Patterns of single photon emission tomography (SPECT) among patients with dementia in the memory clinic at Siriraj Hospital.

OBJECTIVE: The authors hypothesized that there is a pattern difference in cerebralperfusion of the 99-Technitium L, L-ethyl cysteinate dimer Single Photon Emission Computer Tomography (99-Tc ECD SPECT) between mild and moderate to severe dementia. MATERIAL AND METHOD: The authors reported a retrospective study in the Memory Clinic, Siriraj Hospital between January 2001 and October 2003 including only patients with Alzheimer's disease, vascular dementia, and mixed dementia. Clinical dementia rating (CDR) was used to document dementia severity. Patterns of hypoperfusion were classified into no definite hypoperfusion, regional hypoperfusion, and diffused hypoperfusion. RESULTS: One hundred and seven patients were included in the present study. Only mean Thai Mental State Examination (TMSE) score was different between the two groups. There was no significant correlation between pattern of hypoperfusion in brain SPECT and severity of dementia. CONCLUSION: The authors cannot demonstrate the pattern of hypoperfusion of 99-Tc ECD SPECT among patients' difference in dementia severity.

SPECT as an aid for clinicians in the diagnosis of alzheimer's disease: A case report and review of current diagnostic approaches and the need forearly accurate diagnosis to optimize treatment.

A case of 66 year-old male with Alzheimer's dementia with classical 99mTc-ECD SPECT imaging findings is reported. The history, physical examination, and investigation, are described. Biological markers which are new used for the diagnosis of Alzheimer's dementia and current treatment are discussed.

Superior mesenteric artery aneurysm: A report of two cases.

Two cases of superior mesenteric artery (SMA) aneurysm were reported; one with atherosclerosis and the other was mycotic in origin. Preoperative investigations included plain radiography, ultrasonography, computed tomography with contrast injection, angiography and nuclearscanning. SMA aneurysm was then diagnosed and the patient underwent operation. Results of the operations were satisfactory. It is suggested that early and correct diagnosis is critical in minimizing morbidity and mortality in the patients with SMA aneurysm.

Perchlorate discharge test.

A variety of perchlorate discharge techniques was performed and the criteria for interpretation varied according to the techniques employed. The modified technique, 10 microcurrie of Na131 I was injected into the patient with a 10 minute serial recording for 1 hour ; KC 104 300 mg/25 ml was given orally and continued with 10 minute serial recording for 30 minutes. This technique can identify the iodide transport defect and organic binding defect of the thyroid gland, and trapping function of the gland. In 25 mormal subjects, the thyroid131 I- content increased during a 60 minute serial recording and after KC 104 was given. The discharge observed during 90 minutes ranged from 1% to (- 55.7%). The range at the 20 – minute uptake is from 4.70% to 11.66% (X ฑ 2 SD). In 15 patients, 3 patients had iodide transport defect, 9 patients organic binding detect, while such defects could not be found for the remaining patients. However, it is possible that the remaining three may have other kinds of defects such as iodotyrosine coupling defect, iodotyrosine dehalogenase defect or abnormal secretion of iodoprotein.

Thallium scan in patients with coronary artery disease: A preliminary report.

Exercise thallium studies of forty-eight patients performed to evaluate coronary artery disease were reviewed. The results of the exercise thallium studies were compared to those of exercise ECG tests done simultaneously, and coronary arteriography performed 2 weeks to more than one year after. The sensitivity and specificity of exercise thallium study were 81.8 and 100 percent whereas those of exercise ECG test were 81.8 and 50 percent, respectively. Sites of abnormalities detected by coronary arteriography correlated with 77.8 percent of thallium studies, but 44.4 percent of exercise ECG tests. The results of exercise thallium studies and exercise ECG tests agreed in 81.3 percent of patients. Exercise thallium study is sensitive and specific and has good correlation with coronary arteriography. It is useful in detection of coronary artery disease, evaluation of extent of the diseased myocardium as well as potency of coronary artery bypass graft.