A vertex view artifact on 99m Tc-pertechnetate brain scan in a child

A Schleif, N Alazraki, S Halpern, M Coel, W Ashburn
1972 Journal of Nuclear Medicine  
The following case report is presented to demon strate an unusual artifact on the vertex view of a brain scintigram study in a small child. CASE REPORT The patient, a small 3-year-old mentally retarded female, was transferred to the University Hospital of San Diego County in a semi-comatose state with a clinical history of progressive weakness, decreased sensorium, and intermittent seizures of 3-week dura tion. A four-view rectilinear brain scan as well as a five-view Anger camera study of the
more » ... amera study of the brain had been performed at another hospital 1 week before her transfer here. The studies were normal at that time. On physical examination the patient was semicomatose. She had hypertonia in the lower extremi ties and alternate hypertonia and hypotonia of the upper extremities. The remainder of the physical examination was unremarkable. Because a diagno sis of possible brain abscess was being considered, an emergency brain scan was performed. The brain scan was normal but demonstrated an unusual arti fact on the vertex view. The patient was eventually discharged after marked clinical improvement with the diagnosis of encephalopathy and hepatitis of unknown etiology. METHODS AND RESULTS After an intravenous injection of 16 mg of sodium iodide to block the uptake of the radiopharmaceutical by the choroid plexus, 6 mCi of 9()niTcO.i~was ad ministered intravenously and five scintiphoto views of the brain were performed on the Pho/Gamma III scintillation camera. Studies were begun at 2 hr and repeated at 12 hr postinjection. Figure 1 shows the results of the 2-hr study. Only the vertex view is abnormal, revealing an apparent intense area of increased uptake on the left. Because this could not be corroborated on the other views, an artifactual finding was suspected. However, the origin of the artifact was not immediately obvious. For this reason, the patient was returned to the nuclear medicine
pmid:5024794 fatcat:wztckdceubgodjsy6vvj4uf6re