Castellino G, Govoni M, Padovan M, Colamussi P, Borrelli M, Trotta F
Sezione di Reumatologia, Dipartimento di Medicina clinica e sperimentale, Università degli Studi di Ferrara, Corso Giovecca 203, 44100 Ferrara, Italy.
Ann Rheum Dis. 2005 Jul;64(7):1022-7. doi: 10.1136/ard.2004.026773. Epub 2005 Jan 7.
To determine whether single photon emission tomography (SPECT) and magnetic resonance spectroscopy (1H-MRS) can predict the appearance of new lesions in systemic lupus erythematosus (SLE), detectable by magnetic resonance imaging (MRI).
(99)Tc(m)-HMPAO-SPECT, brain MRI, and (1)H-MRS were done in eight women with SLE (mean age 31.8 years; disease duration 5.5 years). NAA/Cho, NAA/Cre, and Cho/Cre ratios were assessed in hypoperfused and normoperfused areas detected by SPECT that were normal on MRI examination. Reference values were obtained in 20 normal healthy controls. In five patients, MRI was repeated four to six years after the first evaluation.
Mean NAA/Cho and Cho/Cre ratios in hypoperfused and normoperfused frontal areas were, respectively, lower and higher than control. There were no differences in NAA/Cre ratios. Mean Cho/Cre ratios were increased in hypoperfused v normoperfused brain areas (mean (SD): 1.43 (0.27) v 1.00 (0.07); p<0.023). NAA/Cre ratios were not altered (2.18 (0.30) v 1.99 (0.28); p = 0.381). Three of five patients who had a second MRI had new lesions in areas previously abnormal on MRS and SPECT but normal on first MRI. One patient with positive MRI, SPECT, and MRS showed an increase in the number of MRI lesions; one patient with negative MRI, SPECT, and MRS did not show any new lesions.
Abnormalities reflecting altered perfusion or neuronal-chemical changes can be demonstrated by functional imaging techniques even in the absence of morphological lesions detectable by MRI. The abnormal areas identified by SPECT and MRS may predict future parenchymal damage.
确定单光子发射断层扫描（SPECT）和磁共振波谱成像（1H-MRS）能否预测系统性红斑狼疮（SLE）中新发病变的出现，这些病变可通过磁共振成像（MRI）检测到。
对8名SLE女性患者（平均年龄31.8岁；病程5.5年）进行了（99）Tc（m）-HMPAO-SPECT、脑部MRI和（1）H-MRS检查。在SPECT检测到的灌注不足和灌注正常区域（MRI检查正常）评估NAA/Cho、NAA/Cre和Cho/Cre比值。在20名正常健康对照者中获取参考值。5名患者在首次评估后4至6年重复进行了MRI检查。
灌注不足和灌注正常的额叶区域的平均NAA/Cho和Cho/Cre比值分别低于和高于对照组。NAA/Cre比值无差异。灌注不足与灌注正常的脑区平均Cho/Cre比值升高（平均值（标准差）：1.43（0.27）对1.00（0.07）；p<0.023）。NAA/Cre比值未改变（2.18（0.30）对1.99（0.28）；p = 0.381）。5名进行第二次MRI检查的患者中有3名在先前MRS和SPECT异常但首次MRI正常的区域出现了新病变。1名MRI、SPECT和MRS均为阳性的患者MRI病变数量增加；1名MRI、SPECT和MRS均为阴性的患者未出现任何新病变。
即使在没有MRI可检测到的形态学病变的情况下，功能成像技术也能显示反映灌注改变或神经化学变化的异常。SPECT和MRS识别出的异常区域可能预测未来的实质损害。
