期刊
JOURNAL OF THE NEUROLOGICAL SCIENCES
卷 442, 期 -, 页码 -出版社
ELSEVIER
DOI: 10.1016/j.jns.2022.120441
关键词
Reversible cerebral vasoconstriction syndrome; Blood -brain barrier; emission computed tomography; Blood-brain barrier; 99mTc-ethyl cysteinate dimer single-photon
This study investigated the application of 99mTc-ECD SPECT in the course of RCVS, showing that reduced cerebral uptake persisted in the late stage even after vasoconstriction and headache subsided. BBB breakdown and/or brain tissue damage may underlie this phenomenon, indicating 99mTc-ECD SPECT as an effective neuroimaging method to detect brain functional abnormalities throughout the treatment course of RCVS.
Background: Blood-brain barrier (BBB) breakdown is considered a key step in the pathophysiology of reversible cerebral vasoconstriction syndrome (RCVS); however, its temporal course remains unclear. Based on the characteristics and dynamics of 99mTc-ethyl cysteinate dimer (99mTc-ECD) as a tracer, 99mTc-ECD single-photon emission computed tomography (SPECT) can detect not only hypoperfusion but also BBB breakdown and/or brain tissue damage. Therefore, this study aimed to investigate this course using 99mTc-ECD SPECT. Methods: Between 2011 and 2019, we enrolled seven patients (one male and six female patients) with RCVS without ischemic or hemorrhagic stroke or posterior reversible encephalopathy syndrome. 99mTc-ECD SPECT was performed repeatedly in each patient. SPECT data were statistically analyzed using an easy Z-score imaging system. Results: Thunderclap headache was the initial symptom in all the patients and was most commonly triggered by bathing (three patients). All the patients exhibited vasoconstriction and reduced cerebral uptake of 99mTc-ECD during the acute stage. Follow-up assessment from 3 to 16 months showed that reduced cerebral uptake persisted in all the patients, even after the vasoconstriction had resolved. Conclusion: Reduced cerebral uptake of 99mTc-ECD persisted in the late stage of RCVS, even after vasoconstriction and headache subsided. BBB breakdown and/or brain tissue damage may underlie this phenomenon. 99mTc-ECD SPECT is an effective neuroimaging method to detect brain functional abnormalities, reflecting BBB breakdown or tissue damages, throughout the treatment course of RCVS.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据