Technetium-99m ECD Brain Single Photon Emission Computed Tomography in a Patient with Delayed Neurological Sequelae after Carbon Monoxide Poisoning

Single photon emission computed tomography (SPECT) with technetium-99m ethyl cysteinate dimmer ((superscript 99m)Tc-ECD) performed in a 45-year-old male patient with delayed neurological sequelae after carbon monoxide (CC) poisoning about one month after anoxic insult. The initial brain SPECT at delayed onset of neuropsychiatric symptoms showed high-grade hypoperfusion images throughout the cerebral cortex. The follow- up SPECT examination performed 3 months after initial scan showed the diffuse hypoperfusion images had become lighter but remained to a degree in bilateral frontal lobes, paralleled by clinical outcome. Any change in cerebral blood flow was correlated with clinical or brain CT or MRI evidence of delayed deficits in this case. The high utility of SPECT brain imaging in determining the diagnosis or prognosis of CO poisoning was discussed in comparison with brain CT or MRI findings.