The role of FDG-PET, HMPAO-SPET and MRI in the detection of brain involvement in patients with systemic lupus erythematosus

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• 作者：Chia-Hung Kao ; Jung-Liang Lan ; Sheng-Ping ChangLai ; Ko-Kaung Liao ; Rouh-Fang Yen and Poon-Ung Chieng
• 关键词：Key words ; Fluorine ; 18 2 ; fluoro ; 2 ; deoxy ; d ; glucose ; Positron emission tomography ; Technetium ; 99m hexamethylpropylene amine oxime ; Single ; photon emission tomography ; Magnetic resonance imaging ; Systemic lupus erythematosus
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：1999
• 出版时间：February 1999
• 年：1999
• 卷：26
• 期：2
• 页码：129-134
• 全文大小：97 KB

文摘

Involvement of the brain is one of the most important complications of systemic lupus erythematosus (SLE); however, its diagnosis is difficult due to the lack of effective imaging methods. We combined three brain imaging modalities – positron emission tomography with fluorine-18 2-fluoro-2-deoxy-d-glucose (FDG-PET), single-photon emission computed tomography with technetium-99m hexamethylpropylene amine oxime (HMPAO-SPET) and magnetic resonance imaging (MRI) – in order to detect brain involvement in SLE. Thirty-seven SLE patients, aged 22–45 years, were divided into three groups. Group 1 (G1) consisted of ten patients with major neuropsychiatric manifestations; group 2 (G2) consisted of 15 patients with minor manifestations; and group 3 (G3) consisted of 12 patients without manifestations. FDG-PET findings were abnormal in 51 % of patients: 90 % of G1, 67 % of G2 and 0 % of G3 patients respectively. HMPAO-SPET findings were abnormal in 62 % of patients: 100 % of G1, 73 % of G2 and 17 % of G3 patients respectively. MRI findings were abnormal in 35 % of patients: 70 % of G1, 40 % of G2 and 0 % of G3 patients respectively. Grey matter was more commonly involved than white matter; 62 % of patients presented with lesions in the cerebral cortex, 27 % with lesions in the basal ganglion, 5 % with lesions in the cerebellum, and 19 % with lesions in white matter. No white matter lesions were found on FDG-PET or HMPAO-SPET. However, in 19 % of patients, MRI demonstrated abnormally high signal lesions in white matter. Forty-three percent of cases had positive serum anticardiolipin antibodies (ACA). However, ACA was not related to FDG-PET, HMPAO-SPET or MRI findings. It may be concluding that HMPAO-SPET is a more sensitive tool for detecting brain involvement in SLE patients when compared with FDG-PET or MRI. However, MRI is necessary for detecting lesions in white matter.