Chen J J H, Wang J Y, Chang Y M, Su S Y, Chang C T, Sun S S, Kao C H, Lee C C
Section of Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Scand J Rheumatol. 2007 May-Jun;36(3):226-32. doi: 10.1080/03009740601153790.
Technetium-99m ethyl cysteinate dimer (Tc-99m ECD) brain single photon emission computed tomography (SPECT) has been used to detect abnormal regional cerebral blood flow (rCBF) in women with primary fibromyalgia (FM). The main aim of this study was to investigate the rCBF deficit in concomitant FM patients and compare it with primary FM.
An observational study was designed to analyse the SPECT findings in 92 female patients recruited from January 2002 to January 2004. Differences in the rCBF hypoperfusive areas between 49 primary and 29 concomitant FM patients were assessed in different areas of the brain using the chi(2)-test for statistical significance.
Tc-99m ECD brain SPECT in 71 FM patients revealed heterogeneous rCBF in comparison to the homogeneous scan in 14 control patients. The most prominent rCBF hypoperfusive region in both primary and concomitant FM groups was the left temporoparietal area, followed by the thalamus, right temporoparietal, frontal, and basal ganglia areas. Differences in rCBF hypoperfusion in these areas for both FM groups were not significant (all p>0.5).
Reduced rCBF at cortical regions, in addition to previously reported areas at the thalamus and the subcortical nucleus, in FM patients was demonstrated in this study. The perfusion deficit areas were similar between primary and concomitant FM when the underlying disease activity was quiescent. The feasibility of using this neuroimaging study to differentiate FM from the primary disease, such as rheumatoid arthritis (RA)-associated depression and neuropsychiatric lupus, should be considered.
锝-99m 半胱氨酸乙酯二聚体（Tc-99m ECD）脑单光子发射计算机断层扫描（SPECT）已被用于检测原发性纤维肌痛（FM）女性患者的异常局部脑血流（rCBF）。本研究的主要目的是调查合并其他疾病的 FM 患者的 rCBF 不足情况，并将其与原发性 FM 患者进行比较。
设计了一项观察性研究，以分析 2002 年 1 月至 2004 年 1 月招募的 92 名女性患者的 SPECT 检查结果。使用卡方检验评估 49 例原发性 FM 患者和 29 例合并其他疾病的 FM 患者在脑不同区域的 rCBF 灌注不足区域的差异，以确定统计学意义。
与 14 名对照患者的均匀扫描相比，71 例 FM 患者的 Tc-99m ECD 脑 SPECT 显示 rCBF 不均匀。原发性 FM 组和合并其他疾病的 FM 组中最显著的 rCBF 灌注不足区域是左侧颞顶叶区域，其次是丘脑、右侧颞顶叶、额叶和基底神经节区域。两组 FM 患者在这些区域的 rCBF 灌注不足差异不显著（所有 p>0.5）。
本研究证实，FM 患者除了先前报道的丘脑和皮质下核区域外，皮质区域的 rCBF 也减少。当潜在疾病活动静止时，原发性 FM 患者和合并其他疾病的 FM 患者的灌注不足区域相似。应考虑使用这种神经影像学研究来区分 FM 与原发性疾病，如类风湿关节炎（RA）相关的抑郁症和神经精神性狼疮的可行性。
