 1%. Die Zirkulationsstudie und die statische Untersuchung waren in je 7% falsch pathologisch. Bei 46 von 83 Patienten mit einem raumfordernden Hirnprozeß war die kombinierte Untersuchung pathologisch (55%). In nur drei Fällen (4%) war die Zirkulationsstudie und in 28% war die statische Untersuchung verändert und damit der alleinige Hinweis auf einen expansiven Hirnprozeß. Unsere Resultate sprechen dafür, daß eine pathologische Zirkulationsstudie allein wenig Information enthält. Beim Meningeom und subduralem Hämatom gibt die Zirkulationsstudie jedoch eine zusätzliche Information, falls die statische Untersuchung pathologisch ist. Die kombinierte Radionukliduntersuchung kann bei Patienten mit Verdacht auf supra- tentorielle raumfordernde Hirnprozesse empfohlen werden.

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