Quantitative evaluation of crossed cerebellar diaschisis, using voxel-based analysis of Tc-99m ECD brain SPECT

Abstract

BACKGROUND: In the recent literature there is no consensus
regarding the relationships between crossed cerebellar diaschisis
(CCD) with the primary lesion size, severity or location.
Thus, the aim of the present study was to investigate relationship
between the size and severity of cerebral lesions and CCD in patients
with chronic stroke, using voxel-based analysis of Tc-99m
ECD single-photon emission computed tomography (SPECT).

MATERIAL AND METHODS: We retrospectively reviewed data
of 57 patients with chronic ischemic lesions localized unilaterally
in the cerebral hemisphere. SPECT evaluation was performed
with the voxel-based analysis. The percentage inter-hemispheric
asymmetry index (AI) and the volume of abnormal clusters of
voxels (CV) were ascertained for hypoperfusion in the supratentorial
lesion and contralateral cerebellum.

RESULTS: CCD was present in 35.1% cases. In Group CCD
(+), the CV and AI of supratentorial hypoperfusion (median
128.1 ml and 21.9%, respectively) were significantly higher
compared with Group CCD(–) (median 41.4 ml and 18.0%,
respectively). Statistically significant correlation was found
between CV of supratentorial and cerebellar perfusion defects
(r = 0.4; p < 0.05), between AI of supratentorial and cerebellar
perfusion defects (r = 0.6; p < 0.05) and between CV of supratentorial defect and AI of cerebellar perfusion defects (r = 0.6; p < 0.05).

CONCLUSIONS: Our data suggest, that in the chronic stage
of stroke, the size and severity of the supratentorial lesion are
determinants of CCD, correlating with the degree of cerebellar
hypoperfusion.