Tumor-like accumulation on Tl-201SPECT in subacute hemorrhagic cerebral infarction

A 75-year-old woman was hospitalized for left hemiplegia. Intratumoral hematoma was considered likely based on the findings of computed tomographic (CT) images, and TI-201 SPECT was performed for further differentiation. Early SPECT images showed tumor-like accumulation in the right basal ganglia. However, the accumulation was washed out on delayed SPECT. Final diagnosis by a follow-up study was subacute hemorrhagic infarction. Although early TI-201 SPECT may show positive results for subacute hemorrhagic infarction, a delayed TI-201 SPECT can show a wash-out pattern that may be specific for this infarction. Early TI-201 SPECT may show tumor-like accumulation for subacute hemorrhagic infarction. This should be kept in mind in the analysis of TI-201 SPECT studies when cerebral infarction is being differentiated from brain tumor.