Alessandro Stecco MD, Abstract Co-Author: Nothing to Disclose

Alessandro Littera, Presenter: Nothing to Disclose

Alessandra Ferrari, Abstract Co-Author: Nothing to Disclose

Carlo Civardi, Abstract Co-Author: Nothing to Disclose

Roberto Cantello, Abstract Co-Author: Nothing to Disclose

Alessandro Carriero, Abstract Co-Author: Nothing to Disclose

The aim of our study is the evaluation of the role of Perfusion CT (PCT) to monitor and study hemilateral movement disorders.

We enrolled 9 patients, aged from 40 to 70 years, 3 with hemilateral discynetic syndrome (hemichorea-hemiballismus) and 6 with hemilateral dystonic syndrome. Informed consent was given. All patients underwent dynamic perfusion CT (multi-detector row CT scanner; thick/speed 10mm, 1sec rotation time, 80 kV, 190-200 mA). 50 ml of non-ionic contrast medium (Ultravist 370 mg/ml) were injected in the antecubital vein, and 200 images were acquired with CINE mode through a transverse plain including the basal ganglia. Our hypotesis was that hemilateral movement disorders should present with differences in perfusion parameters between the two sides; so we compared mean Cerebral Blood Flow (CBF), Cerebral Blood Volume (CBV) and Mean Transit Time (MTT) by positioning small circular ROIs on order of 5-7 mm² at the level of putamen (6 ROIs), the head of caudate nucleus (4 ROIs), and talamus (4 ROIs). Statistical analysis of the differeces was conducted by mean of a two tailed t-test.

We analyzed the difference between the two sides, considering the contralateral side to the pathologic movements as the pathological one. One of our patients moved during the CTP examination, and was therefore excluded. On a total of 8 patients 6 over 8 (75%) presented hypoperfusion at the level of the head of caudate nucleus, 2 (25%) no differences between the two sides; 3 over 8 (37,5%) presented hyperperfusion, 1 (12,5%) hypoperfusion and 4 (50%) no differences at the level of putamen; 3 over 8 hypoperfusion (37,5%), 3 (37,5%) hyperperfusion, and 2 (25%) no difference at the lavel of talamus. Statistical analysis showed no significancy for the evidenced perfusion differences.

We conclude that CTP could result as an interesting new method to analyze and evalue patients with hemilateral movement disorders, giving in particular informations about the functional status of the basal ganglia, showing directly their asymmetrical perfusion.

Stecco, A, Littera, A, Ferrari, A, Civardi, C, Cantello, R, Carriero, A, CT Perfusion (CTP) in the Evaluation of Basal Ganglia Perfusion in Patients Affected by Movement Disorders.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4405986.html