Assessment of cerebral blood flow in patients with eating disorders in the acute clinical phase using Tc99m-HMPAO SPECT

To assess the status of cerebral perfusion in patients with eating disorders (ED) in the acute phase of the disease. Seventeen patients, with a mean age of 22 years, diagnosed with ED according to DSM-III-R (Diagnostic and Statistical Manual of Mental Disorders) criteria and under close clinical monitoring were studied in the initial acute phase of their disease. Brain SPECT with 15 mCi of Tc99m HMPAO was performed on all patients and assessed using visual and semi-quantitative analysis. The latter was carried out by obtaining left/right indices in sixteen symmetrical 5 × 5 pixel regions of interest (ROI) in three transverse slices, one below the cantho-meatal line and two above, at 2 and 5 cm, respectively. Visual analysis showed hypoperfusion of the anteroinferior region of the left temporal lobe in 7/17 patients, and in the homonymous region of the right temporal lobe in 1/17. Semi-quantitative analysis did not show statistically significant differences in the slices above the cantho-meatal line when the means of the asymmetry indices were compared between the anterior (frontal), middle (temporal and parietal) and posterior (occipital) regions of each slice, obtaining values ranging between 0.99 ± 0.05 and 1.02 ± 0.03. However, in the lowest slice, the anterior (temporal) region showed a mean asymmetry value of 0.89 ± 0.15, and on comparing it with the mean of the asymmetry indices of the posterior region (cerebellum), it showed a statistically significant difference (p < 0.05). Patients with ED frequently show hypoperfusion of the anteroinferior region of the temporal lobe, predominantly in the left hemisphere, in the acute phase of the illness. Valorar el estado de la perfusión cerebral en pacientes con trastornos de la conducta alimentaria (TCA) en fase aguda de la enfermedad. Se estudiaron 17 pacientes, con una edad media de 22 años, diagnosticados de TCA según los criterios del DSM-III-R ( Diagnostic and Statistical Manual of Mental Disorders) bajo control clínico estrecho en la fase aguda inicial de su enfermedad. A cada paciente se le realizó una tomografía computarizada por emisión de fotón único (SPECT) cerebral con 15 mCi de hexametil propileno amino oxima (HMPAO)-Tc99m que fue valorado mediante análisis visual y semicuantitativo. Este último se realizó obteniendo índices izquierda/derecha en 16 regiones de interés (ROI) simétricas de 5 × 5 píxeles en tres cortes transversales, uno por debajo de la línea canto-meatal y dos por encima, a 2 y 5