Prognostication of Recovery in Patients With Acute Ischemic Stroke Through the Use of Brain SPECT With

Background and Purpose—We hypothesized that technetium-99m-ethylene dicysteine-metronidazole (99mTc-EC-MN) localizes to brain tissue that is hypoxic but viable. This study prospectively evaluated the relationship between neurological outcome and uptake of 99mTc-EC-MN in peri-infarcted regions of the brain. Methods—Eight patients with acute ischemic stroke in the territory of the left middle cerebral artery underwent 99mTc-EC-MN and 99mTc-ethyl cysteinate dimer (ECD) brain SPECTs on the same day during the subacute stage (10.32.5 days). The infarct volumes from 99mTc-ECD images (IVECD), infarct volumes from diffusion-weighted MRI images (IVDW), and hypoxic volume (HV) from 99mTc-EC-MN images were calculated. The net infarct volume (NIVECD) was defined as IVECD minus HV. The National Institutes of Health Stroke Scale scores were measured on admission an