Middle cerebral artery infarct demonstrated on bone scintigraphy

Crawshaw, James; Allan, Richard B.

doi:10.1007/s00259-006-0181-8

Cited by 1 publication

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“…Incidental cerebral uptake of bone imaging agents has been found in 0.17% of bone scans and in most cases is the result of intracranial malignancy (2). Extra-osseous uptake of bone imaging agents in cerebral infarction has been reported sporadically (3)(4)(5)(6)(7)(8). A breakdown in the normal blood-brain barrier results in abnormal ionic calcium flux into the cells following altered cell membrane integrity leading to precipitation of calcium salts which eventually binds to 99m Tc-phosphate.…”

Section: Discussionmentioning

confidence: 99%

“…There has been no literature describing in detail the critical period of the appearance and the disappearance of bone seeking tracer accumulation in cerebral infarct. Short interval follow-up exams using bone imaging tracer are difficult in practice, whereas bone scintigraphy can probably demonstrate cerebral infarcts as increased uptake in acute or subacute phase (within 18 days of onset) and as normalized one in chronic phase (after the 6th week of onset) based on previous case reports (3)(4)(5)(6)(7)(8).…”

Section: Discussionmentioning

confidence: 99%

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Embolic infarction followed by serial bone SPECT and MR fusion images -the door to SPECT/MR-

et al. 2010

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We recently experienced a case of cerebral infarction incidentally found by whole body bone scintigraphy for the detection of bone metastasis from renal cell carcinoma. Additional bone SPECT and brain MR fusion images clearly demonstrated the wedge-shaped uptake of tracer corresponded to the abnormal intensity reflecting subacute cerebral infarction. Follow-up bone scan and fused images with MRI showed complete resolution of the abnormal uptake in chronic phase. A breakdown in the normal blood-brain barrier results in abnormal ionic calcium flux into the cells following altered cell membrane integrity leading to precipitation of calcium salts which eventually binds to bone imaging tracer such as (99m)Tc-methylene diphosphonate. That is, increased accumulation of bone seeking agents represents lethal cell death. The recent development of software and hardware has enabled the fusion of functional and anatomic images. Image fusion between SPECT with various tracers and MRI is expected to provide clues as to the underlying cause of diseases and to decide our treatment planning in the near future.

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