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Tc-99m MDP uptake resulting from acute middle cerebral artery territory infarction.

Cerebral uptake of Tc-99m methylene diphosphonate is rare, occurring in less than 0.2% of patients undergoing bone scintigraphy. A case of acute cerebral infarction detected by Tc-99m methylene diphosphonate (MDP) scintigraphy is presented, demonstrating Tc-99m MDP uptake in the middle cerebral artery territory on delayed phase imaging. The findings were confirmed to be the result of cerebral infarction on computed tomography. This case highlights the role of extraosseous uptake of Tc-99m MDP in the detection of previously unrecognized pathology. Cerebral uptake of Tc-99m MDP is not specific for infarction and may occur in intracranial malignancy or with intracranial calcification from any cause.