A 65-year-old woman sustained a head injury, subarachnoid hemorrhage (SAH), and hydrocephalus. A ventriculoperitoneal shunt was subsequently implanted. However, the patient developed general weakness and mutism. Clinical evaluation revealed that the shunt was patent. Cisternography was performed by direct intrathecal administration of 6 mCi of technetium-99m diethylene triamine pentaacetic acid ( 99m Tc-DTPA) by means of a lumbar puncture. The planar images showed the classic heart-shaped pattern of normal pressure hydrocephalus (NPH). Cisternography using SPECT/CT was also performed and revealed that the butterfly shape of increased radioactivity was clearly and definitely located in the bilateral lateral ventricles with the help of CT images. Compared with traditional planar images, the SPECT/CT makes the diagnosis of NPH more accurate and easier. Key words: SPECT/CT, normal pressure hydrocephalus, cisternograph
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