SPET brain imaging with 201 diethyldithiocarbamate in acute ischaemic stroke
Thirty-five patients with acute ischaemic stroke were studied within 24 h after hospital admission with thallium 201 diethyldithiocarbamate single photon emission tomography (201TI-DDC SPET) and X-ray computed tomography (CT).201TI-DDC is a non-redistributing agent that allows postponed imaging after early administration and early therapeutic intervention. In 16 patients both investigations were performed within 24 h after stroke onset. The sensitivity of SPET was 94% and of CT 81 % in the first 24 h, when hypodensity and obliteration of sulci were used as CT reading criteria. When only hypodensity was used as a criterion, the sensitivity of CT was 50% in this group. Sensitivity of CT compared with SPET became increasingly better in patients with older infarcts (1–18 days). In two-thirds of patients, the lesion demonstrated on SPET was larger than that on CT, and this was especially so with older infarcts. Crossed cerebellar diaschisis occurred in 69% of patients. The high sensitivity of201TI-DDC SPET in the first 24 h after ischaemic stroke and the favourable properties of this radiopharmaceutical make it a method of interest in the assessment of initial perfusion defects in early experimental stroke therapies.