Technetium Tc-99m ethyl cysteinate dimer brain single-photon emission CT in mild traumatic brain injury: a prospective study

AJNR Am J Neuroradiol. 2006 Feb;27(2):447-51.


Purpose: To explore the role of single-photon emission CT (SPECT) in initial diagnostic evaluation of patients with mild traumatic brain injury (MTBI) and to identify subgroups in which it may serve as a useful diagnostic tool.

Materials and methods: Patients with MTBI seen during a 14-month period were prospectively included in this study. All patients had a CT of head within 12 hours of injury and SPECT by using technetium Tc99m ethyl cysteinate dimer (Tc99m-ECD) within 72 hours of injury. Both SPECT and CT findings were compared with clinical features such as posttraumatic amnesia (PTA), postconcussion syndrome (PCS), and loss of consciousness (LOC).

Results: Ninety-two patients with MTBI underwent SPECT in the study period. There were 28 children and 64 adults, with male-to-female ratio of 4.5 to 1. CT findings were abnormal in 31 (34%) and SPECT in 58 (63%). The most common abnormality was hypoperfusion in the frontal lobe(s) in adults and the temporal lobe in children. A significantly higher number of perfusion abnormalities were seen in patients with PTA (P = .03), LOC (P = .02), and PCS (P = .01) than in patients without these symptoms. Compared to CT, SPECT had a much higher sensitivity for detecting an organic basis in these subgroup, of patients (P < .05).

Conclusion: Tc99m-ECD SPECT can be used as a complementary technique to CT in initial evaluation of patients with MTBI. It is particularly useful in patients having PCS, LOC, or PTA with normal CT scan.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Brain / diagnostic imaging
  • Brain / physiopathology
  • Brain Concussion / diagnostic imaging*
  • Brain Concussion / physiopathology
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / physiopathology
  • Child
  • Child, Preschool
  • Cysteine / analogs & derivatives*
  • Female
  • Glasgow Coma Scale
  • Humans
  • Infant
  • Male
  • Middle Aged
  • Organotechnetium Compounds*
  • Post-Concussion Syndrome / diagnostic imaging
  • Post-Concussion Syndrome / physiopathology
  • Prognosis
  • Prospective Studies
  • Regional Blood Flow / physiology
  • Sensitivity and Specificity
  • Tomography, Emission-Computed, Single-Photon*
  • Tomography, X-Ray Computed*


  • Organotechnetium Compounds
  • technetium Tc 99m bicisate
  • Cysteine