rCBF

Question 1

RP
Dose
Admin
TTI

Answer 1

20 - 30 mCi Tc99m HMPAO & ECD
IV
Wait 90 minutes to image

Question 2

Indications

Answer 2

Evaluate convulsive disorders
Evaluate neuropsychiatric disorders
Assess cognitive function
Evaluate cerebral ischemia or infarct

Question 3

Contraindications

Answer 3

Patient is too agitated

DC benzodiazabines, vasodilators, vasoconstrictors, ACE

Question 4

Patient Prep

Answer 4

DC benzo, vasodilator/constrictor, ACE
No caffeine, nicotine, alcohol x 24 hrs
Patient must be in quiet room

Question 5

Positioning

Images

Answer 5

Supine with head in head lock
Head first
Shoulders are limiting factor - arms down
NO MOVEMENT IN ANY DIRECTION
SPECT 360

Question 6

Target Organ
Critical Organ
Route of Excretion
Localization

Answer 6

Target: Brain - grey matter
Critical: Brain and bladder
Excretion: Urinary
Localization: Compartmentalization

Question 7

Procedure

Answer 7

Ictal imaging - Inject post seizure wait 90 minutes to image
Inter-ictal imaging - Inject and wait 90 minutes (low light)
After both ictal and inter-ictal we can subtract images to show perfusion abnormalities

Question 8

Diamox

Answer 8

Pharmacological stressor - Vasodilator
Dose: 1 g over 2 min IV
Wait 20 minutes and inject RP
Baseline done on separate day

Question 9

Computer Set Up

Answer 9

128 x 128 with 1.3 - 1.5 zoom 
LEHR
Elliptical 360 SPECT
20 - 40 seconds/stop
64 stops
Get sagittals, coronals and transaxials

Question 10

Processing

Answer 10

gamma.wustl.edu
Extra temporal lobe epilepsy
More grey than white matter
Electrotherapy treatment
occipital - visual stimulus
Rt frontal lobe more than Lt

Question 11

Labels

Answer 11

Name
DOB
MRN
Date of exam
Hospital
Referring physician
Dose
Dose rate
Frame rate
View ID
Right / Left
Tech initials