CEREBRAL PALSY � COMPARISON OF DYNAMIC SUSCEPTIBILITY CONTRAST ENHANCED MRI PERFUSION IMAGING AND SPECT PERFUSION IMAGING

Dr. Gurdarshdeep Singh Madan; Col Giriraj Singh; Dr K S Rana; Brig MJ Jacob

Volume : VII, Issue : I, January - 2017

CEREBRAL PALSY � COMPARISON OF DYNAMIC SUSCEPTIBILITY CONTRAST ENHANCED MRI PERFUSION IMAGING AND SPECT PERFUSION IMAGING

Dr. Gurdarshdeep Singh Madan, Col Giriraj Singh, Dr K S Rana, Brig Mj Jacob

Abstract :

Cereal Palsy is a static encephalopathy with prenatal, perinatal and post natal hypoxic ain injury being its major causes. The morphological abnormalities in Cereal Palsy are well documented. Fifty five patients (36 males, 19 females; age range: 1 yr – 13 yrs 8 months) with clinically diagnosed cereal palsy were evaluated by Single–photon emission computed tomography (SPECT) after giving 5–10 mCi of ^99mTc –ECD intravenously and evaluated using a low energy – high resolution gamma camera and T2* T2* Dynamic Susceptibility Contrast Enhanced MRI (DSC MRI) with SE Echo Planar Imaging sequence after injecting 0.2 mmol/kg bodyweight of Gadolinium based contrast. The clinical subtypes were spastic quadriplegia (n =28, 50.9%), spastic diplegia (n=16, 29.1%), spastic hemiplegia (n=6, 10.1%), mixed CP( n=2), hypotonic, extrapyramidal and ataxic CP (n=1). On SPECT, hypoperfusion was noted in frontal lobe in 81.5%, followed by temporal (62.9%), basal ganglia (29.6%), occipital (25.6%), thalamus ( 22.2%), cerebellum (3.7%). However, DSC MRI demonstrated hypoperfusion in frontal lobe in 78.8%, followed by parietal (75%), temporal (63.5%), basal ganglia (34.6%), thalamus (30.8%) and occipital (21.2%). The comparison of two modalities show good agreement with kappa values as measure of agreement varying from 0.371 to 0.805 and p values varying from 0.006 to <0.001.