By G A Taylor, S T Treves
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Single photon emission computed tomography and positron emission tomography play an important role in the evaluation of the pediatric brain. These methods can depict regional cerebral perfusion and glucose metabolism and provide maps of the location, quantification, and biokinetics of specific receptors. In addition, these techniques can detect rapid changes due to normal brain activity in different functional conditions or those caused by pharmacologic or cognitive stimulation. 4 Because of its relative complexity, this method was limited to a small number of research institutes and therefore did not become widely used.
An example of SPECT recording is as follows: Using a multi-detector system, each detector rotates 360 degrees around the patient’s head. Total imaging time is approximately 20 minutes. Very young children and children who are unable or unwilling to cooperate may require sedation. Sedation may affect brain activity and is usually given after injection of the tracer. Methods There are four methods for perfusion brain SPECT: (1) a single controlled baseline study, (2) an ictal study, (3) an activation study, and (4) a split-dose study.
Hence brain SPECT offers an effective way of following the natural history of moyamoya disease, and its noninvasive nature may offer an attractive alternative to serial arteriography. 46 Once a diagnosis is suspected by CT or MRI, the next step is usually an angiogram to confirm the diagnosis and to see the anatomy of the vessels involved. Often nuclear medicine studies such as SPECT are used to demonstrate the decreased blood and oxygen supply to areas of the brain involved with moyamoya disease.