[abstract] 18F-DEXOYGLUCOSE POSITRON EMISSION TOMOGRAPHY (PET) IN THE EVALUATION OF NEUROLOGICAL DECOMPRESSION ILLNESS

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[abstract] 18F-DEXOYGLUCOSE POSITRON EMISSION TOMOGRAPHY (PET) IN THE EVALUATION OF NEUROLOGICAL DECOMPRESSION ILLNESS

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Title: [abstract] 18F-DEXOYGLUCOSE POSITRON EMISSION TOMOGRAPHY (PET) IN THE EVALUATION OF NEUROLOGICAL DECOMPRESSION ILLNESS
Author: Moon, RE; Hoffman, JM; Hanson, MW; Reiman, RE; Coleman, RE; Theil, DR; Fawcett, TA; Fracica, PJ; Gorback, MS; Massey, EW
Abstract: Advanced imaging techniques may demonstrate structural (CT, MRI), perfusion (Xe-enhanced CT, SPECT [single photon emission computed tomography]) or metabolic abnormalities (PET) in patients with decompression illness (DCI). Studies using SPECT have suggested cerebral perfusion abnormalities in divers with pure spinal cord DCI. PET has a higher resolution than SPECT and is more likely to reflect abnormal cellular function. Using PET, we looked for areas of cerebral hypometabolism in divers with neurological DCI. 17 divers (11 male, 6 female) (ages 21 -46 years; mean 33.8) were evaluated. 5 patients had predominantly cortical symptoms, 7 had predominantly spinal cord symptoms, and 5 had mixed symptomatology. Median delay between accident and scan was 11 weeks (range 5 days to 340 weeks). 9/17 divers had abnormal neurological exams at the time of the scan. Scans were obtained in supine position after injection of 10 mC of 18F-DG. Using a CTI instrument, with 8.6 mm in-plane resolution, 15 image planes were obtained covering the entire intracranial contents, with 8 mm plane thickness. Scans were graded independently by two radiologists on the following scale: I-definitely normal, II-probably normal, III-equivocal, IV-probably abnormal, V-definitely abnormal. The majority (14/17) of the scans were graded normal or probably normal. TABLE: Grade, I, II, III, IV, V; Cortical abnormalities, 5, 2, 1, 1, 1; Spinal cord abnormalities only, 2, 5, 0, 0, 0; Total, 7, 7, 1, 1, 1; . A grade V scan was obtained 5 days after an accident in a diver who had profound dysphasia and hemiparesis. Another diver who complained of memory lapses and disequilibrium after an arterial gas embolism had a grade IV scan 11 weeks after the incident. We conclude that in the absence of neurological signs or symptoms, there is no significant evidence of regional cerebral hypometabolism in patients with DCI. Physical exam remains the primary diagnostic tool in identifying neurologic decompression illness.
URI: http://archive.rubicon-foundation.org/6477
Date: 1991

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  • UHMS Meeting Abstracts
    This is a collection of the published abstracts from the Undersea and Hyperbaric Medical Society (UHMS) annual meetings.

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