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Effects of cranioplasty in cerebral blood perfusion using quantification with 99m-Tc HMPAO SPECT-CT

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dc.contributor.authorGaliana, Álvaro
dc.contributor.authorRuiz, Sebastián
dc.contributor.authorAlén, J.F.
dc.contributor.authorGómez Grande, Adolfo
dc.contributor.authorPanero, Irene
dc.contributor.authorVega, Diana
dc.contributor.authorGarcía Pérez, Daniel
dc.contributor.authorGutiérrez, Elena
dc.contributor.authorRomero, Carmen
dc.contributor.authorLagares, Alfonso
dc.contributor.authorTabuenca, María José
dc.contributor.authorParedes, Igor
dc.contributor.departmentFarmacología
dc.contributor.otherFarmacia
dc.date.accessioned2026-02-23T12:32:47Z
dc.date.available2026-02-23T12:32:47Z
dc.date.copyright© 2022, American Society of Neuroimaging.
dc.date.issued2022-10-17
dc.description.abstractBackground and Purpose: Syndrome of the trephined or sinking skin flap syndrome is an underdiagnosed condition of craniectomized patients that usually improves after cranioplasty. Among the pathophysiological theories proposed, the changes of cerebral blood perfusion (CBP) caused by cranial defects might have a role in the neurological deficiencies observed. We aim to assess the regional cortex changes in CBP after cranioplasty with Technetium 99m hexamethylpropylene-amine oxime (99mTc-HMPAO) SPECT-CT. Methods: Twenty-eight craniectomized patients subject to cranioplasty were studied with 99mTc-HMPAO SPECT-CT in three different times, before cranioplasty, a week, and 3 months after. The images were processed with quantification software comparing CBP of 24 cortical areas with a reference area, and with a database of controls. A mixed effects model and T-Student were used. Results: CBP increased significantly in both hemispheres after cranioplasty, either using ratio (β = .019, p-value = .030 first postsurgical SPECT-CT and β = .021, p-value = .015 in the second study, vs. presurgical) or Z-score (β = .220, p-value = .026 and β = .279, p-value = .005, respectively). Nine areas of the damaged side had a significant lower CBP ratio and Z-score than the undamaged. Posterior cingulate showed an increased CBP ratio (p-value = .034) and Z-score (p-value = .028) in the first postsurgical SPECT-CT. These posterior cingulate changes represent a 4.83% increase in ratio and 91.04% in Z-Score (p-value = .035 and .040, respectively). Conclusion: CBP changes significantly in specific cortical areas after cranioplasty. Posterior cingulate changes might explain some improvements in attention impairments. SPECT-CT could be a useful tool to assess CBP changes in these patients and might be helpful in their clinical management.
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dc.identifier.citationGaliana Á, Ruiz S, Alén JF, Gómez Grande A, Panero I, Vega D, García-Pérez D, Gutiérrez E, Romero C, Lagares A, Tabuenca MJ, Paredes I. Effects of cranioplasty in cerebral blood perfusion using quantification with 99m-Tc HMPAO SPECT-CT. J Neuroimaging. 2023 Jan;33(1):174-183. doi: 10.1111/jon.13058.
dc.identifier.doihttps://doi.org/10.1111/jon.13058Digital Object Identifier (DOI)
dc.identifier.eissn1552-6569
dc.identifier.issn051-2284
dc.identifier.urihttp://hdl.handle.net/10201/210761
dc.languageeng
dc.publisherWiley
dc.relationInstituto de Salud Carlos III, Grant/Award Number: PI16/01939; European Union
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/doi/10.1111/jon.13058
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subjectCraniectomy
dc.subjectCranioplasty
dc.subjectHMPAO
dc.subjectSPECT-CT
dc.subjectSyndrome of the trephined
dc.subjectCerebral blood perfusion
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleEffects of cranioplasty in cerebral blood perfusion using quantification with 99m-Tc HMPAO SPECT-CT
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublicationes
relation.isAuthorOfPublication2f2500a1-1b27-4420-820c-db8c16e79afd
relation.isAuthorOfPublication.latestForDiscovery2f2500a1-1b27-4420-820c-db8c16e79afd
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