Cerebral Manifestations of Systemic Lupus Erythematosus in the Image of 99m Tc-HMPAO SPECT

In 20 patients (14 women, 6 men) with a cerebral symptomatology associated with lupus erythema- tosus (SLE) meeting ARA criteria of 1982, aged 21–53 years dispensarized in 1996–1997 in the Rheumatological Institute in Prague examinations of the regional cerebral blood flow (rCBF) were made using single photon emission tomography (SPECT) after administration of 99m Tc-HMPAO. In all examined patients regardless of the assumed activity of the disease the character of the cerebral symptomatology and the number and extent of abnormalities on examination by magnetic resonance (in six patients the pathological finding on MRI was not even found) the authors provided evidence of multiple focal pathology as regards rCBF distribution. The mean number of foci per examination was 4.2 without a significant difference in individual patient groups with cerebral focal or diffuse symptomatology. The majority of foci was in the left hemisphere (62), in particular in the frontal (16), temporal (21), parietal (9) lobe and in the insula (6), i.e. in the area supplying the art. cerebri media l.sin. The picture of perfusion abnormalities supplements the morphological information provided by MRI. Both methods must be considered essential for comprehensive evaluation of cerebral affections in SLE.

Key words:
systemic lupus erythematosus with a cerebral symptomatology (neuropsychiatric lupus erythematosus), regional cerebral blood flow – rCBF), Tc-HMPAO BRAIN SPECT