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The value of eZIS analysis of Tc-99m ECD SPECT on identifying cerebellar hypoperfusion in a patient with superficial siderosis

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: Brain perfusion single photon computed tomography (SPECT) is a functional imaging modality and has been widely utilized in evaluation of various kinds of neurological disorders. Easy z-score imaging system (eZIS) is a computer-assisted statistical analysis, based on the comparison with age-classified ethyl cysteinate dimer (ECD) normal database, which provides objectively interpretation of Tc-99m ECD brain perfusion SPECT.

Introduction:: Here we presented a 64-year-old male with dizziness, spin sensation, nausea, and vomiting in the emergency room, and brain computed tomography scan showed only small hypodensity lesion in cerebellum. Tc-99m ECD SPECT was performed for evaluating occult cerebral ischemia, infarction, and/or degeneration, but no remarkable abnormality could be identified by experienced readers on conventional display. The result of eZIS showed remarkable hypoperfusion in cerebellum and mild hypoperfusion in bilateral frontal and parietal lobes. Magnetic resonance imaging (MRI) confirmed severe atrophy of anterior cerebellar lobe. In addition, MRI showed diffuse hypointensity signals along with cerebrospinal fluid spaces, especially those areas with hypoperfusion on SPECT, compatible with typical appearances of superficial siderosis.

Conclusion:: This presented case demonstrates the value of software analysis with eZIS on enhancing the diagnostic value of brain perfusion SPECT for detecting brain lesions at an uncommon location due to a rare disease.

No MeSH data available.


Related in: MedlinePlus

Axial T2-weighted brain magnetic resonance imaging showed diffuse hypointensity signals (white arrows) along with the cerebrospinal fluid spaces, most severe in the cerebellar folia (A), and also around pons (A), higher interhemispheric fissure (B), lower interhemispheric fissure and Sylvian fissure (C), and spinal cord (D).
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Figure 3: Axial T2-weighted brain magnetic resonance imaging showed diffuse hypointensity signals (white arrows) along with the cerebrospinal fluid spaces, most severe in the cerebellar folia (A), and also around pons (A), higher interhemispheric fissure (B), lower interhemispheric fissure and Sylvian fissure (C), and spinal cord (D).

Mentions: In order to elucidate the nature of hypoperfusion abnormalities shown on SPECT, brain MRI was performed for further correlation. The T2-weighted images showed diffuse hypointensity signals along with the CSF spaces, most severe in the cerebellar folia (Fig. 3A), and also around pons (Fig. 3A), interhemispheric fissure (Fig. 3B), lower interhemispheric fissure, Sylvian fissure (Fig. 3C), and spinal cord (Fig. 3D), consistent with typical appearances of hemosiderin deposition. In addition, remarkable atrophy of anterior cerebellar lobe was noted, explaining the reason of severe hypoperfusion shown on brain SPECT. In combinations of all the clinical and imaging findings, a final diagnosis of SS was made. Because this report just reviewed previous data and did not involve any human trials, there is no need to conduct special ethic review, and the ethical approval is not necessary. Informed consent was signed by the patient for the publication of this report and its related images.


The value of eZIS analysis of Tc-99m ECD SPECT on identifying cerebellar hypoperfusion in a patient with superficial siderosis
Axial T2-weighted brain magnetic resonance imaging showed diffuse hypointensity signals (white arrows) along with the cerebrospinal fluid spaces, most severe in the cerebellar folia (A), and also around pons (A), higher interhemispheric fissure (B), lower interhemispheric fissure and Sylvian fissure (C), and spinal cord (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134873&req=5

Figure 3: Axial T2-weighted brain magnetic resonance imaging showed diffuse hypointensity signals (white arrows) along with the cerebrospinal fluid spaces, most severe in the cerebellar folia (A), and also around pons (A), higher interhemispheric fissure (B), lower interhemispheric fissure and Sylvian fissure (C), and spinal cord (D).
Mentions: In order to elucidate the nature of hypoperfusion abnormalities shown on SPECT, brain MRI was performed for further correlation. The T2-weighted images showed diffuse hypointensity signals along with the CSF spaces, most severe in the cerebellar folia (Fig. 3A), and also around pons (Fig. 3A), interhemispheric fissure (Fig. 3B), lower interhemispheric fissure, Sylvian fissure (Fig. 3C), and spinal cord (Fig. 3D), consistent with typical appearances of hemosiderin deposition. In addition, remarkable atrophy of anterior cerebellar lobe was noted, explaining the reason of severe hypoperfusion shown on brain SPECT. In combinations of all the clinical and imaging findings, a final diagnosis of SS was made. Because this report just reviewed previous data and did not involve any human trials, there is no need to conduct special ethic review, and the ethical approval is not necessary. Informed consent was signed by the patient for the publication of this report and its related images.

View Article: PubMed Central - PubMed

ABSTRACT

Introduction:: Brain perfusion single photon computed tomography (SPECT) is a functional imaging modality and has been widely utilized in evaluation of various kinds of neurological disorders. Easy z-score imaging system (eZIS) is a computer-assisted statistical analysis, based on the comparison with age-classified ethyl cysteinate dimer (ECD) normal database, which provides objectively interpretation of Tc-99m ECD brain perfusion SPECT.

Introduction:: Here we presented a 64-year-old male with dizziness, spin sensation, nausea, and vomiting in the emergency room, and brain computed tomography scan showed only small hypodensity lesion in cerebellum. Tc-99m ECD SPECT was performed for evaluating occult cerebral ischemia, infarction, and/or degeneration, but no remarkable abnormality could be identified by experienced readers on conventional display. The result of eZIS showed remarkable hypoperfusion in cerebellum and mild hypoperfusion in bilateral frontal and parietal lobes. Magnetic resonance imaging (MRI) confirmed severe atrophy of anterior cerebellar lobe. In addition, MRI showed diffuse hypointensity signals along with cerebrospinal fluid spaces, especially those areas with hypoperfusion on SPECT, compatible with typical appearances of superficial siderosis.

Conclusion:: This presented case demonstrates the value of software analysis with eZIS on enhancing the diagnostic value of brain perfusion SPECT for detecting brain lesions at an uncommon location due to a rare disease.

No MeSH data available.


Related in: MedlinePlus