Brain scintigraphy with Tc99-pertechnetate in the evaluation of patients with cerebrovascular lesions

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Abstract
Brain scintigraphy with 99mTc-pertechnetate (99mTc-scan) was performed 4 times in 95 consecutive stroke patients: on average 5 days, 18 days, 103 days and 194 days after the stroke. The type (infarct, hematoma), size and localization of the lesion were evaluated by CT-scan performed 3 times in all: on average 3 days, 18 days and 207 days after the stroke. The detection rate of 99mTc-scan was 31% on day 5, 47% on day 18, 18% on day 103 and 9% on day 194. The detection rate was highly dependent upon: the localization of the lesion, i.e., superficially localized lesions were nearly always identified (90%), while infarcts localized deep in the hemisphere were identified in only 20% of the patients; the size of the lesion, i.e., large deep infarcts were seen with a much higher frequency than small deep infarcts. The detection rate of the CT-scan was practically not dependent upon the time of investigation: 63% on day 3, 70% on day 18, 69% on day 207. The detection rate of the 99mTc-scan and CT-scan was nearly identical for large superficially localized lesions 2-3 wk after the stroke. In this period, however, CT-scan identified 30 deep infarcts. Only 12 of these were identified by 99mTc-scan.