الفهرس 
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Abstract
Background: Tc-HMPAO SPECT is a non-invasive technology that has a potential diagnostic tool in stroke. Several studies have supported the predictive value of SPECT in stroke prognosis.
Purpose: Studying the role of Tc-HMPAO SPECT in assessment of rCBF changes in acute stroke patients and evaluation of its role in early diagnosis and prognosis of stroke.
Material and Methods: Forty Egyptian patients presented with acute onset of stroke were subjected to the Oxford shire community stroke project classification, national institutes of health stroke scale, CT brain and single photon emission computed tomography at day one of stroke onset. At day seven, 30 patients were reevaluated by NIHSS to assess the clinical outcome and SPECT to follow the pattern of cerebral perfusion.
Results: At day one: CT scans were positive in only 18 (45%) patients, while SPECT scans were positive in all 40 (100%) patients (p<0.001). NIHSS was significantly higher in patients with corticosubcortical lesions than in patients with cortical hypoperfusion on SPECT (p<0.01). NIHSS was worst with large hypoperfusion than small hypoperfusion on SPECT (p<0.001). the less the radiotraceruptake on SPECT, the worse the NIHSS (p<0.01). There was a statistically significant negative correlation between NIHSS and rCBF (r=-0.640).
At day seven: rCBF was highly significantly better (r=0.59). NIHSS at day 7 was worse in patients with corticosubcortical hypoperfusion lesions than in patients with cortical hypoperfusion on SPECT at day 1 (p<0.01). the larger the size of hypoperfusion on SPECT at day 1, the worse the NIHSS at day 7. (p<0.05). the less the radiotracer uptake on SPECT at day 1, the worse the NIHSS at day 7 (p<0.05). the less the rCBF at day 1, the worse the NIHSS at day 7 (r= -0.685, p<0.001).
Conclusion: SPECT was more sensitive than CT in detecting acute cerebral ischemia. There was significant relation between clinical assessment of stroke patients and findings on SPECT at day one.
Tc-HMPAO SPECT could predicts early clinical outcome of stroke.