Tc-99(m)-HMPAO brain SPET in patients with pseudotumour cerebri

The aim of this study was to look for regional cerebral blood flow (rCBF) abnormalities in patients with a recent diagnosis of pseudotumour cerebri (PTC) and to compare Tc-99(m)-hexamethylpropylene amine oxime (Tc-99(m)-HMPAO) cerebral single photon emission tomographic (SPET) findings with those of X-ray computed tomography (CT) and magnetic resonance imaging (MRI). Seventeen consecutive patients aged 14-50 years (mean = 29 years) without previous drug treatment for PTC underwent Tc-99(m)-HMPAO SPET, cranial CT and MRI studies. No patient had evidence of intracranial mass lesions on the CT or MRI scans. Qualitative analysis of the Tc-99(m)-HMPAO SPET studies revealed impaired rCBF in nine (53%) patients. The CT and MRI studies revealed an empty sella in two patients, dural sinus thrombosis in one and a slit ventricle in another. Eight of the 13 patients with normal CT and MRI results had rCBF abnormalities. In contrast, three patients with CT and MRI abnormalities had a normal Tc-99(m)-HMPAO scan. Our results suggest that patients with PTC have functional abnormalities that are revealed by Tc-99(m)-HMPAO brain SPET.