Karabacak N I, Ozturk G, Gucuyener K, Gokcora N, Gursel T
Department of Nuclear Medicine, Gazi University Medical School, Ankara, Turkey.
Childs Nerv Syst. 1997 Oct;13(10):560-2. doi: 10.1007/s003810050138.
Chemotherapy of the central nervous system may cause neurotoxicity in children with acute lymphocytic leukemia. We evaluated regional blood flow in a 6-year-old child presenting with akinetic mutism, using 99mTc-HMPAO single photon emission tomography (SPECT) following high-dose intravenous methotrexate therapy. While findings in X-ray computerized tomography were decreased density in bilateral basal ganglia and thalamic nuclei with diffusely decreased attenuation of the periventricular white matter, a global, frontal dominant profoundly abnormal perfusion pattern involving both gray and white matter was observed in the SPECT study. Treatment of the central nervous system with high dose intravenous chemotherapy may cause profound abnormalities in white and gray matter blood flow and early assessment of the neurotoxicity may be identified by 99mTc-HMPAO SPECT in the pediatric age group.
中枢神经系统化疗可能会导致急性淋巴细胞白血病患儿出现神经毒性。我们对一名6岁的运动不能性缄默症患儿进行了评估，在大剂量静脉注射甲氨蝶呤治疗后，使用99mTc-HMPAO单光子发射断层扫描（SPECT）来检测局部脑血流。X线计算机断层扫描结果显示双侧基底神经节和丘脑核密度降低，脑室周围白质弥漫性衰减降低，而SPECT研究中观察到一种累及灰质和白质的、以额叶为主的广泛性灌注模式明显异常。大剂量静脉化疗治疗中枢神经系统可能会导致白质和灰质血流出现严重异常，在儿童年龄组中，99mTc-HMPAO SPECT可能有助于早期评估神经毒性。
